bluuebunny/crossref_metadata_2025 huggingface dataset:
White-matter integrity and hearing acuity decline in healthy subjects: Magnetic resonance tractography
Authors: Alhazmi Fahad H
Published: March 2020

Aim

The association between hearing acuity and white-matter (WM) microstructure integrity was evaluated in a normal healthy population with a variety of hearing acuity using an automated tractography technique known as TRACULA (TRActs Constrained by UnderLying Anatomy) in order to investigate whether hearing acuity decline is correlated with brain structural connectivity.

Methods

Forty healthy controls were recruited to this study, which used a Siemens 3T Trio with a standard eight-channel head coil. Hearing acuity was assessed using pure-tone air conduction audiometry (Amplivox 2160, with Audiocups to eliminate noise and allow accurate pure-tone audiometry). Handedness and anxiety and depression were assessed for all participants in this study using the Edinburgh Handedness Inventory and the Hospital Anxiety and Depression Scale, respectively.

Results

This study showed a significant reduction in WM volume of the left cingulum angular bundle (CAB; t = 2.32, p = 0.02) in the mild to moderate hearing-loss group (238 ± 223 mm2) compared to the group with normal hearing (105  ± 121 mm2). The WM integrity of the left CAB was found to be significantly different ( t = 2.06, p = 0.04) in the mild to moderate hearing-loss group (0.18 ± 0.06 mm2/s) compared to the group with normal hearing (0.22 ± 0.05 mm2/s). The WM integrity of the left anterior thalamic radiation (ATR) was found to be significantly different ( t = 2.58, p = 0.014) in the mild to moderate hearing-loss group (0.33 ± 0.05 mm2/s) compared to the group with normal hearing (0.37 ± 0.03 mm2/s). A significant negative correlation was found between age and the WM integrity of the right ATR ( r = −0.33, p = 0.038), and between hearing acuity and the WM integrity of the right ATR ( r = −0.38, p = 0.013) and left CAB ( r = −0.36, p = 0.019). Discussion and conclusion: An important finding in this study is that brain structural connectivity changes in the left hemisphere seem to be associated with age-related hearing loss found mainly in the ATR and CAB tracts.
Replicability of the Curvature Effect as a Function of Presentation Time and Response Measure in Japanese Observers
Authors: Maezawa Tomoki , Tanda Tomoyuki , Kawahara Jun I.
Published: March 2020

Although objects with curved contours are generally preferred over those with sharp-angled contours, the strength of this preference varies according to several factors. In the present study, non-Western Japanese observers viewed and rated their preferences (e.g., liking or attractiveness) for real and meaningless objects with curved or sharp-angled contours. We varied the presentation time (90 ms vs. until a response was received) and the response measure (like/dislike vs. 1–100 rating scale). When using like/dislike ratings, a preference for curved objects was found only when images of real objects were presented briefly (90 ms), whereas this effect was reversed (i.e., increased preference for sharp-angled contours) when using the 1 to 100 scale under the until-response condition. In addition, the curvature effect was not observed for real objects when the like/dislike rating and the until-response condition were employed or when the 1 to 100 scale and 90 ms presentation time were used. The curvature effect for meaningless objects remained unstable regardless of presentation time or response measure. Similar to the preference for real objects, a preference for sharp-angled objects was observed when preference was measured using a 1 to 100 rating scale. Taken together, the present findings indicate that the preferences for curved objects were situation-dependent in Japanese observers.
Dual mobility total hip arthroplasty for salvaging failed internal fixation for neck of femur fractures
Authors: Luthra Jatinder Singh , Al Ghannami Suwailim , Al Habsi Salim , Ghosh Soubhik
Published: March 2020

Internal fixation is commonly used to treat fractures in the hip. However, failure of proximal femoral fracture fixation is common and treated with total hip replacement (THR). The aim of this study is to present our midterm results of dual mobility (DM) THR for failed internal fixation of proximal femur fractures. Between 2010 and 2015, a total of 28 cases of failed internal fixation for hip fractures were treated through DM total hip arthroplasty. Two patients died during the early postoperative period due to medical complications. The average follow-up was 3.4 years. We had one patient with superficial surgical site infection which was managed by local wound debridement and dressings. The average Harris hip score was 85. DM THR is the procedure of choice for revising failed internal fixation for hip fractures in our patients with good clinical outcome.
Predictive Factors for Failure of Meniscal Repair: A Retrospective Dual-Center Analysis of 918 Consecutive Cases
Authors: Ronnblad Erik , Barenius Bjorn , Engstrom Bjorn , Eriksson Karl
Published: March 2020

Background:

Meniscal surgery is one of the most common surgical procedures performed by orthopaedic surgeons. Over the past decade, awareness has increased regarding the importance of meniscal preservation to prevent the development of osteoarthritis in the knee joint. Removal of meniscal tissue can lead to a high risk of cartilage degeneration, and moreover, meniscus-preserving surgery rather than meniscal resection is likely to have better long-term outcomes. Success rates after meniscal repair range from 60% to 95%, but many reports are based on a small number of patients.

Purpose/Hypothesis:

The purpose of this study was to review all meniscal repairs and potential predictors for failure during a 12-year period. We hypothesized that meniscal anchors, lateral repairs, and repairs made in conjunction with an anterior cruciate ligament reconstruction (ACLR) would have fewer failures than meniscal arrows, medial repairs, and isolated repairs. We also hypothesized that younger patients and acute tears would be associated with fewer failures.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

This study was a dual-center, retrospective analysis on consecutive meniscal repairs. The surgical protocols were reviewed, including type of tear, location, associated injury to the knee, and surgery. The study endpoint was failure of repair, defined as a need for reoperation and secondary partial or total meniscal resection, within 3 years. Kaplan-Meier analysis was performed to assess repair survival, with multivariate Cox regression to adjust for confounders.

Results:

A total of 954 meniscal repairs were performed on 918 patients (536 male patients [58%]; 382 female patients [42%]) with a mean age of 26 years (range, 12-60 years). The failure rate for the entire cohort was 22.5%. Bioabsorbable arrows had significantly more failures than all-inside sutures with anchors (hazard ratio [HR], 1.8; 95% CI, 1.2-2.5; P = .002). Medial meniscal repairs had a higher failure rate than lateral meniscal repairs (HR, 3.7; 95% CI, 2.3-6.0; P < .001). Simultaneous ACLR resulted in less failure than when no simultaneous ACLR was performed (HR, 0.5; 95% CI, 0.3-0.9; P = .009). Age at repair and acuity of tear did not affect the outcome ( P = .6 and .07, respectively).

Conclusion:

The failure rate after meniscal repair was significantly higher on the medial side, especially when using arrows. Meniscal repairs performed concomitantly with an ACLR result in fewer reoperations.
Air vs Gas Tamponade During Macular Hole Repair Surgery
Authors: Patel Shriji N. , Law Janice , Cherney Edward , Recchia Franco , Kim Stephen J.
Published: March 2020

Purpose:

This work investigates the visual and anatomical outcomes of full-thickness macular hole (FTMH) repair surgery using air in comparison to gas tamponade.

Methods:

A retrospective consecutive review of medical records was undertaken of all patients undergoing pars plana vitrectomy for idiopathic FTMH at an academic practice from January 2010 to May 2017. Each operative report was reviewed to investigate the agent used for tamponade at the end of the surgery. Preoperative hole duration and size as measured using optical coherence tomography as well as successful postoperative hole closure were recorded. Use of gas or air was not randomized and was instilled at surgeon discretion.

Results:

The final analysis included 211 eyes. Gas was used as the tamponade agent in 171 of the 211 eyes; most of these eyes (144 of 171) received sulfur hexafluoride (SF6) and the remainder received perfluoropropane (C3F8). Forty eyes underwent only a complete fluid-air exchange without any gas placement following vitrectomy. There was no statistically significant difference between the 2 groups in mean preoperative macular hole size ( P = .43). Nine of the 171 macular holes receiving gas tamponade failed to close (5.3%). One of the 40 macular holes receiving only air failed to close (2.5%). There was no statistically significant difference in hole closure rates between the 2 groups ( P = .45).

Conclusions:

Air served as an equally efficacious internal tamponade agent in comparison to nonexpansile gas following idiopathic FTMH repair surgery.
Competitive Enterprise Education: Developing a Concept
Authors: Brentnall Catherine
Published: March 2020

In this article, I argue that limited attention has been given to the competitive nature of enterprise education targeted at school level, obscuring the fundamental composition of many activities. While concepts such as enterprise education and entrepreneurship education are framed broadly for primary and secondary educators, focused on skills development and confidence building, it can simultaneously be observed that prescribed activities are often competitive. Yet this competitiveness—and its assumed benefits and potential drawbacks—is not clearly distinguished in the literature. Therefore, my broad objective in this article is to develop the concept of Competitive Enterprise Education (CEE) and consider its implications. As part of this endeavor, a linear model synthesized from existing policy is presented, which illustrates assumptions which underpin CEE. I argue that this ordered and rational logic does not reflect the messy human and social context of such activities. An alternative, more realistic, model of CEE is offered, which points to the myriad potential outcomes possible through these activities. The implications of CEE are discussed. Ultimately, by conceptually distinguishing the ubiquitous practice of CEE, new and relevant lines of enquiry and thinking are opened up for researchers and practitioners.
Treatment patterns of patients diagnosed with major headache disorders: A retrospective claims analysis
Authors: Kudrow David , Munjal Sagar , Bensimon Leah , Lokhandwala Tasneem , Yue Binglin , Coutinho Anna D’Souza , Silberstein Stephen D
Published: March 2020

Objective:

To describe patient characteristics, treatment patterns, and health care costs among patients diagnosed with major headache disorders overall and by type (tension-type headache [TTH], migraine, cluster headache [CH], or >1 primary headache type), and secondarily to evaluate drug treatment patterns among triptan initiators with a major headache diagnosis.

Methods:

Using US claims data from January 2012 through December 2017, we identified adults with evidence of a major headache disorder: TTH, migraine, or CH; the first diagnosis date was deemed the index date. To evaluate triptan use specifically, patients who initiated triptans were identified; the first triptan claim date was deemed the index date. Patient characteristics, treatment patterns (concomitant treatments, adherence, number of fills), and annual health care costs data were obtained.

Results:

Of the 418,779 patients diagnosed with major headache disorders, the following 4 cohorts were created: TTH (8%), migraine (87%), CH (1%), and >1 primary headache type (4%). The majority used analgesic (54–73%) and psychotropic (57–81%) drugs, primarily opioids (36–53%). Headache-related costs accounted for one-fifth of all-cause costs. Of the 229,946 patients who initiated triptans, the following 7 study cohorts were analyzed: sumatriptan (68%), rizatriptan (21%), eletriptan (5%), zolmitriptan (3%), naratriptan (2%), frovatriptan (1%), and almotriptan (<1%). The major concomitant analgesic medication classes were opioids (41%) and nonsteroidal anti-inflammatory drugs (34%).

Conclusion:

The primary headache disorder treatment paradigm is complex, with significant variability. Predominant concomitant use of opioids and switching to opioids is of concern, necessitating solutions to minimize opioid use. Switching to non-oral/fast-acting or targeted preventive therapies should be considered.
Calreticulin haploinsufficiency augments stem cell activity and is required for onset of myeloproliferative neoplasms
Authors: Shide Kotaro , Kameda Takuro , Kamiunten Ayako , Ozono Yoshinori , Tahira Yuki , Yokomizo-Nakano Takako , Kubota Sho , Ono Masaya , Ikeda Kazuhiko , Sekine Masaaki , Akizuki Keiichi , Nakamura Kenichi , Hidaka Tomonori , Kubuki Yoko , Iwakiri Hisayoshi , Hasuike Satoru , Nagata Kenji , Sashida Goro , Shimoda Kazuya
Published: March 2020

Mutations in JAK2, MPL, or CALR are detected in more than 80% of myeloproliferative neoplasm (MPN) patients and are thought to play a driver role in MPN pathogenesis via autosomal activation of the JAK-STAT signaling cascade. Mutant CALR binds to MPL, activates downstream MPL signaling cascades, and induces essential thrombocythemia in mice. However, embryonic lethality of Calr-deficient mice precludes determination of a role for CALR in hematopoiesis. To clarify the role of CALR in normal hematopoiesis and MPN pathogenesis, we generated hematopoietic cell-specific Calr-deficient mice. CALR deficiency had little effect on the leukocyte count, hemoglobin levels, or platelet count in peripheral blood. However, Calr-deficient mice showed some hematopoietic properties of MPN, including decreased erythropoiesis and increased myeloid progenitor cells in the bone marrow, and extramedullary hematopoiesis in the spleen. Transplantation experiments revealed that Calr haploinsufficiency promoted the self-renewal capacity of hematopoietic stem cells. We generated CALRdel52 mutant transgenic mice with Calr haploinsufficiency as a model that mimics human MPN patients and found that Calr haploinsufficiency restored the self-renewal capacity of hematopoietic stem cells damaged by CALR mutations. Only recipient mice transplanted with Lineage－Sca1+c-kit+ cells harboring both CALR mutation and Calr haploinsufficiency developed MPN in competitive conditions, showing that CALR haploinsufficiency was required for the onset of CALR-mutated MPNs.
Aromatase is a novel neosubstrate of cereblon responsible for immunomodulatory drug–induced thrombocytopenia
Authors: Tochigi Taro , Miyamoto Toshihiro , Hatakeyama Kiwamu , Sakoda Teppei , Ishihara Daisuke , Irifune Hidetoshi , Shima Takahiro , Kato Koji , Maeda Takahiro , Ito Takumi , Handa Hiroshi , Akashi Koichi , Kikushige Yoshikane
Published: March 2020

Immunomodulatory drugs (IMiDs) are key agents for the treatment of multiple myeloma and myelodysplastic syndrome with chromosome 5q deletion. IMiDs exert their pleiotropic effects through the recruitment of neosubstrates to cereblon, a substrate receptor of the E3 ubiquitin ligase complex; therefore, identification of cell-specific neosubstrates is important to understand the effects of IMiDs. In clinical practice, IMiDs induce thrombocytopenia, which frequently results in the discontinuation of IMiD treatment. In the current study, we sought to identify the molecular mechanism underlying thrombocytopenia induced by IMiD treatment. We found that IMiDs strongly impaired proplatelet formation, a critical step in functional platelet production, through the inhibition of autocrine estradiol signaling in human megakaryocytes. Furthermore, we identified aromatase, an indispensable enzyme for estradiol biosynthesis, as a novel neosubstrate of cereblon. IMiDs promoted the recruitment of aromatase to cereblon, resulting in the degradation of aromatase in a proteasome-dependent manner. Finally, aromatase was significantly degraded in the bone marrow of patients with multiple myeloma who developed thrombocytopenia with IMiD treatment. These data suggest that aromatase is a neosubstrate of cereblon that is responsible for IMiD-induced thrombocytopenia.
Pseudomonas infections among hospitalized adults in Latin America: a systematic review and meta-analysis
Authors: Ponce de Leon Alfredo , Merchant Sanjay , Raman Gowri , Avendano Esther , Chan Jeffrey , Tepichin Hernandez Griselda , Sarpong Eric
Published: March 2020

Background

Treatment of resistant Pseudomonas aeruginosa infection continues to be a challenge in Latin American countries (LATAM). We synthesize the literature on the use of appropriate initial antibiotic therapy (AIAT) and inappropriate initial antibiotic therapy (IIAT) in P. aeruginosa infections, and the literature on risk factors for acquisition of resistant P. aeruginosa among hospitalized adult patients in LATAM.

Methods

MEDLINE, EMBASE, Cochrane, and LILAC were searched between 2000 and August 2019. Abstracts and full-text articles were screened in duplicate. Random effects meta-analysis was conducted when studies were sufficiently similar.

Results

The screening of 165 citations identified through literature search yielded 98 full-text articles that were retrieved and assessed for eligibility, and 19 articles conducted in Brazil (14 articles), Colombia (4 articles), and Cuba (1 article) met the inclusion criteria. Of 19 eligible articles, six articles (840 subjects) examined AIAT compared to IIAT in P. aeruginosa infections; 17 articles (3203 total subjects) examined risk factors for acquisition of resistant P. aeruginosa; and four articles evaluated both. Four of 19 articles were rated low risk of bias and the remaining were deemed unclear or high risk of bias. In meta-analysis, AIAT was associated with lower mortality for P. aeruginosa infections (unadjusted summary OR 0.48, 95% CI 0.28–0.81; I2 = 59%), compared to IIAT and the association with mortality persisted in subgroup meta-analysis by low risk of bias (3 articles; unadjusted summary OR 0.46, 95% CI 0.28–0.81; I2 = 0%). No meta-analysis was performed for studies evaluating risk factors for acquisition of resistant P. aeruginosa as they were not sufficiently similar. Significant risk factors for acquisition of resistant P. aeruginosa included: prior use of antibiotics (11 articles), stay in the intensive care unit (ICU) (3 articles), and comorbidity score (3 articles). Outcomes were graded to be of low strength of evidence owing to unclear or high risk of bias and imprecise estimates.

Conclusion

Our study highlights the association of AIAT with lower mortality and prior use of antibiotics significantly predicts acquiring resistant P. aeruginosa infections. This review reinforces the need for rigorous and structured antimicrobial stewardship programs in the LATAM region.
Association between lipoprotein(a) (Lp(a)) levels and Lp(a) genetic variants with coronary artery calcification
Authors: Pechlivanis Sonali , Mahabadi Amir A. , Hoffmann Per , Nöthen Markus M. , Broecker-Preuss Martina , Erbel Raimund , Moebus Susanne , Stang Andreas , Jöckel Karl-Heinz
Published: March 2020

Background

To examine the association between lipoprotein(a) (Lp(a)) levels, LPA (rs10455872 and rs3798220) and IL1F9 (rs13415097) single nucleotide polymorphisms (SNPs) with coronary artery calcification (CAC), an important predictor for coronary artery disease (CAD).

Methods

We used data from 3799 (mean age ± SD: 59.0 ± 7.7 years, 47.1% men) Heinz Nixdorf Recall study participants. We applied linear regression models to explore the relation between the log-transformed Lp(a) levels and LPA and IL1F9 SNPs with loge (CAC + 1). The association between the SNPs and log-transformed Lp(a) levels was further assessed using linear regression. The models were adjusted for age and sex (Model 1) and additionally for Lp(a) levels (Model 2).

Results

We observed a statistically significant association between log-transformed Lp(a) levels and CAC (Model 1: beta per log-unit increase in Lp(a) levels = 0.11; 95% confidence interval [95% CI] [0.04; 0.18], p = 0.002). Furthermore, the LPA SNP rs10455872 showed a statistically significant association with CAC (Model 1: beta per allele = 0.37 [0.14; 0.61], p = 0.002). The association between rs10455872 and CAC was attenuated after adjustment for Lp(a) levels (Model 2: beta per allele = 0.26 [− 0.01; 0.53], p = 0.06). Both LPA SNPs also showed a statistically significant association with Lp(a) levels (Model 1: betars10455872 per allele: 1.56 [1.46; 1.65], p < 0.0001 and betars3798220 per allele: 1.51 [1.33; 1.69], p < 0.0001)). The Mendelian randomization analysis showed that Lp(a) is a causal risk factor for CAC (estimate per log-unit increase in Lp(a) levels (95% CI), p: 0.27 [0.11; 0.44], p = 0.001). The IL1F9 SNP did not show any statistically significant association with Lp(a) levels or with CAC.

Conclusions

We provide evidence for the association of LPA rs10455872 with higher levels of Lp(a) and CAC in our study. The results of our study suggest that rs10455872, mediated by Lp(a) levels, might play a role in promoting the development of atherosclerosis leading to cardiovascular disease events.
Case report: a 58 -year -old man with small kidneys and elevated liver enzymes
Authors: Dash Jonathan , Saudan Patrick , Paoloni-Giacobino Ariane , Moll Solange , de Seigneux Sophie
Published: March 2020

Background

The conjunction of hepatitis and renal disease can be seen in several clinical context, including karyomegalic nephritis (KIN). Karyomegalic nephritis (KIN) is a rare genetic disease, with less than 50 cases reported, which incidence is probably underestimated. We report here an unusual case presentation of KIN with obtention of several organ biopsies and a novel mutation leading to the disease.

Case presentation

A 58 year old Caucasian without relevant family history presents with advanced chronic kidney disease, elevated liver enzymes and recurrent pulmonary infection. Familial history was negative. Renal biopsy revealed a chronic tubulo-intertsitial nephritis with enlarged and irregular hyperchromatic nuclei. Karyomegalic nephritis (KIN) was confirmed by genetic testing with a non-sense mutation and a deletion in the Fanconi anemia associated nuclease 1 (FAN1) gene.

Conclusions

KIN is rare disease to be suspected in the presence of renal disease, biological hepatitis and recurrent pulmonary infections, even without a familial history. Diagnosis of this condition is crucial to perform family screening, avoid progression factors, and adapt post transplantation immunosuppression. Finally, avoiding familial heterozygote donors appears of major importance in this condition.
Differing views regarding diet and physical activity: adolescents versus parents’ perspectives
Authors: Azar Kristen M. J. , Halley Meghan , Lv Nan , Wulfovich Sharon , Gillespie Katie , Liang Lily , Goldman Rosas Lisa
Published: March 2020

Background

Today, approximately one in five United States adolescents age 12 to 19 years is obese and just over a third are either overweight or obese. This study examines how parents and peers influence diet and physical activity behaviors of older adolescents (14–18 years) with overweight or obesity to inform weight management interventions.

Methods

Adolescent participants included 14 to 18-year-olds with a Body Mass Index (BMI) greater than the 85th percentile for their age and sex who were receiving care in a large healthcare system in Northern California. Adolescents and their parents participated in separate focus groups and interviews (if not able to attend focus groups) that were held at the same time in the same location. We used qualitative thematic analysis to identify common themes discussed in the adolescent and parent focus groups as well as paired analysis of adolescent-parent dyads.

Results

Participants included 26 adolescents and 27 parents. Adolescent participants were 14 to 18 years old. Half were female and the participants were almost evenly distributed across year in school. The majority self-identified as White (56%) and Asian (36%).Three themes were identified which included 1) parents overestimated how supportive they were compared to adolescents’ perception 2) parents and adolescents had different views regarding parental influence on adolescent diet and physical activity behaviors 3) parents and adolescents held similar views on peers’ influential role on lifestyle behaviors.

Conclusion

Parents’ and adolescents’ differing views suggest that alignment of parent and adolescent expectations and behaviors for supporting effective weight management could be incorporated into interventions.
Homoprejudiced violence among Chinese men who have sex with men: a cross-sectional analysis in Guangzhou, China
Authors: Wu Dan , Yang Eileen , Huang Wenting , Tang Weiming , Xu Huifang , Liu Chuncheng , Baral Stefan , Day Suzanne , Tucker Joseph D.
Published: March 2020

Background

Homoprejudiced violence, defined as physical, verbal, psychological and cyber aggression against others because of their actual or perceived sexual orientation, is an important public health issue. Most homoprejudiced violence research has been conducted in high-income countries. This study examined homoprejudiced violence among men who have sex with men (MSM) in Guangzhou, China.

Methods

MSM in a large Chinese city, Guangzhou, completed an online survey. Data about experiencing and initiating homoprejudiced violence was collected. Multivariable logistic regression analyses, controlling for age, residence, occupation, heterosexual marriage, education and income, were carried out to explore associated factors.

Results

A total of 777 responses were analyzed and most (64.9%) men were under the age of 30. Three-hundred-ninety-nine (51.4%) men experienced homoprejudiced violence and 205 (25.9%) men perpetrated homoprejudiced violence against others. Men who identified as heterosexual were less (AOR = 0.6, 95% CI: 0.4–0.9) likely to experience homoprejudiced violence compared to men who identified as gay. Men who experienced homoprejudiced violence were more likely to initiate homoprejudiced violence (AOR = 2.44, 95% CI: 1.6–3.5). Men who disclosed their sexual orientation to other people were more likely to experience homoprejudiced violence (AOR = 1.8, 95% CI:1.3–2.5).

Conclusions

These findings suggest the importance of further research and the implementation of interventions focused on preventing and mitigating the effects of homoprejudiced violence among MSM in China.
A population-based study on healthcare-seeking behaviour of persons with symptoms of respiratory and gastrointestinal-related infections in Hong Kong
Authors: Zhang Qiqi , Feng Shuo , Wong Irene O. L. , Ip Dennis K. M. , Cowling Benjamin J. , Lau Eric H. Y.
Published: March 2020

Background

Studies on healthcare-seeking behaviour usually adopted a patient care perspective, or restricted to specific disease conditions. However, pre-diagnosis symptoms may be more relevant to healthcare-seeking behaviour from a patient perspective. We described healthcare-seeking behaviours by specific symptoms related to respiratory and gastrointestinal-related infections.

Methods

We conducted a longitudinal population-based telephone survey in Hong Kong. We collected data on healthcare-seeking behaviour specific to symptoms of respiratory and gastrointestinal-related infections and also associated demographic factors. We performed descriptive analyses and estimated the proportion of participants who sought medical consultation, types of services utilized and duration from symptom onset to healthcare seeking, by different age groups. Post-stratification was used to compensate non-response and multiple imputation to handle missing and right-censored data.

Results

We recruited 2564 participants who reported a total of 4370 illness episodes and 7914 symptoms. Fatigue was the most frequently reported symptom, followed by headache and runny nose, with 30-day incidence rate of 9.1, 7.7, and 7.7% respectively. 78% of the participants who had fever sought medical consultation, followed by those with rash (60%) and shortness of breath (58%). Older adults (aged ≥55y) who had symptoms including fever, sore throat, and headache had a significantly higher consultation rate comparing to the other age groups. The 30-day incidence rates of influenza-like illness (ILI) and acute respiratory illness (ARI) were 0.8 and 7.2% respectively, and the consultation rates among these participants were 91 and 64%. Private general practitioner clinics was the main service utilized by participants for most of the symptoms considered, especially those related to acute illness such as fever, diarrhoea and vomiting. Chinese medicine clinics were mostly likely to be visited by participants with low back pain, myalgia and fatigue. Among participants who have sought medical services, most were within 3 days of symptom onset.

Conclusions

Healthcare-seeking behaviour were different by symptoms and age. Characterization of these patterns provides crucial parameters for estimating the full burden of common infectious diseases from facility-based surveillance system, for planning and allocation of healthcare resources.
Mid-term to long-term results of primary arthroscopic Bankart repair for traumatic anterior shoulder instability: a retrospective study
Authors: Panzram Benjamin , Kentar Yasser , Maier Michael , Bruckner Thomas , Hetto Pit , Zeifang Felix
Published: March 2020

Background

The arthroscopic method offers a less invasive technique of Bankart repair for traumatic anterior shoulder instability. The aim of the study is to determine the mid−/long-term functional outcome, failure rates and predictors of failure after primary arthroscopic Bankart repair for traumatic anterior shoulder instability.

Methods

A total of 100 patients were primarily operated using arthroscopic Bankart repair after traumatic anterior shoulder instability. Medical records were retrospectively reviewed, and patients were assessed using postal questionnaire after a mean follow-up of 8.3 years [3–14]. Clinical assessment was performed using Constant score, Rowe score, and American Shoulder and Elbow Surgeons score.

Results

The overall recurrence rate was 22%. The Kaplan-Meier failure-free survival estimates.

were 80% at 5 years and 70% at 10 years. Nearly half (54.5%) of recurrences occurred at 2 years postoperative. Compared with normal shoulder, there were statistical differences in all 3 scores. Failure rate was significantly affected by age at the time of surgery with 86% of recurrence cases observed in patients aged 30 years or younger. Nevertheless, Younger age at the time of surgery (P = 0.007) as well age at the time of initial instability (P = 0.03) was found to correlate negatively with early recurrence within 2 years of surgery. Among those with recurrent instability, recurrence rate was found to be higher if there had been more than 5 instability episodes preoperatively (P = 0.01). Return to the preinjury sport and occupational level was possible in 41 and 78%, respectively.

Conclusion

Failure-free survival rates dropped dramatically over time. Alternative reconstruction techniques should be considered in those aged ≤30 years due to the high recurrence rate.
M2 bone marrow-derived macrophage-derived exosomes shuffle microRNA-21 to accelerate immune escape of glioma by modulating PEG3
Authors: Yang Fan , Wang Tiecheng , Du Peng , Fan Haitao , Dong Xushuai , Guo Hua
Published: March 2020

Background

Growing studies have focused on the role of microRNA-21 (miR-21) in glioma, thus our objective was to discuss the effect of M2 bone marrow-derived macrophage (BMDM)-derived exosomes (BMDM-Exos) shuffle miR-21 on biological functions of glioma cells by regulating paternally expressed gene 3 (PEG3).

Methods

Seventy-one cases of human glioma tissues and 30 cases of non-tumor normal brain tissues were collected and stored in liquid nitrogen. PEG3 and miR-21 expression in glioma tissues was tested. The fasting venous blood of glioma patients and healthy control was collected and centrifuged, and then the supernatant was stored at − 80 °C refrigerator. The contents of interferon (IFN)-γ and transforming growth factor-β1 (TGF-β1) in serum were tested by ELISA. Glioma cells and normal glial cells were cultured to screen the target cells for further in vitro experiments. BMDM-Exos was obtained by ultra-high speed centrifugation and then was identified. BMDM-Exos was co-cultured with U87 cells to detect the biological functions. The fasting venous blood of glioma patients was extracted and treated with ethylene diamine tetraacetic acid-K2 anti-freezing, and then CD8+T cells were isolated. CD8+T cells were co-cultured with U87 cells to detect the CD8+T proliferation, cell cytotoxic activity, U87 cell activity, as well as IFN-γ and TGF-β1 levels. Moreover, BALB/c-nu/nu mice was taken, and the human-nude mouse glioma orthotopic transplantation model was established with U87 cells, and then mice were grouped to test the trends in tumor growth. The brain of mice (fixed by 10% formaldehyde) was sliced to detect the expression of Ki67 and proliferating cell nuclear antigen (PCNA). The spleen of mice was taken to prepare single-cell suspension, and the percentage of T lymphocytes in spleen to CD8+T cells was detected.

Results

PEG3 expression was decreased and miR-21 expression was increased in glioma cells and tissues. Depleting miR-21 or restoring PEG3 suppressed growth, migration and invasion as well as accelerated apoptosis of glioma cells, also raised CD8+T proliferation, cell cytotoxic activity, and IFN-γ level as well as decreased U87 cell activity and TGF-β1 level. BMDM-Exos shuttle miR-21 promoted migration, proliferation and invasion as well as suppressed apoptosis of glioma cells by reducing PEG3. Exosomes enhanced the volume of tumor, Ki67 and PCNA expression, reduced the percentage of CD8+T cells in glioma mice.

Conclusion

BMDM-Exos shuffle miR-21 to facilitate invasion, proliferation and migration as well as inhibit apoptosis of glioma cells via inhibiting PEG3, furthermore, promoting immune escape of glioma cells.
Inequalities in reproductive health care use in five West-African countries: A decomposition analysis of the wealth-based gaps
Authors: Ogundele Oluwasegun Jko , Pavlova Milena , Groot Wim
Published: March 2020

Background

Family planning and maternal care services have become increasingly available in West Africa but the level of non-use remains high. This unfavorable outcome may be partly due to the unaffordability of reproductive health care services.

Methods

Using the Demographic Health Survey data from Burkina Faso, Niger, Nigeria, Ghana, and Senegal, we perform a decomposition analysis to quantify the contribution of socio-demographic characteristics to disparities in exposure to mass media information on family planning, use of modern contraceptives, adequate antenatal care visits, facility-based childbirth and C-section between low-wealth and high-wealth women.

Results

Our study shows that differences in maternal characteristics between the wealth groups explain at least 40% of the gap in exposure to mass media family planning information, 30% in modern contraceptive use, 24% of adequate antenatal care visits, 47% of the difference in facility-based childbirths, and 62% in C-section. Lack of information on pregnancy complications, living in rural residence, religion, lack of autonomy in health facility seeking decision, need to pay, and distance explains the disparity in reproductive health care use across all countries. In countries with complete fee exemption policies for specific groups in the population, Ghana, Niger, and Senegal, the inequality gaps between wealth groups in having an adequate number of antenatal care visits and facility-based childbirth are smaller than in countries with partial or no exemption policies. But this is not the case for C-section.

Conclusions

There is evidence that current policies addressing the cost of maternal care services may increase the wealth-based inequality in maternal care use if socio-demographic differences are not addressed. Public health interventions are needed to target socio-demographic disparities and health facility seeking problems that disadvantage women in poor households.
Search for polyoma-, herpes-, and bornaviruses in squirrels of the family Sciuridae
Authors: Schulze Vanessa , Lurz Peter W. W. , Ferrari Nicola , Romeo Claudia , Steele Michael A. , Marino Shealyn , Mazzamuto Maria Vittoria , Calvignac-Spencer Sébastien , Schlottau Kore , Beer Martin , Ulrich Rainer G. , Ehlers Bernhard
Published: March 2020

Background

Squirrels (family Sciuridae) are globally distributed members of the order Rodentia with wildlife occurrence in indigenous and non-indigenous regions (as invasive species) and frequent presence in zoological gardens and other holdings. Multiple species introductions, strong inter-species competition as well as the recent discovery of a novel zoonotic bornavirus resulted in increased research interest on squirrel pathogens. Therefore we aimed to test a variety of squirrel species for representatives of three virus families.

Methods

Several species of the squirrel subfamilies Sciurinae, Callosciurinae and Xerinae were tested for the presence of polyomaviruses (PyVs; familyPolyomaviridae) and herpesviruses (HVs; familyHerpesviridae), using generic nested polymerase chain reaction (PCR) with specificity for the PyV VP1 gene and the HV DNA polymerase (DPOL) gene, respectively. Selected animals were tested for the presence of bornaviruses (familyBornaviridae), using both a broad-range orthobornavirus- and a variegated squirrel bornavirus 1 (VSBV-1)-specific reverse transcription-quantitative PCR (RT-qPCR).

Results

In addition to previously detected bornavirus RNA-positive squirrels no more animals tested positive in this study, but four novel PyVs, four novel betaherpesviruses (BHVs) and six novel gammaherpesviruses (GHVs) were identified. For three PyVs, complete genomes could be amplified with long-distance PCR (LD-PCR). Splice sites of the PyV genomes were predicted in silico for large T antigen, small T antigen, and VP2 coding sequences, and experimentally confirmed in Vero and NIH/3T3 cells. Attempts to extend the HV DPOL sequences in upstream direction resulted in contiguous sequences of around 3.3 kilobase pairs for one BHV and two GHVs. Phylogenetic analysis allocated the novel squirrel PyVs to the generaAlpha- andBetapolyomavirus, the BHVs to the genusMuromegalovirus, and the GHVs to the generaRhadinovirusandMacavirus.

Conclusions

This is the first report on molecular identification and sequence characterization of PyVs and HVs and the detection of bornavirus coinfections with PyVs or HVs in two squirrel species. Multiple detection of PyVs and HVs in certain squirrel species exclusively indicate their potential host association to a single squirrel species. The novel PyVs and HVs might serve for a better understanding of virus evolution in invading host species in the future.
Differences in expression of Peroxisome Proliferator-activated Receptor-γ in early-onset preeclampsia and late-onset preeclampsia
Authors: Permadi W. , Mantilidewi K. I. , Khairani A. F. , Lantika U. A. , Ronosulistyo A. R. , Bayuaji H.
Published: March 2020

Objective

PPARγ is a ligand-binding transcription factor that has been reported to be implicated in lipid metabolism, immune function, and cellular growth and differentiation. It has been suspected to play a role in the pathophysiology of preeclampsia, although the mechanism is yet to be elaborated. This study aims to investigate the expression of PPARγ in early onset preeclampsia (EOPE), late onset preeclampsia (LOPE), and normal pregnancy. We conducted this study using primary trophoblastic cell culture incubated with serum from EOPE, LOPE, and normal pregnancy. The expression of PPARγ in these cells was analyzed using Western Blot. Statistical analysis was performed using one-way ANOVA and Bonferroni’s post hoc test. p < 0.05 is considered significant.

Results

Serum from normal pregnant women and EOPE did not induce any difference in the expression of PPAR-γ (p > 0.05). In contrast, expression of PPAR-γ was increased in those cells induced by serum from LOPE (p < 0.001). Therefore, we conclude that hypothetically PPAR-γ might play role in the pathophysiology of LOPE but not in EOPE. Other possibility is the activity of PPAR-γ in EOPE is inversely correlated with its expression, therefore the high enzymatic activity of PPAR-γ is tightly regulated by attenuating its expression.
Bacterial delivery of the anti-tumor azurin-like protein Laz to glioblastoma cells
Authors: Mansour Manar , Ismail Shehab , Abou-Aisha Khaled
Published: March 2020

Salmonella typhimurium VNP-20009 (VNP) is a non-pathogenic attenuated strain, which, as a facultative anaerobe, preferentially accumulates in hypoxic regions of solid tumors. Here, VNP was utilized as a delivery vehicle of the anti-tumor protein Lipidated azurin, Laz, which is produced by the meningitis-causing bacterium Neisseria meningitides. In brain cancer cells, Laz has been demonstrated to induce apoptosis through an interaction with the tumor suppressor protein p53. In this study, the laz gene, including its signal sequence, was cloned downstream of a hypoxia inducible promoter (HIP-1), before being electroporated into VNP. Successful ectopic expression and export of the Laz protein by VNP under hypoxic conditions were confirmed by Western blot analysis of the cell-free culture medium. Effective expression of Laz by VNP was investigated in two glioblastoma cell lines: LN-229 and U-373, with the latter line carrying a mutated version of p53; as well as in the breast cancer line MCF-7. Cytotoxicity of the VNP-Laz was assessed by determining the fluorescence of the apoptotic marker caspases 3/7. Compared to the purified Laz, VNP-Laz, significantly induced apoptosis in MCF-7, LN-229 and, to a much lower extent in U-373 cells, suggesting a p53-linked mechanism. Our results might represent a new approach of targeted gene delivery and suggest a potential application in brain tumor therapy.
Thyroid hormone receptor beta is critical for intestinal remodeling during Xenopus tropicalis metamorphosis
Authors: Shibata Yuki , Tanizaki Yuta , Shi Yun-Bo
Published: March 2020

Background

Thyroid hormone (T3) is critical for development in all vertebrates. The mechanism underlying T3 effect has been difficult to study due to the uterus-enclosed nature of mammalian embryos. Anuran metamorphosis, which is dependent on T3 but independent of maternal influence, is an excellent model to study the roles of T3 and its receptors (TRs) during vertebrate development. We and others have reported various effects of TR knockout (TRα and TRβ) during Xenopus tropicalis development. However, these studies were largely focused on external morphology.

Results

We have generated TRβ knockout animals containing an out-frame-mutation of 5 base deletion by using the CRISPR/Cas9 system and observed that TRβ knockout does not affect premetamorphic tadpole development. We have found that the basal expression of direct T3-inducible genes is increased but their upregulation by T3 is reduced in the intestine of premetamorphic homozygous TRβ knockout animals, accompanied by reduced target binding by TR. More importantly, we have observed reduced adult stem cell proliferation and larval epithelial apoptosis in the intestine during T3-induced metamorphosis.

Conclusions

Our data suggest that TRβ plays a critical role in intestinal remodeling during metamorphosis.
Clinical implications of recurrent gene mutations in acute myeloid leukemia
Authors: Yu Jifeng , Li Yingmei , Zhang Danfeng , Wan Dingming , Jiang Zhongxing
Published: March 2020

Acute myeloid leukemia (AML) is a genetically heterogeneous clonal malignancy characterized by recurrent gene mutations. Genomic heterogeneity, patients’ individual variability, and recurrent gene mutations are the major obstacles among many factors that impact treatment efficacy of the AML patients. With the application of cost- and time-effective next-generation sequencing (NGS) technologies, an enormous diversity of genetic mutations has been identified. The recurrent gene mutations and their important roles in acute myeloid leukemia (AML) pathogenesis have been studied extensively. In this review, we summarize the recent development on the gene mutation in patients with AML.
Design of knee support device based on four-bar linkage and hydraulic artificial muscle
Authors: Kittisares Sarin , Nabae Hiroyuki , Endo Gen , Suzumori Koichi , Sakurai Ryo
Published: March 2020

One of the main challenges for the elderly is insufficient lower limb strength during sit-to-stand movement, which may be improved by supporting the joint externally. Existing lower extremity exoskeletons use perfect revolute joints as knee joints, which do not match with human joint biomechanics. They also require a complex control system to produce the required torque at the corresponding joint angle. In this study, a knee support device using four-bar joint mechanism and hydraulic artificial muscle (HAM) was designed. A previously proposed four-bar linkage joint was modified to accommodate the HAM. In addition, the Angled Bar was proposed to exploit HAM’s force-contraction relationship to generate the desired torque at the corresponding angle only by applying constant hydraulic pressure without the use of a complex control system. The device was able to generate a maximum output of 126.55 Nm torque at 100$$^{\circ }$$∘ knee joint angle during loading and 70.69 Nm torque at 100$$^{\circ }$$∘ during unloading at 3 MPa pressure. The root-mean-square error of the knee extension torque curve was 13.01 Nm. Experiment with a healthy participant showed significant reduction in muscle activity with the assist from the device. The maximum processed EMG signal with and without assist were 52.10 and 20.93 $${\upmu \mathrm{V}}$$μV, respectively.
Ant colony optimization for slope stability analysis applied to an embankment failure in eastern India
Authors: Mishra Mayank , Basson Mandeep Singh , Ramana Gunturi Venkata , Vassallo Roberto
Published: March 2020

The safety of road embankments is mainly assessed in the engineering practice by limit equilibrium analyses. Locating the critical slip surface of embankments and calculating the corresponding factor of safety is a crucial task. In this paper, the continuous ant colony optimisation algorithm is used to analyse the stability of slopes with non-circular slip surfaces. To illustrate the proposed procedure, one example from published literature and another engineering case study of a landslide at a road construction site in India is analysed. This latter study is supplemented by the results of geotechnical investigations performed before and after the failure of the embankment. The results demonstrate that the proposed technique identifies correctly the critical slip surface and can thus be used for engineering applications.
Political views on a further deregulation of the European road haulage market
Authors: Keuchel Stephan , Beckschwarte Thomas , Ernst Fabian
Published: March 2020

Within the broad ongoing review of the legislation of the European road haulage market the European Commission presented in May 2017 several proposals to clarify the regulation of the market, especially market access, driving and rest periods, and the application of the posted workers directive. The paper aims to show economic implications of the suggested regulation on the basis of two round trip models and to outline the differences of political and regional interests by analysing the ammendments to the proposals handed in by members of the political groups of the different Member States.

The proposed regulation can be viewed as a further deregulation of the market with further shifts of markets shares in international and cabotage markets. This in turn is reflected by distinct regional differences of amendments of members within the different political groups.