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Identifying risk factors for suicidal ideation (SI) is necessary for suicide prevention. Associations between self-reported physical activity (PA) and sedentary time and SI in the general population have been found. The current study examines these associations in adults with major depressive disorder (MDD) using objective measures of PA and sedentary time.

Sedentary time and PA were measured with an activPAL inclinometer/accelerometer over 7 days in 52 adults with MDD. Presence and severity of SI was examined with the Mini International Neuropsychiatric Interview. Multinomial logistic regressions examined associations between accelerometer-derived behaviors and SI classification in the full sample and a subsample experiencing a major depressive episode (MDE).

Sedentary time and PA measures were not significantly associated with SI in the full sample. In those experiencing an MDE, higher light ambulatory PA was associated with lower odds of reporting Low SI compared to None and for Moderate/High SI compf light ambulatory PA may be a modifiable risk factor for SI during an MDE. We also demonstrated the feasibility of collecting objective data with accelerometers in this population. AMG510 Future studies are needed to replicate findings to determine whether increasing light ambulatory PA could be useful in suicide prevention during an MDE.HighlightsLight physical activity was associated with lower odds of suicidal ideation.Suicidal ideation was not associated with sedentary or moderate-to-high activity.It is possible to collect objective data for adults with depression.The epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) gefitinib and erlotinib were approved for metastatic or relapsed non-small cell lung cancer (NSCLC) in Japan in 2002 and 2007, respectively. EGFR mutation testing was also approved in 2007. Although clinical trials showed efficacy in NSCLC patients harboring activating EGFR mutations, these effects have rarely been reported in real-world practice. We evaluated changes in survival in NSCLC patients following introduction of these agents and EGFR mutation testing by extracting patients diagnosed with NSCLC from 1993 through 2011 from six prefectural population-based cancer registries in Japan. Relative survival (RS) was calculated by sex, histological subtype, and cancer stage. We conducted interrupted time series analysis to assess survival changes following introduction of EGFR-TKIs and EGFR mutation testing. 120,068 patients with NSCLC were analyzed. One- and three-year RS gradually increased in overall NSCLC for men and women. For adenocarcinoma, among men, slopes of 1- and 3-year RS increased steeply in patients diagnosed from 2007 through 2011; among women, significant level increases were seen in 1-year RS in patients diagnosed in 2002 (4.55% [95% confidence interval 1.76-7.33]) and 2007 (3.40% [1.27-5.52]). These significant level increases were particularly obvious in women with adenocarcinoma at an advanced stage. Our results suggest that recent improvements in survival in men and women with adenocarcinoma are due at least partly to introduction of EGFR-TKIs into real-world practice, and to prescription based on appropriate patient selection following introduction of EGFR mutation testing into real-world practice in Japan.

Contrast-enhanced harmonic endoscopic ultrasound (CEH-EUS) has been used in the differential diagnosis of benign and malignant tumors by visualization of tumor microcirculation and perfusion. However, its diagnostic role in submucosal tumors (SMTs), especially leiomyomas and gastric submucosal tumors (GISTs) was rarely studied. The aim of this study was to analyze the diagnostic role of CEH-EUS for SMTs (<50 mm) and the value of assessing the malignant potential of GISTs.

We retrospectively included patients with tumors <50 mm in diameter who underwent preoperative EUS and CEH-EUS examination and had pathologically confirmed as leiomyomas and GISTs. To analyze the imaging features of CEH-EUS with pathological diagnosis as the gold standard and evaluate its diagnostic value.

This study included 10 cases of leiomyomas and 38 cases of GISTs. Under CEH-EUS detection, 86.9% of GISTs showed hyper-enhancement, 89.5% showed diffuse enhancement, 39.5% showed non-enhancing spots, and 97.4% showed obvious caGISTs.

Through this study, CEH-EUS has a good differential diagnostic ability for leiomyomas and GISTs, and has a high value in predicting the risk of GISTs.

Various products are available for lightening hair. There are no data on which applications are actually used in hairdressing, impeding proper estimation of actual exposure and necessary preventive measures.

To assess information about availability, usage and formulation of lightening preparations in the German hairdressing trade.

A market survey was conducted and hairdressers were surveyed by online questionnaires.

Of 783 hairdressers clicking the link, 565 hairdressers (91.2% female, mean age of 40.2 ± 11.7 years) from all German states responded (response rate 72.2%). The questionnaire survey has shown that available hair-lightening preparations in the German hairdressing trade are (multiple selection possible) dust-free (88.5%) and non-dust-free bleaching powders (22.1%), bleaching creams (41.9%), high-lifting hair colour creams (88.8%) and normal hair colour creams (58.4%). Five hundred eighteen (91.7%) hairdressers favour lightening hair with powder. The market survey revealed that bleaching powders and creams contain potassium persulfate, ammonium persulfate and sodium persulfate or combinations of these persulfate salts.

Hairdressers are exposed to various hair-lightening applications containing different chemicals. Preventive measures need to address adverse skin and respiratory effects. Implementation of targeted health education already in early career stages (i.e., apprenticeship) seems advisable and can be maintained by refresher trainings.

Hairdressers are exposed to various hair-lightening applications containing different chemicals. Preventive measures need to address adverse skin and respiratory effects. Implementation of targeted health education already in early career stages (i.e., apprenticeship) seems advisable and can be maintained by refresher trainings.

Obstructive sleep apnea (OSA) and hypertension are interrelated diseases linked to gut dysbiosis. This study aimed to investigate the effect of OSA on the gut microbiome in the context of hypertension and vice versa.

Of 211 consecutively screened patients, 52 completed polysomnography study, medical history questionnaires, and fecal sample collection. 16S rRNA gene sequencing was performed on fecal samples, and diversity, richness, and microbial taxa were analyzed using bioinformatics.

Alpha diversity showed slightly decreased diversity in OSA and hypertension groups without significant difference, and the hypoxia burden index (HBI) showed a weak positive correlation with Chao1 index (r=0.342, p <0.05) in OSA patients. Firmicutes-to-Bacteroidetes ratio was higher in patients with than without OSA. In hypertensive patients, those with OSA had higher

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, and unidentified Lachnospiraceae levels than those without OSA. Conversely, in OSA patients, hypertensive patients had lower

and

levels.

The present study suggests a possible compensatory mechanism for gut microbiome changes in sleep apnea pathophysiology. The positive correlation between HBI and alpha diversity, and increase in certain genera of Ruminococcaceae and Lachnospiraceae in OSA patients may represent an adaptive response to hypoxia.

The present study suggests a possible compensatory mechanism for gut microbiome changes in sleep apnea pathophysiology. The positive correlation between HBI and alpha diversity, and increase in certain genera of Ruminococcaceae and Lachnospiraceae in OSA patients may represent an adaptive response to hypoxia.There has been growing interest in the past century in improving understanding of the development and treatment of psychopathology of children, with increasing government funding of research in the past two decades. However, child and adolescent psychiatry excellence in clinical care has not been well-documented in the existing literature. This article provides examples of clinical excellence in paediatric mental health to supplement existing guidelines for the clinical practice of paediatric psychiatry. A review of the literature identified 204 unique peer-reviewed articles that were then further evaluated for applicability and relevance to the definition of clinical excellence as outlined by the Miller-Coulson Academy of Clinical Excellence (MCACE). Cases were then identified and selected for each domain of clinical excellence as they apply to child and adolescent psychiatry and to provide a model for patient care.KEYPOINTSClinical excellence in child and adolescent psychiatry has not previously been defined or extensively documented.The Miller-Coulson Academy of Clinical Excellence (MCACE) has developed a systematic method to measuring excellence in clinical care and created a definition of clinical excellence.The MCACE defined the domains of clinical excellence as communication and interpersonal skills, professionalism and humanism, diagnostic acumen, skilful negotiation of the healthcare system, knowledge, scholarly approach to clinical practice, exhibiting a passion for patient care and modelling clinical excellence, and collaborating with investigators to advance science and discovery.There are numerous case examples in the literature that represent mastery in paediatric psychiatry in these areas.Clinicians in paediatric mental health will likely benefit from future research on evidence-based approaches to training and education in these domains of clinical excellence.In the present world chitin is used enormously in various fields, such as biopharmaceuticals, medical and clinical bioproducts, food packaging, etc. However, its development has been curbed by the impaired performance and cumbersome dissolution process when chitin materials are dissolved and regenerated by physical or chemical methods. To further obtain the regenerated chitin fiber material with improved performance, silk fibroin was introduced into the chitin matrix material, and chitin/silk fibroin biocompatible composite fibers were obtained by formic acid/calcium chloride/ethanol ternary system and top-down wet spinning technology. The produced composite fibers outperformed previously reported chitin-silk composites in terms of the tensile strength (160 MPa) and failure strain (25%). The fibers also performed good cell compatibility and strong cellular affinity for non-toxicity. The cell viabilities of the fibers were about 20% greater than those of silk fiber after three days of co-culture with NIH-3T3. Furthermore, no hemolysis occurs in the presence of chitin/silk fibers, demonstrating their superior hemocompatibility. The fibers had a hemolysis index as low as 1%, which is far lower than the acceptable level of 5%. The material offers prospective opportunities for biomaterial applications in anticoagulation, absorbable surgical sutures, etc.