Psychoactive drug use (PDU) is reported in up to 40% of trauma patients and is associated with a higher rate of in-hospital complications. However, little is known about its long-term impact on ...trauma patients. We aimed to assess the long-term functional, mental, and psychosocial outcomes of PDU in trauma patients 6 to 12 months after injury.
Trauma patients with moderate to severe injuries (Injury Severity Score, >9) who had a toxicology screen upon admission to one of three level 1 trauma centers were contacted by phone 6 to 12 months postinjury. Psychoactive drug use was defined as the presence of a psychoactive, nonprescribed substance on toxicology screen including amphetamine, barbiturate, benzodiazepine, cannabinoid, methamphetamine, methadone, opioid, oxycodone, methylenedioxymethamphetamine (ecstasy), phencyclidine, tricyclic antidepressant, and cocaine. The interviews systematically evaluated functional limitations, social functioning, chronic pain, and mental health (posttraumatic stress disorder, depression, anxiety). Patients with a score of ≤47 on the Short-Form Health Survey version 2.0 social functioning subdomain were considered to have social dysfunction. Multivariable regression models were built to determine the independent association between PDU and long-term outcomes.
Of the 1,699 eligible patients, 571 (34%) were included in the analysis, and 173 (30.3%) screened positive for PDU on admission. Patients with PDU were younger (median age interquartile range, 43 28-55 years vs. 66 46-78 years, p < 0.001), had more penetrating injuries (8.7% vs. 4.3%, p = 0.036), and were less likely to have received a college education (41.3% vs. 54.5%, p = 0.004). After adjusting for patients' characteristics including the presence of a baseline psychiatric comorbidity, patients with PDU on admission were more likely to suffer from daily chronic pain, mental health disorders, and social dysfunction 6 to 12 months after injury. There was no difference in the functional limitations between patients with and without PDU.
On the long term, PDU in trauma patients is strongly and independently associated with worse mental health, more chronic pain, and severe impairment in social functioning. A trauma hospitalization presents an opportunity to identify patients at risk and to mitigate the long-term impact of PDU on recovery.
Prognostic/epidemiologic, level III.
Socioeconomic status (SES) is defined as a total measure of an individual’s economic or social position in relation to others. Income and educational level are often used as quantifiable objective ...measures of SES but are inherently limited. Perceived SES (p-SES), refers to an individual’s perception of their own SES. Herein, we assess the correlation between objective SES (o-SES) as defined by income and educational level and p-SES after injury and compare their associations with long-term outcomes after injury.
Moderate-to-severely injured patients admitted to a Level 1 trauma center were asked to complete a phone-based survey assessing functional and mental health outcomes, social dysfunction, chronic pain, and return to work/school 6-12 mo postinjury. o-SES was determined by income and educational level (low educational level: high school or lower; low income: live in zip code with median income/household lower than the national median). p-SES was determined by asking patients to categorize their SES. The correlation coefficient between o-SES and p-SES was calculated. Multivariate logistic regression models were built to determine the associations between o-SES and p-SES and long-term outcomes.
A total of 729 patients were included in this study. Patients who reported a low p-SES were younger, more likely to suffer penetrating injuries, and to have a weak social support network. Twenty-one percent of patients with high income and high educational level classified their p-SES as low or mid-low, and conversely, 46% of patients with low education and low income classified their p-SES as high or mid-high. The correlation coefficient between p-SES and o-SES was 0.2513. After adjusting for confounders, p-SES was a stronger predictor of long-term outcomes, including functional limitations, social dysfunction, mental health outcomes, return to work/school, and chronic pain than was o-SES.
Patient-reported p-SES correlates poorly with o-SES indicating that the commonly used calculation of income and education may not accurately capture an individuals’ SES. Furthermore, we found p-SES to be more strongly correlated with long-term outcome measures than o-SES. As we strive to improve long-term outcomes after injury, p-SES may be an important variable in the early identification of individuals who are likely to suffer from worse long-term outcomes after injury.
Toxoplasma gondii and Neospora caninum are structurally similar parasites, with many hosts in common. The prevalence of antibodies to T. gondii and N. caninum was determined in sera from dogs from ...Durango City, Mexico. Using a modified agglutination test, antibodies to T. gondii were found in 52 (51.5%) of the 101 dogs with titers of 1:25 in 27, 1:50 in 11, 1:100 in 5, 1:200 in 4, 1:400 in 2, 1:800 in 2, and 1:3,200 or higher in 1. Antibodies to N. caninum were determined by the indirect immunofluorescent antibody test (IFAT) and the Neospora sp. agglutination test (NAT). Two of the 101 dogs had N. caninum antibodies; these dogs did not have T. gondii antibodies, supporting the specificity of the tests used. The N. caninum antibody titers of the 2 dogs were: 1:400 by IFAT and 1:200 by NAT in 1, and 1:25 by NAT and IFAT in the other. Results indicate that these 2 structurally similar protozoans are antigenically different.
It is well known that among of all the components of hydrotreating systems used in the industrial processes, the heat exchangers that pre-heat the reactor suffer the greatest degree of degradation by ...pitting corrosion due to extreme temperature exposure. Typically, two different mathematical analysis were used to estimate the probability of failure by metal loss as a consequence of pitting corrosion mechanism: short-term and long-term corrosion rate (STCR and LTCR, respectively), as designated by API 510 standard method. However, the results are often misunderstood when the difference between the calculated data of STCR and LTCR is large. For this reason, in this research the STCRs and LTCRs models were fitted to a generalized extreme value distribution (GEVD) to characterize the metal loss that take place in four heat exchangers, as well as to determine what kind of corrosion rate model is better for predicting the metal loss estimation. According to the results obtained in this research, the STCR model appears to be the most appropriate analysis for estimating future metal loss by pitting corrosion for the heat exchangers reactors used in hydrotreating systems.
The effect of the boron potential on the thickness and the mechanical properties of borided layers was evaluated. The boron potential was established by means of the available atoms of boron ...contained in a control volume inside a cylinder. The cylinders were manufactured from AISI 316L steel, and the boriding treatment was performed using the powder pack technique at a temperature of 1273 K over an exposure time of 6 h. Four different internal diameters of the cylinders were evaluated (3.17, 4.76, 6.35, and 7.93 mm). The mechanical properties were evaluated using the Berkovich instrumented indentation technique. The results showed a clear influence of the boron potential on the mechanical properties of the layers. The hardness of the layers was stablished in the range of 16.22 to 21.16 GPa. Young’s modulus values were stablished in the range of 255.96 to 341.37 GPa. Also the fracture toughness and brittleness of the layers reflected the influence of the boron potential supplied during the boriding process. Finally, the influence of the boron potential on the constant of parabolic growth (K) was also established as a function of the inner diameter of the cylinders.
Background:
Clinically relevant anti-carbamylated (anti-CarP) antibodies are detected in up to 45% of rheumatoid arthritis (RA) patients and are associated with severe radiological progression, ...higher disease activity, and significantly more disability when studied in early phases of arthritis.
Objectives:
We aimed to determine the prevalence of anti-CarP antibodies in Mexican Hispanics with established RA and to assess their relationship with disease activity.
Methods:
A cohort study was conducted in 278 patients with established RA during an 18-month follow-up. We measured IgG/IgM/IgA rheumatoid factor (RF), IgG anticitrullinated protein antibodies (ACPA) and IgG/IgM/IgA anti-CarP antibodies using enzyme-linked immunosorbent assay (ELISA). For disease activity, we performed the 28-joint disease activity score with erythrocyte sedimentation rate (DAS28-ESR). Repeated measures one-way ANOVA was used to test the association between anti-CarP IgG antibody status and longitudinal DAS28-ESR scores. Patients were evaluated at baseline and at 6, 12, and 18 months during follow-up.
Results:
Anti-CarP IgG antibodies were positive in 47.8% of patients and, accounting for all isotypes, in 9.5% of patients with negative RF and ACPA. Triple antibody positivity was present in 42.6% of patients in our sample. Anti-CarP IgG antibody positivity did not show statistically significant differences in mean DAS28-ESR when compared to anti-CarP IgG antibody negative patients at baseline, 6, 12 or 18 months.
Conclusion:
Anti-CarP IgG antibodies are present in almost 50% of RA patients and, accounting for all isotypes, in 9% of RF and ACPA negative patients. Anti-CarP IgG antibody positivity was not associated to a higher disease activity measured by DAS28-ESR in Hispanic patients with established RA.
References:
Shi J, Knevel R, Suwannalai P, Van Der Linden MP, Janssen GMC, Van Veelen PA, et al. Autoantibodies recognizing carbamylated proteins are present in sera of patients with rheumatoid arthritis and predict joint damage. Proc Natl Acad Sci U S A. 2011;108:17372–17377.
Table 1.
Anti-CarP antibody status by isotype in a cohort of 278 patients with established RA.
Mean (SD
)
Antibody positivity,
n (%
)
95% CI
RF IgA
a
266.9 (460.5)
155 (58.9)
53.0 to 64.9
RF IgM
a
406.8 (611.9)
188 (71.5)
66.0 to 77.0
RF IgG
a
36.1 (249.6)
44 (16.7)
12.2 to 21.3
ACPA IgG
a
191.01 (411.1)
144 (54.8)
48.7 to 60.8
Anti-CarP IgA
b
212.9 (464.2)
74 (26.6)
21.4 to 31.8
Anti-CarP IgM
b
381.6 (762)
89 (32)
26.5 to 37.5
Anti-CarP IgG
b
227.5 (402.5)
133 (47.8)
41.9 to 53.8
a
Data were available for 263 patients. Units are RU/mL.
b
Data were available for 278 patients. Units are AU/mL. RF, rheumatoid factor; ACPA, anticitrullinated protein antibodies; Anti-CarP, anti-carbamylated protein antibodies; IgG, immunoglobulin; SD, standard deviation; 95% CI, 95% confidence intervals.
Figure 1.
Disclosure of Interests:
David Vega-Morales Grant/research support from: This research was funded as an Investigator Initiated Study by UCB (IIS-2015-104068). The sponsor did not have any role in the design or outcomes of this study., Mario Alberto Garza Elizondo: None declared, Leendert A Trouw: None declared, Karina Itzel González Márquez: None declared, Ernesto Torres-Lopez: None declared, Myriam Eguia Bernal: None declared, SALVADOR AZAHEL LOREDO ALANIS: None declared, Tayde Sarahi Gracia-Arechiga: None declared, Brenda Roxana Vázquez Fuentes: None declared, Diana Daniela Castañeda Martínez: None declared, Martha Mariana Castañeda-Martínez: None declared, Cesar Vidal Solis: None declared, Andres Mendiola-Jimenez: None declared, Mario Cesar Salinas-Carmona: None declared, Pablo Herrera-Sandate: None declared, Alberto Cárdenas: None declared, Gerardo Eugenio Rodriguez-Sanchez: None declared, Dionicio Ángel Galarza-Delgado: None declared
The Gulf of Mexico is an important crude oil reserve worldwide, and the oyster
Crassostrea virginica
is an excellent candidate to study the oil spill impacts on marine invertebrates. In this work, ...the concentrations of polycyclic aromatic hydrocarbons (PAHs) and aliphatic hydrocarbons (AHs) from eight productive oyster areas in the Gulf of Mexico were measured on sediment, water, and tissues from
C. virginica
. In water, the highest AHs concentration was detected in Tamiahua (0.50 ng/mL), while for PAHs, the highest concentration was > 0.10 ng/mL in Tampamachoco. In sediment, Tamiahua and Tampamachoco lagoons had the highest AHs concentrations with values near 2.5 μg/g dry weight. Considering the PAHs, Tamiahua, Carmen, and Tampamachoco lagoons registered the highest levels, with values > 60 ng/g dry weight. In tissues from
C. virginica
, La Pesca, Cármen and Mecoacán presented the highest PAHs concentrations with values between 0.20 and 0.25 μg/g dry weight. Furthermore, from the molecular analysis of genes related with different phases of the xenobiotic detoxification process such as hypoxia inducible factor (
hif-1a
), cytochrome P450 10 (
cyp10
), flavin mono-oxygenase (
fmo
), glutathione S-transferase (
gstΩ1
), multidrug resistant protein (
mdrd1
), catalase (
cat
), among others, the differences between lagoons were significant (
P
< 0.05) and generally with Las Enramadas showing the highest expression levels. From genes evaluated in this study,
hif-1a
,
cyp10
,
fmo
,
mdrd1
and
cat
presented the highest expression differentials between lagoons. The above allowed us to validate the utility of molecular markers in the assessment of the hydrocarbons effect on oyster under the conditions from the Southern Gulf of Mexico.
We aimed to determine the prevalence of anti-carbamylated protein (anti-CarP) antibodies in Mexican Hispanics with established rheumatoid arthritis (RA) and to assess their relationship with disease ...activity.
A cohort study was conducted in 278 patients with established RA during an 18-month follow-up. We measured IgG/IgM/IgA rheumatoid factor (RF), IgG anticitrullinated protein antibodies (ACPA) and IgG/IgM/IgA anti-CarP antibodies using enzyme-linked immunosorbent assay (ELISA). For disease activity, we performed the 28-joint disease activity score with erythrocyte sedimentation rate (DAS28-ESR). Repeated measures one-way ANOVA was used to test the association between anti-CarP IgG antibody status and longitudinal DAS28-ESR scores. Patients were evaluated at baseline and at 6, 12, and 18 months during follow-up.
Anti-CarP IgG antibodies were positive in 47.8% of patients and, accounting for all isotypes, in 9.5% of patients with negative RF and ACPA. Triple antibody positivity was present in 42.6% of patients in our sample. Anti-CarP IgG antibody positivity did not show statistically significant differences in mean DAS28-ESR when compared to anti-CarP IgG antibody negative patients at baseline, 6, 12 or 18 months.
Anti-CarP IgG antibodies are not associated to a higher disease activity in Hispanic patients with established RA. Our findings suggest that the clinical value of measuring anti-CarP antibodies in RA diminishes over time.
Aside from the positive benefits of wind energy, wind farms often bring environmental problems such as noise production and wildlife collision. However, little is known about the effects of wind ...farms on the ecology of tropical landbirds. In this study, we evaluated changes in bird-community diversity, composition, and structure directly beneath wind turbines, 200 m away from turbines, and in nearby croplands and secondary forests. In general, our results show (1) a gradient of species richness, with values highest in croplands and secondary forests, intermediate values 200 m from turbines, and lowest values beneath turbines, (2) fairly similar bird abundance for all treatments, with values highest in secondary forests in autumn and lowest 200 m from turbines in autumn, (3) bird communities highly similar at each season, but communities at 0 and 200 m from turbines differed strongly in autumn and communities at the rest of the studied sites differed strongly during both spring and autumn, (4) evenness of the bird community greater in secondary forests and croplands and lower at both distances from wind turbines, and (5) the area covered by croplands outside the wind farm played an important role, often related to increases in species richness. Our results also suggest that wind farms have a greater effect on wintering migrants than on residents; however, further studies are required for such a comparison to be tested robustly.
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