bluuebunny/crossref_metadata_2025 huggingface dataset:
Discrepancy between true ankle dorsiflexion and gait kinematics and its association with severity of planovalgus foot deformity
Authors: Sung Ki Hyuk , Chung Chin Youb , Lee Kyoung Min , Kwon Ki Bum , Lee Jeong Hyun , Park Moon Seok
Published: April 2020

Background

In planovalgus deformity with triceps contracture, a midfoot break happens, and ankle dorsiflexion (ADF) occurs at the mid-tarsal joint during gait. Results of standard 3D gait analysis may misinterpret the true ankle dorsiflexion because it recognizes the entire foot as a single rigid segment. We performed this study to investigate whether the severity of planovalgus deformity is associated with the discrepancy between the value of ADF evaluated by physical examination and 3-dimensional (3D) gait analysis. In addition, we aimed to identify the radiographic parameters associated with this discrepancy and their relationships.

Methods

Consecutive 40 patients with 65 limbs (mean age, 11.7 ± 5.5 years) with planovalgus foot deformity and triceps surae contracture were included. All patients underwent 3D gait analysis, and weightbearing anteroposterior (AP) and lateral (LAT) foot radiographs. ADF with knee extension was measured using a goniometer with the patient’s foot in an inverted position.

Results

Twenty-one limbs underwent operation for planovalgus foot deformity, and 56 limbs underwent operation for equinus deformity. The difference between ADF on physical examination and ADF at initial contact on gait analysis was 17.5 ± 8.4°. Differences between ADF on physical examination and ADF at initial contact on gait analysis were significantly associated with the LAT talus-first metatarsal angle (p = 0.008) and calcaneal pitch angle (p = 0.006), but not associated with the AP talus-first metatarsal angle (p = 0.113), talonavicular coverage angle (p = 0.190), talocalcaneal angle (p = 0.946), and naviculocuboid overlap (p = 0.136).

Conclusion

The discrepancy between ADF on physical examination and 3D gait analysis was associated with the severity of planovalgus deformity, which was evaluated on weightbearing LAT foot radiographs. Therefore, physicians should be cautious about interpreting results from 3D gait analysis and perform a careful physical examination to assess the degree of equinus deformity in patients with planovalgus foot deformity.
Circulating betatrophin/ANGPTL8 levels correlate with body fat distribution in individuals with normal glucose tolerance but not those with glucose disorders
Authors: Zheng Jing , Liu Juan , Hong Beverly S. , Ke Weijian , Huang Minmin , Li Yanbing
Published: April 2020

Background

The relationship between betatrophin/ANGPTL8 and obesity has been investigated using body mass index (BMI); however, since BMI reflects overall adiposity rather than body fat distribution, it remains unclear whether fat deposition in different areas of the body affects betatrophin expression. Here, we investigated the correlation between circulating betatrophin levels and body fat distribution in patients with different glucose tolerance.

Methods

We performed a cross-sectional study in 128 participants with impaired glucose tolerance (IGT; n = 64) or normal glucose tolerance (NGT; n = 64). Circulating betatrophin levels were detected by enzyme-linked immunosorbent assay (ELISA). Body fat distribution (subcutaneous, visceral, and limb fat) was measured by magnetic resonance imaging (MRI) and a body fat meter.

Results

After controlling for age, sex, and BMI, betatrophin was correlated positively with visceral adipose tissue-to-subcutaneous adipose tissue ratio (VAT/SAT ratio; r = 0.339, p = 0.009) and negatively with body fat ratio (BFR; r = − 0.275, p = 0.035), left lower limb fat ratio (LLR; r = − 0.330, p = 0.011), and right lower limb fat ratio (RLR; r = − 0.288, p = 0.027) in the NGT group, with these correlations remaining after controlling for triglycerides. VAT/SAT ratio (standardized β = 0.419, p = 0.001) was independently associated with serum betatrophin levels; however, betatrophin was not associated with body fat distribution variables in the IGT group.

Conclusions

Circulating betatrophin levels correlated positively with VAT/SAT ratio and negatively with lower limb fat, but not with subcutaneous or upper limb fat, in individuals with normal glucose tolerance. Thus, betatrophin may be a potential biomarker for body fat distribution in individuals without glucose disorders.
Increased tooth mobility after fixed orthodontic appliance treatment can be selectively utilized for case refinement via positioner therapy - a pilot study
Authors: Keilig L. , Goedecke J. , Bourauel C. , Daratsianos N. , Dirk C. , Jäger A. , Konermann A.
Published: April 2020

Background

Increased tooth mobility persists after fixed orthodontic appliance removal, which is therapeutically utilized for post-treatment finishing with positioners. As such a fine adjustment is only required for selected teeth, the aim of this pilot study was to investigate tooth mobility in vivo on corrected and uncorrected subgroups under positioner therapy.

Methods

Mobility was measured on upper teeth of 10 patients (mean age 16.8) by applying loadings for 0.1, 1.0 and 10.0 s with a novel device directly after multibracket appliance debonding as much as 2d, 1, 2 and 6 weeks later. Positioners were inserted at day 2. Specimens were divided into Group C (teeth corrected via positioner), Group N (uncorrected teeth adjacent to teeth from group C), and Group U (uncorrected teeth in an anchorage block). Untreated individuals served as controls (n = 10, mean age 22.4). Statistics were performed via Kolmogorov-Smirnov test and Welch’s unequal variances t-test for comparisons between groups. P < 0.05 was considered statistically significant.

Results

After 1 week, tooth mobility in Group U almost resembled controls (13.0–15.7 N), and reached physiological values after 6 weeks (17.4 N vs. 17.3 N in controls). Group C (9.0–13.4 N) and Group N (9.2–14.7 N) maintained increased mobility after 6 weeks. Tooth mobility was generally higher by reason of long loading durations (10.0 s).

Conclusions

Positioner therapy can selectively utilized increased tooth mobility upon orthodontic fixed appliance treatment for case refinements. Here, uncorrected teeth in anchorage blocks are not entailed by unwanted side effects and recover after 6 weeks post treatment. Corrected teeth and their neighbors exhibit enhanced mobility even after 6 weeks, which represents a necessity for the proper correction of tooth position, and concurrently arouses the requirement for an adequate retention protocol.
The family talk intervention for families when a parent is cared for in palliative care – potential effects from minor children’s perspectives
Authors: Eklund Rakel , Alvariza Anette , Kreicbergs Ulrika , Jalmsell Li , Lövgren Malin
Published: April 2020

Background

Children show long-term psychological distress if family communication and illness-related information are poor during and after a parent’s illness and death. Few psychosocial interventions for families with minor children living with a parent who has a life-threatening illness have been evaluated rigorously. Even fewer interventions have been family-centered. One exception is the Family Talk Intervention (FTI), which has shown promising results regarding increased illness-related knowledge and improved family communication. However, FTI has not yet been evaluated in palliative care. This study therefore aimed to explore the potential effects of FTI from the perspectives of minor children whose parent is cared for in specialized palliative home care.

Methods

This pilot intervention study involves questionnaire and interview data collected from children after participation in FTI. Families were recruited from two specialized palliative home care units. To be included, families must include one parent with life-threatening illness, at least one child aged 6–19 years, and understand and speak Swedish. Twenty families with a total of 34 children participated in FTI; 23 children answered the questionnaire, and 22 were interviewed after participation.

Results

The children reported that FTI increased their knowledge about their parents’ illness. They said the interventionist helped them to handle school-related problems, establish professional counselling, and find strength to maintain everyday life. Children aged 8–12 reported that talking with their parents became easier after FTI, whereas communication was unchanged for teenagers and between siblings. Children also reported having been helped to prepare for the future, and that they benefitted from advice about how to maintain everyday life and minimize conflicts within the family.

Conclusions

Children who participated in FTI reported that it was helpful in many ways, providing illness-related information and improving family communication when a parent has a life-threatening illness. Other potential positive effects reported by the children were that FTI facilitated their preparation for the future, decreased family conflicts, and started to build up resilience.

Trial registration

ClinicalTrials.gov, IdentifierNCT03119545, retrospectively registered 18 April 2017
Using patient-reported measures to drive change in healthcare: the experience of the digital, continuous and systematic PREMs observatory in Italy
Authors: De Rosis Sabina , Cerasuolo Domenico , Nuti Sabina
Published: April 2020

Background

The use of Patient Reported Experience Measures (PREMs) has great potential in healthcare service improvement, but a limited use. This paper presents an empirical case of PREMs innovation in Italy, to foster patient data use up to the ward level, by keeping strengths and addressing weaknesses of previous PREMs survey experiences. The paper reports key lessons learned in this ongoing experience of action research, directly involving practitioners.

Methods

The aim of this paper is to present the results of an ongoing action research, encompassing the innovation of PREMs collection, reporting and use, currently adopted by 21 hospitals of two Italian regions. The continuous and systematic PREMs collection has been implemented between 2017 and 2019 and includes: a continuous web-based administration, using web-services; an augmented and positive questionnaire matching standard closed-ended questions with narrative sections; the inclusion and benchmarking of patient data within a shared performance evaluation system; public disclosure of aggregated anonymized data; a multi-level and real-time web-platform for reporting PREMs to professionals. The action research was carried out with practitioners in a real-life and complex context. The authors used multiple data sources and methods: observations, feedback of practitioners, collected during several workshops and meetings, and analysis of preliminary data on the survey implementation.

Results

A continuous and systematic PREMs observatory was developed and adopted in two Italian regions. PREMs participation and response rates tend to increase over time, reaching stable percentages after the first months. Narrative feedback provide a ‘positive narration’ of episodes and behaviours that made the difference to patients and can inform quality improvement actions. Real-time reporting of quantitative and qualitative data is enabling a gratifying process of service improvement and people management at all the hospitals’ levels.

Conclusions

The PREMs presented in this paper has been recognized by healthcare professionals and managers as a strategic and positive tool for improving an actual use of PREMs at system and ward levels, by measuring and highlighting positive deviances, such as compassionate behaviours.
A case report of familial 4q13.3 microdeletion in three individuals with syndromic intellectual disability
Authors: Maldžienė Živilė , Vaitėnienė Evelina M. , Aleksiūnienė Beata , Utkus Algirdas , Preikšaitienė Eglė
Published: April 2020

Background

Interstitial 4q deletions are rare chromosomal alterations. Most of the previously reported deletions involving the 4q13.3 region are large chromosomal alterations with a common loss of band 4q21 resulting in marked growth restriction, severe intellectual disability, and absent or severely delayed speech. A microdeletion of 4q13.3 hasn’t been previously reported. We discuss the involvement of genes and the observed phenotype, comparing it with that of previously reported patients.

Case presentation

We report on a 4q13.3 microdeletion detected in three affected individuals of a Lithuanian family. The clinical features of two affected children and their affected mother are very similar and include short stature, congenital heart defect, skeletal anomalies, minor facial anomalies, delayed puberty, and intellectual disability. Whole genome SNP microarray analysis of one child revealed an interstitial 4q13.3 microdeletion, 1.56 Mb in size. FISH analysis confirmed the deletion in the proband and identified the same deletion in her affected sib and mother, while it was not detected in a healthy sib. Deletion includes ADAMTS3, ANKRD17, COX18, GC, and NPFFR2 protein-coding genes.

Conclusions

Our findings suggest that 4q13.3 microdeletion is a cause of a recognizable phenotype of three affected individuals. The detected microdeletion is the smallest interstitial deletion in 4q13. We highlight ADAMTS3, ANKRD17 and RNU4ATAC9P as candidate genes for intellectual disability, growth retardation and congenital heart defect.
Repeated fed-batch strategy and metabolomic analysis to achieve high docosahexaenoic acid productivity in Crypthecodinium cohnii
Authors: Liu Liangsen , Wang Fangzhong , Pei Guangsheng , Cui Jinyu , Diao Jinjin , Lv Mingming , Chen Lei , Zhang Weiwen
Published: April 2020

Background

Docosahexaenoic acid (DHA) is essential for human diet. However, high production cost of DHA using C. cohnii makes it currently less competitive commercially, which is mainly caused by low DHA productivity. In recent years, repeated fed-batch strategies have been evaluated for increasing the production of many fermentation products. The reduction in terms of stability of culture system was one of the major challenges for repeated fed-batch fermentation. However, the possible mechanisms responsible for the decreased stability of the culture system in the repeated fed-batch fermentation are so far less investigated, restricting the efforts to further improve the productivity. In this study, a repeated fed-batch strategy for DHA production using C. cohnii M-1-2 was evaluated to improve DHA productivity and reduce production cost, and then the underlying mechanisms related to the gradually decreased stability of the culture system in repeated fed-batch culture were explored through LC– and GC–MS metabolomic analyses.

Results

It was discovered that glucose concentration at 15–27 g/L and 80% medium replacement ratio were suitable for the growth of C. cohnii M-1-2 during the repeated fed-batch culture. A four-cycle repeated fed-batch culture was successfully developed and assessed at the optimum cultivation parameters, resulting in increasing the total DHA productivity by 26.28% compared with the highest DHA productivity of 57.08 mg/L/h reported using C. cohnii, including the time required for preparing seed culture and fermentor. In addition, LC– and GC–MS metabolomics analyses showed that the gradually decreased nitrogen utilization capacity, and down-regulated glycolysis and TCA cycle were correlated with the decreased stability of the culture system during the long-time repeated fed-batch culture. At last, some biomarkers, such as Pyr, Cit, OXA, FUM, l-tryptophan, l-threonine, l-leucine, serotonin, and 4-guanidinobutyric acid, correlated with the stability of culture system of C. cohnii M-1-2 were identified.

Conclusions

The study proved that repeated fed-batch cultivation was an efficient and energy-saving strategy for industrial production of DHA using C. cohnii, which could also be useful for cultivation of other microbes to improve productivity and reduce production cost. In addition, the mechanisms study at metabolite level can also be useful to further optimize production processes for C. cohnii and other microbes.
Insight into the role of p62 in the cisplatin resistant mechanisms of ovarian cancer
Authors: Yan Xiao-Yu , Qu Xian-Zhi , Xu Long , Yu Si-Hang , Tian Rui , Zhong Xin-Ru , Sun Lian-Kun , Su Jing
Published: April 2020

Cisplatin is a platinum-based first-line drug for treating ovarian cancer. However, chemotherapy tolerance has limited the efficacy of cisplatin for ovarian cancer patients. Research has demonstrated that cisplatin causes changes in cell survival and death signaling pathways through its interaction with macromolecules and organelles, which indicates that investigation into the DNA off-target effects of cisplatin may provide critical insights into the mechanisms underlying drug resistance. The multifunctional protein p62 works as a signaling hub in the regulation of pro-survival transcriptional factors NF-κB and Nrf2 and connects autophagy and apoptotic signals, which play important roles in maintaining cell homeostasis. In this review, we discuss the role of p62 in cisplatin resistance by exploring p62-associated signaling pathways based on current studies and our work. Insights into these resistance mechanisms may lead to more effective therapeutic strategies for ovarian cancer by targeting p62.
Herbal melanin inhibits colorectal cancer cell proliferation by altering redox balance, inducing apoptosis, and modulating MAPK signaling
Authors: Al-Obeed Omar , El-Obeid Adila Salih , Matou-Nasri Sabine , Vaali-Mohammed Mansoor-Ali , AlHaidan Yazeid , Elwatidy Mohammed , Al Dosary Hamad , Alehaideb Zeyad , Alkhayal Khayal , Haseeb Adil , McKerrow James , Ahmad Rehan , Abdulla Maha-Hamadien
Published: April 2020

Background

Colorectal carcinoma is one of the most deadly cancers that requests effective and safe chemotherapy. Evaluation of natural product-based anticancer drugs as adjuvant treatment with fewer side effects is largely unexplored research fields. Herbal melanin (HM) is an extract of the seed coats of Nigella sativa that modulates an inflammatory response through toll-like receptor 4 (TLR4). This TLR4 receptor is also involved in the modulation of apoptosis. We therefore explored the anticancer potential of HM and specifically its effect on the molecular mechanisms underlying adenocarcinoma and metastatic colorectal cancer (mCRC) cell death in vitro.

Methods

Cell viability was evaluated using the MTT assay. Cellular reactive oxygen species (ROS), glutathione levels, and apoptotic status were assessed using fluorometric and colorimetric detection methods. HM-induced apoptotic and other signaling pathways were investigated using Western blot technology and mitochondrial transition pore assay kit. TLR4 receptor downregulation and blockade were performed using siRNA technology and neutralizing antibody, respectively.

Results

Our results showed that HM inhibited the proliferation of the colorectal adenocarcinoma HT29 and mCRC SW620 cell lines. Furthermore, HM enhanced ROS production and decreased glutathione levels. HM-induced apoptosis was associated with mitochondrial outer membrane permeability and cytochrome c release, inhibition of the Bcl2 family proteins, and activation of caspase-3/-7. In addition, HM modulated MAPK pathways by activating the JNK pathway and by inhibiting ERK phosphorylation. TLR4 receptor downregulation enhanced HM-induced apoptosis while TLR4 receptor blockade partially alleviated HM-inhibited ERK phosphorylation.

Conclusion

Altogether, these findings indicate that HM exerts pro-apoptotic effects and inhibits MAPK pathway through TLR4 in mCRC and colorectal adenocarcinoma cells, suggesting HM as a promising natural-based drug for the treatment of colorectal cancer.
Correction to: The effect of western diet on mice brain lipid composition
Authors: Pakiet Alicja , Jakubiak Agnieszka , Czumaj Aleksandra , Sledzinski Tomasz , Mika Adriana
Published: April 2020

The original version of this article [1], published on 27 November 2019, contained incorrect calculations.
Effects of natural polyphenol-rich pomegranate juice supplementation on plasma ion and lipid profiles following resistance exercise: a placebo-controlled trial
Authors: Ammar Achraf , Trabelsi Khaled , Bailey Stephen J. , Turki Mouna , Bragazzi Nicola Luigi , Boukhris Omar , El Abed Kais , Bouaziz Mohamed , Ayadi Fatma , Driss Tarak , Souissi Nizar , Chtourou Hamdi , Hökelmann Anita
Published: April 2020

Background

Pomegranate juice (POMj) contains abundant soluble polyphenolic antioxidant compounds and is recommended for its cardioprotective/atheroprotective properties. However, very few studies have investigated the efficacy of POMj supplementation to alter physiological responses during intensive physical exercise. This placebo-controlled study aimed to examine whether supplementation with natural polyphenol-rich-POMj could influence the ionic or lipid responses to an intensive resistance training session in elite athletes.

Methods

Nine elite weightlifters (21 ± 1 years) performed two Olympic-weightlifting sessions after ingesting placebo and POMj supplements. Venous blood samples were collected at rest and 3 min after each session for assessment of plasma sodium ([Na+]), potassium ([K+]), chloride ([Cl−]), calcium ([Ca2+]), triglyceride ([TG]) and high-density lipoprotein ([HDL-C]), low-density lipoprotein ([HDL-C]) and total ([TC]) cholesterol concentrations.

Results

Plasma [K+] and [TG] were lowered post-exercise compared to resting values in the PLA condition (p = 0.03 for K+ and p = 0.02 for TG) with no pre-to-post exercise differences in the other plasma ion and lipid markers (p > 0.05). Compared to rest, plasma [Na+] and [Cl−] were increased (p = 0.04, %change = 4.10% for Na+ and p = 0.02, %change = 4.44% for Cl−), but there were no differences in the other plasma ion or lipid markers post-exercise after POMj supplementation (p > 0.05). Post-exercise plasma [Na+], [Cl−], and [HDL-C] were greater following POMj supplementation compared to PLA (p = 0.01 for Cl- and HDL-C, p = 0.02 for Na+, and p = 0.04 for TC), with no between-supplement post-exercise differences in the other ion and lipid markers (p > 0.05).

Conclusion

In conclusion, supplementation with POMj has the potential to attenuate the acute imbalance of plasma [K+] and to improve blood lipid responses (i.e., HDL-C) following resistance exercises in elite weightlifters. However, further large research in both athletic and non-athletic populations is needed to corroborate these preliminary observations and to elucidate the potential underlying mechanisms and translational potential of our novel observations.

Trial registration

Name of the registry:ClinicalTrials.gov PRS

The registration number:NCT02697903.

Date of Registry: 03/03/2016 ‘Retrospectively registered’.

The registration title: Pomegranate Improve Biological Recovery Kinetics in Elite Weightlifter.

Graphical abstract
Recent developments and emerging trends of mass spectrometric methods in plant hormone analysis: a review
Authors: Wang Liyuan , Zou Yilin , Kaw Han Yeong , Wang Gang , Sun Huaze , Cai Long , Li Chengyu , Meng Long-Yue , Li Donghao
Published: April 2020

Plant hormones are naturally occurring small molecule compounds which are present at trace amounts in plant. They play a pivotal role in the regulation of plant growth. The biological activity of plant hormones depends on their concentrations in the plant, thus, accurate determination of plant hormone is paramount. However, the complex plant matrix, wide polarity range and low concentration of plant hormones are the main hindrances to effective analyses of plant hormone even when state-of-the-art analytical techniques are employed. These factors substantially influence the accuracy of analytical results. So far, significant progress has been realized in the analysis of plant hormones, particularly in sample pretreatment techniques and mass spectrometric methods. This review describes the classic extraction and modern microextraction techniques used to analyze plant hormone. Advancements in solid phase microextraction (SPME) methods have been driven by the ever-increasing requirement for dynamic and in vivo identification of the spatial distribution of plant hormones in real-life plant samples, which would contribute greatly to the burgeoning field of plant hormone investigation. In this review, we describe advances in various aspects of mass spectrometry methods. Many fragmentation patterns are analyzed to provide the theoretical basis for the establishment of a mass spectral database for the analysis of plant hormones. We hope to provide a technical guide for further discovery of new plant hormones. More than 140 research studies on plant hormone published in the past decade are reviewed, with a particular emphasis on the recent advances in mass spectrometry and sample pretreatment techniques in the analysis of plant hormone. The potential progress for further research in plant hormones analysis is also highlighted.
Development of a universal endogenous qPCR control for eukaryotic DNA samples
Authors: Mittelberger Cecilia , Obkircher Lisa , Oberkofler Vicky , Ianeselli Alan , Kerschbamer Christine , Gallmetzer Andreas , Reyes-Dominguez Yazmid , Letschka Thomas , Janik Katrin
Published: April 2020

Background

Phytoplasma are obligate intracellular plant-pathogenic bacteria that infect a broad range of plant species and are transmitted by different insect species. Quantitative real-time PCR (qPCR) is one of the most commonly used techniques for pathogen detection, especially for pathogens that cannot be cultivated outside their host like phytoplasma. PCR analysis requires the purification of total DNA from the sample and subsequent amplification of pathogen DNA with specific primers. The purified DNA contains mainly host DNA and only a marginal proportion is of phytoplasmal origin. Therefore, detection of phytoplasma DNA in a host DNA background must be sensitive, specific and reliable and is highly dependent on the quality and concentration of the purified DNA. DNA quality and concentration and the presence of PCR-inhibitors therefore have a direct impact on pathogen detection. Thus, it is indispensable for PCR-based diagnostic tests to validate the DNA preparation and DNA integrity before interpreting diagnostic results, especially in case that no pathogen DNA is detected. The use of an internal control allows to evaluate DNA integrity and the detection of PCR-inhibiting substances. Internal controls are generally host-specific or limited to a defined group of related species. A control suitable for the broad range of phytoplasma hosts comprising different insect and plant species is still missing.

Results

We developed a primer and probe combination that allows amplification of a conserved stretch of the eukaryotic 28S rDNA gene. The developed endogenous qPCR control serves as a DNA quality control and allows the analysis of different eukaryotic host species, including plants, insects, fish, fungi, mammals and human with a single primer/probe set in single- or multiplex assays.

Conclusions

Quality and performance control is indispensable for pathogen detection by qPCR. Several plant pathogens are transmitted by insects and have a broad range of host species. The newly developed endogenous control can be used with all so far tested eukaryotic species and since multiplexing is possible, the described primer and probe set can be easily combined with other PCR-based pathogen detection systems.
Functional movement compensations persist in individuals with hip osteoarthritis performing the five times sit-to-stand test 1 year after total hip arthroplasty
Authors: Esbjörnsson Anna-Clara , Naili Josefine E.
Published: April 2020

Background

Methods to quantify and evaluate function are important for development of specific rehabilitation interventions. This study aimed to evaluate functional movement compensation in individuals with hip osteoarthritis performing the five times sit-to-stand test and change following total hip arthroplasty. To this end, trajectories of the body’s center of mass in the medial-lateral and anterior-posterior dimensions were quantified prior to and 1 year after total hip arthroplasty and compared to a healthy control group.

Methods

Twenty-eight individuals with hip osteoarthritis and 21 matched healthy controls were enrolled in this prospective study. Within 1 month prior to and 1 year after total hip arthroplasty, performance on the five times sit-to-stand test was evaluated using three-dimensional motion analysis and perceived pain using a visual analog scale. The center of mass trajectories for the medial-lateral and the anterior-posterior dimensions were identified, and the area under the curve was calculated, respectively. Repeated measures ANOVA were used to evaluate differences in the area under the curve, between pre- and postoperative performance, and between participants with hip osteoarthritis and controls.

Results

Preoperatively, individuals with hip osteoarthritis displayed a larger contralateral shift (p < 0.001) and forward displacement of the center of mass (p = 0.022) compared to controls. After surgery, deviations in both dimensions were reduced (medial-lateral p = 0.013; anterior-posterior p = 0.009). However, as compared to controls, the contralateral shift of the center of mass remained larger (p = 0.010), indicative of persistent asymmetric limb loading. Perceived pain was significantly reduced postoperatively (p < 0.001).

Conclusions

By quantifying the center of mass trajectory during five times sit-to-stand test performance, functional movement compensations could be detected and evaluated over time. Prior to total hip arthroplasty, individuals with hip osteoarthritis presented with an increased contralateral shift and forward displacement of the center of mass, representing a strategy to reduce pain by unloading the affected hip and reducing required hip and knee extension moments. After surgery, individuals with total hip arthroplasty displayed a persistent increased contralateral shift as compared to controls. This finding has implications for rehabilitation, where more focus must be directed towards normalizing loading of the limbs.
Diagnosis support systems for rare diseases: a scoping review
Authors: Faviez Carole , Chen Xiaoyi , Garcelon Nicolas , Neuraz Antoine , Knebelmann Bertrand , Salomon Rémi , Lyonnet Stanislas , Saunier Sophie , Burgun Anita
Published: April 2020

Introduction

Rare diseases affect approximately 350 million people worldwide. Delayed diagnosis is frequent due to lack of knowledge of most clinicians and a small number of expert centers. Consequently, computerized diagnosis support systems have been developed to address these issues, with many relying on rare disease expertise and taking advantage of the increasing volume of generated and accessible health-related data. Our objective is to perform a review of all initiatives aiming to support the diagnosis of rare diseases.

Methods

A scoping review was conducted based on methods proposed by Arksey and O’Malley. A charting form for relevant study analysis was developed and used to categorize data.

Results

Sixty-eight studies were retained at the end of the charting process. Diagnosis targets varied from 1 rare disease to all rare diseases. Material used for diagnosis support consisted mostly of phenotype concepts, images or fluids. Fifty-seven percent of the studies used expert knowledge. Two-thirds of the studies relied on machine learning algorithms, and one-third used simple similarities. Manual algorithms were encountered as well. Most of the studies presented satisfying performance of evaluation by comparison with references or with external validation. Fourteen studies provided online tools, most of which aimed to support the diagnosis of all rare diseases by considering queries based on phenotype concepts.

Conclusion

Numerous solutions relying on different materials and use of various methodologies are emerging with satisfying preliminary results. However, the variability of approaches and evaluation processes complicates the comparison of results. Efforts should be made to adequately validate these tools and guarantee reproducibility and explicability.
Challenges in recruiting and retaining adolescents with abuse-related posttraumatic stress disorder: lessons learned from a randomized controlled trial
Authors: Vogel Anna , Comtesse Hannah , Rosner Rita
Published: April 2020

Background

Research on effective recruitment and retention strategies for adolescents and young adults suffering from posttraumatic stress disorder is scarce. The aim of the current study was to provide data on recruitment sources, barriers, and facilitators for participation in a randomized controlled trial for young individuals with histories of sexual and/or physical abuse.

Methods

Study participants aged 14 to 21 were asked to complete a checklist on individual sources of recruitment, barriers, and facilitators for participation in the trial. Fifty-three out of the 80 study participants who were contacted completed the checklist (66.3%).

Results

Most respondents reported multiple recruitment sources, with online and media advertising search strategies indicated most frequently (45.4% of all mentions), followed by practitioner-referred sources (38.7%). Respondents’ reported barriers included additional demands of the trial (60.3%), followed by distress caused by having to talk about painful topics (15.5%). The most frequently indicated facilitators were the organizational setting (55.1%) and monetary incentives (22.2%), followed by social support (12.0%) and non-monetary incentives (10.2%). No significant differences were observed between adolescent and young adult respondents with the exception that adolescents reported significantly more frequently that they had learned about the trial from their caregiver.

Conclusions

Our findings permit the formulation of recommendations for planning and conducting trials with this clientele. Future research is needed on how specific barriers can be effectively overcome.
What clinical crew competencies and qualifications are required for helicopter emergency medical services? A review of the literature
Authors: Masterson Siobhán , Deasy Conor , Doyle Mark , Hennelly David , Knox Shane , Sorensen Jan
Published: April 2020

Background

Patients served by Helicopter Emergency Medical Services (HEMS) tend to be acutely injured or unwell and in need of stabilisation followed by rapid and safe transport. It is therefore hypothesised that a particular clinical crew composition is required to provide appropriate HEMS patient care. A literature review was performed to test this hypothesis.

Methods

MEDLINE, EMBASE, Web of Science and the Cochrane Database of Systematic Reviews were systematically searched from 1 January 2009 to 30 August 2019 to identify peer-reviewed articles of relevance. All HEMS studies that mentioned ‘staffing’, ‘configuration’, ‘competencies’ or ‘qualifications’ in the title or abstract were selected for full-text review.

Results

Four hundred one studies were identified. Thirty-eight studies, including one systematic review and one randomised controlled trial, were included. All remaining studies were of an observational design. The vast majority of studies described clinical crews that were primarily doctor-staffed. Descriptions of non-doctor staff competencies were limited, with the exception of one paramedic-staffed model.

Conclusions

HEMS clinical crews tended to have a wider range of competencies and experience than ground-based crews, and most studies suggested a patient outcome benefit to HEMS provision. The conclusions that can be drawn are limited due to study quality and the possibility that the literature reviewed was weighted towards particular crewing models (i.e. primarily doctor-staffed) and countries. There is a need for trial-based studies that directly compare patient outcomes between different HEMS crews with different competencies and qualifications.
Comparative effectiveness of post-discharge strategies for hospitalized smokers: Study protocol for the Helping HAND 4 randomized controlled trial
Authors: Rigotti Nancy A. , Schnitzer Kristina , Davis Esa M. , Regan Susan , Chang Yuchiao , Kelley Jennifer H. K. , Notier Anna E. , Gilliam Karen , Douaihy Antoine , Levy Douglas E. , Singer Daniel E. , Tindle Hilary A.
Published: April 2020

Background

Tobacco smoking remains the leading preventable cause of death in the US. A hospital admission provides smokers with a unique opportunity to stop smoking because it requires temporary tobacco abstinence while illness may enhance motivation to quit. Hospital interventions must continue post-discharge to increase tobacco abstinence long-term, but how best to accomplish this remains unclear. Building on two previous randomized controlled trials, each of which tested smoking cessation interventions that began in hospital and continued after discharge, this trial compares two interventions that provide sustained smoking cessation treatment after hospital discharge with the goal of improving long-term smoking cessation rates among hospitalized smokers.

Methods/design

Helping HAND 4 is a three-site randomized controlled trial that compares the effectiveness of two active interventions for producing validated past 7-day tobacco abstinence 6 months after hospital discharge. Smokers who are admitted to three hospitals receive a standard in-hospital smoking intervention, and those who plan to quit smoking after discharge are recruited and randomly assigned to two interventions that begin at discharge, Personalized Tobacco Care Management (PTCM) or Quitline eReferral. Each lasts 3 months. At discharge, PTCM provides 8 weeks of free nicotine replacement (NRT; a participant’s choice of patch, gum, lozenge, or a combination) and then proactive smoking cessation support using an automated communication platform and live contact with a tobacco treatment specialist who is based in the health care system. In the eReferral condition, a direct referral is made from the hospital electronic health record to a community-based resource, the state’s telephone quitline. The quitline provides up to 8 weeks of free NRT and offers behavioral support via a series of phone calls from a trained coach. Outcomes are assessed at 1, 3, and 6 months after discharge. The study hypothesis is that PTCM will produce higher quit rates than eReferral.

Discussion

Helping HAND 4 is a pragmatic trial that aims to evaluate interventions in real-world conditions. This project will give hospital systems critical evidence-based tools for meeting National Hospital Quality Measures for tobacco treatment and maximizing their ability to improve cessation rates and overall health for the millions of smokers hospitalized annually in the US.

Trial registration

Prospectively registered prior to start of enrollment at Clinicaltrials.gov, NCT03603496 (July 27, 2018). https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S00084MJ&selectaction=Edit&uid=U00002G7&ts=2&cx=ff0oxn
Hypotheses, rationale, design, and methods for prognostic evaluation of a randomized comparison between patients with coronary artery disease associated with ischemic cardiomyopathy who undergo medical or surgical treatment: MASS-VI (HF)
Authors: Rezende Paulo Cury , Hueb Whady , Bocchi Edimar Alcides , Farkouh Michael , Junior Carlos Vicente Serrano , Lima Eduardo Gomes , Silva Expedito Eustáquio Ribeiro , Dallan Luis Alberto Oliveira , Gaiotto Fabio Antonio , Garzillo Cibele Larrosa , Rochitte Carlos Eduardo , Nomura Cesar Higa , Scudeler Thiago Luis , Soares Paulo Rogério , Jatene Fabio Biscegli , Ramires José Antonio Franchini , Filho Roberto Kalil
Published: April 2020

Background

Ischemic cardiomyopathy and severe left ventricular dysfunction are well established to represent the main determinants of poor survival and premature death compared with preserved ventricular function. However, the role of myocardial revascularization as a therapeutic alternative is not known to improve the long-term prognosis in this group of patients. This study will investigate whether myocardial revascularization contributes to a better prognosis for patients compared with those treated with drugs alone and followed over the long term.

Methods

The study will include 600 patients with coronary artery disease associated with ischemic cardiomyopathy. The surgical or drug therapy option will be randomized, and the events considered for analysis will be all-cause mortality, nonfatal infarction, unstable angina requiring additional revascularization, and stroke. The events will be analyzed according to the intent-to-treat principle. Patients with multivessel coronary disease and left ventricular ejection fraction measurements of less than 35% will be included. In addition, myocardial ischemia will be documented by myocardial scintigraphy. Markers of myocardial necrosis will be checked at admission and after the procedure.

Discussion

The role of myocardial revascularization (CABG) in the treatment of patients with coronary artery disease and heart failure is not clearly established. The surgical option of revascularizing the myocardium is a procedure designed to reduce the load of myocardial hibernation in patients with heart failure caused by coronary artery disease. On the other hand, the assessment of myocardial viability is frequently used to identify patients with left ventricular ischemic dysfunction in which CABG may add survival benefit. However, the effectiveness of this option is uncertain. The great difficulty in establishing the efficacy of surgical intervention is based on the understanding of viability without ischemia. Thus, this study will include only patients with viable and truly ischemic myocardium to correct this anomaly.

Trial registration

Evaluation of a randomized comparison between patients with coronary artery disease associated with ischemic cardiomyopathy submitted to medical or surgical treatment: MASS-VI (HF), ISRCTN77449548, Oct 10th, 2019 (retrospectively registered).
Gout is associated with an increased risk for incident heart failure among older adults: the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort study
Authors: Colantonio Lisandro D. , Saag Kenneth G. , Singh Jasvinder A. , Chen Ligong , Reynolds Richard J. , Gaffo Angelo , Plante Timothy B. , Curtis Jeffrey R. , Bridges S. Louis , Levitan Emily B. , Chaudhary Ninad S. , Howard George , Safford Monika M. , Muntner Paul , Irvin Marguerite Ryan
Published: April 2020

Background

Gout has been associated with a higher risk for coronary heart disease (CHD) and stroke in some prior studies. Few studies have assessed the association of gout with incident heart failure (HF).

Methods

We analyzed data from 5713 black and white men and women ≥ 65.5 years of age in the population-based REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort study who had Medicare coverage without a history of HF, CHD, or stroke at baseline between 2003 and 2007. Gout was defined by ≥ 1 hospitalization or ≥ 2 outpatient visits with a diagnosis code for gout in Medicare claims prior to each participant’s baseline study examination. REGARDS study participants were followed for HF hospitalization, CHD, stroke, and all-cause mortality as separate outcomes through December 31, 2016. Analyses were replicated in a random sample of 839,059 patients ≥ 65.5 years of age with Medicare coverage between January 1, 2008, and June 30, 2015, who were followed through December 31, 2017.

Results

Among REGARDS study participants included in the current analysis, the mean age at baseline was 72.6 years, 44.9% were men, 31.4% were black, and 3.3% had gout. Over a median follow-up of 10.0 years, incidence rates per 1000 person-years among participants with and without gout were 13.1 and 4.4 for HF hospitalization, 16.0 and 9.3 for CHD, 9.3 and 8.2 for stroke, and 55.0 and 37.1 for all-cause mortality, respectively. After multivariable adjustment for sociodemographic variables and cardiovascular risk factors, hazard ratios (95% CI) comparing participants with versus without gout were 1.97 (1.22, 3.19) for HF hospitalization, 1.21 (0.79, 1.84) for CHD, 0.83 (0.48, 1.43) for stroke, and 1.08 (0.86, 1.35) for all-cause mortality. The multivariable-adjusted hazard ratio for HF hospitalization with reduced and preserved left ventricular ejection fraction among participants with versus without gout was 1.77 (95% CI 0.83, 3.79) and 2.32 (95% CI 1.12, 4.79), respectively. The multivariable-adjusted hazard ratio for heart failure hospitalization associated with gout among the 839,059 Medicare beneficiaries was 1.32 (95% CI 1.25, 1.39).

Conclusion

Among older adults, gout was associated with an increased risk for incident HF but not for incident CHD, incident stroke, or all-cause mortality.
Effects of industrial effluents on the quality of water in Namanve stream, Kampala Industrial and Business Park, Uganda
Authors: Angiro Christopher , Abila Patrick P’Odyek , Omara Timothy
Published: April 2020

Objective

Kampala Industrial and Business Park (KIBP) is one of the premier and the most successful Ugandan industrial complexes that impact the inner Murchison bay of Lake Victoria. The current study aimed at evaluating the effect of industrial effluents on the physicochemical and microbiological quality of water taken from four different sites along Namanve stream in KIBP, Wakiso district, Uganda.

Results

All the water quality parameters were below WHO maximum permissible limits except turbidity, electrical conductivity and Escherichia coli count. Mean values of the monitored water quality parameters increased from the point of effluent discharge downstream of Namanve stream.
Asymptotically almost periodic dynamics on delayed Nicholson-type system involving patch structure
Authors: Zhang Hong , Cao Qian , Yang Hedi
Published: April 2020

This paper explores a delayed Nicholson-type system involving patch structure. Applying differential inequality techniques and the fluctuation lemma, we establish a new sufficient condition which guarantees the existence of positive asymptotically almost periodic solutions for the addressed system. The results of this article are completely new and supplement the previous publications.
The Crank–Nicolson finite element method for the 2D uniform transmission line equation
Authors: Ren Hulin , Fan Yiting , Luo Zhendong
Published: April 2020

We develop the Crank–Nicolson finite element (CNFE) method for the two-dimensional (2D) uniform transmission line equation, study the stability and existence as well as error estimates for the CNFE solutions of the 2D uniform transmission line equation by strict theoretical approaches. We verify the correctness of the obtained theoretical results by means of numerical tests.
Some higher norm inequalities for composition of power operators
Authors: Li Huacan , Li Qunfang
Published: April 2020

In this paper, we first prove the local $L^{s}$Ls norm estimate of composite operators $\triangle^{k}G^{m}(u)$△kGm(u) by use of the $L^{s}$Ls norm of u. Then we establish the local and global higher norm inequalities of $\triangle^{k}G^{m}(u)$△kGm(u). Simultaneously, we also give a global higher norm estimate with Radon measure. Finally, as applications of these results, we give two examples to estimate the higher norm of $\triangle^{k}G^{m}(u)$△kGm(u).