From a cycle to a period: the potential role of BDNF as plasticity and phase-specific biomarker in cocaine use disorder

Cocaine Use Disorder (CUD) is one of the diseases with the greatest social and health impact, due to the high cost of rehabilitation management and the high risk of dangerous behavior and relapse. This pathology frequently leads to unsuccessful attempts to interrupt the consumption, resulting in relapses and a vicious circle binge/intoxication, withdrawal/negative affect, and preoccupation/anticipation (craving). The alternation of these phases in addictions was well illustrated by Koob and colleagues in the so-called “addictive cycle”, which nowadays represents a landmark in the addiction field. Recently, there has been an increased interest in the international literature for biomarkers able to explain the several phases of addiction, and one of the most studied biomarkers is undoubtedly Brain-derived Neurotrophic Factor (BDNF). In this perspective article, we discuss the potential role of BDNF as biomarker of the CUD phases described in the “Addictive Cycle”, speculating about the close relationship between BDNF fluctuations and the clinical course of CUD. Furthermore, we discuss BDNF potential role as “staging” biomarker, able to predict disease worsening. Finding valuable biomarkers of CUD severity and disease stage could shift clinicians' attention from the perspective of behavioral symptomatic treatment to a novel brain-based approach, allowing more effective and targeted therapeutic strategies to be developed, thus determining major benefits for CUD patients.

Climate Change and Child Health – Importance of Pediatricians for Parents

Background: Children are among the most vulnerable to suffer from health consequences due to climate change. Parents as caregivers play an important role in protecting them adequately. Pediatricians are regularly seen as highly-trusted health professionals, but it remains unclear whether they are an information source for parents regarding climate change and health. According to the Health Action Process Approach, parents’ risk perception is an important pre-intender for intention building. Methods: A sample of parents (N = 243) living in Germany completed an online, cross-sectional survey distributed in summer 2020. Regarding climate change and health, we asked about information sources, relevance estimation, and risk perception of parents. Multiple linear regression with general and individual risk perception as outcomes were used to analyze the effect of knowledge and personal relevance. Results: Parents seek information about climate change and health primarily via internet and social media. Pediatricians are rarely considered as suitable information source. Parents see the highest risk for their child through increasing air pollutants and stronger UV-radiation. Relevance (β = .52, t = 5.79, p < .001) and knowledge (β = .02, t = .36, p = .72) explain 18.2% of general risk perception (F(5, 208) = 9.25, p < .001, ΔR2 = .13). The effect is lower (13%) for individual risk perception (F(5, 189) = 5.67, p < .001, ΔR2 = .07). Conclusions: Pediatricians can play a valuable role in informing parents about climate change and health; nevertheless, they are not yet seen as suitable information sources by parents. Results demonstrate that knowledge about climate change and health is not sufficient to increase risk perception of parents, but strengthening risk perception is possible through rising relevance estimation. When informing parents about the expected health impact of climate change, this should be considered.

Analisis Dampak Operaional PLTU Jeranjang Terhadap Kondisi Sosial dan Ekonomi Masyarakat Di Kabupaten Lombok Barat

PLTU Jeranjang, West Lombok Regency, is a power plant that uses low-calorie coal. The activities and all power generation activities, including the PLTU Jeranjang, have the potential to have an impact on the social and economic conditions of the community around the power plant location. More in-depth research is needed regarding the impact on social and economic conditions, especially in the Jeranjang area. The aims of this research are (1) to find out how big the social and economic impact of the operational activities of PLTU Jeranjang on the community around the area of PLTU Jeranjang. (2) As a reflection and reference in efforts to increase the national electrification ratio with its impact on environmental, social, economic, and cultural conditions. The method used is a qualitative method by applying questionnaires, interviews and field observations to collect data. While the research sample used purposive sampling by considering the selection of respondents, ease of access, cost and time of the study. This study resulted that the community experienced a decrease in income up to 79%, especially fishermen and farmers. However, the level of anxiety is relatively low because %URS only reached 56%. The health impact that is often experienced by the community throughout the year is Upper Respiratory Tract Infection (ARI). The magnitude of the disturbance in fishing activities is classified as having a sufficient impact because 71% of fisherman feel a change in the typology of fishing which has an impact on the economy. The amount of disturbance to fishing activities is quite adequate with an FAI value of 0.003391. The operational activities of the PLTU Jeranjang as a whole have an impact that is still included in the low category so that this impact can be minimized by optimizing the monitoring, control, treatment, and information disclosure between the PLTU Jeranjang and the community.

Immediately provisionalized tapered conical connection implants for single-tooth restorations in the maxillary esthetic zone: a 5-year prospective single-cohort multicenter analysis

Objectives This open, single-cohort, multicenter, prospective study investigated the efficacy of immediately provisionalized tapered conical connection implant for single-tooth restorations in the anterior and premolar regions of the maxilla after 5 years of function. Materials and methods All implants were placed in healed sites and immediately provisionalized. MBLs, soft-tissue parameters, and oral-health impact profile (OHIP) were evaluated at implant insertion, 6, 12, 24, 36, and 60 months. Paired Wilcoxon signed-rank tests and Kaplan–Meier survival analysis was used for statistical and implant survival/success analyses, respectively. Results Seventy-seven patients (81 implants) completed the 5-year follow-up. The 5-year cumulative survival and success rates were 97.8%, and the mean MBL change from implant insertion to 5 years was − 0.80 ± 1.13 mm. Optimal papilla index scores were observed at 90.1% of sites at 5 years compared with 32.8% of sites at insertion. Pink esthetic score, modified bleeding and plaque indices, and OHIP showed statistically significant improvement at the 5-year follow-up. Conclusions Immediately provisionalized tapered conical connection implants promote marginal bone stability and excellent esthetic outcomes after 5 years of function. Clinical relevance This treatment is a viable option for patients requiring immediately provisionalized single-tooth restorations in the esthetic zone and shows favorable long-term clinical outcomes, including marginal bone stability and excellent esthetics.

Quality of life after sialendoscopy: prospective non-randomized study

Background The symptomatic (swelling and pain) salivary gland obstructions are caused by sialolithiasis and salivary duct stenosis, negatively affecting quality of life (QOL), with almost all candidates for clinical measures and minimally invasive sialendoscopy. The impact of sialendoscopy treatment on the QOL has been little addressed nowadays. The objective is to prospectively evaluate the impact of sialendoscopy on the quality of life of patients undergoing sialendoscopy due to benign salivary obstructive diseases, measured through QOL questionnaires of xerostomia degree, the oral health impact profile and post sialendoscopy satisfaction questionnaires. Result 37 sialendoscopies were included, most young female; there were 64.5% sialolithiasis and 35.4% post-radioiodine; with 4.5 times/week painful swelling symptoms and 23.5 months symptom duration. The pre- and post-sialendoscopy VAS values were: 7.42 to 1.29 (p < 0.001); 86.5% and 89.2% were subjected to sialendoscopy alone and endoscopic dilatation respectively; 80.6% reported improved symptoms after sialendoscopy in the sialolithiasis clinic (p < 0.001). The physical pain and psychological discomfort domain scores were mostly impacted where sialendoscopy provided relief and improvement (p < 0.001). We found a positive correlation between sialendoscopy and obstructive stone disease (p < 0.001) and no correlation in sialendoscopy satisfaction in xerostomia patients (p = 0.009). Conclusions We found improved symptoms with overall good satisfaction after sialendoscopy correlated with stones; and a negative correlation between xerostomia. Our findings support the evident indication of sialendoscopy for obstructive sialolithiasis with a positive impact on QOL and probably a relative time-dependent indication for stenosis/other xerostomia causes that little improved QOL satisfaction. Level of evidence 2b—Prospective non-randomized study. Trial registration: WHO Universal Trial Number (UTN): U1111-1247-7028; Brazilian Clinical Trials Registry (ReBeC): RBR-6p8zfs.

Estimating the potential public health impact of fibre enrichment: a UK modelling study

For improving human health, reformulation can be a tool as it allows individuals to consume products of choice while reducing intake of less desirable nutrients, such as sugars and fats, and potentially increasing intake of beneficial nutrients such as fibre. The potential effects of reformulating foods with increased fibre on diet and on health needs to be better understood. The objective of this statistical modelling study was to understand how fibre enrichment can affect the diet and health of consumers. The UK National Diet and Nutrition Survey (NDNS) datasets from 2014 - 2015 and 2015 - 2016 were utilised to evaluate intakes of fibre and Kilocalories with a dietary intake model. Foods and beverages eligible for fibre enrichment were identified (n = 915) based on EU legislation for fibre content claims. Those people who meet Dietary Reference Values (DRVs) and fibre enrichment health outcomes such as weight, cardiovascular disease and type 2 diabetes risk reductions were quantified pre and post fibre reformulation via Reynolds et al, D’Agostino et al, and QDiabetes algorithms, respectively. The fibre enrichment intervention showed a mean fibre intake in the UK of 19.9 g/day, signifying a 2.2 g/day increase from baseline. Modelling suggested that 5.9% of subjects could achieve a weight reduction, 72.2% a reduction in cardiovascular risk, and 71.7% a reduced risk of type 2 diabetes risk with fibre fortification (all p ≤ 0.05). This study gave a good overview of the potential public health benefits of reformulating food products using a straightforward enrichment scenario.

Vitamin D deficiency associations with metabolic, bone turnover and adverse general health markers in community free living adults

Background Although there is some evidence that vitamin D deficiency is highly prevalent in the Middle East, however its health impact is still not clear. The aim of this study was to assess the prevalence, causes and health implications of vitamin D deficiency in local United Arab Emirates (UAE) citizens. Methods A cross-sectional study was conducted on community free living adults living in the city of Al Ain, UAE. Following informed written consent eligible subject’s blood and urine samples were taken for measurements of vitamin D [25(OH)D], metabolic and bone turnover markers. Clinical assessment that includes general and self-rated health, muscle health, and physical activity were also performed. Results A total of 648 subjects (491 female) were included in this analysis. Their mean (SD) age was 38 (12) years. Mean 25(OH)D was 24 ng/ml (range: 4–67) with 286 (44%) subjects found to have vitamin D deficiency (< 20 ng/ml), 234 (36%) subjects have insufficiency (20-32 ng/ml) and 128 (20%) subjects have optimal concentrations (> 32 ng/ml). 25(OH)D concentrations were significantly higher in local indigenous UAE subjects compared to other Arab expatriates (p = 0.071). Although there were no statistically significant differences in clinical markers between groups, however, utra-sensitive C-reactive protein (us-CRP), parathyroid hormone (PTH), body mass index (BMI) and the bone markers U-PYD and PYD/CR were higher in vitamin D deficient older subjects aged ≥50 years and female subjects younger than 50 years respectively compared to those with insufficiency or optimal concentrations (p value < 0.05. Multiple logistic regression analysis revealed significant and independent association between 25(OH)D status and age and sex (p < 0.05). Conclusion Older subjects with vitamin D deficiency have increased BMI, inflammation and PTH compared with those with insufficiency or optimal concentrations. Co-existence of obesity and vitamin D deficiency may have increased adverse health effects.