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Despite the cost and health consequences, a large number of people continue to smoke cigarettes worldwide every day. Notwithstanding, there have been a number of interventions to help people stop smoking but, in general, these have produced only limited success, and better interventions are needed. Accruing evidence affirmed that rumination and executive function play a pivotal role in cigarette smoking behavior, and in this editorial, we describe and discuss the key findings between these constructs and smoking, and argue that an impairment in executive functions does not act alone, but interacts with rumination by directing attention to depressive thoughts, thereby reducing the ability of smokers to engage in constructive behaviors, such as quitting smoking. Finally, we offer a new theory-driven model based on a deep understanding of the interactions between executive functions and rumination and potential moderator effects.The food enzyme α-amylase (4-α-d-glucan glucanohydrolase; EC 3.2.1.1) is produced with the genetically modified Bacillus licheniformis strain NZYM-KE by Novozymes A/S. The genetic modifications do not give rise to safety concerns. ABT-199 The food enzyme is free from viable cells of the production organism and its DNA. The α-amylase is intended to be used in starch processing for the production of glucose syrups and other starch hydrolysates, and distilled alcohol production. Since residual amounts of the food enzyme are removed by the purification steps applied during the production of glucose syrups and distillation, no dietary exposure was calculated. Genotoxicity tests did not indicate a safety concern. The systemic toxicity was assessed by means of a repeated dose 90-day oral toxicity study in rats. The Panel identified a no observed adverse effect level at the highest dose of 1,100 mg TOS/kg body weight (bw) per day. A search for similarity of the amino acid sequence of the food enzyme to known allergens was made and one match was found. The Panel considered that, under the intended conditions of use, the risk of allergic sensitisation and elicitation reactions by dietary exposure cannot be excluded, but the likelihood is considered to be low. Based on the data provided, the Panel concluded that this food enzyme does not give rise to safety concerns under the intended conditions of use.In accordance with Article 6 of Regulation (EC) No 396/2005, the applicant Landwirtschaftliches Technologiezentrum Augustenberg submitted a request to the competent national authority in Germany to modify the existing maximum residue level (MRL) for the active substance phenmedipham in strawberries. Noting that at least one additional trial is missing, an MRL of 0.7 mg/kg was derived for the intended NEU use of phenmedipham on strawberries. Adequate analytical methods for enforcement are available to control the residues of phenmedipham in strawberries at the validated limit of quantification (LOQ) of 0.01 mg/kg. Since the current MRL application was submitted before the finalisation of the EU pesticides peer review of the renewal of the approval of phenmedipham, the consumer exposure assessment was performed according to the conclusions on the toxicity of phenmedipham from the first approval under Directive 91/414/EEC. Accordingly, the long-term intake of residues of phenmedipham resulting from the existing and the intended uses is unlikely to present a risk to consumer health. EFSA notes that the present assessment does not take into account the data gaps identified in the context of the renewal of the approval of phenmedipham under Regulation (EC) No 1107/2009, which prevented experts to derive toxicological reference values (TRVs) for phenmedipham, to derive the risk assessment residue definition for fruit crops and to conclude on the toxicity of relevant metabolites.In accordance with Article 6 of Regulation (EC) No 396/2005, the applicant Syngenta France SAS submitted a request to the competent national authority in France to amend the residue definition for risk assessment and to modify the existing maximum residue levels (MRLs) for the active substance acibenzolar-S-methyl in beans (with pods) and peas (with pods). The toxicological data submitted in support of this MRL application were found to be sufficient to conclude that the plant metabolite 4-OH acibenzolar acid is not genotoxic in vitro, however lacking investigation of the general toxicity, a definitive conclusion cannot be derived whether 4-OH acibenzolar acid (free and conjugated) should be included or excluded from the residue definition for risk assessment for all commodities belonging to the groups of leafy crops and pulses/oilseeds. The data submitted in support of the request were found to be sufficient to derive MRL proposals on the basis of the current residue definition (sum of acibenzolar-S-methyl a of residues of 4-OH acibenzolar acid. The reliable end points appropriate for use in regulatory risk assessment are presented.This report of the EFSA and the European Centre for Disease Prevention and Control presents the results of zoonoses monitoring activities carried out in 2019 in 36 European countries (28 Member States (MS) and eight non-MS). The first and second most reported zoonoses in humans were campylobacteriosis and salmonellosis, respectively. The EU trend for confirmed human cases of these two diseases was stable (flat) during 2015-2019. The proportion of human salmonellosis cases due to Salmonella Enteritidis acquired in the EU was similar to that in 2017-2018. Of the 26 MS reporting on Salmonella control programmes in poultry, 18 met the reduction targets, whereas eight failed to meet at least one. The EU prevalence of Salmonella target serovar-positive flocks has been stable since 2015 for breeding hens, laying hens, broilers and fattening turkeys, with fluctuations for breeding turkey flocks. Salmonella results from competent authorities for pig carcases and for poultry tested through national control programmes were more frequently positive than those from food business operators. Shiga toxin-producing Escherichia coli (STEC) infection was the third most reported zoonosis in humans and increased from 2015 to 2019. Yersiniosis was the fourth most reported zoonosis in humans in 2019 with a stable trend in 2015-2019. The EU trend of confirmed listeriosis cases remained stable in 2015-2019 after a long period of increase. Listeria rarely exceeded the EU food safety limit tested in ready-to-eat food. In total, 5,175 food-borne outbreaks were reported. Salmonella remained the most detected agent but the number of outbreaks due to S. Enteritidis decreased. Norovirus in fish and fishery products was the agent/food pair causing the highest number of strong-evidence outbreaks. The report provides further updates on bovine tuberculosis, Brucella, Trichinella, Echinococcus, Toxoplasma, rabies, West Nile virus, Coxiella burnetii (Q fever) and tularaemia.
This study aims to investigate whether there is a significant difference between typical and atypical parenchymal patterns in the development of fibrosis, which is the most crucial factor affecting morbidity in pulmonary sarcoidosis.
In our hospital, 145 cases with Siltzbach Types 2 and 3 sarcoidoses diagnosed by clinical, radiological, and histopathologic were retrospectively investigated. Perilymphatic nodules, accompanying mosaic attenuation, and interlobular septal thickening and central peribronchovascular bunch-like thickening on high-resolution computed tomography were assessed as typical. Solid nodules, galaxy finding, consolidation, ground-glass opacity, isolated mosaic attenuation, and interlobular septal thickening, and pleural fluid were accepted as atypical findings. Findings indicating fibrosis were fine and rough reticular opacity, traction bronchiectasis, volume loss, and cystic changes. For the analysis of variables, SPSS 25.0 program was used.
Ten (16%) of the 61 cases with typical findings and 16 (19%) of the 84 with atypical findings developed fibrosis (
= 0.827). The mean age of cases with fibrosis was higher. With the cut-off of 50 years, sensitivity was 61.5%, and specificity was 68.9%. The highest fibrosis rate was in cases with ground glass pattern (
= 7/17), whereas higher reversibility rates were in those with miliary pattern (
= 9/12) and galaxy sign (
= 5/6).
The incidence of fibrosis is higher in the atypical group with no significant difference. The incidence of fibrosis differs in each atypical pattern, being highest in ground-glass opacity and lowest in the miliary pattern.
The incidence of fibrosis is higher in the atypical group with no significant difference. The incidence of fibrosis differs in each atypical pattern, being highest in ground-glass opacity and lowest in the miliary pattern.
Accurate staging of disease severity and its serial monitoring thus is central to the effective management protocols of interstitial lung disease (ILD).
The aim is to evaluate the effectiveness of semi-quantitative parameters of lung ultrasound (LUS) in patients of ILD as a means of staging disease severity.
LUS of 47 patients of ILD and 20 age-matched controls was performed, and findings such as B-line distance, pleural thickening, subpleural changes, decreased lung sliding, and fragmented pleural lining were charted, and an LUS score was done using these parameters. Findings were compared with the Modified Medical Research Council (MMRC) dyspnea grade and spirometry parameters.
The presence of B-lines and fragmented pleural lining were the most common findings observed in patients of ILD. Predicted forced vital capacity (FVC) and predicted forced expiratory volume in 1 s (FEV1) showed a good correlation with all the LUS parameters. B-line distance was the most significant LUS parameter to predict the variability in predicted FEVI, FVC, and MMRC dyspnea score. LUS severity score also showed good negative correlation with predicted FEV1 (
= -0.674,
< 0.001) and predicted FVC (
= -0.65,
< 0.001). LUS severity score of 4 or more predicted MMRC dyspnea score of > 3 with 82% sensitivity and 70% specificity.
Semi-quantitative LUS score and B-line distance can provide a simple but effective estimate of disease severity in ILD.
Semi-quantitative LUS score and B-line distance can provide a simple but effective estimate of disease severity in ILD.
Electromagnetic navigational bronchoscopy (ENB) is an excellent tool to diagnose peripheral pulmonary nodules, especially in the setting of emphysema and pulmonary fibrosis. However, most of these procedures are done by interventional pulmonologists and academic tertiary centers under general anesthesia. Studies evaluating the diagnostic utility of this tool in safety-net community hospitals by pulmonologists not formally trained in this technology are lacking. The objective was to evaluate the diagnostic yield of ENB done in such a setting and its associated complications.
Retrospective chart review of consecutive ENB procedures over 5 years from 2014, since its inception in our institution-a safety-net community based hospital was performed. Multiple variables were analyzed to assess their impact on diagnostic yields.
After exclusion criteria were applied, 72 patients with 76 procedures were eventually included within our study, with an overall 1-year diagnostic yield of 80.2%. Sensitivity for malignancy was 73% and negative predictive value of 65%.
