bluuebunny/crossref_metadata_2025 huggingface dataset:
Exposure to lead-free frangible firing emissions containing copper and ultrafine particulates leads to increased oxidative stress in firing range instructors
Authors: McNeilly Ryan J. , Schwanekamp Jennifer A. , Hyder Logan S. , Hatch John P. , Edwards Brett T. , Kirsh Jacob A. , Jackson Jerimiah M. , Jaworek Thomas , Methner Mark M. , Duran Christin M.
Published: May 2022

Background

Since the introduction of copper based, lead-free frangible (LFF) ammunition to Air Force small arms firing ranges, instructors have reported symptoms including chest tightness, respiratory irritation, and metallic taste. These symptoms have been reported despite measurements determining that instructor exposure does not exceed established occupational exposure limits (OELs). The disconnect between reported symptoms and exposure limits may be due to a limited understanding of LFF firing byproducts and subsequent health effects. A comprehensive characterization of exposure to instructors was completed, including ventilation system evaluation, personal monitoring, symptom tracking, and biomarker analysis, at both a partially enclosed and fully enclosed range.

Results

Instructors reported symptoms more frequently after M4 rifle classes compared to classes firing only the M9 pistol. Ventilation measurements demonstrated that airflow velocities at the firing line were highly variable and often outside established standards at both ranges. Personal breathing zone air monitoring showed exposure to carbon monoxide, ultrafine particulate, and metals. In general, exposure to instructors was higher at the partially enclosed range compared to the fully enclosed range. Copper measured in the breathing zone of instructors, on rare occasions, approached OELs for copper fume (0.1 mg/m3). Peak carbon monoxide concentrations were 4–5 times higher at the partially enclosed range compared to the enclosed range and occasionally exceeded the ceiling limit (125 ppm). Biological monitoring showed that lung function was maintained in instructors despite respiratory symptoms. However, urinary oxidative stress biomarkers and urinary copper measurements were increased in instructors compared to control groups.

Conclusions

Consistent with prior work, this study demonstrates that symptoms still occurred despite exposures below OELs. Routine monitoring of symptoms, urinary metals, and oxidative stress biomarkers can help identify instructors who are particularly affected by exposures. These results can assist in guiding protective measures to reduce exposure and protect instructor health. Further, a longitudinal study is needed to determine the long-term health consequences of LFF firing emissions exposure.
The role of health systems for health security: a scoping review revealing the need for improved conceptual and practical linkages
Authors: Brown Garrett Wallace , Bridge Gemma , Martini Jessica , Um Jimyong , Williams Owain D. , Choupe Luc Bertrand Tsachoua , Rhodes Natalie , Ho Zheng Jie Marc , Chungong Stella , Kandel Nirmal
Published: May 2022

Background

Practical links between health systems and health security are historically prevalent, but the conceptual links between these fields remain under explored, with little on health system strengthening. The need to address this gap gains relevance in light of the COVID-19 pandemic as it demonstrated a crucial relationship between health system capacities and effective health security response. Acknowledging the importance of developing stronger and more resilient health systems globally for health emergency preparedness, the WHO developed a Health Systems for Health Security framework that aims to promote a common understanding of what health systems for health security entails whilst identifying key capacities required.

Methods/ results

To further explore and analyse the conceptual and practical links between health systems and health security within the peer reviewed literature, a rapid scoping review was carried out to provide an overview of the type, extent and quantity of research available. Studies were included if they had been peer-reviewed and were published in English (seven databases 2000 to 2020). 343 articles were identified, of those 204 discussed health systems and health security (high and medium relevance), 101 discussed just health systems and 47 discussed only health security (low relevance). Within the high and medium relevance articles, several concepts emerged, including the prioritization of health security over health systems, the tendency to treat health security as exceptionalism focusing on acute health emergencies, and a conceptualisation of security as ‘state security’ not ‘human security’ or population health.

Conclusion

Examples of literature exploring links between health systems and health security are provided. We also present recommendations for further research, offering several investments and/or programmes that could reliably lead to maximal gains from both a health system and a health security perspective, and why these should be explored further. This paper could help researchers and funders when deciding upon the scope, nature and design of future research in this area. Additionally, the paper legitimises the necessity of the Health Systems for Health Security framework, with the findings of this paper providing useful insights and evidentiary examples for effective implementation of the framework.
Influence of the sociodemographic profile of hunters on the knowledge and use of faunistic resources
Authors: Souza Jeferson de M. , Lins Neto Ernani M. F. , Ferreira Felipe S.
Published: May 2022

Background

Hunting wild animals is essential for nutrition, clothing, predator control and disease treatment. As part of a system based on food choices and uses, it is influenced by ecological, economic and sociocultural patterns. In this context, the aim is to identify the game fauna of interest in the Brazilian semiarid region; indicate the methods, uses, patterns of choices and cultural importance of the fauna and identify which sociodemographic variables influence the knowledge and use of faunal resources.

Methods

Information on hunting and fauna use was obtained through semi-structured interviews, complemented with free interviews and informal conversations. The cultural importance of the species was calculated through the current use value. The generalized linear model was created to verify whether the sociodemographic profile of hunters influences the knowledge and use of game species.

Results

The results showed a representativeness of 56 species. The group of birds was the most representative in terms of taxonomic richness (48.2%), followed by the group of mammals (26.8%), reptiles (21.4%) and amphibians (3.6%). The animals mentioned are used for food, trade, control hunting (slaughter of animals considered invaders of property or harmful to humans), pets, zootherapy and ornamentation. Sociodemographic variables shaped the knowledge of faunal resources, in which the age of hunters showed a negative correlation with the number of known species.

Conclusions

The meaning and forms of use attributed to each species depend on ecological, economic and sociocultural factors, which dictate the relationship between human communities and natural resources. Socioeconomic variables shape hunting patterns in all its aspects, whether in perception that hunters have of the resources, forms of use and utilization of hunting strategies.
A review of the disruption of breastfeeding supports in response to the COVID-19 pandemic in five Western countries and applications for clinical practice
Authors: Turner Sarah , McGann Bridget , Brockway Meredith ’Merilee’
Published: May 2022

Background

The COVID-19 pandemic has significantly altered how breastfeeding support is provided, resulting in mixed breastfeeding outcomes and experiences for mothers. The World Health Organization has consistently supported breastfeeding from the beginning of the pandemic. However, recommendations from obstetrical and gynaecological societies within individual countries have varied in their alignment with this guidance, resulting in inconsistent recommendations. It is unknown how breastfeeding guidelines, maternal breastfeeding experiences, and breastfeeding initiation and duration compared across five Western countries. The current study is comprised of two parts, each with a different objective. Part One objective: to review pandemic-related changes in professional society guidelines on breastfeeding support in Australia, New Zealand, Canada, the United Kingdom, and the United States; and Part Two objective: to conduct a narrative review to summarize the evidence of how the pandemic has changed breastfeeding initiation, duration, and mothers’ breastfeeding experiences during the pandemic in these five countries and provide recommendations for clinical lactation support.

Methods

We searched for indicators that are impactful on breastfeeding outcomes: skin-to-skin contact, rooming in, direct breastfeeding and breast washing, in the five countries mentioned above and compared these to the recommendations from the World Health Organization. Next, we conducted a narrative review of the literature from these five countries to explore how the pandemic altered breastfeeding outcomes and used this information to provide suggestions for clinical practice moving forward.

Results

Recommendations on the four practices above differed by country and were not always in alignment with the World Health Organization recommendations. Mother-infant separation after birth in the United States was associated with a lower prevalence of breastfeeding initiation and duration. While some mothers reported positive breastfeeding experiences during the pandemic, many mothers indicated negative experiences related to decreased social and professional support.

Conclusions

The pandemic can inform practice recommendations and can be viewed as an opportunity to permanently modify existing methods to support breastfeeding families. The use of virtual care increased during the pandemic and should continue with specific considerations for prioritizing in-person care. This will help to provide more timely and accessible support for breastfeeding mothers.
Radiological changes in shoulder osteoarthritis and pain sensation correlate with patients’ age
Authors: Märtens Nicole , März Vincent , Bertrand Jessica , Lohmann Christoph H. , Berth Alexander
Published: May 2022

Purpose

Osteoarthritis (OA) is one of the most common musculoskeletal disorders in the aging population. The correlation of radiographic OA severity, disability and pain is variable and inconsistent for the different joints. This study aims to elucidate the relationship between histological and radiological signs of shoulder OA with pain sensation and functional impairment to potentially adapt the recommendation for surgical treatment for primary total shoulder arthroplasty (TSA).

Methods

Forty-four patients with shoulder OA undergoing TSA using an anatomic stemless implant were included in this study. The radiological OA severity was scored pre-operatively on true ap X-rays according to the Kellgren–Lawrence score (KL-Score). Acromial types according to Bigliani were defined by pre-operative radiological images. The histological OA severity was determined according to the OARSI-Score using bone–cartilage sections from loaded areas of the humeral head. Pain was quantified using the visual analog scale (VAS). The functional status was assessed by the items “mobility” and “strength” out of the Constant–Murley score (CS Score). Demographic data including BMI, age, gender, diabetes mellitus and smoking were recorded.

Results

There was no correlation between radiographic and histological severity in shoulder OA. However, a correlation of age and the severity of radiological changes was observed. Further, pain did not correlate with histological or radiological scores, whereas it correlated with age and the presence of diabetes mellitus. The functional shoulder status (mobility, strength) correlated with the severity of radiological changes, but not with the histologic scoring, which correlated with nicotine abuse.

Conclusion

This study shows that increased age is the main determinant of radiological changes in shoulder OA, as well as pain. Therefore, age and pain sensation should be considered as important parameters for the recommendation for TSA.
Does minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) influence functional outcomes and spinopelvic parameters in isthmic spondylolisthesis?
Authors: Ali Elsayed Mohamed Selim , El-Hewala Tarek Abdelsamad , Eladawy Amr Mohamed , Sheta Reda Ali
Published: May 2022

Purpose

We assessed the efficacy of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in patients with low-grade isthmic spondylolisthesis.

Methods

We included 24 symptomatic patients who underwent MIS-TLIF between December 2017 and December 2020. Patients were followed up clinically by the Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS) for back and VAS for leg pain, as well as radiological radiographs after 6 weeks, 6 months, and at final follow-up (at least 12 months). Measured parameters included C7 sagittal vertical axis (SVA), pelvic tilt (PT), pelvic incidence (PI), sacral slope (SS), Meyerding slip grades, lumbar lordosis (LL), L1–L4 angle, L4–S1 angle, and segmental lordosis (SL) of the affected segment. The mismatch between the PI and LL was also measured.

Results

VAS for back, VAS for leg pain, and ODI significantly improved postoperatively (all p < 0.001). We observed significantly decreased mean values of PT and slip percentage and increased mean values of SS and LL (all p < 0.05). We observed a significant reduction in L1–L4 lordosis and a significant increase in L4–S1 lordosis. The final PT, SS, and LL (total and L1–L4) were significantly higher in group III patients (n = 15) than the values of group II patients (n = 9). None of the patients became unbalanced postoperative, and all patients had a normal matching between the PI and the LL postoperatively.

Conclusions

MIS-TLIF is a safe procedure for managing low-grade isthmic spondylolisthesis with significant improvement in clinical and radiological outcomes. It can correct and maintain a proper spinopelvic alignment.
Medialization of trochlear groove was correlated with extended lateral trochlear in trochlear dysplasia: a transverse CT analysis
Authors: Dong Conglei , Zhao Chao , Kong Lingce , Piao Kang , Hao Kuo , Wang Fei
Published: May 2022

Purpose

To investigate the difference of trochlear width between normal and dysplastic trochlear and to analyze whether the medialization of trochlear groove was correlated with abnormal width of trochlear facets in trochlear dysplasia.

Methods

This study involved CT scans of fifty knees with trochlear dysplasia (TD group) and fifty knees without obvious trochlear dysplasia (Normal group). The linear distance from the medial femoral epicondyle to the various reference points was measured on axial CT images which included the medial edge of medial trochlear facet (dMTE), trochlear groove (dTG), and the lateral edge of lateral trochlear facets (dLTE). The medial and lateral trochlear width was calculated and standardized by the width of the anatomical epicondylar axis. Pearson’s correlation analysis was performed between the dTG and the width of the medial and lateral trochlear.

Results

The reliability of the results was good. Intraclass correlation coefficient (ICC) ranged from 0.89 to 0.97. The dMTE was significantly greater in the TD group than the normal group (32.7 ± 5.1% vs. 29.6 ± 3.5%, p = 0.009). There was no significant difference in the dLTE between groups. The dTG was reduced in the TD group compared with the normal group (45.2 ± 4.1% vs. 49.1 ± 3.9%, p = 0.019). In the TD group, there was a significant reduction in the medial trochlear width (13.9 ± 4.1% vs. 19.4 ± 2.9%, p < 0.001) and a significant increase in the lateral trochlear width (31.3 ± 4.0% vs. 26.9 ± 3.6%, p < 0.001) compared with the normal group. The dTG was significantly correlated with the lateral trochlear width (r value = − 0.693, p < 0.001) and not correlated with the medial trochlear width (r value = 0.044, p = 0.766) in trochlear dysplasia.

Conclusions

This study demonstrated that dysplasia of trochlear morphology was related to the reduction of medial trochlear width and increase in lateral trochlear width. The medialization of trochlear groove was significantly correlated with the increased lateral trochlear width.
Cytotoxicity of tranexamic acid to tendon and bone in vitro: Is there a safe dosage?
Authors: Bolam Scott M. , O’Regan-Brown Arama , Konar Subhajit , Callon Karen E. , Coleman Brendan , Dalbeth Nicola , Monk A. Paul , Musson David S. , Cornish Jillian , Munro Jacob T.
Published: May 2022

Introduction

Tranexamic acid (TXA) has been shown to be effective at reducing peri-operative blood loss and haemarthrosis in arthroplasty and arthroscopic soft tissue reconstructions. Intra-articular application, as an injection or peri-articular wash, is becoming increasingly common. Recent studies have shown TXA has the potential to be cytotoxic to cartilage, but its effects on human tendon and bone remain poorly understood. The aim of this study was to investigate whether TXA has any detrimental effects on tendon-derived cells and osteoblast-like cells and determine whether there is a safe dosage for clinical application.

Materials and methods

Primary tendon-derived cells and osteoblast-like cells were harvested from hamstring tendons and trabecular bone explants, respectively, and analysed in vitro with a range of TXA concentrations (0 to 100 mg/ml) at time points: 3 and 24 h. The in vitro toxic effect of TXA was investigated using viability assays (alamarBlue), functional assays (collagen deposition), fluorescent microscopy and live/apoptosis/necrosis staining for cell death mechanisms in 2D monolayer and 3D collagen gel cell culture.

Results

There was a significant (P < 0.05) decrease in tendon-derived cell and osteoblast-like cell numbers following treatment with TXA ≥ 50 mg/ml after 3 h and ≥ 20 mg/ml after 24 h. In tendon-derived cells, increasing concentrations > 35 mg/ml resulted in significantly (P < 0.05) reduced collagen deposition. Fluorescence imaging confirmed atypical cellular morphologies with increasing TXA concentrations and reduced cell numbers. The mechanism of cell death was demonstrated to be occurring through apoptosis.

Conclusions

Topical TXA treatment demonstrated dose- and time-dependent cytotoxicity to tendon-derived cells and osteoblast-like cells with concentrations 20 mg/ml and above in isolated 2D and 3D in vitro culture. On the basis of these findings, concentrations of less than 20 mg/ml are expected to be safe. Orthopaedic surgeons should show caution when considering topical TXA treatments, particularly in soft tissue and un-cemented arthroplasty procedures.
Virchow node of an unusual aetiology – the experience of a clinical case
Authors: Borges-Canha Marta , Sérgio-Neves João , Albuquerque Inês , Pacheco João , Silva Maria Manuel , Oliveira Ana Isabel , Carvalho Davide
Published: May 2022

Background

The cause of adult adenomegalies may be defiant. On the other hand, ectopic thyroid is a rare condition that happens in every 1:100000 to 300,000 of healthy individuals. Here, we present a case report that joins these two clinical rare and defiant challenges.

Clinical case

Forty-seven-year-old woman, with known thyroid nodules for several years. She had no other relevant personal or familiar history. At our appointment she had no complaints. At the physical examination she had a palpable right thyroid nodule (previously known). The routine blood analysis showed normal thyroid function. The routine cervical ultrasonography showed no dimensional progression of the known thyroid nodules and identified a 31x18mm nodule at the left supraclavicular fossa. The patient underwent a cervical, thoracic, and abdominal computed tomography that exhibited no relevant findings, such as abdominal malignancies. The cytology of the nodule showed characteristics that were “compatible with a benign follicular nodule in ectopic thyroid tissue”.

Conclusion

This is a rare case in which we incidentally found a follicular nodule in ectopic thyroid tissue in the left supraclavicular fossa. Given the rarity of the situation, clinical sense is the mainstay of treatment and follow-up.
Strongyloides stercoralis infection in dogs in Austria: two case reports
Authors: Unterköfler Maria Sophia , Eipeldauer Iris , Merz Sophie , Pantchev Nikola , Hermann Josef , Brunthaler René , Basso Walter , Hinney Barbara
Published: May 2022

Background

Strongyloides stercoralis is endemic in tropical and subtropical regions, but reports of infections in central and northern Europe have been recently increasing. Infections occur mainly in humans and dogs. In dogs, both dog-adapted and zoonotic S. stercoralis genotypes seem to occur. Clinical manifestations mainly include gastrointestinal and respiratory signs. The severity of the disease can vary greatly and depends on the immune status of the host. The infection is potentially fatal in immunosuppressed individuals, either medically induced or due to an underlying disease, in which hyperinfections and disseminated infections with extraintestinal parasite dissemination may occur.

Methods

Diagnosis was based on coproscopy, including flotation and the Baermann funnel technique, histology of small intestinal biopsies and molecular analysis of mitochondrial cytochrome oxidase subunit I (COI) and hypervariable regions I and IV (HVR I and HVR IV) of the nuclear 18S rDNA loci.

Results

Two independent cases of severe canine S.stercoralis infection in Austria are presented. In both cases, S. stercoralis was detected in histological sections of the small intestine and with the Baermann funnel technique. Molecular analysis revealed strains with zoonotic potential. Case 1 was a 1-year-old female French bulldog with a long history of respiratory and gastrointestinal signs, severe emaciation and apathy before S.stercoralis infection was diagnosed. Treatment with moxidectin (2.5 mg/kg body weight [BW], oral route) did not eliminate the infection, but treatment with ivermectin (0.2 mg/kg BW, subcutaneously) was successful. Case 2 consisted of two 2-month-old Pomeranian puppies, one female and one male, from a litter of four, which died soon after presenting dyspnoea and haemorrhagic diarrhoea (female) or torticollis (male); S.stercoralis infection was first diagnosed post-mortem.

Conclusion

More attention should be paid to this nematode because although it appears to be rare in Austria, it is easily overlooked on standard coproscopy unless a Baermann funnel technique is used, and even then, it can be missed. Moxidectin is not always successful in eliminating the infection, and treatment with ivermectin should be considered in cases of infection.

Graphical Abstract
Resident perception on the impact of point-of-care ultrasound in clinical care at a family medicine training program in Zambia
Authors: Haldeman Matthew S. , Kunka Evaristo , Makasa Mpundu , Birkland Bassim
Published: May 2022

Background

Patient access to necessary medical imaging in low- and middle-income countries (LMICs) remains a major obstacle, complicating clinician decision-making and compromising patient outcomes.

Methods

We implemented a longitudinal point-of-care ultrasound (POCUS) training program at a new Family Medicine residency in Zambia and subsequently evaluated residents’ perceptions on the impact of POCUS in patient care. Data were documented by the scanning resident via a post-scan survey, which assessed if/how the scan assisted in medical management, and if/how the scan changed that management. The primary endpoint was frequency of scans assisting and changing management. Data were summarized using descriptive statistics.

Results

Over the 1-year study period, 366 patient encounters occurred in which POCUS was utilized, resulting in a total of 542 unique POCUS scans. POCUS assisted in decision-making in 95.6% (350/366) of patient encounters, most commonly by helping to determine a diagnosis. POCUS changed management in 65.8% (235/357) of patient encounters, most commonly leading to a medication change.

Conclusions

Zambian resident physicians perceived POCUS to be very helpful in their clinical decision-making. These data support the need to advance POCUS education at the residency level throughout LMICs, which may be an ideal strategy to promote widespread utilization of POCUS in low-resource settings globally.
LncRNA MCM3AP-AS1 is downregulated in diabetic retinopathy and promotes cell apoptosis by regulating miR-211/SIRT1
Authors: Xia Zhaoxia , Yang Chaoying , Yang Xiaoxi , Wu Shuduan , Feng Zhizhen , Qu Lei , Chen Xianghua , Liu Linyu , Ma Yanling
Published: May 2022

Aim

This study aimed to investigate the role of lncRNA MCM3AP-AS1 in diabetic retinopathy (DR).

Methods

Plasma MCM3AP-AS1 levels in DR patients (n = 80), T2DM patients (n = 80), and Controls (n = 80) were measured by qPCR and compared using ANOVA (one-way) and Tukey test. The expressions of lncRNA MCM3AP-AS1 and miR-211 in Human retinal pigment epithelial cells (hRPE) line ARPE-19 were detected by RT-qPCR. Western blot and annexin V-FITC staining were performed to investigate the role of MCM3AP-AS1/SIRT1 in ARPE-19 cell proliferation and apoptosis in vitro.

Results

We observed that MCM3AP-AS1 was downregulated in DR patients 25 comparing to T2D patients without significantly complications. Bioinformatics analysis showed that MCM3AP-AS1 might bind miR-211. However, no significant correlation between these two factors was observed in DR patients. Consistently, overexpression of MCM3AP-AS1 and miR-211 failed to affect the expression of each other in hRPE. Interestingly, MCM3AP-AS1 overexpression upregulated SIRT1, a target of miR-211. Moreover, MCM3AP-AS1 was downregulated in DR patients compared to type 2 diabetic mellitus patients without significant complications. In RPEs, high glucose treatment downregulated MCM3AP-AS1. Cell apoptosis analysis showed that MCM3AP-AS1 and SIRT1 overexpression decreased the apoptotic rate of RPEs, and miR-211 overexpression reduced the effect of MCM3AP-AS1 and SIRT1 overexpression.

Conclusion

MCM3AP-AS1 is downregulated in DR and promotes cell apoptosis by regulating miR-211/SIRT1.
Mitral regurgitation quantified by CMR 4D-flow is associated with microvascular obstruction post reperfused ST-segment elevation myocardial infarction
Authors: Assadi Hosamadin , Grafton-Clarke Ciaran , Demirkiran Ahmet , van der Geest Rob J. , Nijveldt Robin , Flather Marcus , Swift Andrew J. , Vassiliou Vass S. , Swoboda Peter P. , Dastidar Amardeep , Greenwood John P. , Plein Sven , Garg Pankaj
Published: May 2022

Objectives

Mitral regurgitation (MR) and microvascular obstruction (MVO) are common complications of myocardial infarction (MI). This study aimed to investigate the association between MR in ST-elevation MI (STEMI) subjects with MVO post-reperfusion. STEMI subjects undergoing primary percutaneous intervention were enrolled. Cardiovascular magnetic resonance (CMR) imaging was performed within 48-hours of initial presentation. 4D flow images of CMR were analysed using a retrospective valve tracking technique to quantify MR volume, and late gadolinium enhancement images of CMR to assess MVO.

Results

Among 69 patients in the study cohort, 41 had MVO (59%). Patients with MVO had lower left ventricular (LV) ejection fraction (EF) (42 ± 10% vs. 52 ± 8%, P < 0.01), higher end-systolic volume (98 ± 49 ml vs. 73 ± 28 ml, P < 0.001) and larger scar volume (26 ± 19% vs. 11 ± 9%, P < 0.001). Extent of MVO was associated with the degree of MR quantified by 4D flow (R = 0.54, P = 0.0003). In uni-variate regression analysis, investigating the association of CMR variables to the degree of acute MR, only the extent of MVO was associated (coefficient = 0.27, P = 0.001). The area under the curve for the presence of MVO was 0.66 (P = 0.01) for MR > 2.5 ml. We conclude that in patients with reperfused STEMI, the degree of acute MR is associated with the degree of MVO.
Improving research integrity: a framework for responsible science communication
Authors: Ciubotariu Ilinca I. , Bosch Gundula
Published: May 2022

Research integrity, an essential precept of scientific inquiry and discovery, comprises norms such as Rigor, Reproducibility, and Responsibility (the 3R’s). Over the past decades, numerous issues have arisen that challenge the reliability of scientific studies, including irreproducibility crises, lack of good scientific principles, and erroneous communications, which have impacted the public’s trust in science and its findings. Here, we highlight one important component of research integrity that is often overlooked in the discussion of proposals for improving research quality and promoting robust research; one that spans from the lab bench to the dissemination of scientific work: responsible science communication. We briefly outline the role of education and institutions of higher education in teaching the tenets of good scientific practice and within that, the importance of adequate communications training. In that context, we present our framework of responsible science communication that we live by and teach to our students in courses and workshops that are part of the Johns Hopkins Bloomberg School of Public Health R3 Center for Innovation in Science Education.
The kyphosis–lordosis difference parameter and its utility in understanding the pathogenesis of adolescent idiopathic scoliosis
Authors: Gardner Adrian , Berryman Fiona , Pynsent Paul
Published: May 2022

Objective

The relationship of sagittal spinal shape in the pathogenesis of adolescent idiopathic scoliosis (AIS) is recognised. What is not clear is the relationship between the sagittal shape of those without scoliosis and the potential development of AIS, including the greater prevalence in females. The use of a new parameter, the kyphosis–lordosis (KL) difference, was developed to explore this further.

Results

The KL difference was calculated for 117 males and 79 females over seven years with 831 measures made. For females, the KL difference, between the ages of 9 and 12 ½ years, decreases from 5° to nearly 0° until starting to climb again from the age of 14 years, back to 5° by the age of 16 ½ years. For males, there is a gradual decline from 9° at age 9 years to 5° at age 17 years. Both age and sex were statistically significant in the development of the parameter. When comparing to previously published data around the true, de-rotated, sagittal shape of the scoliotic spine, the KL difference has utility in explaining the female predominance in the prevalence of AIS. This adds to the weight of evidence behind understanding why AIS develops.
A feasible and reliable self-administered parental assessment of children’s lifestyle (SAPLACL): an ancillary study based on the VIF program
Authors: Vanhelst Jérémy , Deken Valérie , Boulic Gaëlle , Duhamel Alain , Romon Monique
Published: May 2022

Objectives

In children, achieving an acceptable degree of accuracy from dietary or physical activity (PA) assessments remains a challenge. Children tend to overestimate their time spent in daily PA and underestimate their dietary intake of fat and sugar. Because parents play a key role in family lifestyle decisions, including children’s food choices and PA levels, it is important to investigate the responses of parents regarding their children’s lifestyle habits. We aimed to develop a Self-Administered Parental Assessment of Children’s Lifestyle (SAPLACL) questionnaire and test its feasibility and reliability in 191 parents (29 fathers and 162 mothers).

Results

For each part of the questionnaire, the rate of missing or improper responses ranged from 0 to 24%. The highest proportion of problems in understanding was reported for the dietary intake dimension, especially for snacking in front of the TV. Some difficulty was also found regarding the question on leisure PA. Test–retest agreement was observed in 54.7–100% of the respondents. Overall, the kappa coefficients were favorable. Thus, the parent self-report questionnaire is a valid and accurate tool for analyzing children’s lifestyle habits in France.
Children’s social evaluation toward prestige-based and dominance-based powerholders
Authors: Amakusa Masahiro , Meng Xianwei , Kanakogi Yasuhiro
Published: May 2022

Objective

Social scientists have suggested two typical ways of acquiring social power: dominance approach (gaining social power by applying violence, coercion, threat, and punishment) and prestige approach (gaining admiration and liking by demonstrating competence and sharing experience and knowledge). However, little is known about how people recognize and evaluate the differentiated process of the approaches, and even less about the early development of these processes. In the current study, 5–6-year old children heard stories about pairs comprising a dominance-based and a prestige-based powerholder, chose one of the powerholders as their friend and leader, and predicted which powerholder will gain the contested resources.

Results

Compared to a dominance-based powerholder, children were more likely to choose a prestige-based powerholder as a friend and leader in different situations. Moreover, children predicted that prestige-based powerholders, and not dominance-based powerholders, would gain contested resources. These findings suggest that since childhood, human beings tend to be biased to not only judge prestige-based aspects as socially preferable, but also endorse the prestige-based powerholders’ priority to possess valuable resources, which subsequently strengthens their high social status. These early childhood preferences can be instrumental in providing more harmonious environments for children in educational and daily contexts.
Streamline-based three-dimensional peak-velocity tracing of transvalvular flow using four-dimensional flow cardiac magnetic resonance imaging for left ventricular diastolic assessment in aortic regurgitation: a case report
Authors: Njoku Paul , Wardley James , Garg Pankaj
Published: May 2022

Background

Doppler transthoracic echocardiography is routinely performed to measure peak mitral inflow velocities in the assessment of left ventricular diastolic function. The limitations of echocardiography are well documented, but its accuracy in the measurement of transmitral peak velocity in the presence of aortic valve regurgitation has not yet been compared with four-dimensional flow cardiac magnetic resonance imaging. Four-dimensional flow cardiac magnetic resonance imaging offers time-resolved cross-sectional velocity information that can be used to investigate mitral inflow peak velocity. We present a case report demonstrating the potential superior capabilities of four-dimensional flow cardiac magnetic resonance imaging in accurately detecting mitral inflow velocities over Doppler echocardiography in patients with aortic regurgitation.

Case presentation

A 67-year-old Caucasian female presented to our outpatient cardiology clinic with exertional dyspnea. Doppler transthoracic echocardiography identified moderate to severe aortic regurgitation. Mapping of mitral inflow peak velocities proved challenging with Doppler echocardiography. Additionally, four-dimensional flow cardiac magnetic resonance imaging with automated three-dimensional flow streamlines was performed, which allowed for more accurate detection of mitral inflow peak velocities.

Conclusions

Doppler echocardiography has a limited role in mitral inflow assessment where aortic regurgitation is present. In such cases, four-dimensional flow cardiac magnetic resonance imaging is an alternative imaging technique that may circumvent this issue and allow mitral inflow assessment.
Treatment of MDA5-positive dermatomyositis complicated by gangrenous cholecystitis with tofacitinib
Authors: Luo Man , Chen Long , He Huan , He Fang
Published: May 2022

Background

Dermatomyositis is a rare idiopathic inflammatory disease with diverse presentations that can have varying degrees of cutaneous and systemic involvement. This phenotypic heterogeneity makes DM a therapeutic challenge. Some therapeutic drugs, such as hormones and immunosuppressants, have poor therapeutic effects. In recent years, tofacitinib has been reported to be effective in the treatment of dermatomyositis.

Case presentation

We report a case of anti-MDA5 antibody-positive dermatomyositis that was relieved after treatment with tofacitinib, during which gallbladder gangrene and suppurative cholecystitis occurred. After cholecystectomy, we continued to use tofacitinib and achieved a good therapeutic effect.

Conclusions

Tofacitinib is effective in the treatment of anti-MDA5 antibody-positive dermatomyositis, but the risk of infection is increased. It can still be used after infection control. Close follow-up should be performed during the use of tofacitinib.
Clinical significance of NF2 alteration in grade I meningiomas revisited; prognostic impact integrated with extent of resection, tumour location, and Ki-67 index
Authors: Teranishi Yu , Okano Atsushi , Miyawaki Satoru , Ohara Kenta , Ishigami Daiichiro , Hongo Hiroki , Dofuku Shogo , Takami Hirokazu , Mitsui Jun , Ikemura Masako , Komura Daisuke , Katoh Hiroto , Ushiku Tetsuo , Ishikawa Shumpei , Shin Masahiro , Nakatomi Hirofumi , Saito Nobuhito
Published: May 2022

NF2 alteration is the most commonly–found genetic abnormality in meningiomas and is known to initiate events for aggressive-type meningiomas. Whereas the prognosis of meningiomas differs depending on their epigenomic/transcriptomic profile, the effect of NF2 alteration on the prognosis of benign meningiomas is not fully elucidated. This study aimed to probe the importance of NF2 alteration in prognosis of WHO grade I meningiomas. A long-term retrospective follow-up (5.3 ± 4.5 years) study involving 281 consecutive WHO grade I meningioma patients was performed. We assessed tumour recurrence in correlation with extent of resection (EOR), histopathological findings, tumour location, and NF2 alteration. “NF2 meningioma” was defined as meningiomas with presence of NF2 mutation and/or 22q loss. Overall, NF2 meningioma per se was not a predictor of prognosis in the whole cohort; however, it was a predictor of recurrence in supratentorial meningiomas, together with EOR and Ki-67. In a striking contrast, NF2 meningioma showed a better prognosis than non-NF2 meningioma in infratentorial lesion. Supratentorial NF2 meningiomas had higher Ki-67 and forkhead box protein M1 expression than those of others, possibly explaining the worse prognosis in this subtype. The combination of NF2 alteration, high Ki-67 and supratentorial location defines subgroup with the worst prognosis among WHO grade I meningiomas. Clinical connotation of NF2 alteration in terms of prognosis of WHO grade I meningioma differs in an opposite way between supratentorial and infratentorial tumors. Integrated anatomical, histopathological, and genomic classifications will provide the best follow-up schedule and proactive measures.
Prevalence of non-carious cervical lesions and orthodontic treatment: a retrospective study
Authors: Gomes Rafaella Rodrigues , Zeola Livia Fávaro , Barbosa Tiago Augusto Quirino , Fernandes Neto Alfredo Júlio , de Araujo Almeida Guilherme , Soares Paulo Vinícius
Published: May 2022

Background

This study aimed to assess the distribution of non-carious cervical lesions (NCCLs) by tooth type, investigate the prevalence of NCCLs in patients undergoing orthodontic treatment, and identify the possible associated factors.

Material and methods

A total of 160 patients were enrolled in this retrospective study. Data on the following variables were collected from pre-and post-orthodontic treatment records: age, sex, Angle’s malocclusion, facial pattern, number of activation sessions, compensatory treatment, and retreatment. Frontal, right and left lateral intraoral photographs of each patient were evaluated to identify the presence or absence of NCCLs in each tooth and assess the distribution of NCCLs in the 3840 teeth from the enrolled patients. Furthermore, patients were classified as NCCLs present, irrespective of the number of NCCLs on the teeth or NCCL absent. Bivariate and multivariate Poisson regression analyses with robust variance were used to assess the association between the NCCLs and each independent variable. Prevalence ratio and 95% confidence intervals were calculated and p < 0.05 was considered statistically significant.

Results

The prevalence of NCCLs before and after orthodontic treatment was 22.71% and 30.91%, respectively. Premolars were the most affected teeth, followed by the first molars, canines, and incisors. After statistical analysis, age was found to be the variable factor that influenced the prevalence ratio, with NCCL being the most prevalent when orthodontic treatment was performed in adulthood.

Conclusions

Premolars were most commonly affected by NCCLs. Furthermore, age seemed to contribute to the increased prevalence of NCCLs in adults undergoing orthodontic treatment.
Big social data as a service (BSDaaS): a service composition framework for social media analysis
Authors: Ali Kashif , Hamilton Margaret , Thevathayan Charles , Zhang Xiuzhen
Published: May 2022

Social media provides an infrastructure where users can share their data at an unprecedented speed without worrying about storage and processing. Social media data has grown exponentially and now there is major interest in extracting any useful information from the social media data to apply in various domains. Currently, there are various tools available to analyze the large amounts of social media data. However, these tools do not consider the diversity of the social media data, and treat social media as a uniform data source with similar features. Thus, these tools lack the flexibility to dynamically process and analyze the social media data according to its diverse features. In this paper, we develop a ‘Big Social Data as a Service’ (BSDaaS) composition framework that extracts the data from various social media platforms, and transforms it into useful information. The framework provides a quality model to capture the dynamic features of social media data. In addition, our framework dynamically assesses the quality features of the social media data and composes appropriate services required for various information analyses. We present a social media based sentiment analysis system as a motivating scenario and conduct experiments using real-world datasets to show the efficiency of our approach.
Clinical impact of preoperative diaphragm dysfunction on early outcomes and ventilation function in lung transplant: a single-center retrospective study
Authors: Huh Sungchul , Cho Woo Hyun , Kim Dohyung , Son Bong Soo , Yeo Hye Ju
Published: May 2022

Background

Clinical impact of preoperative diaphragm dysfunction on lung transplantation has not been studied. We aimed to evaluate how preoperative diaphragm dysfunction affects clinical outcomes and ventilation function after transplantation.

Methods

We retrospectively enrolled 102 patients. Ultrasound for diagnosis of diaphragm dysfunction was performed on all patients both before and after lung transplantation. The primary outcome was to compare prolonged mechanical ventilation after transplantation according to the preoperative diaphragm dysfunction. Secondary outcomes compared global inhomogeneity index and lung volume after transplantation. Multivariate regression analysis were used to evaluate the association between preoperative diaphragm dysfunction and prolonged mechanical ventilation after transplantation.

Results

A total of 33 patients (32.4%) had preoperative diaphragm dysfunction, and half of them (n = 18) recovered their diaphragm function after transplantation. In contrast, 15 patients (45.5%) showed postoperative diaphragm dysfunction. The ratio of prolonged mechanical ventilation after transplantation was significantly higher in the preoperative diaphragm dysfunction group (p = 0.035). The postoperative durations of mechanical ventilation, intensive care unit and hospital stays were higher in the preoperative diaphragm dysfunction group, respectively (p < 0.05). In the multivariate regression analysis, preoperative diaphragm dysfunction was significantly associated with prolonged mechanical ventilation after transplantation (Odds ratio 2.79, 95% confidence interval 1.07–7.32, p = 0.037). As well, the preoperative diaphragm dysfunction group showed more inhomogeneous ventilation (p < 0.05) and lower total lung volume (p < 0.05) after transplantation. In addition, at 1 month and 3 months after transplantation, FVC was significantly lower in the preoperative diaphragm dysfunction group (p < 0.05).

Conclusions

Preoperative diaphragm dysfunction was associated with prolonged mechanical ventilation after lung transplantation.
Arsenic through aquatic trophic levels: effects, transformations and biomagnification—a concise review
Authors: Ghosh Devanita , Ghosh Anwesha , Bhadury Punyasloke
Published: May 2022

Arsenic (As) contamination is a major global environmental concern with widespread effects on health of living organisms including humans. In this review, the occurrence (sources and forms) of As representing diverse aquatic habitats ranging from groundwater to marine environment has been detailed. We have provided a mechanistic synopsis on direct or indirect effects of As on different organismal groups spanning from bacteria, algae, phytoplankton, zooplankton and higher trophic levels based on a review of large number of available literature. In particular, special emphasis has been laid on finfishes and shellfishes which are routinely consumed by humans. As part of this review, we have also provided an overview of the broadly used methods that have been employed to detect As across ecosystems and organismal groups. We also report that the use of As metabolites as an index for tracking Astot exposure in humans require more global attention. Besides, in this review we have also highlighted the need to integrate ‘omics’ based approaches, integration of third and fourth generation sequencing technologies for effective pan-geographical monitoring of human gut microbiome so as to understand effects and resulting consequences of As bioaccumulation.