bluuebunny/crossref_metadata_2025 huggingface dataset:
Parental understanding of crucial medical jargon used in prenatal prematurity counseling
Authors: Rau Nicole M. , Basir Mir A. , Flynn Kathryn E.
Published: July 2020

Background

Parent-clinician shared decision making is the recommended model for the care of premature infants; thus, clinicians provide prenatal prematurity counseling to parents in the event of a mother’s hospitalization for premature birth. However, parental understanding of medical jargon commonly used during prematurity counseling is unknown.

Methods

Within an overall research agenda to develop and test an educational aid for prenatal prematurity education, we designed the Parental Knowledge of Premature Birth questionnaire. To evaluate parental comprehension of the medical jargon contained within the questionnaire, we conducted cognitive interviews, a formal method for evaluating comprehension and response to questionnaire items. Parents were recruited from a Level IV Neonatal Intensive Care Unit; purposeful recruitment ensured diversity with respect to gender, race, literacy level, and child’s gestational age. Data collection and analysis followed standard qualitative methods for cognitive interviewing. We report on the insights gained from these cognitive interviews regarding parental understanding of crucial medical jargon commonly used during prenatal prematurity counseling.

Results

Participants included 10 women and 6 men who ranged in age from 23 to 38 years and represented Black/African-American (38%), Asian (6%), and white (56%) backgrounds. Five participants (31%) had less than a high school education or reading level below 9th grade (Wide Range Achievement Test version 4 reading subtest). In the first round of interviews, parents of all education and literacy levels had difficulty with medical jargon commonly used in prematurity counseling. Terms that parents found difficult to understand included “gestational age”, “mild or no developmental problems”, and “neonatologist”. Modified terms tested in a second round of interviews showed improved comprehension.

Conclusion

Cognitive interviews provided empirical testing of parental understanding of crucial medical jargon and highlighted that language commonly used during prenatal prematurity counseling is not understood by many parents. For parents to participate in shared decision making, plain language should be used to maximize their understanding of medical information.
Role of MMP-9 in epithelial-mesenchymal transition of thyroid cancer
Authors: Li Yuanchun , He Jing , Wang Feng , Wang Xin , Yang Fan , Zhao Chunyang , Feng Chunling , Li Tiejun
Published: July 2020

Background

The purpose of this study is to explore the role and mechanism of MMP-9 in the EMT process of thyroid cancer (TC), so as to provide a basis for clinical exploration of invasion and metastasis process of TC, looking for biological markers of tumor metastasis and molecular intervention therapy.

Methods

Western blot and RT-PCR were employed to detect the expression of MMP-9 in human normal thyroid cell line HT-ori3 and human TC cell lines IHH-4 (PTC), FTC-133, and 8505C. Expression levels of EMT-related markers: epithelial cell marker E-cadherin and stromal cell marker Vimentin in TGF-1-induced TC cell lines were detected by Western blot and RT-PCR, respectively. The effects of MMP-9 downregulation on cell invasion and metastasis were investigated by wound-healing assay and cell invasion experiment.

Results

The protein and mRNA expression levels of MMP-9 in TC cell lines were increased compared with the human normal thyroid cell line HT-ori3. When TGF-β1 was added, the expression of EMT and Vimentin increased while the expression of E-cadherin decreased. Compared with the control group, the TC cells stably transfected with MMP-9 shRNA showed inhibited EMT, decreased Vimentin expression, and increased E-cadherin expression. The induction of TGF-β1 did not promote the occurrence of EMT in TC cells which were stably transformed with MMP-9 shRNA. The addition of TGF-β1 to TC cells increased the ability of the cells to migrate and invade. Compared with the control group, the migration and invasion ability of TC cells stably transfected with MMP-9 shRNA was significantly reduced, and the induction of TGF-β1 could not restore the migration and invasion ability of cells without MMP-9.

Conclusions

In conclusion, we found that MMP-9 can be used as a biomarker for TC, which can promote the EMT process of TGF-β1 induced TC, and thus affecting the cell migration and invasion ability.
Blue toe syndrome caused by emboli from anomalous left atrial septal pouch thrombus: a case report
Authors: Pradhan Snehasis , Gresa Kciku , Röing genannt Nölke Jan-Peter , Trappe Hans-Joachim
Published: July 2020

Background

Left atrial septal pouches (LASPs) are a relatively newly described but common anatomical cardiac variant thought to be associated with atrial fibrillation (AF) and cardio-embolic stroke. Blue toe syndrome (BTS) describes ischemic changes in the toes due to microembolisation of the digital arteries. Establishing the etiology of BTS is vital so that the underlying cause can be treated. Here we describe the first case of BTS arising due to emboli from LASP thrombus arising on a background of new-onset AF.

Case presentation

A 65-year-old man presented with a two-day history of progressive painful swelling and bluish-purple discoloration of the second and fourth toes of his left foot and new-onset AF. Tests for hypercoagulability disorders were negative. Duplex ultrasound and CT angiography excluded deep venous thrombosis and an absence of embolus, thrombus, or occlusion in the arterial tree in the lower extremities bilaterally, so BTS was diagnosed. While transthoracic echocardiography and chest CT initially showed no cardiac abnormalities or mural thrombus, subsequent transesophageal echocardiography revealed a LASP with an associated pedunculated thrombus. The affected toes were amputated due to wet gangrene, but the patient recovered well with thrombus resolution after anticoagulation.

Conclusion

The presence of a LASP in the absence of any other identifiable cause of BTS should trigger careful investigation of the interatrial septum, preferably using a multimodality imaging approach. The possibility that LASPs may not merely be an innocent bystander but a causative mechanism for peripheral ischemia must be considered.
Introduction of birth dose of hepatitis B virus vaccine to the immunization program in Ethiopia: an economic evaluation
Authors: Memirie Solomon Tessema , Desalegn Hailemichael , Naizgi Mulugeta , Nigus Mulat , Taddesse Lisanu , Tadesse Yared , Tessema Fasil , Zelalem Meseret , Girma Tsinuel
Published: July 2020

Background

Hepatitis B virus (HBV) infection is an important cause of morbidity and mortality with a very high burden in Africa. The risk of developing chronic infection is marked if the infection is acquired perinatally, which is largely preventable through a birth dose of HBV vaccine. We examined the cost-effectiveness of a birth dose of HBV vaccine in a medical setting in Ethiopia.

Methods

We constructed a decision analytic model with a Markov process to estimate the costs and effects of a birth dose of HBV vaccine (the intervention), compared with current practices in Ethiopia. Current practice is pentavalent vaccination (DPT-HiB-HepB) administered at 6, 10 and 14 weeks after birth. We used disability-adjusted life years (DALYs) averted to quantify the health benefits while the costs of the intervention were expressed in 2018 USD. Analyses were based on Ethiopian epidemiological, demographic and cost data when available; otherwise we used a thorough literature review, in particular for assigning transition probabilities.

Results

In Ethiopia, where the prevalence of HBV among pregnant women is 5%, adding a birth dose of HBV vaccine would present an incremental cost-effectiveness ratio (ICER) of USD 110 per DALY averted. The estimated ICER compares very favorably with a willingness-to-pay level of 0.31 times gross domestic product per capita (about USD 240 in 2018) in Ethiopia. Our ICER estimates were robust over a wide range of epidemiologic, vaccine effectiveness, vaccine coverage and cost parameter inputs.

Conclusions

Based on our cost-effectiveness findings, introducing a birth dose of HBV vaccine in Ethiopia would likely be highly cost-effective. Such evidence could help guide policymakers in considering including HBV vaccine into Ethiopia’s essential health services package.
Protocol: examining the effectiveness of an adaptive implementation intervention to improve uptake of the VA suicide risk identification strategy: a sequential multiple assignment randomized trial
Authors: Bahraini Nazanin H. , Matarazzo Bridget B. , Barry Catherine N. , Post Edward P. , Forster Jeri E. , Dollar Katherine M. , Dobscha Steven K. , Brenner Lisa A.
Published: July 2020

Background

In 2018, the Veterans Health Administration (VHA) mandated implementation of a national suicide risk identification strategy (Risk ID). The goal of Risk ID is to improve the detection and management of suicide risk by standardizing suicide risk screening and evaluation enterprise-wide. In order to ensure continuous quality improvement (QI), ongoing evaluation and targeted interventions to improve implementation of Risk ID are needed. Moreover, given that facilities will vary with respect to implementation needs and barriers, the dose and type of intervention needed may vary across facilities. Thus, the objective of this study is to examine the effectiveness of an adaptive implementation strategy to improve the uptake of suicide risk screening and evaluation in VHA ambulatory care settings. In addition, this study will examine specific factors that may impact the uptake of suicide risk screening and evaluation and the adoption of different implementation strategies. This protocol describes the stepped implementation approach and proposed evaluation plan.

Methods

Using a sequential multiple assignment randomized trial (SMART) design, two evidence-based implementation strategies will be evaluated: (1) audit and feedback (A&F); (2) A&F plus external facilitation (A&F + EF). Implementation outcomes of interest include uptake of secondary suicide risk screening and uptake of comprehensive suicide risk evaluation (stages 2 and 3 of Risk ID). Secondary outcomes include rates of other clinical outcomes (i.e., safety planning) and organizational factors that may impact Risk ID implementation (i.e., leadership climate and leadership support).

Discussion

This national QI study will use a SMART design to evaluate whether an adaptive implementation strategy is effective in improving uptake of a mandated VHA-wide suicide risk screening and evaluation initiative. If this study finds that the proposed stepped implementation strategy is effective at increasing uptake and maintaining performance improvements, this approach may be used as an overarching QI strategy for other national suicide prevention programs.

Trial registration

ClinicalTrials.gov NCT04243330. Registered 28 January 2020
Clinician-centric diagnosis of rare genetic diseases: performance of a gene pertinence metric in decision support for clinicians
Authors: Segal Michael M. , George Renee , Waltman Peter , El-Hattab Ayman W. , James Kiely N. , Stanley Valentina , Gleeson Joseph
Published: July 2020

Background

In diagnosis of rare genetic diseases we face a decision as to the degree to which the sequencing lab offers one or more diagnoses based on clinical input provided by the clinician, or the clinician reaches a diagnosis based on the complete set of variants provided by the lab. We tested a software approach to assist the clinician in making the diagnosis based on clinical findings and an annotated genomic variant table, using cases already solved using less automated processes.

Results

For the 81 cases studied (involving 216 individuals), 70 had genetic abnormalities with phenotypes previously described in the literature, and 11 were not described in the literature at the time of analysis (“discovery genes”). These included cases beyond a trio, including ones with different variants in the same gene. In 100% of cases the abnormality was recognized. Of the 70, the abnormality was ranked #1 in 94% of cases, with an average rank 1.1 for all cases. Large CNVs could be analyzed in an integrated analysis, performed in 24 of the cases. The process is rapid enough to allow for periodic reanalysis of unsolved cases.

Conclusions

A clinician-friendly environment for clinical correlation can be provided to clinicians who are best positioned to have the clinical information needed for this interpretation.
Infectious disease outbreaks among forcibly displaced persons: an analysis of ProMED reports 1996–2016
Authors: Desai Angel N. , Ramatowski John W. , Marano Nina , Madoff Lawrence C. , Lassmann Britta
Published: July 2020

Background

The United Nations Refugee Agency (UNHCR) estimates the number of forcibly displaced people increased from 22.7 million people in 1996 to 67.7 million people in 2016. Human mobility is associated with the introduction of infectious disease pathogens. The aim of this study was to describe the range of pathogens in forcibly displaced populations over time using an informal event monitoring system.

Methods

We conducted a retrospective analysis of ProMED, a digital disease monitoring system, to identify reports of outbreak events involving forcibly displaced populations between 1996 and 2016. Number of outbreak events per year was tabulated. Each record was assessed to determine outbreak location, pathogen, origin of persons implicated in the outbreak, and suspected versus confirmed case counts.

Results

One hundred twenty-eight independent outbreak events involving forcibly displaced populations were identified. Over 840,000 confirmed or suspected cases of infectious diseases such as measles, cholera, cutaneous leishmaniasis, dengue, and others were reported in 48 destination countries/territories. The average rate of outbreak events concerning forcibly displaced persons per total number of reports published on ProMED per year increased over time. The majority of outbreak events (63%) were due to acquisition of disease in the destination country.

Conclusion

This study found that reports of outbreak events involving forcibly displaced populations have increased in ProMED. The events and outbreaks detected in this retrospective review underscore the importance of capturing displaced populations in surveillance systems for rapid detection and response.
The origins and genomic diversity of American Civil War Era smallpox vaccine strains
Authors: Duggan Ana T. , Klunk Jennifer , Porter Ashleigh F. , Dhody Anna N. , Hicks Robert , Smith Geoffrey L. , Humphreys Margaret , McCollum Andrea M. , Davidson Whitni B. , Wilkins Kimberly , Li Yu , Burke Amanda , Polasky Hanna , Flanders Lowell , Poinar Debi , Raphenya Amogelang R. , Lau Tammy T. Y. , Alcock Brian , McArthur Andrew G. , Golding G. Brian , Holmes Edward C. , Poinar Hendrik N.
Published: July 2020

Vaccination has transformed public health, most notably including the eradication of smallpox. Despite its profound historical importance, little is known of the origins and diversity of the viruses used in smallpox vaccination. Prior to the twentieth century, the method, source and origin of smallpox vaccinations remained unstandardised and opaque. We reconstruct and analyse viral vaccine genomes associated with smallpox vaccination from historical artefacts. Significantly, we recover viral molecules through non-destructive sampling of historical materials lacking signs of biological residues. We use the authenticated ancient genomes to reveal the evolutionary relationships of smallpox vaccination viruses within the poxviruses as a whole.
Differential chromatin accessibility landscape reveals structural and functional features of the allopolyploid wheat chromosomes
Authors: Jordan Katherine W. , He Fei , de Soto Monica Fernandez , Akhunova Alina , Akhunov Eduard
Published: July 2020

Background

Our understanding of how the complexity of the wheat genome influences the distribution of chromatin states along the homoeologous chromosomes is limited. Using a differential nuclease sensitivity assay, we investigate the chromatin states of the coding and repetitive regions of the allopolyploid wheat genome.

Results

Although open chromatin is found to be significantly enriched around genes, the majority of MNase-sensitive regions are located within transposable elements (TEs). Chromatin of the smaller D genome is more accessible than that of the larger A and B genomes. Chromatin states of different TEs vary among families and are influenced by the TEs’ chromosomal position and proximity to genes. While the chromatin accessibility of genes is influenced by proximity to TEs, and not by their position on the chromosomes, we observe a negative chromatin accessibility gradient along the telomere-centromere axis in the intergenic regions, positively correlated with the distance between genes. Both gene expression levels and homoeologous gene expression bias are correlated with chromatin accessibility in promoter regions. The differential nuclease sensitivity assay accurately predicts previously detected centromere locations. SNPs located within more accessible chromatin explain a higher proportion of genetic variance for a number of agronomic traits than SNPs located within more closed chromatin.

Conclusions

Chromatin states in the wheat genome are shaped by the interplay of repetitive and gene-encoding regions that are predictive of the functional and structural organization of chromosomes, providing a powerful framework for detecting genomic features involved in gene regulation and prioritizing genomic variation to explain phenotypes.
Physiological evidence that three known mutations in the para-sodium channel gene confer cypermethrin knockdown resistance in Rhipicephalus microplus
Authors: Cossío-Bayúgar Raquel , Miranda-Miranda Estefan , Martínez-Ibañez Francisco , Narváez-Padilla Verónica , Reynaud Enrique
Published: July 2020

Background

Acaricide resistance is a central problem for the control of the cattle tick Rhipicephalus microplus. The physiological effects and phenotypes of the mutations that cause acaricide resistance are not always well understood or characterized. Single nucleotide polymorphisms (SNPs) that confer cypermethrin knockdown resistance (kdr) have been reported in R. microplus. These SNPs have been associated and correlated with pyrethroid resistance although there is no direct physiological evidence that their presence does confer kdr in this organism.

Methods

Resistant and susceptible strain resistance profiles were obtained using the larval packet discriminating dose assay. The relevant genomic regions of the para-sodium channel were amplified using standard PCR; SNPs were detected by sequencing the corresponding amplicons. Ovary response to cypermethrin exposure/treatment was evaluated using videometrical analysis.

Results

We found that the pyrethroid resistance trait is stable in a resistant reference strain after years without selection, suggesting that the resistance conferring mutations are fixed in the population. In this strain, a change in the structure of the pre-synaptic para-sodium channel caused by the G184C, the C190A and the T2134A SNPs appears to confer resistance. These mutations are absent in the susceptible strain used as control. We demonstrate that cypermethrin blocks ovary contraction in cypermethrin-susceptible ticks. We also show that ovaries from organisms that carry the kdr associated SNPs still contract at cypermethrin concentrations that completely block ovary contraction in the susceptible strain. The configuration of the experimental system excludes a xenobiotic detoxification mechanism.

Conclusions

This is the first report that presents physiological evidence that the presence of the G184C, the C190A, and the T2134A mutations in the para-sodium channel correlates with maintaining muscle contractility in R. microplus exposed to cypermethrin. These SNPs may confer cypermethrin resistance in this organism by avoiding presynaptic blockage, inhibiting the flaccid muscle paralysis characteristic of this acaricide. The videometric assay that we previously validated can be used to detect more rapidly than other assays that involve larval mortality kdr-like cypermethrin resistant tick strains, permitting to directly assay adult pre-engorged females after they are collected on the field without waiting until eggs are laid and larvae eclose.
Phylogenetic lineage of GII.17 norovirus identified among children in South-South, Nigeria
Authors: Osazuwa Favour , Grobler Hailey Seth , Johnson William
Published: July 2020

Objectives

Norovirus is a major cause of diarrhea among children worldwide. This present report highlight’s the genetic homology patterns of GII.17 noroviruses detected among children under-5 years of age with diarrhea in the South-South, region of Nigeria. Stool specimens were collected from 300 children with diarrhea and analyzed for norovirus using conventional reverse transcriptase-Polymerase Chain Reaction. Sequencing of the capsid region was performed to genotype the strains

Results

36/300 (12.0%) of patients were positive for norovirus by RT-PCR. 7/36 (19.4%) (5 GI.3 and 2 GI.5) were GI others where typed to be GII. All GII.17 norovirus identified in this study, 3/29 (10.3%) where typed to belong to the recently discovered GII.17 Kawasaki strain. This study report for the first time the detection of norovirus GII.17 Kawasaki strain in South-South, region of Nigeria.
Properties of solutions to fractional p-subLaplace equations on the Heisenberg group
Authors: Wang Xinjing , Du Guangwei
Published: July 2020

The aim of this paper is to study properties of solutions to the fractional p-subLaplace equations on the Heisenberg group. Based on the maximum principles and the generalization of the direct method of moving planes, we obtain the symmetry and monotonicity of the solutions on the whole group and the Liouville property of solutions on a half space.
Retraction Note: Normal families of solutions for modified equilibrium equations and their applications
Authors: Tan Yili , Ding Weiyong , Wang Yourong , Jiang Zongjing
Published: July 2020

The Editors-in-Chief have retracted this article [1] because its results are invalid. It also shows considerable overlap with an article by Lu and Sun [2] that was simultaneously under consideration. Additionally, the article shows evidence of authorship manipulation. The authors have not responded to any correspondence regarding this retraction.
Common fixed point theorems for two and three mappings
Authors: El Harrak Meryeme , Hajji Ahmed
Published: July 2020

In this paper, we provide common fixed point theorems for two and three commuting mappings which generalize Darbo’s fixed point theorem. An explicit example is given for illustration.
Burn injuries related to E-cigarettes reported to poison control centers in the United States, 2010–2019
Authors: Wang Baoguang , Liu Sherry T. , Rostron Brian , Hayslett Camille
Published: July 2020

Background

United States (U.S.) national data indicate that 2035 individuals with burn injuries from e-cigarette explosions presented to U.S. hospital emergency departments (EDs) in 2015–2017. This national estimate is valuable for understanding the burden of burn injuries from e-cigarette explosions among individuals who presented to EDs. However, little is known about individuals who experienced e-cigarette-related burns but may not present to EDs or health care facilities.

Findings

We analyzed data from the National Poison Data System (NPDS) to describe frequency and characteristics of e-cigarette-related burn cases in the U.S. in 2010–2019. NPDS contains information collected during telephone calls to poison control centers (PCCs) across the U.S., including e-cigarette-related burns and other unintended events. During 2010–2019, 19,306 exposure cases involving e-cigarettes were documented in NPDS. Of those, 69 were burn cases. The number of burn cases increased from one in 2011 to a peak of 26 in 2016, then decreased to three in 2019. The majority of the burn cases occurred among young adults aged 18–24 years (29.0%; n = 20) and adults aged 25 years or older (43.5%; n = 30); 14.4% (n = 10) occurred among individuals ≤17 years old. Of the 69 burn cases, 5.8% (n = 4) were admitted to a hospital; 65.2% (n = 45) were treated and released; 15.9% (n = 11) were not referred to a health care facility (HCF); 4.4% (n = 3) refused referral or did not arrive at an HCF; and 8.7% (n = 6) were lost to follow-up or left the HCF against medical advice. Nearly one-third (30.4%; n = 21) of the cases had a minor effect (symptoms resolved quickly), 47.8% (n = 33) had a moderate effect (symptoms were more pronounced and prolonged than in minor cases, but not life-threatening), and 2.9% (n = 2) had a major effect (life-threatening symptoms).

Conclusions

Approximately one-fifth of e-cigarette-related burn cases reported to PCCs were not referred to or did not arrive at an HCF. Some burn cases had serious medical outcomes. The burn cases mostly affected young adults and adults aged 25 years or older. The number of burn cases in NPDS represents a small portion of e-cigarette-related burn cases but it can serve as a complementary data source to traditional injury surveillance systems.
Visual quality of juvenile myopes wearing multifocal soft contact lenses
Authors: Huang Xiaopeng , Wang Feifu , Lin Zhiyi , He Yifan , Wen Shuyun , Zhou Ling , Lu Fan , Jiang Jun
Published: July 2020

Background

It is unclear whether multifocal soft contact lenses (MFSCLs) affect visual quality when they are used for myopia control in juvenile myopes. The aim of this study was, therefore, to investigate the effect of MFSCLs on visual quality among juvenile myopia subjects.

Methods

In a prospective, intervention study, thirty-three juvenile myopes were enrolled. Visual perception was assessed by a quality of vision (QoV) questionnaire with spectacles at baseline and after 1 month of MFSCL wear. At the one-month visit, the high (96%) contrast distance visual acuity (distance HCVA) and low (10%) contrast distance visual acuity (distance LCVA) were measured with single vision spectacle lenses, single vision soft contact lenses (SVSCLs) and MFSCLs in a random order. Wavefront aberrations were measured with SVSCLs, with MFSCLs, and without any correction.

Results

Neither distance HCVA (p > 0.05) nor distance LCVA (p > 0.05) revealed any significant difference between MFSCLs, SVSCLs and single vision spectacle lenses. The overall score (the sum of ten symptoms) of the QoV questionnaire did not show a statistically significant difference between spectacles at baseline and after 1 month of MFSCL wear (p = 0.357). The results showed that the frequency (p < 0.001), severity (p = 0.001) and bothersome degree (p = 0.016) of halos were significantly worse when wearing MFSCLs than when wearing single vision spectacle lenses. In contrast, the bothersome degree caused by focusing difficulty (p = 0.046) and the frequency of difficulty in judging distance or depth perception (p = 0.046) were better when wearing MFSCLs than when wearing single vision spectacle lenses. Compared with the naked eye, MFSCLs increased the total aberrations (p < 0.001), higher-order aberrations (p < 0.001), trefoil (p = 0.023), coma aberrations (p < 0.001) and spherical aberrations (SA) (p < 0.001). Compared with the SVSCLs, MFSCLs increased the total aberrations (p < 0.001), higher-order aberrations (p < 0.001), coma aberrations (p < 0.001) and SA (p < 0.001). The direction of SA was more positive (p < 0.001) with the MFSCLs and more negative (p = 0.001) with the SVSCLs compared with the naked eye.

Conclusions

Wearing MFSCLs can provide satisfactory corrected visual acuity (both distance HCVA and distance LCVA). Although the lenses increased the aberrations, such as total aberrations and higher-order aberrations, there were few adverse effects on the distance HCVA, distance LCVA and visual perception after 1 month of MFSCL use.

Trial registration

Chinese Clinical Trial Registry: ChiCTR-OOC-17012103. Registered 23 July 2017,http://www.chictr.org.cn/usercenter.aspx
Emerging roles of Toll-like receptor 9 in cardiometabolic disorders
Authors: Nishimoto Sachiko , Fukuda Daiju , Sata Masataka
Published: July 2020

Growing evidence suggests that damage-associated molecule patterns (DAMPs) and their receptors, pattern recognition receptors (PRRs), are associated with the progression of cardiometabolic disorders, including obesity-related insulin resistance and atherosclerosis. Cardiometabolic disorders share sterile chronic inflammation as a major cause; however, the exact mechanisms are still obscure. Toll-like receptor 9 (TLR9), one of the nucleic acid-sensing TLRs, recognizes DNA fragments derived from pathogens and contributes to self-defense by activation of the innate immune system. In addition, previous studies demonstrated that TLR9 recognizes DNA fragments released from host cells, accelerating sterile inflammation, which is associated with inflammatory diseases such as autoimmune diseases. In obese adipose tissue and atherosclerotic vascular tissue, various stresses release DNA fragments and/or nuclear proteins as DAMPs from degenerated adipocytes and vascular cells. Recent studies indicated that the activation of TLR9 in immune cells including macrophages and dendritic cells by recognition of these DAMPs promotes inflammation in these tissues, which causes cardiometabolic disorders. This review discusses recent advances in understanding the role of sterile inflammation associated with TLR9 and its endogenous ligands in cardiometabolic disorders. New insights into innate immunity may provide better understanding of cardiometabolic disorders and new therapeutic options for these major health threats in recent decades.
First stage psychometric testing of a new instrument for adolescents with visual impairment: the Participation and Activity Inventory for Children and Youth (PAI-CY) 13–17 years
Authors: Elsman Ellen B. M. , van Nispen Ruth M. A. , van Rens Gerardus H. M. B.
Published: July 2020

Background

To assess participation of children with visual impairment, the Participation and Activity Inventory for Children and Youth (PAI-CY) was recently developed. This study assessed some initial psychometric properties of the PAI-CY 13–17 years version, and investigated its feasibility.

Methods

Adolescents with visual impairment and their parents (n = 72 dyads) completed the self-report and proxy-report version of the 58-item PAI-CY, an evaluation form and several questionnaires measuring related constructs. Item deletion was informed by item responses, inter-item correlations, test-retest reliability, adolescent-parent agreement and participants’ feedback. Known-group validity and concurrent validity with related questionnaires were investigated for the final item-set.

Results

Twelve items had > 20% missing values, whereas 39 items showed floor effects. Eight item pairs showed high inter-item correlations. Test-retest reliability was acceptable for most items (kappa ≥0.4). Evaluation forms showed that over 90% of respondents was neutral to very positive regarding several feasibility aspects such as administration time and comprehensiveness. Adolescent-parent agreement was mostly low. These results informed the deletion of three items. Known-group validity seemed adequate since PAI-CY scores were significantly worse for participants with comorbidity compared to those without. A trend towards worse scores for participants with more severe visual impairment was also observed. Correlations between the PAI-CY and related questionnaires confirmed concurrent validity.

Conclusions

Initial psychometric properties of the PAI-CY 13–17 were acceptable, although more work is needed to assess other psychometric properties, such as the underlying construct. Following implementation in low vision care to assess participation needs, enabling larger samples, acceptability of the PAI-CY 13–17 to end-users should be carefully monitored, especially if alterations are made based on the current study.
Why the preclinical imaging field needs nuclear medicine technologists and radiographers?
Authors: Dillenseger J.-P. , Choquet P. , Snay E. R. , Fragoso Costa P.
Published: July 2020

Introduction

Preclinical imaging is still seen as a new field, and its recognition as a specific topic occurring only about 20 years ago. Nuclear medicine technologists (NMTs) and radiographers’ skills covering technical, anatomical and clinical fields can be highly beneficial to preclinical imaging research centres: many tasks and knowledge are complementary between clinics and preclinical laboratories. Our goal is to reach a consensus on the required set of competencies needed to translate the work of NMTs and radiographers from the clinic to the preclinical laboratory, particularly in regard to multimodal imaging.

Preclinical imaging environment

Currently, all imaging modalities used in clinical routine (ultrasound, CT, MRI, PET, SPECT, radiographs) are available, using specific architectures allowing for the spatial resolution and sensitivity needed for small rodents (which are the most commonly used species in research). Ideally, a preclinical laboratory should produce images/examinations at a high throughput in order to meet the statistical expectations of the studies (while respecting the 3R principles for animal research) and the care and welfare of each individual. To reach the quality and throughput expectations of such an organization, specific qualified professionals are needed to complete the scientific/research staff.

Where NMTs and radiographers fit in

The increasing use of preclinical imaging requires professionals who can put imaging procedures into action, ensuring a significant success throughput. NMTs and radiographers have a variety of skills that work well within a preclinical laboratory, with the ability to perform the following tasks independently: animal preparation, positioning, monitoring and anaesthesia recovery, acquisition parameter programming, archiving and data processing, device quality controls, surface cleaning and disinfection, radioactive and biological waste management, radiation safety for users, use of hot lab equipment and auxiliary equipment, injected products and material management. In light of the current European Qualification Framework, a set of skills, knowledge and competencies were defined to cover the whole set of duties and tasks deliverable to an NMT or radiographer working in a preclinical laboratory. One of the key responsibilities of the NMT or radiographer is related to compliance on animal care and welfare when undertaking any animal procedures, including imaging.

Conclusion

We believe that NMTs and radiographers’ skills match perfectly with the requirements of a preclinical imaging lab, and that they could be considered a keystone of such an organization in the future. Moreover, some evidence has also shown that an experienced NMT or radiographer in this sector can take on roles as research investigators.
The association between rheumatoid arthritis and periodontal disease in a population-based cross-sectional case-control study
Authors: Renvert Stefan , Berglund Johan Sanmartin , Persson G. Rutger , Söderlin Maria K.
Published: July 2020

Background

The association between rheumatoid arthritis (RA) and periodontitis remains unclear.

Methods

We studied oral health and periodontitis in a population-based case-control study of individuals with ≥10 remaining teeth ≥61 years of age and either with, or without a diagnosis of RA. 126 dentate individuals with RA were recruited together with age-matched control individuals without RA. The control individuals were recruited from the general population from the same city (n = 249). A dental examination including a panoramic radiograph was performed on all participants. All individuals with RA were examined and medical records were reviewed by a rheumatologist. In the control group, none of the participants presented with symptoms of RA and their medical records were also negative.

Results

The RA group included more women (66.7% vs. 55.8%) (p < 0.01). Individuals in the RA group had a higher body mass index (BMI) (p < 0.001). A diagnosis of periodontitis was more common in the RA group (61.1%) than in the control group (33.7%) (p = 0.001). Binary logistic regression analysis identified that a BMI > 25 (OR 6.2, 95% CI 3.6, 10.5, p = 0.000), periodontitis (OR 2.5 95% CI 1.5, 4.2 p = 0.000), and female gender (OR 2.3, 95% CI 1.3–4.0, p = 0.003) were associated with RA.

Conclusion

RA was associated a diagnosis of periodontitis.
Association between opioid use disorder (tramadol) and serum level of interleukin-2
Authors: Darweesh Alaa-Eldin , Agban M. , Mohammed Mona H. , Gabra Romany H.
Published: July 2020

Background

Tramadol hydrochloride is a centrally acting analgesic drug that has turned out to be a drug of growing interest due to its success in the management of pain in humans. By considering the twin mechanism of action of tramadol, as the activation of the opioid and of the monoaminergic systems, the potential immunological effects of this drug should be considered and be evaluated. Studies show that Tramadol induces an improvement of postoperative immune suppression and increases NK cell activity, lymphocyte proliferation, and IL-2 production which may be linked to its addictive potentiality. The present study aims to investigate the possible association between opioid use disorder (tramadol) and the serum level of interleukin-2 (IL-2).

An observational cross sectional study conducted at the Outpatient Clinic and Inpatient Unit of the Addiction Management Unit of the Neurology and Psychiatry Department of Assiut University Hospital. Assessment of serum level of IL-2 for 59 male patients diagnosed with opioid use disorder (tramadol) according to DSM-5 compared to 32 cross-matched male individuals as a control group.

Results

Comparing the serum level of IL-2 in patients with opioid use disorder (tramadol) with that of the controls, it was found that the patients with opioid use disorder (tramadol) have significantly higher serum level of IL-2 (318.69 ± 35.89) than that of controls (260.45 ± 30.08) (P= 0.01). Patients with tramadol urine assay (> 200 ng/ml) have significantly higher serum level of IL-2.

Conclusion

The current study found that patients with opioid use disorder (tramadol) have significantly elevated serum levels of IL-2 than healthy controls. Also, this elevation was dose related.
Doppler ultrasound contribution in vesico-peritoneal and vesico-cutaneous fistulas diagnosis: two case reports of a new sign
Authors: Adigo Amégninou Mawuko Yao , Adambounou Kokou , Kouevi-Koko Tete Edem , Bakpatina-Batako Kpalma Duga , Adjénou Komlanvi
Published: July 2020

Background

Report cases of vesico-peritoneal and vesico-cutaneous fistulas suspected to Doppler ultrasound confirmed by CT scan/conventional cystography and successfully treated.

Case presentation

Two male patients of 35- and 36-year-old, without any medical past history, had presented anuria and absence of miction respectively after a road traffic accident and a piece of wood penetrating the left thigh. The physical examination revealed lower limbs hematoma and severe abdominal pain in the man of 35 years and a sutured wound of the left thigh of 4 cm with a bright liquid flowing from it with the characteristic smell of urine in the man of 36 years. A Doppler ultrasound was made. The Doppler had shown normal ureteral jets but with a third abnormal flux which went from interior to exterior of the urinary bladder for the first patient and from the bladder to the left inguinal cutaneous tissue for the second patient. The treatment was a Foley’s catheter into the bladder with antibiotics in the two cases after excision and separate suture of the peritoneum and bladder during umbilical laparotomy in the first case. The suites were simples.

Conclusions

The diagnostic contribution of CT/conventional cystography is well known and undisputed, but for Doppler ultrasound, it is anecdotal like in these cases we report. Nevertheless, there is a need to evaluate the semiological value of Doppler ultrasound contribution on a greater sample.
Cardiac MRI in evaluation of post-operative congenital heart disease and complications
Authors: Saraya Samira , Woodard Pamela , Bhalla Sanjeev , Gutierrez Fernando , Saraya Mahmoud , Soliman Hazem Hamed
Published: July 2020

Background

The aim of this work is to assess the uses of cardiac MR in evaluating post-operative congenital heart disease procedures and related complications.

Results

This is a retrospective study done in between December 2015 and October 2017, including 71 patients with age ranging from 6 months to 33 years (mean age 16.75). All of the patients were referred for post-operative evaluation after echocardiographic examination to exclude post-operative complications and to plan for re-intervention if needed. Forty-three percent of patients suffered from post-operative complications. The most common congenital heart disease coming for post-operative evaluation was tetralogy of Fallot (TOF) which represented 32% of the cases. The most common post-operative complication in all procedures was pulmonary branch stenosis (12.6%) followed by patch dilatation (9.8 %) and right ventricular failure (7%). In 7 patients following TOF repair, there was aneurysmal dilatation of the patch with significant pulmonary regurgitation. The regurgitation fraction was less than 40% in 3 of them, while the remaining 4 cases showed regurgitation fraction of more than 40%, an indication for re-intervention.

Conclusion

MRI is an extremely useful imaging method for evaluation of normal and abnormal findings after surgical repair for congenital heart disease. It is effective in providing long-term surveillance and identifying post-procedural complications, which allowed us to further intervene on a timely manner when deemed necessary.
Thermal tolerance and hypoxia tolerance are associated in blacktip reef shark (Carcharhinus melanopterus) neonates
Authors: Bouyoucos Ian A. , Morrison Phillip R. , Weideli Ornella C. , Jacquesson Eva , Planes Serge , Simpfendorfer Colin A. , Brauner Colin J. , Rummer Jodie L.
Published: July 2020

Thermal dependence of growth and metabolism can influence thermal preference and tolerance in marine ectotherms, including threatened and data-deficient species. Here, we quantified the thermal dependence of physiological performance in neonates of a tropical shark species (blacktip reef shark, Carcharhinus melanopterus) from shallow, nearshore habitats. We measured minimum and maximum oxygen uptake rates (ṀO2), calculated aerobic scope, excess post-exercise oxygen consumption and recovery from exercise, and measured critical thermal maxima (CTmax), thermal safety margins, hypoxia tolerance, specific growth rates, body condition and food conversion efficiencies at two ecologically relevant acclimation temperatures (28 and 31°C). Owing to high post-exercise mortality, a third acclimation temperature (33°C) was not investigated further. Acclimation temperature did not affect ṀO2 or growth, but CTmax and hypoxia tolerance were greatest at 31°C and positively associated. We also quantified in vitro temperature (25, 30 and 35°C) and pH effects on haemoglobin–oxygen (Hb–O2) affinity of wild-caught, non-acclimated sharks. As expected, Hb–O2 affinity decreased with increasing temperatures, but pH effects observed at 30°C were absent at 25 and 35°C. Finally, we logged body temperatures of free-ranging sharks and determined that C. melanopterus neonates avoided 31°C in situ. We conclude that C. melanopterus neonates demonstrate minimal thermal dependence of whole-organism physiological performance across a seasonal temperature range and may use behaviour to avoid unfavourable environmental temperatures. The association between thermal tolerance and hypoxia tolerance suggests a common mechanism warranting further investigation. Future research should explore the consequences of ocean warming, especially in nearshore, tropical species.
Three new suggested guidelines for increased transparency regarding open access article processing charges (APCs)
Authors: Teixeira da Silva Jaime A.
Published: July 2020

The article processing charge (APC) lies at the heart of the gold open access (GOA) business model. Small and larger society-based, as well as commercial publishers, rely – to different extents – on the APC and the GOA model to thrive. There is wide debate regarding what amount of APC is considered to be exploitative, and the issue of low APCs is often erroneously associated with “predatory” OA publishing. Independent of this debate, there is still, surprisingly, considerable opacity related to the APC used to cover the cost of  GOA. In a bid to increase transparency, a simple 3-point plan at increasing academic and financial transparency of authors and journals/publishers regarding APCs is proposed: 1) indicate which author paid the APC in multi-author papers; 2) indicate the value of the APC paid; 3) provide online proof or certification of APC payment, including the indication of any discounts or waivers.
On Sports Biomechanics Methodology
Authors: Papageorgiou Konstantinos
Published: July 2020

Sports biomechanics is one of the most fascinating and formalised disciplines in sports science. While it uses a host of methods, on closer look, it lacks a thorough epistemological / methodological foundation besides what it implicitly borrows from the sciences it uses, such as mathematics and physics. Here, I shall attempt to portray what such a basic epistemological understanding would include and also try to address issues directly related to such an approach. I shall start by describing the most general context in which sports biomechanics exist and then, I will attempt to provide a structural context to bridge the gap between sports biomechanics and practice. Concluding with some ideas about the future of biomechanics.
Η επίδραση προβλημάτων ακροτάτων στο λογισμό μεταβολών
Authors: Βεργίνης Γεώργιος , Καρούσης Χρήστος , Κρητικίδη Αιμιλία , Λάμπρου Χρήστος , Λέου Μαριάννα , Τζοβαρίδου Γεωργία
Published: July 2020

ΠΕΡΙΛΗΨΗΘα ερευνήσουμε με ποιες μεθόδους αντιμετωπίστηκαν ιστορικά προβλήματα ακροτάτων και κωνικών τομών και κατά πόσο το αποτύπωμα των μεθόδων αυτών ανιχνεύεται στη θεωρητική βάση του διαφορικού λογισμού.Η θεμελίωση της θεωρίας λόγων και η εισήγηση της μεθόδου εξάντλησης από τον Εύδοξο (~330 π.Χ.) αποτέλεσαν ισχυρά εργαλεία στο έργο του Αρχιμήδη (~250 π.Χ.) και τον οδήγησαν στην εξαιρετικής ευφυίας μηχανική σύλληψη του τετραγωνισμού τμήματος παραβολής.Διερευνούμε το πρόβλημα μέγιστου όγκου του Kepler (1613) και στη συνέχεια της βραχυστόχρονης καμπύλης από τον Bernoulli (1696), με το geogebra ισχυρό ανιχνευτικό εργαλείο σε καθένα από τα θέματα.Μέσα από τη διαδρομή αυτή παρακολουθούμε πώς μεταβλήθηκαν και διαμορφώθηκαν οι έννοιες του απειροστού και της εφαπτομένης.Σκοπός μας είναι να αναδειχθεί η πρωτοποριακή ιδέα που ενυπάρχει σε καθένα από τα θέματα αυτά, εστιάζοντας περισσότερο στη διαδικασία επίλυσης παρά στην ίδια τη λύση.