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Environmental laws and politics, the relevance of implementing regulation of the presence of emerging pollutants in Mexico: a systematic review
No full textAim: To carry out a systematic review of the environmental regulation applicable to emerging pollutants at the international level, with a special interest in Mexico.Methods: The search for articles and documents was carried out under the criteria of the PRISMA statement (Preferred Reporting Items for Systematic Reviews and Meta-Analysis), in databases such as Pub-Med, Scopus, Science Direct, Jane’s, Dimensions, Google Scholar, as well as the Comprehensive System of Standards and Evaluation of the Ministry of the Interior of Mexico.Results: 3089 documents were reviewed, and considering the inclusion, exclusion, and quality criteria, 2 tables were constructed, the first with 24 scientific articles and the second with 7 Mexican standards.Conclusion: The regulation of emerging pollutants is a critical issue that must involve all sectors (for example, political, economic, social, and environmental). For this, it is necessary to coordinate the government, society and consider the experiences of other countries for its implementation. It was also identified that the issues of access to information and education programs have a significant impact on compliance with environmental regulations and that there is little scientific evidence on this matter
Pharmacologic therapies for the low cardiac output syndrome in children after cardiac surgery: evidence of their efficacy and trends in their use
No full textThe low cardiac output syndrome describes the phenomenon of the reduction of cardiac output that can occur following cardiac surgery requiring cardiopulmonary bypass. If unrecognized or untreated, this condition can result in significant morbidity and mortality. Along with non-pharmacologic therapies, pharmacologic agents used to help manage the low cardiac output syndrome include catecholamine inotropes, inodilators, systemic vasodilators, pulmonary vasodilators, and other classes of medications. We summarize the rationale and key evidence supporting the use of these therapies in children. In addition, utilizing provider surveys and registry reviews, we describe the current trends in the use of these medications and the variation demonstrated between providers and centers. Given the heterogeneous etiology of low cardiac output syndrome, successful management requires that pharmacologic therapies be tailored to the physiologic derangements of each patient
SB Knife Jr: characteristics and tips on how to use
No full textWidespread adoption of colorectal endoscopic submucosal dissection (ESD) in clinical practice is lagging despite the peer evidence that it permits en bloc resection of large lesions that can be curative and facilitate pathological staging, thereby improving management. Limited adoption of colorectal ESD is likely due to technical challenges and a steep learning curve. Most conventional ESD devices are used without fixing the target, making them difficult to maneuver and thus creating a potential risk of perforation. Comparatively, a scissor-type knife, such as the SB Knife Jr, enables grasping of the target tissue, facilitating controlled dissection of tissue being held between the blades. This potentially prevents unexpected muscular layer injury. Colorectal ESD with the SB Knife Jr does not require complex endoscopic maneuvering or advanced skills for safe ESD. Since the incision and dissection procedure using the SB Knife Jr is different from that of conventional ESD knives, familiarization with its features is vital. In this review, we focus on the use of the SB Knife Jr for colorectal ESD. The basic colorectal ESD procedure using the SB Knife Jr consists of grasping, pulling, and cutting. By repeating these steps, circumferential incision, submucosal dissection, and hemostasis can be performed with a single device. For incision and dissection, a circumferential mucosal incision is performed similar to “cutting paper”. Submucosal dissection is performed with the image of “connecting the dots at the appropriate dissection depth”. The SB Knife Jr is useful as a secondary device in challenging ESD procedures, and surgeons should master its use
State of evidence and future perspectives in minimally invasive management of gastroesophageal reflux disease (GERD)
No full textThe future of minimally invasive treatment of gastroesophageal reflux disease (GERD) will be realized through collaborative precision medicine more than any foreseeable new technology. Multidisciplinary foregut societies are fostering the collaboration and expertise needed to provide a personalized treatment of GERD. Patient-centric therapy will consider combination therapies’ clinical successes. Taking a patient uncontrolled on medication to controlled via a combination of medicine and a procedure will replace the historical mutual exclusivity of acid-suppressive medication or surgery as a treatment for GERD. Research directed at precision medicine will focus on subgroup analysis rather than randomized controlled trials. Recognition of the crural diaphragm as a reflux barrier which fails in GERD patients regardless of the presence of an axial hernia has resulted from modalities such as 3-D high-resolution impedance manometry, endoscopic ultrasound, functional luminal impedance planimetry. More precise patient selection for purely endoscopic therapies will be possible.The concept of hernia reduction will be replaced by calibration of the crural repair to restore its sphincteric function. Partnering a surgically calibrated hernia repair partnered with interventional gastrointestinal endoscopic reinforcement of the lower esophageal sphincter will foster physician alliances and offer patient-centric alternatives to traditional fundoplication. As such, laparoscopic Nissen Fundoplication will lose its historical primacy and be relegated to the most severe GERD. Magnetic sphincter augmentation (LINX®), varing degrees of partial fundoplication, and endoluminal therapies with or without hiatal hernia repair will become the mainstay of GERD AntiReflux Procedures. Radio Frequency modulation (Stretta®) may be an alternative to neuromodulators in treating the acid-sensitive esophagus. The nascent era of endoscopic robotics will improve precision, reproducibility and revive natural orifice transluminal endoscopic surgery
Biological evidence of cancer stem-like cells and recurrent disease in osteosarcoma
No full textSarcomas are a large family of cancers originating in the mesenchyme. Composed of more than 100 histological subtypes, soft tissue and bone sarcomas remain clinically challenging, particularly in children and adolescents in whom sarcomas are the second most common malignant entities. Osteosarcoma is the main primary bone tumor in adolescents and young adults and is characterized by a high propensity to induce distant metastatic foci and become multi-drug resistant. The innate and acquired resistance of osteosarcoma can be explained by high histological heterogeneity and genetic/molecular diversity. In the last decade, the notion of cancer stem-like cells (CSCs) has emerged. This subset of cancer cells has been linked to drug resistance properties, recurrence of the disease, and therapeutic failure. Although CSCs remain controversial, many elements are in favor of them playing a role in the development of the drug resistance profile. The present review gives a brief overview of the most recent biological evidence of the presence of CSCs in osteosarcomas and their role in the drug resistance profile of these rare oncological entities. Their use as promising therapeutic targets is discussed
Rabies: knowledge, attitudes and practices in the Suhum municipality of Ghana
No full textAim: The world is racing behind time to get dog-mediated human rabies eradicated by 2030. In response, Ghana has developed a rabies control strategy that awaits implementation. The Ghana chapter of Rabies in West Africa piloted a 3-year One Health rabies control programme in Suhum Municipality of the Eastern Region, Ghana. Questionnaires were administered as part of the exercise to gather information on local rabies-related perceptions and practices, with the aim of identifying knowledge, attitude, and practice gaps that may antagonise control efforts and endanger human life.Methods: A cross-sectional study was conducted from March to November 2020. The study involved 316 conveniently sampled households (individual per household) from three randomly selected sub-municipalities in Suhum Municipality. Data were analysed with IBM SPSS version 26.Results: Of the 316 households interviewed, 82% (n = 259) of respondents were aware of rabies, of which 78.8% (n = 204) were found to have good knowledge about rabies. Rabies awareness was significantly associated with age (P = 0.004), sex (P = 0.042), and level of education (P = 0.0405). Although a majority (76.8%) of dog bite victims reported to the hospital, only 7.1% practiced wound cleansing while a significant number (32.2%) were involved in several myth-laden traditional remedies.Conclusion: This study found that most of the respondents are aware and have good knowledge about rabies. However, their practices in disease prevention and control were poor. Continued and strengthened education through One-Health collaboration of stakeholders and the cooperation of the local community will be required for effective rabies control
Characterization of freshwater snail intermediate hosts of schistosomes in four communities from Osun State, Southwest Nigeria
No full textAim: Freshwater snails of the genus Bulinus act as essential intermediate hosts of Schistosoma haematobium, a trematode parasite that causes urogenital schistosomiasis. The snails are widely distributed throughout Nigerian waters. Since species identification of the Bulinus snails is important for appropriate control strategies of urogenital schistosomiasis, this study therefore aimed at identifying the Bulinus species responsible for transmission of the infection in four communities located in an endemic Local Government Area of Nigeria. It also aimed at using restriction fragment length polymorphism (RFLP) as a more affordable method than sequencing to characterize Bulinus snails from schistosomiasis endemic regions in Nigeria.Methods: In this study, 100 freshwater snails morphologically identified as Bulinus species were collected from four communities located in a previously reported schistosomiasis endemic Local Government Area (LGA), namely Olorunda LGA in Oshun State, Southwest Nigeria. All snails were screened for schistosome infection using polymerase chain reaction (PCR) targeting the DraI gene. Molecular identification of the snails was done by PCR amplification of their entire internal transcribed spacer region including the 5.8S ribosomal RNA gene and RFLP. Results: Five of the 100 snails were positive for schistosome infection. PCR-RFLP profiles showed bands of different sizes for 26 other snails including the schistosome-infected ones. RFLP analysis showed that 11 of the snails belonged to the freshwater snails of the genus Physa while 13 belonged to the freshwater snails of the genus Bulinus, including Bulinus globosus (8) and B. truncatus (5). The species of the remaining two snails could not be resolved using the reference profiles from our previous studies.Conclusion: This study confirmed previous observations that limited morphological uniqueness within the Bulinus groups hinders their identification, and RFLP is a cheaper alternative method to sequencing that can be used by laboratories with limited resources for Bulinus species identification
Tau-targeting therapy in Alzheimer’s disease: critical advances and future opportunities
No full textAlzheimer’s disease (AD) is a progressive neurodegenerative disorder characterized by two pathological hallmark lesions: extracellular plaques composed of β-amyloid (Aβ) peptide and intracellular neurofibrillary tangles made up of highly phosphorylated tau protein. Over the past two decades, most disease-modifying therapies against AD have been developed mainly on the basis of the amyloid cascade hypothesis with a focus on Aβ. However, these agents yielded only limited benefits against disease progression, which prompts us to revitalize the long-neglected tau hypothesis. Tau protein is a microtubule-associated protein, which can stabilize microtubules, regulate microtubule assembly, and affect the morphology and growth of neuronal axons. Much more importantly, the degree of tau pathology is more closely related to cognitive decline in AD patients than that of Aβ pathology. Therefore, tau-targeting therapy seems to be a promising approach to combat AD. This review describes the research progress of tau-targeting therapy in AD, with an emphasis on immunotherapy. The current challenges and future perspectives in this field are also discussed
Fabrication method and performance of a light-responsive hydrogel microvalve in a microfluidic chip
No full textMicrofluidic technology has potential advantages in the complex manipulation of microfluidics on small-sized chips. However, it is difficult to integrate microvalves with complex flow channel structures, and this has limited the miniaturization of microfluidic systems and their portable applications. Light-responsive hydrogel (LRH) materials can rapidly change their volume under laser irradiation and can be used to prepare flexible microvalves to realize the integrated control of microfluidics. A simple fabrication method for an LRH microvalve on a microfluidic chip is proposed. The microspheres, as control elements of the microvalve based on an LRH modified with Laponite RD nanoclay and ferriferous oxide (Fe3O4) nanoparticles, are prepared through a T-shaped flow channel. The microvalve is assembled on the microfluidic chip with a normally closed circulation channel. The open/close performance of the microvalve is represented by the color change of the photonic crystal material. The results show that the LRH microspheres shrink and the flow channel opens after laser irradiation for 2 s. After stopping the laser at 18 s, the valve core swells and the flow channel closes
Near-room-temperature reversible switching of quadratic optical nonlinearities in a one-dimensional perovskite-like hybrid
No full textThe switching of quadratic nonlinear optical (NLO) effects between two or more NLO states of solid-state materials represents an intriguing new branch in the field of photoelectrics and optics. While structural phase transitions have shown potential in this field, near-room-temperature reversible NLO switches have rarely been reported. To exploit new NLO switching materials within the structurally flexible class of hybrid perovskites, here, we synthesize a one-dimensional perovskite-like hybrid, (MP)PbBr3 (where MP+ is a 1-methylpyrrolidinium cation), through a facile solution method, which exhibits strong second harmonic generation (SHG) activities with an intensity of ~1.6 times as large as potassium dihydrogen phosphate. Intriguingly, (MP)PbBr3 enables the near-room-temperature reversible switching of SHG properties, showing a large NLO switching contrast of up to ~40 between its SHG-active and SHG-inactive phases, beyond most of its liquid counterparts. Further microscopic structural analyses reveal that the dynamic ordering of the organic MP+ cation and inorganic chain-like skeleton triggers its centrosymmetric (P63/mmc) to acentric (P212121) phase transition at 316 K upon cooling, resulting in a crucial contribution to its NLO switching properties. This work illustrates the potential of this material as a candidate for solid-state NLO switches and will promote the development of NLO materials within the family of low-dimensional hybrid perovskites
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