Use and Awareness of Heated Tobacco Products in Europe

BackgroundHeated tobacco products (HTP) are new forms of tobacco consumption with limited information available on their use among the general population. Our objective was to analyze the prevalence and associations of use of HTP across 11 countries in Europe.MethodsWithin the TackSHS Project, in 2017–2018 we conducted a cross-sectional study with information on HTP use in the following countries: Bulgaria, England, France, Germany, Greece, Italy, Latvia, Poland, Portugal, Romania and Spain. In each country, face-to-face interviews were performed on a representative sample of around 1,000 subjects aged ≥15 years, for a total of 10,839 subjects.ResultsOverall, 27.8% of study participants were aware of HTPs, 1.8% were ever HTP users (ranging from 0.6% in Spain to 8.3% in Greece), and 0.1% were current users. Men were more frequently HTP ever users than women (adjusted odds ratio [aOR] 1.47; 95% confidence interval [CI], 1.11–1.95). Ever HTP use was inversely related to age (P for trend <0.001) and more frequent in ex-smokers (compared with never smokers, aOR 4.32; 95% CI, 2.69–6.95) and current smokers (aOR 8.35; 95% CI, 5.67–12.28), and in electronic cigarette past users (compared with never users, aOR 5.48; 95% CI, 3.46–8.68) and current users (aOR 5.92; 95% CI, 3.73–9.40).ConclusionsIn 2017–2018, HTP use was still limited in Europe among the general population; however, the dual use of these products, their high use among younger generations, and the interest of non-smokers in these products are worrying and indicate the need for close monitoring in terms of prevalence and the characteristics of users.Key words: heated tobacco products, heat-not-burn tobacco products, IQOS, survey, Europe     

Bilateral endogenous fungal endophthalmitis

Endogenous endophthalmitis is a rare and severe intraocular infection which can be vision-threatening. We describe a case of bilateral fungal endogenous endophthalmitis in a 64-year-old male which was successfully treated with systemic administration of fluconazole followed by pars plana vitrectomy with an intravitreous injection of amphotericin B.     

An experimental investigation into the effect of periodic motion on proton dosimetry using polymer gel dosimeters and a programmable motion platform

Organ motion in proton therapy affects treatment dose distribution during both double-scattering (DS) and uniform-scanning (US) deliveries. We investigated the dosimetric impact of target motion using three-dimensional polymer gel dosimeters and a programmable motion platform. A simple one-beam treatment plan with 16 cm range and 6 cm modulation was generated from the treatment planning system (TPS) in both the DS and US modes. One gel dosimeter was irradiated with a stationary DS beam. Two other gel dosimeters were irradiated with the DS and US beams while they moved in the same sinusoidal motion profile using a programmable motion platform. The dose distribution of the stationary DS delivery agreed with the TPS plan. Dosimetric comparisons between DS motion delivery and the MATLAB-based motion model showed insignificant differences. Dose-volume histograms of a cylindrical target volume inside the gel dosimeters showed target coverage degradation caused by motion. A three-dimensional gamma index calculation (3% and 3 mm) confirmed different dosimetric impacts from DS and US with the same target motion. This polymer-gel-dosimeter-based study confirmed the dosimetric impact of intrafraction target motion and its interplay with temporal delivery of different energy layers in US proton treatments.     

Linking hematopoiesis to endochondral skeletogenesis through analysis of mice transgenic for collagen X

Each skeletal element where marrow develops is first defined by a hypertrophic cartilage blueprint. Through programmed tissue substitution, the cartilaginous skeletal model is replaced by trabecular bone and marrow, with accompanying longitudinal tissue growth. During this process of endochondral ossification, hypertrophic cartilage expresses a unique matrix molecule, collagen X. Previously we reported that transgenic mice with dominant interference collagen X mutations develop variable skeleto-hematopoietic abnormalities, manifested as growth plate compressions, diminished trabecular bone, and reduced lymphatic organs (Nature 1993, 365:56). Here, histology and flow cytometry reveal marrow hypoplasia and impaired hematopoiesis in all collagen X transgenic mice. A subset of mice with perinatal lethality manifested the most severe skeletal defects and a reduction of marrow hematopoiesis, highlighted by a lymphocyte decrease. Thymic reduction is accompanied by a paucity of cortical immature T cells, consistent with the marrow's inability to replenish maturing cortical lymphocytes. Diminished spleens exhibit indistinct lymphatic nodules and red pulp depletion; the latter correlates with erythrocyte-filled vascular sinusoids in marrows. All mice display reduced B cells in marrows and spleens, and elevated splenic T cells. These hematopoietic defects underscore an unforeseen link between hypertrophic cartilage, endochondral ossification, and establishment of the marrow microenvironment required for blood cell differentiation.     

Highly Accurate Antibody Assays for Early and Rapid Detection of Tuberculosis in African and Asian Elephants

Tuberculosis (TB) in elephants is a reemerging zoonotic disease caused primarily by Mycobacterium tuberculosis. Current methods for screening and diagnosis rely on trunk wash culture, which has serious limitations due to low test sensitivity, slow turnaround time, and variable sample quality. Innovative and more efficient diagnostic tools are urgently needed. We describe three novel serologic techniques, the ElephantTB Stat-Pak kit, multiantigen print immunoassay, and dual-path platform VetTB test, for rapid antibody detection in elephants. The study was performed with serum samples from 236 captive African and Asian elephants from 53 different locations in the United States and Europe. The elephants were divided into three groups based on disease status and history of exposure: (i) 26 animals with culture-confirmed TB due to M. tuberculosis or Mycobacterium bovis, (ii) 63 exposed elephants from known-infected herds that had never produced a culture-positive result from trunk wash samples, and (iii) 147 elephants without clinical symptoms suggestive of TB, with consistently negative trunk wash culture results, and with no history of potential exposure to TB in the past 5 years. Elephants with culture-confirmed TB and a proportion of exposed but trunk wash culture-negative elephants produced robust antibody responses to multiple antigens of M. tuberculosis, with seroconversions detectable years before TB-positive cultures were obtained from trunk wash specimens. ESAT-6 and CFP10 proteins were immunodominant antigens recognized by elephant antibodies during disease. The serologic assays demonstrated 100% sensitivity and 95 to 100% specificity. Rapid and accurate antibody tests to identify infected elephants will likely allow earlier and more efficient treatment, thus limiting transmission of infection to other susceptible animals and to humans.Tuberculosis (TB) in captive elephants has been recognized as a reemerging zoonotic disease since at least the 1960s (22, 24, 26). In the past decade, growing numbers of elephant TB cases due to Mycobacterium tuberculosis or Mycobacterium bovis have been reported, presumably as a result of increased surveillance (11, 16, 25, 28). North American populations of African (Loxodonta africana) and Asian (Elephas maximus) elephants are declining, while captive breeding is historically poor. Efforts to maintain a self-sustaining captive population are hindered by TB-related issues. Many infected elephants may never exhibit clinical signs, whereas others with progressive disease may do so only in the terminal stages, thus making it difficult to recognize TB early (22, 24). Shedding of organisms during the preclinical period results in environmental contamination and presents a high risk of transmission to humans, elephants, and other mammals (11, 20, 27, 31).The diagnostic value of the only existing antemortem testing method (i.e., culture of trunk wash samples) officially recommended by the United States Department of Agriculture (USDA) is limited by poor accuracy, slow turnaround time for sample processing, variable specimen quality, and sample acquisition logistics (11, 16, 25). Antibody detection assays have shown promising potential for identification of elephants infected with M. tuberculosis or M. bovis (10, 16). The new version of the Guidelines for the Control of Tuberculosis in Elephants 2008 (4) was recently approved by the United States Animal Health Association TB Committee. The document, including certain serologic tests, along with trunk wash culture for routine surveillance, is currently under USDA review to be adopted. This study describes the use of three novel serologic techniques (the ElephantTB Stat-Pak kit, multiantigen print immunoassay [MAPIA], and the dual-path platform [DPP] test) designed for early and accurate detection of TB in elephants.     

Polar Phonon Behaviour in Polycrystalline Bi-Doped Strontium Titanate Thin Films

Strontium titanate-based materials with ferroelectric or relaxor-like properties have drawn vast attention as polar dielectrics for electronics and telecommunications. Here, we study the lattice dynamics in sol–gel-derived Sr_1−1.5xBi_xTiO₃ thin films with x = 0.0053 and 0.167, deposited on Al₂O₃ substrates, using a variable-temperature far-infrared spectroscopy in a transmittance mode. Bi doping, known to induce a low-frequency dielectric relaxation in SrTiO₃ (ST) ceramics and films, due to off-centre dopant ion displacements generating electric dipoles, is shown to affect the polar phonon behaviour of thin films. We show that in weakly Bi-doped films, the low-frequency polar TO1 mode softens on cooling but less than in undoped ST. In heavily Bi-doped ST films, this mode displays no significant frequency variation with temperature from 300 to 10 K. The polar phonon behaviour of polycrystalline Bi-doped ST thin films is comparable with that of Bi-doped ST ceramics, which exhibit dielectric relaxations and harden soft-mode behaviour instead of the ferroelectric phase transition.     

Mg2+ Doping Effects on the Structural and Dielectric Properties of CaCu3Ti4O12 Ceramics Obtained by Mechanochemical Synthesis

In this study, ceramic CaCu₃Ti₄O₁₂ (CCTO) and CaCu_3−xMg_xTi₄O₁₂ solid solutions in which 0.1 ≤ x ≤ 0.5 were prepared by the mechanochemical method, realized by a high-energy ball milling technique. The effects of the Mg²⁺ ion concentration and sintering time on the dielectric response in the prepared ceramics were investigated and discussed. It was demonstrated that, by the use of a sufficiently high energy of mechanochemical treatment, it is possible to produce a crystalline product after only 2 h of milling the mixture of the oxide substrates. Both the addition of magnesium ions and the longer sintering time of the mechanochemically-produced ceramics cause excessive grain growth and significantly affect the dielectric properties of the materials. The X-ray diffraction (XRD) analysis showed that all of the as-prepared solid solutions, CaCu_3−xMg_xTi₄O₁₂ (0.0 ≤ x ≤ 0.5), regardless of the sintering time, exhibit a cubic perovskite single phase. The dielectric study showed two major contributions associated with the grains and the grain boundaries. The analysis of the electric modules of these ceramics confirmed the occurrence of Maxwell–Wagner type relaxation, which is dependent on the temperature.