Repetitive transcranial magnetic stimulation for smoking cessation: a pivotal multicenter double‐blind randomized controlled trial

Repetitive transcranial magnetic stimulation (rTMS) is a non‐invasive brain stimulation method increasingly used to treat psychiatric disorders, primarily depression. Initial studies suggest that rTMS may help to treat addictions, but evaluation in multicenter randomized controlled trials (RCTs) is needed. We conducted a multicenter double‐blind RCT in 262 chronic smokers meeting DSM‐5 criteria for tobacco use disorder, who had made at least one prior failed attempt to quit, with 68% having made at least three failed attempts. They received three weeks of daily bilat­eral active or sham rTMS to the lateral prefrontal and insular cortices, followed by once weekly rTMS for three weeks. Each rTMS session was administered following a cue‐induced craving procedure, and participants were monitored for a total of six weeks. Those in abstinence were monitored for additional 12 weeks. The primary outcome measure was the four‐week continuous quit rate (CQR) until Week 18 in the intent‐to‐treat efficacy set, as determined by daily smoking diaries and verified by urine cotinine measures. The trial was registered at ClinicalTrials.gov ({"type":"clinical-trial","attrs":{"text":"NCT02126124","term_id":"NCT02126124"}}NCT02126124). In the intent‐to‐treat analysis set (N=234), the CQR until Week 18 was 19.4% following active and 8.7% following sham rTMS (X²=5.655, p=0.017). Among completers (N=169), the CQR until Week 18 was 28.0% and 11.7%, respectively (X²=7.219, p=0.007). The reduction in cigarette consumption and craving was significantly greater in the active than the sham group as early as two weeks into treatment. This study establishes a safe treatment protocol that promotes smoking cessation by stimulating relevant brain circuits. It represents the first large multicenter RCT of brain stimulation in addiction medicine, and has led to the first clearance by the US Food and Drug Administration for rTMS as an aid in smok­ing cessation for adults.     

Climate, land-use and Prosopis ferox recruitment in the Quebrada de Humahuaca, Jujuy, Argentina

Prosopis ferox grows in upper-elevation, inter-montane valleys between 2600 and 3800 m in Northwestern Argentina and Southern Bolivia. Throughout its range, P. ferox has largely been used as local fuel, building material and food for livestock. In order to evaluate the causes of the recent increase in P. ferox density and range distribution, we compare tree recruitment of P. ferox at 15 stands in the Quebrada de Humahuaca, Jujuy, Argentina, with the environmental and socioeconomic changes in the past 150–200 years. Based on tree recruitment, a general pattern of greater establishment from the mid-1970s to 1990 was identified. This regional pattern is consistent with precipitation variations during the 20th century showing abundant rainfall in the 1970s and 1980s. In addition, historical records indicate that the density of domestic grazers decreased dramatically in the second half of the 20th century. The reduction of browsing by livestock might have also favored the P. ferox recruitment over this interval. However, during the 1990s reduced establishment has occurred at a time of low stock densities suggesting significant precipitation is necessary for the expansion and establishment of these forests. Simply reducing stocking levels will not lead to the long-term recovery of these forests.     

Introduction and evaluation of case-based learning in the first foundational course of an undergraduate medical curriculum

Case-based learning (CBL) has been proposed as an effective method to promote student knowledge and motivation. The timing and methods for implementation have varied among schools, and data regarding the effectiveness of this pedagogy compared to other learning modalities are inconclusive. We introduced five different cases in the first course of our medical school as part of small-group CBL, and monitored student satisfaction and performance in summative evaluations. We observed that (1) students were very satisfied with the CBL sessions; (2) performance in essay examinations was significantly higher in CBL topics, compared to non-CBL topics, as evaluated at the end of the course, and three months after course conclusion; and (3) there was a trend of higher performance in multiple-choice questions about CBL topics, but this was not statistically significant. Our results indicate that CBL is an acceptable pedagogy to be incorporated from the beginning of undergraduate medical education to promote acquisition and retention of knowledge, students’ interest in foundational sciences, and integration of basic science disciplines and clinical medicine. When evaluating knowledge acquired using the CBL method, integrative essays represent a valuable tool to assess the depth of comprehension and application of information.     

Molecular Epidemiology of Trypanosomatids and <Emphasis Type="Italic">Trypanosoma cruzi</Emphasis> in Primates from Peru

We determined the prevalence rate and risk of infection of Trypanosoma cruzi and other trypanosomatids in Peruvian non-human primates (NHPs) in the wild (n = 126) and in different captive conditions (n = 183). Blood samples were collected on filter paper, FTA cards, or EDTA tubes and tested using a nested PCR protocol targeting the 24Sα rRNA gene. Main risk factors associated with trypanosomatid and T. cruzi infection were genus and the human–animal context (wild vs captive animals). Wild NHPs had higher prevalence of both trypanosomatids (64.3 vs 27.9%, P < 0.001) and T. cruzi (8.7 vs 3.3%, P = 0.057), compared to captive NHPs, suggesting that parasite transmission in NHPs occurs more actively in the sylvatic cycle. In terms of primate family, Pitheciidae had the highest trypanosomatid prevalence (20/22, 90.9%) and Cebidae had the highest T. cruzi prevalence (15/117, 12.8%). T. cruzi and trypanosomatids are common in Peruvian NHPs and could pose a health risk to human and animals that has not been properly studied.     

Effects of chlorpyrifos on enzymatic systems of Cydia pomonella (Lepidoptera: Tortricidae) adults

The control program of codling moth (Cydia pomonella L.) in the Río Negro and Neuquén Valley is intended to neonate larvae. However, adults may be subjected to sublethal pesticide concentrations generating stress which might enhance both mutation rates and activity of the detoxification system. This study assessed the exposure effects of chlorpyrifos on target enzyme and, both detoxifying and antioxidant systems of surviving adults from both a laboratory susceptible strain (LSS) and a field population (FP). The results showed that the FP was as susceptible to chlorpyrifos as the LSS and, both exhibited a similar chlorpyrifos‐inhibitory concentration 50 (IC₅₀) of acetylcholinesterase (AChE). The FP displayed higher carboxylesterase (CarE) and 7‐ethoxycoumarine O‐deethylase (ECOD) activities than LSS. Both LSS and FP showed an increase on CarE activity after the exposure to low‐chlorpyrifos concentrations, followed by enzyme inhibition at higher concentrations. There were no significant differences neither in the activities of glutathione S‐transferases (GST), catalase (CAT) and superoxide dismutase (SOD) nor in the reduced glutathione (GSH) content between LSS and FP. Moreover, these enzymes were unaffected by chlorpyrifos. In conclusion, control adults from the FP exhibited higher CarE and ECOD activities than control adults from the LSS. AChE and CarE activities were the most affected by chlorpyrifos. Control strategies used for C. pomonella, such as rotations of insecticides with different modes of action, will probably delay the evolution of insecticide resistance in FPs from the study area.     

Amylosucrase‐mediated β‐carotene encapsulation in amylose microparticles

The β‐carotene embedded amylose microparticles (BC‐AmMPs) were prepared in one‐step by utilizing the unique catalytic activity of amylosucrase from Deinococcus geothermalis (DgAS), which synthesizes linear amylose chains using sucrose as the sole substrate. Synthesized amylose chains self‐assembled with β‐carotene to form well‐defined spherical microparticles with an encapsulation yield of 65%. The BC‐AmMPs produced (average diameter ～8 µm) were bright orange due to the embedded β‐carotene, and this was confirmed by Raman analysis. XRD showed BC‐AmMPs had a B‐type amylose crystal structure with a degree of crystallinity lower than that of AmMPs. This lower crystallinity of AmMP after BC encapsulation was confirmed by DSC analysis. Decreased enthalpy of gelatinization (ΔH_gel) of BC‐AmMP implied that molecular order within the amylose microstructure was influenced by the presence of BC. The stability of BC against environmental stresses, such as UV light and oxidative stress, was significantly enhanced by its encapsulation. The authors propose a new approach to the preparation of an amylose based carrier system for active compounds or expensive food ingredients with poor stabilities during storage or processing. Given that amylose is a safe food material, the devised encapsulation system will find wide range of practical applications in the food industry. © 2017 American Institute of Chemical Engineers Biotechnol. Prog., 33:1640–1646, 2017     

Arbuscular mycorrhizal fungi in the growth and extraction of trace elements by Chrysopogon zizanioides (vetiver) in a substrate containing coal mine wastes

Vetiver (Chrysopogon zizanioides) is a fast-growing, high biomass producing plant employed for environmental rehabilitation. The study evaluated the effects of arbuscular mycorrhizal fungi (AMF) on the growth and trace element phytoextracting capabilities of vetiver in a substrate containing coalmine wastes in Southern Brazil. AMF included Acaulospora colombiana, Acaulospora morrowiae, Acaulospora scrobiculata, Dentiscutata heterogama, Gigaspora margarita, and Rhizophagus clarus. Among those, A. colombiana, G. margarita, and R. clarus promoted higher growth. AMF stimulated average increments in the accumulated P of 82% (roots), 194% (shoots first harvest—90 days) and 300% (shoots second harvest—165 days) and affected the phytoextraction of trace elements by vetiver, with larger concentrations in the roots. Plants inoculated with A. colombiana, A. morrowiae, and A. scrobiculata, in addition to the control, presented the highest levels of Cu and Zn in the roots. Overall, G. margarita stimulated the highest production of biomass, and, therefore, showed the most significant levels of trace elements in the plants. This work shows the benefits of certain AMF (especially A. morrowiae, G. margarita, and R. clarus) for the production of biomass and P uptake by vetiver, demonstrating the potential of those species for the rehabilitation of coal-mine-degraded soils.