Elemental state of the organism of workers and population as manifestation of adaptation to the technogenic effect of metals: new methodological approaches

The problem of adaptive, prepathological and pathological reactions of the body to the action of exogenous chemicals is closely intersected with the assessment of the norm and its fluctuations. The imbalance of chemical elements in the human body directly affects the functioning of almost all organs and systems, causing significant stress of adaptation mechanisms. In this article we study the elemental state of the human body depending on the physiological state (endocrine pathology and professional contact with heavy metals), analyze the correlation between macro- and microelements and assess the degree of adaptability of the body. In the work the elemental state of the human body, taking into account not only the absolute values of the concentrations of elements in the hair and whole blood was studied, the adaptability of the body according to the indicators of elemental imbalance in the blood and hair of volunteers, individuals with endocrine pathology (autoimmune thyroiditis and type II diabetes mellitus) and for those working in conditions of contact with heavy metals (for jewelers, welders and batterymen) is analyzed. The results of the study indicate that various non-specific adaptation reactions are accompanied by changes in the elemental state of a person. Under the prevailing pathology of the endocrine system (diabetes mellitus or autoimmune thyroiditis), the adaptation of the body was determined as a stage of tension and is associated with the duration of the disease. In persons exposed to professional contact with heavy metals (Mn, Cr, Pb, Ag), adaptation depended on the nature and duration of professional contact with them: the highest tension of adaptation processes was found in jewelers, and the least in welders and batterymen, which is associated with the duration of professional contact with these metals. The high number of connections between the elements indicates the tension of adaptive reactions in people with endocrine pathology and especially in jewelry workers. Adaptation to the high content of metals in the air of welders and batteries due to the longer experience of these workers and adaptation to production conditions with a decrease in the number of correlations between the elements, as a means of reliable operation.

Study of features of humoral immune response to the new coronavirus infection COVID-19 among healthcare workers

Relevance. Since the beginning of the epidemic in China, there have been reports of nosocomial cases of SARSCoV-2 infection, including among medical workers. Studies of the intensity of humoral immune response to the SARSCoV-2 virus among medical workers who are much more likely to have professional contact with COVID-19 patients than are of particular importance. The aim is to study the seroprevalence and features of the humoral immune response to SARS-CoV-2 among medical workers. Materials and methods. The study included 61 medical workers from a multidisciplinary hospital in Kazan, which was redesigned to provide medical care to patients with new coronavirus infection, using the method of random sampling. The control group consisted of 60 non-medical workers. For the determination of IgG, a solid-phase ELISA was used. Statistical processing of the results was carried out using MS Excel software. The error of the relative value (M±m) was calculated, and the 95% confidence interval of the frequency of occurrence. To assess the significance of differences, the Student’s test (t-test) was used for independent samples. Results. The proportion of those seropositive to SARS-CoV-2 in the study group was 45.9%, compared with 21.7% in the control group. Among medical workers seropositive to the SARS-CoV-2 virus, the proportion of asymptomatic forms was 18.5%, mild forms — 53.6%, moderate forms and severe forms 25%. Two forms of the formation of a humoral immune response among seropositive ones were revealed: the first is characterized by the gradual elimination of specific IgG antibodies to SARSCoV-2 after 8 weeks from the onset of the first symptoms of COVID-19, the second form is an increase in specific IgG to SARS-CoV-2 and a higher value of the coefficient level of IgM positivity to SARS-CoV-2 after 8–10 weeks from the onset of the first symptoms. The group of seropositive, “raising antibodies”, prevailed over the group of individuals “eliminating antibodies”. Among seropositive medical workers, two forms of the formation of a humoral immune response were revealed: synchronous with the parallel elimination of IgG and IgM antibodies and a parallel increase in IgG and IgM. Conclusion. The study of the level of humoral immunity to COVID-19 in medical workers is important in terms of planning both anti-epidemic measures and predicting the effectiveness of the response to vaccination to SARS-CoV-2.

Return to Play After Arthroscopic Management of Rotator Cuff Tears in Professional Contact Athletes (245)

Objectives: Rotator cuff tears are rare injuries in professional contact athletes and there is limited data to help guide players and team physicians regarding outcomes after surgical management. The purpose of this study was to report on the clinical outcomes and return to play rates of professional contact athletes that underwent arthroscopic management of rotator cuff tears at our institution. Methods: A retrospective review was performed on 10 rotator cuff tears in 9 professional contact athletes that underwent arthroscopic management of a rotator cuff tear from 2002-2019 at our institution. 8 tears occurred in elite American football players, 7 from the NFL and 1 from the CFL. The remaining 2 rotator cuff tears were identified in professional hockey players from the NHL. The average age of the players was 28.7 ± 4.8 years. Patient information included age, sport, position played, date of injury, date of surgery and length of time from surgery to return to play. Surgical data included tear size, acuity and pattern as well as procedure performed (debridement vs repair). Both intra and post-operative complications were documented. The primary outcome measure was the ability to return to play and the number of games played after surgery was documented. As in other similar studies, return to play was defined as the ability to participate in at least 1 full regular-season game after surgery. Return to play and career length data were collected through publicly available internet sources (NFL, CFL and NHL statistical websites) as well as from the team’s medical staff. Results: 80% of the professional contact athletes that underwent arthroscopic management of a rotator cuff tear in this study were able to return to play at the same professional. The average age of the players that returned to play was 27.3 ± 4.2 years and the average time to return to play was 7.9 ± 1.9 months. 8 of the 10 tears occurred in professional football players and the majority of these injuries (6 of 8) occurred in defensive players. 2 of the 10 tears occurred in professional hockey players from the NHL and both were offensive players. All of these players regained sufficient range of motion, strength and function to pass a pre-participation physical performed by their team’s medical staff and all participated in at least one regular season game. For the football players, the average playing experience after surgery was 32 ± 25 games played. For the hockey players, the average playing experience after surgery was 22 ± 11games played. 9 of the 10 tears were full thickness tears that underwent arthroscopic single row repair while 1 was a partial tear that was debrided. The average tear size was 1.95 ±0.9 cm. The average number of suture anchors used was 1.35 ± 0.7. All tears involved the supraspinatus rotator cuff tendon and 4 were classified as small tears (<1cm), 3 as medium tears (1-3cm) and 2 as large tears (3-5cm). 7 of the 10 tears underwent acute surgical repair (<2 weeks from date of injury), while 3 players underwent delayed surgical intervention at the end of the season. The delay in surgical intervention did not appear to negatively impact healing rates or the ability to return to play. Other factors that did not appear to influence return to play included type of sport, position, type of procedure (debridement vs repair) or the number of suture anchors used in the repair. Post-operative imaging was available in 8 of the 10 tears and 7 of 8 (88%) demonstrated a healed repair. No intra-operative complications were noted. 2 veteran players with large (3-5cm) full thickness tears did not return to play. The average age of these players was 34.5 years and both had > 10 years of professional playing experience. One of these players was an NFL player that demonstrated a repair failure at 6 months on post-operative imaging and elected to retire rather than undergo revision surgery. The second was an NHL player that retired for reasons unrelated to his shoulder, despite a good clinical outcome and a healed repair on post-operative imaging. To our knowledge, none of the remaining players have undergone subsequent surgical intervention or revision surgery on their injured shoulder. Conclusions: This is one of only a few studies since 1996 to report on the clinical outcomes after operative management of rotator cuff tears in elite professional contact athletes. The majority (80%) of the professional contact athletes in this series were able to return to play at the same professional level after arthroscopic management of a symptomatic rotator cuff tear. Older players with > 10 years of professional experience and large rotator cuff tears were less likely to return to play after surgical intervention.

An advanced self-care delivery model for leg ulcer management: a service evaluation

Background: Lower limb ulceration is a common cause of suffering in patients and its management poses a significant burden on the NHS, with venous leg ulcers (VLUs) being the most common hard-to-heal wound in the UK. It is estimated that over one million patients in the UK have lower limb ulceration, of which 560,000 were categorised as VLUs, with a cost burden of over £3 billion each year. Objective: The aim of this service evaluation was to assess the effects of implementing a self-care delivery model on clinical outcomes with the intention of limiting face-to-face health professional contact to one appointment every 6 weeks. Method: A suitability assessment was conducted and a cohort of patients were moved to a self-care delivery model. Patient data were collected, anonymised and independently analysed, comparing time to healing against data on file from a previous report. Results: This highlighted that, in 84 of the 95 patients selected, the VLUs had healed by week 24 on the pathway, a further 10 patients' VLUs had healed by week 42 and only one remaining patient reached 42 weeks without healing. Conclusion: These results support the hypothesis that patients with VLUs can self-care and deliver clinical effectiveness. It is recommended that all services explore the possibility of introducing a self-care model for VLU care.

The duration of labor activity of workers in the production of phthalic anhydride and the imbalance of cellular immunity indicators

Introduction. The phthalic anhydride, which widely used in chemical industry in conditions of chronic ingestion, chronically leads to a disadaptation of immunity, which is a risk factor in the formation of associated production related pathology. The aim of the work is to study the subpopulation profile of lymphocytes and cytokine status in workers engaged in the production of phthalic anhydride with their work experience. Materials and methods. The observation group, totally 68 men, consisted of employees working at the main phthalic anhydride production facility. The workers of the observation group were divided into two subgroups with their work experience at the enterprise: 44 persons with 0 to 10 years of work experience and 24 persons with more than 10 years of work experience. The comparison group - 40 men who had no professional contact with harmful production factors. The chemical-analytical, cytofluorimetric, immunoenzyme methods use during the study. Results. The workers being exposed to phthalic anhydride with up to 10 and more than 10 years of work experience at the enterprise have a phthalic acid content in their blood that is 2.3 and 3.3 times higher, respectively than related to persons who are not in contact with the analyzed harmful production factor (p=0.002-0.033). It was found that longtime workers, engaged in the production of phthalic anhydride, manifested the immune response cellular link dysfunction. Workers employed in the main production of phthalic anhydride with more than 10 years of work experience revealed a prevalence of activation processes (according to CD25+ criterion), inhibition of cytotoxic cell-mediated response (according to CD3+CD16+CD56+ criterion), gyperexpression of Th2-cytokines (according to criterion IL4) relative to values obtained from workers of the production with less than 10 years of work experience in hazardous production conditions (p=0.002-0.033). Conclusions. The duration of employment of the workers, contacting with excessive concentrations of phthalic anhydride in workplace air, contributes to negative dynamics in the imbalance between T-cells and cytokine products. The dynamic monitoring of immunoregulatory indicators in workers occupied in the production of phthalic anhydride will contribute to just-in-time revealing of the immune system violations in order to reduce the risks of formation of associated production-related pathology induced by the chemical production factors.

Frequency and Predictors of Traumatic Encephalopathy Syndrome in a Prospective Cohort of Retired Professional Athletes

Traumatic encephalopathy syndrome (TES) is proposed to represent the long-term impact of repetitive head-injury exposure and the clinical manifestation of chronic traumatic encephalopathy (CTE). This study aimed to evaluate the frequency of TES in a cohort of retired professional contact sport athletes, compare the frequency of TES to clinical consensus diagnoses, and identify predictors that increase the likelihood of TES diagnosis. Participants were 85 retired professional contact sport athletes from a prospective cohort at the University of Texas Southwestern Medical Center and the University of Texas at Dallas. Participants ranged in age from 23 to 79 (M = 55.95, SD = 13.82) and obtained 7 to 19 years of education (M = 16.08, SD = 1.03). Retirees were either non-Hispanic white (n = 62) or African-American (n = 23). Retired athletes underwent a standard clinical evaluation, which included a clinical interview, neurological exam, neuroimaging, neuropsychological testing, and consensus diagnosis of normal, mild cognitive impairment, or dementia. TES criteria were applied to all 85 athletes, and frequencies of diagnoses were compared. Fourteen predictors of TES diagnosis were evaluated using binary logistic regressions, and included demographic, neuropsychological, depression symptoms, and head-injury exposure variables. A high frequency (56%) of TES was observed among this cohort of retired athletes, but 54% of those meeting criteria for TES were diagnosed as cognitively normal via consensus diagnosis. Games played in the National Football League (OR = 0.993, p = 0.087), number of concussions (OR = 1.020, p = 0.532), number of concussions with loss of consciousness (OR = 1.141 p = 0.188), and years playing professionally (OR = 0.976, p = 0.627) were not associated with TES diagnosis. Degree of depressive symptomatology, as measured by the total score on the Beck Depression Inventory-II, was the only predictor of TES diagnosis (OR = 1.297, p &lt; 0.001). Our results add to previous findings underscoring the risk for false positive diagnosis, highlight the limitations of the TES criteria in clinical and research settings, and question the relationship between TES and head-injury exposure. Future research is needed to examine depression in retired professional athletes.

Transfer of Technology through Social Media in Pandemic Perspective

Currently the entire world is passing through a crisis situation caused by corona virus disease 2019 (COVID-19). All activities are shuttered during lockdown but not the primitive activity i.e. Agriculture. Due to Pandemic, the extension professional contact is more digital than physical contact. In recent past extension professionals are using social media as an effective tool for transfer technology due to the enormous penetration of the internet and Smartphone’s among the majority of rural India. The present study was conducted with an objective to focus on the change in usage of social media during pandemic by extension professionals. A structured questionnaire was developed to interview the Krishi Vigyan Kendra (KVK) extension professionals under ATARI, Kolkata (zone- 5) through Google forms. The usage of social media was studied with few indicators viz., time spent on social media, the purpose of using social media and individual trend of using social media in comparison with general and pandemic conditions. The result from the study revealed that extension professionals had a significant positive change in the time spent on social media during the pandemic situation. A drastic change was observed in the time spent categories of 4-6 hours and more than 6 hours (increased by 11.21%) due to lockdown situation. Extension professionals started to reach more participants during pandemic through social media platforms. The majority of the respondents (increased by 15.88%) justified that they could reach 100-500 farmers during pandemic with the help of social media. Positive improvement was observed in the purpose of using social media like sharing knowledge to farming community, using social media for discussion, and to promote new technological advances with the overall raise of 26 percent. More than fifty per cent (60.74%) of total respondents felt that their trend in using social media was at a medium level and only 18.69 percent of respondents felt a high trend in social media usage. From the study we can justify that the extension professionals had a positive change in the usage of social media platforms in a productive way to transfer the technology to the farming community.

Karl Leonhard (1904–88) and his academic influence through the ‘Erlangen School’

The Erlangen University Psychiatric and Mental Clinic was an annexe to the Erlangen Mental Asylum, so when Leonhard worked there he became acquainted with acute and chronic stages of schizophrenia. This can be viewed as a decisive impulse for his later differentiated classification of types of schizophrenia. The suspicion that Leonhard suffered from attention deficit hyperactivity disorder cannot be supported. His reticence concerning social-psychiatric aspects is analysed in the context of his early professional contact with the ‘Erlangen system’ of open care and its Nazi perversion. Leonhard’s role in national-socialism is still uncertain. His unsuccessful attempts to retain the Erlangen Chair of Psychiatry and Mental Illness in 1951 can be viewed as his first difficulty in the tensions between West Germany and East Germany.

Palestinian Attitudes Towards Settlers in the West Bank

We present survey data from 1,573 West Bank Palestinians with which we estimate that the average Palestinian lives 14 km (UI 11 to 18 km) from the closest Israeli settlement. We also show with this data that while Palestinians in general hold negative attitudes towards settlers in the West Bank, Palestinians living in closer proximity to a settlement report more neutral attitudes towards settlers. Multivariate analysis shows that this effect appears to be driven by social and professional contact: Palestinians who have interacted with a settler or worked in a settlement present more positive attitudes towards settlers while distance loses its ability to predict attitudes. Since the onset of the COVID-19 global pandemic, the majority of respondents stated that they have lost either a job or a business from COVID-related restrictions, suggesting that this positive contact effect could dissipate as Palestinians have less reason to interact with Israelis.