bluuebunny/crossref_metadata_2025 huggingface dataset:
Outcomes of Arthroscopic All-Inside Repair Versus Observation in Older Patients With Meniscus Root Tears
Authors: Dragoo Jason L. , Konopka Jaclyn A. , Guzman Roberto A. , Segovia Nicole , Kandil Abdurrahman , Pappas George P.
Published: March 2020

Background:

Meniscus root tears lead to de-tensioning of the meniscus, increased contact forces, and cartilage damage. Management of older patients with root tears is controversial and the efficacy of different treatment options is unclear.

Purpose:

To compare the clinical outcomes of patients with moderate knee osteoarthritis who underwent an all-inside meniscus root repair technique versus nonoperative management for either medial or lateral meniscus root tears.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

Patients with a diagnosed posterior meniscus root tear who underwent arthroscopic repair (AR: 30 knees) or nonoperative treatment with observation (O: 18 knees) were followed for a minimum of 2 years (mean follow-up, 4.4 years). The arthroscopic repair included all-inside sutures to reduce the root back to its remnant (reduction sutures), thereby re-tensioning the meniscus, and 1 mattress suture to strengthen the repair by reapproximating the construct to the posterior capsule. The data collected included the Knee injury and Osteoarthritis Outcome Score (KOOS), Lysholm, Tegner, and Veterans RAND 12-Item Health Survey (VR-12) Physical Component Summary (PCS) and Mental Component Summary (MCS) scores and conversion to total knee arthroplasty (TKA).

Results:

Medial meniscus root tears comprised 80.0% of the AR group and 77.8% of the O group. The average Kellgren-Lawrence grade was 2 in both groups. The baseline scores for the KOOS Symptoms subscale were lower for AR (50.2 ± 19.3) than for O (66.5 ± 16.1) ( P = .003), as were the KOOS Knee-Related Quality of Life scores (AR, 26.7 ± 16.1; O, 39.6 ± 22.1) ( P = .046). No differences were found between groups for the absolute values at follow-up except that follow-up Tegner scores were lower in the O group than in the AR group ( P = .004). Significant improvements were seen in the AR group from baseline to ultimate follow-up in average KOOS subscale scores ( P < .001), Lysholm scores ( P < .001), Tegner scores ( P = .0002), and VR-12 PCS scores ( P < .001), whereas the O group had a significant improvement only in average KOOS Pain ( P = .003), KOOS Function in Daily Living ( P = .006), and VR-12 PCS ( P = .038) scores. Compared with the O group, the AR group had a significantly larger improvement from baseline to follow-up in average KOOS Pain ( P = .009), KOOS Symptoms ( P = .029), and Lysholm scores ( P = .016). During follow-up, 3.3% of the AR group underwent a TKA compared with 33.3% of the O group ( P = .008). The hazard ratio of TKA conversion was 93.2% lower for the AR group compared with the O group ( P = .013).

Conclusion:

All-inside medial or lateral meniscus root repair showed improved functional outcomes and decreased TKA conversion rates compared with nonoperative treatment and may be considered as a treatment option for the management of meniscus root tears in older patients with moderate osteoarthritis.
Life cycle and End-of-Life management options in the footwear industry: A review
Authors: Van Rensburg Melissa L , Nkomo S’phumelele L , Mkhize Ntandoyenkosi M
Published: March 2020

It is well recognized globally that the footwear industry contributes to a large waste stream throughout its life cycle. This article reviews the literature pertaining to the life cycle of footwear products and their End-of-Life (EoL) management strategies. The review discusses critical aspects of the footwear industry, commencing with a background on the growth and consumption of footwear products across the globe. The review provides an overview of the environmental impacts of different footwear materials across their life cycles. In this regard, leather materials are given intense focus due to their poor environmental performance. The review further examines proactive and reactive approaches to footwear waste management, whilst additionally exploring the challenges facing EoL footwear recovery. Finally, pyrolysis is examined as a thermochemical treatment process with value due to its potential to recover materials from post-consumer footwear. The significant findings in this review paper are as follows: (a) leather footwear materials have the most detrimental environmental impacts across their life cycle; (b) there is limited scientific literature on thermochemical processes (particularly pyrolysis) as waste recovery options for post-consumer footwear; and (c) several challenges face the recovery of post-consumer footwear products, including inefficient reverse logistics, mixed product recycling and difficulties establishing a value recovery chain. This review paper recommends further research on pyrolysis as a potential post-consumer footwear recovery option. Exploring the viability of new avenues for footwear waste recovery is significant due to its potential to divert this waste stream from landfills and allow a progression toward a more circular economy.
Highlighting a Nursing Practice Model
Authors: Carroll Karen
Published: March 2020

Nursing’s contribution to the care of patients and families in the interdisciplinary arena requires clarity based on the scientific basis of the discipline. The robustness of a theoretical framework and practice model undergirds the patient experience and outcomes.
The Humanbecoming Concept Inventing Model: Hope
Authors: Doe Mi Jin
Published: March 2020

The scholar explores the meaning of the nursing phenomenon of hope as a universal humanuniverse living experience using the humanbecoming concept inventing model. The now-truth of hope surfacing is envisioning possibles amid burdening challenges arising with the communion-aloneness of seeing the familiar in new light. The ingenuous proclamation of hope as a theoretical statement is imaging powering with the connecting-separating of transforming. The conceptualization of hope using the unique humanbecoming concept inventing model contributes to the advancement of nursing knowledge.
Nursing Theory in the Quest for the Sustainable Development Goals
Authors: Rosa William E. , Dossey Barbara M. , Koithan Mary , Kreitzer Mary Jo , Manjrekar Phalakshi , Meleis Afaf I. , Mukamana Donatilla , Ray Marilyn A. , Watson Jean
Published: March 2020

The 17 United Nations Sustainable Development Goals (SDG) are intended to promote a safe, healthy, and equitable world by the year 2030. Nurses are at the forefront of realizing the 2030 agenda through concerned citizenship and professional leadership. Nursing theory informs knowledge development and theory-guided practice essential for nurses working in all domains and in all nations. Although all extant nursing theories are relevant, a select few are discussed in detail to make explicit the links between theory and SDG realization. Middle-range theories are also valuable in helping to contextualize nursing practice through the lens of the SDGs. The SDGs address five themes - People, Planet, Peace, Prosperity, and Partnership - and theory remains vital to ensure nurses working in all settings are equipped to meet the needs of humanity and the world, now and in the future.
Interest through necessity? The impact of personal health on the stability of political interest in the United Kingdom
Authors: Mattila Mikko , Papageorgiou Achillefs , Rapeli Lauri
Published: March 2020

Interest in politics is a key indicator of citizens’ attitudes towards politics. Scholars disagree whether interest is a stable trait developed during adolescence, or if it changes over the life course. We hypothesise that deteriorating health can destabilise the stable sense of political interest because worsening health makes individuals more dependent on public healthcare and increase their attention to politics. Furthermore, we assume that the impact of health on interest is conditional on income as people with low incomes are dependent on public healthcare. Our results show only limited support for the first hypothesis. However, we found a negative relationship between declining health and increasing interest in the lowest income group. The results are consistent with the life-cycle theory, which presumes that important events in life have consequences even for the most endurable political attitudes. Deteriorating personal health can be a source of motivation to make persons more interested in politics.
Design and testing of communication materials for a breastfeeding social media marketing campaign: Breastfeed4Ghana
Authors: Aryeetey R , Lasisi O , Hromi-Fiedler A , Carroll G , Pérez-Escamilla R , Harding K
Published: March 2020

Breastfeed4Ghana was a social media-based campaign implemented to address identified gaps in the protection, promotion, and support of breastfeeding in Ghana. This paper describes the process of campaign materials development and testing to ensure their cultural and content appropriateness. The 60 campaign materials, each consisting of an image and text message, underwent a process of creation, testing, revision, and finalization. Existing research evidence and infant and young child feeding communication tools that were culturally relevant for Ghana were used to develop the materials. All materials were tested and finalized through an iterative process that incorporated input from six focus group discussions (FGDs) with mothers, and content and technical experts. The materials were revised to ensure scientific accuracy, understandability, and cultural appropriateness of the messages, as well as alignment of the messages with the images. Finalized materials were reviewed and approved by the Ghana Food and Drugs Authority. Analysis for this paper involved summarizing and categorizing the types and sources of input as well as the research team’s responses to the input received. The 60 campaign materials received a total of 132 inputs. Most inputs came from FGDs (78.4%); and most inputs were on the campaign material images. The evidence-informed process of materials creation, use of multiple input sources, and a broad-based iterative process allowed the creation of 60 evidence-based and culturally appropriate materials for a breastfeeding social media campaign in Ghana. This paper could serve as a guide for other social media campaign efforts looking to develop culturally appropriate materials.
Meaningful change: Defining the interpretability of changes in endpoints derived from interactive and mHealth technologies in healthcare and clinical research
Authors: Byrom B , Breedon P , Tulkki-Wilke R , Platko JV
Published: March 2020

Immersive, interactive and mHealth technologies are increasingly being used in clinical research, healthcare and rehabilitation solutions. Leveraging technology solutions to derive new and novel clinical outcome measures is important to the ongoing assessment of clinical interventions. While demonstrating statistically significant changes is an important element of intervention assessment, understanding whether changes detected reflect changes of a magnitude that are considered meaningful to patients is equally important. We describe methodologies used to determine meaningful change and recommend that these techniques are routinely included in the development and testing of clinical assessment and rehabilitation technology solutions.
Inclusion of Theory for Evidence-Based School Counseling Practice and Scholarship
Authors: Lemberger-Truelove Matthew E. , Ceballos Peggy L. , Molina Citlali E. , Dehner Jaclyn M.
Published: March 2020

Evidence-based school counseling requires that practitioners and scholars utilize formal counseling theory. Theories that inform school counseling must cohere with the unique needs of students and school environments. Therefore, we propose that school counseling theories must include the following constituents: (a) qualities of students and school environments, (b) empirical and professional endorsements, (c) school counseling customs, and (c) methodological relevance. We describe the utility of these constituents through example using a school counseling–specific theory, the Advocating Student-within-Environment approach.
The risk of dyspnea in patients treated with third-generation P2Y12 inhibitors compared with clopidogrel: a meta-analysis of randomized controlled trials
Authors: Zhang Na , Xu Weisen , Li Ou , Zhang Bing
Published: March 2020

Background

Ticagrelor and prasugrel are two third-generation oral P2Y12 inhibitors which are more commonly used in clinical practice. However, dyspnea has been consecutively reported in patients using third-generation oral P2Y12 inhibitors. This study aims to compare the risk of dyspnea in patients treated with third-generation P2Y12 inhibitors compared with clopidogrel.

Methods

We systematically searched the PubMed, Cochrane Central Register of Controlled Trials databases, ClinicalTrials.gov and Web of Science for randomized control trials (RCTs) comparing ticagrelor or prasugrel with clopidogrel until July 2019. The primary outcome was the incidence of dyspnea. The risk ratios (RR) and 95% confidence intervals (CI) were estimated using meta-analysis.

Results

We included 25 RCTs involving 63,484 patients in this meta-analysis, including 21 studies on ticagrelor and 4 studies on prasugrel. Compared to the clopidogrel group, third-generation oral P2Y12 inhibitors were associated with an increased risk of dyspnea compared with clopidogrel (RR 2.15, 95% CI 1.59–2.92), which was consistent in the analysis of ticagrelor (RR 2.65, 95% CI 1.87–3.76). However, the adverse effect was not found among patients receiving prasugrel therapy (RR 1.03, 95% CI 0.86–1.22). The increased dyspnea risk of ticagrelor was consistent in subgroups with different follow-up durations (≤ 1 month RR 1.87, 95% CI 1.56–2.24; 1–6 months RR 4.19, 95% CI 1.99–8.86; > 6 months 2.45, 95% CI 1.13–5.34).

Conclusions

Ticagrelor has a higher risk of dyspnea than clopidogrel, which was not observed in patients using prasugrel.
Antenatal depression and its potential causal mechanisms among pregnant mothers in Gondar town: application of structural equation model
Authors: Dadi Abel Fekadu , Miller Emma R. , Woodman Richard , Bisetegn Telake Azale , Mwanri Lillian
Published: March 2020

Background

Various forms of life stressors have been implicated as causes of antenatal depression. However, there is a lack of understanding of which forms of stress lead to antenatal depression and through what mechanisms. Modeling stress processes within a theoretical model framework can enhance an understanding of the mechanisms underlying relationships between stressors and stress outcomes. This study used the stress process model framework to explore the causal mechanisms underlying antenatal depression in Gondar, Ethiopia.

Methods

Questionnaires, using an Online Data collection Kit (ODK) tool were administered face-to-face in 916 pregnant women in their second and third trimesters. Pregnant women were included from six randomly selected urban districts in Gondar, Ethiopia during June and August 2018. The Edinburgh Postnatal Depression Scale (EPDS) was used to screen for antenatal depression. A Structural Equation Model (SEM) was employed to explore the direct, indirect, and total effect of stressors and mediators of antenatal depression.

Result

Sixty-three participants (6.9%) reported symptoms of depression. Of these, 16 (4.7%) and 47 (8.1%) were in their second and third trimesters, respectively. The SEM demonstrated several direct effects on antenatal depression scores including unplanned pregnancy (standardized β = 0.15), having a history of common mental health disorder (standardized β = 0.18) and fear of giving birth to the current pregnancy (standardized β = 0.29), all of which were associated with a higher depression score. Adequate food access for the last 3 months (standardized β = − 0.11) was associated with decreased depression score. Social support (β = − 0.21), marital agreement (β = − 0.28), and partner support (β = −.18) appeared to partially mediate the link between the identified stressors and the risk of antenatal depression.

Conclusion

Both direct and indirect effects contributed to higher antenatal depression score in Ethiopian women. The three psychosocial resources namely marital agreement, social and partner support, mediated reduced antenatal depression scores. Early screening of antenatal depression and enhancing the three psychosocial resources would help to improve maternal resilience.
Clinical judgement, case complexity and symptom scores as predictors of outcome in depression: an exploratory analysis
Authors: Smith M. , Francq B. , McConnachie A. , Wetherall K. , Pelosi A. , Morrison J.
Published: March 2020

Background

Clinical guidelines for depression in adults recommend the use of outcome measures and stepped care models in routine care. Such measures are based on symptom severity, but response to treatment is likely to also be influenced by personal and contextual factors. This observational study of a routine clinical sample sought to examine the extent to which “symptom severity measures” and “complexity measures” assess different aspects of patient experience, and how they might relate to clinical outcomes, including disengagement from treatment.

Methods

Subjects with symptoms of depression (with or without comorbid anxiety) were recruited from people referred to an established Primary Care Mental Health Team using a stepped care model. Each participant completed three baseline symptom measures (the Personal Health Questionnaire (PHQ), Generalised Anxiety Disorder questionnaire (GAD) and Clinical Outcomes in Routine Evaluation (CORE-10)), and two assessments of “case complexity” (the Minnesota-Edinburgh Complexity Assessment Measure (MECAM) and a local complexity assessment). Clinician perception of likely completion of treatment and patient recovery was also assessed. Outcome measures were drop out and clinical improvement on the PHQ.

Results

298 subjects were recruited to the study, of whom 258 had a sufficient dataset available for analysis. Data showed that the three measures of symptom severity used in this study (PHQ, GAD and CORE-10) seemed to be measuring distinct characteristics from those associated with the measures of case complexity (MECAM, previous and current problem count). Higher symptom severity scores were correlated with improved outcomes at the end of treatment, but there was no association between outcome and complexity measures. Clinicians could predict participant drop-out from care with some accuracy, but had no ability to predict outcome from treatment.

Conclusions

These results highlight the extent to which drop-out complicates recovery from depression with or without anxiety in real-world settings, and the need to consider other factors beyond symptom severity in planning care. The findings are discussed in relation to a growing body of literature investigating prognostic indicators in the context of models of collaborative care for depression.
Achievements and challenges in health management for aged individuals in primary health care sectors: a survey in Southwest China
Authors: Li Li , Zhang Rui , Chen Yong , Deng Haoyue , Liu Shili , Wang Geng , Wang Mei , Liang Shengxiang , Xing Wei , Lin Hai , Li Ying
Published: March 2020

Background

China has rapidly transformed into an ageing nation and will be one of the countries with the highest percentage of aged people in 2050. Healthcare management for the aged (HMA) in basic public health service (BPHS), which is delivered by lay healthcare workers (LHWs) in primary health care (PHC) sectors, is an important strategy to address the healthcare challenges that have resulted from ageing in China since 2009. This survey aimed to understand the achievements made and challenges faced by HMA in Southwest China.

Methods

A multilevel stratified random and consecutive sampling method was used to select study places and participants respectively, and mixed research methods were used to collect data from the aged individuals, LHWs and leaders in PHC sectors. SPSS 21.0 was used for data analysis.

Results

Seven hundred seventy-two surveys with aged people (over 60 years old), 16 focus group discussions (FGDs) with 96 aged people, and 32 in-depth interviews with 16 LHWs and 16 leaders were completed in PHC sectors. More than 85% of aged individuals had knowledge and utilization of HMA, and over 94% of these respondents were satisfied with HMA. Meanwhile, challenges in HMA delivery included weakness (unmet items and lack of appropriate assessment indicators) in HMA design, low capacity of PHC sectors and competency of LHWs to deliver HMA, poor health literacy of aged individuals, insufficient funds and a lack of multi-sector cooperation.

Conclusions

Though significant achievements in HMA were observed, this study highlighted the challenges in further quality improvement of HMA delivery program in Southwest China. The “older-person-centered and integrated care” model provided a good theory to improve the quality of HMA by reinforcing the needs-based HMA design, building a comprehensive assessment strategy, improving the capacity of PHC sectors and the LHWs’ competency, and strengthening multi-sector cooperation.
Transscrotal transverse incision for the treatment of middle and low cryptorchidism in children: experience from 796 cases
Authors: Wang Yun-jin , Chen Liu , Zhang Qi-liang , Lin Yu , Cui Xu , Chen Jian-cai , Zhou Chao-ming
Published: March 2020

Background

The purpose of this study was to summarize our clinical experience with transscrotal transverse incision in the treatment of low and middle cryptorchidism in children.

Methods

A total of 796 children with low or middle cryptorchidism participated in this study from March 2012 to May 2018. Transscrotal transverse incision was used to treat low and middle cryptorchidism. Symptoms and signs were followed up at 1 week, 1 month, 3months and every six to 12 months thereafter.

Results

Testicular descent fixation through transverse scrotal incision was successfully performed in all 796 children. All patients were discharged 1–2 days after the operation. During hospitalization and follow-up, 35 patients had complications, including 7 cases of cryptorchidism recurrence, 5 cases of poor scrotal incision healing, and 23 cases of scrotal haematoma. There were no complications, such as bladder injury, testicular atrophy, inguinal hernia or hydrocele.

Conclusion

Transscrotal transverse incision is a safe and feasible method for the treatment of middle and low cryptorchidism. It has the advantages of less trauma and an aesthetic scar after operation.
Feasibility of endometrial sampling by vaginal tampons in women with Lynch syndrome
Authors: Woolderink Jorien M. , De Bock Geertruida H. , van Hemel Bettien M. , Geuken Erwin , Hollema Harry , Werner Naomi , Mourits Marian J.
Published: March 2020

Background

Endometrial sampling for the surveillance of women with Lynch syndrome is an invasive and painful procedure. The aim of this study was to evaluate the feasibility of a less invasive procedure of collecting vital cells by vaginal tampons.

Methods

This was a prospective feasibility study of women scheduled to undergo annual gynecological surveillance, including endometrial sampling. We included consecutive asymptomatic women with Lynch syndrome or first-degree relatives and asked them to insert a vaginal tampon 2–4 h before attending their outpatient appointment. Feasibility was evaluated by the following metrics: patient acceptance, pain intensity of each procedure (assessed by visual analog scale; range 0–10), and the presence of vital cells obtained by tampon-based or endometrial sampling methods. Two pathologists independently evaluated all samples.

Results

In total, 25 of 32 approached women completed the tampon-based procedure, with 23 of these subsequently undergoing invasive endometrial sampling. The median visual analog scale scores for tampon use and invasive endometrial sampling were 0 (range, 0–10) and 5.5 (range, 1–10) (p < 0.001). None of the tampon samples analyzed by cytology showed endometrial cells, but they did contain vital squamous cells and granulocytes. By contrast, 18 (78%) of the invasive endometrial samples contained enough endometrial tissue for analysis. No endometrial abnormalities were found by endometrial sampling.

Conclusions

Tampon-based endometrial surveillance was a well-accepted and non-painful procedure, and although tampons contained vital cells, they did not provide endometrial cells. However, this study was limited to asymptomatic women with Lynch syndrome (no endometrial pathology), indicating that research is needed to evaluate whether the tampon method has any utility for endometrial surveillance in women with Lynch syndrome.
The role of T cell trafficking in CTLA-4 blockade-induced gut immunopathology
Authors: Zhang Shashuang , Liang Wenhua , Luo Lingjie , Sun Shan , Wang Feng
Published: March 2020

Background

Immune checkpoint inhibitor (ICPI) can augment the anti-tumour response by blocking negative immunoregulators with monoclonal antibodies. The anti-cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) antibody is the first ICPI which has shown remarkable benefits in the clinical treatment of cancers. However, the increased activity of the immune system also causes some side effects called immune-related adverse events (irAEs). Colitis is one of the most common irAEs related to anti-CTLA-4 immunotherapy.

Results

We identified that CD4+T cells were the primary responders in CTLA-4 blockade and that the expansion of gut-homing CD4+T cells by anti-CTLA-4 therapy was independent of CD103. We used dextran sulfate sodium (DSS)-induced colitis mice as our model and tested the possibility of using a trafficking-blocking antibody to treat anti-CTLA-4 antibody-induced irAEs. We found that blocking T cell homing increased colitis severity in the context of CTLA-4 blockade and that gut-trafficking blockade had different effects on different Th subsets and could facilitate the proliferation of Th17 cells in the lamina propria (LP).

Conclusions

Our data reveals the fundamental mechanism underlying trafficking-blocking antibody therapy for CTLA-4 blockade-induced colitis and provide a caution in regard to apply trafficking-blocking antibody treatment under CTLA-4 blockade condition.
Characterization of two in vivo challenge models to measure functional activity of monoclonal antibodies to Plasmodium falciparum circumsporozoite protein
Authors: Raghunandan Rama , Mayer Bryan T. , Flores-Garcia Yevel , Gerber Monica W. , Gottardo Raphael , Jhun Hugo , Herrera Sonia M. , Perez-Ramos Daniel W. , Locke Emily , King C. Richter , Zavala Fidel
Published: March 2020

Background

New strategies are needed to reduce the incidence of malaria, and promising approaches include the development of vaccines and monoclonal antibodies (mAbs) that target the circumsporozoite protein (CSP). To select the best candidates and speed development, it is essential to standardize preclinical assays to measure the potency of such interventions in animal models.

Methods

Two assay configurations were studied using transgenic Plasmodium berghei expressing Plasmodium falciparum full-length circumsporozoite protein. The assays measured (1) reduction in parasite infection of the liver (liver burden) following an intravenous (i.v) administration of sporozoites and (2) protection from parasitaemia following mosquito bite challenge. Two human CSP mAbs, AB311 and AB317, were compared for their ability to inhibit infection. Multiple independent experiments were conducted to define assay variability and resultant impact on the ability to discriminate differences in mAb functional activity.

Results

Overall, the assays produced highly consistent results in that all individual experiments showed greater functional activity for AB317 compared to AB311 as calculated by the dose required for 50% inhibition (ID50) as well as the serum concentration required for 50% inhibition (IC50). The data were then used to model experimental designs with adequate statistical power to rigorously screen, compare, and rank order novel anti-CSP mAbs.

Conclusion

The results indicate that in vivo assays described here can provide reliable information for comparing the functional activity of mAbs. The results also provide guidance regarding selection of the appropriate experimental design, dose selection, and group sizes.
Lipoprotein profiling in early multiple sclerosis patients: effect of chronic inflammation?
Authors: Rádiková Žofia , Penesová Adela , Vlček Miroslav , Havranová Andrea , Siváková Monika , Šiarnik Pavel , Žitňanová Ingrid , Imrich Richard , Turčáni Peter , Kollár Branislav
Published: March 2020

Background

Inflammatory cytokines contribute to proatherogenic changes in lipid metabolism by reduction of HDL-cholesterol (HDL-C) levels, impairment of its antiinflammatory and antioxidant functions. Therefore, the protective actions of HDL-C can be limited in chronic inflammatory diseases such as multiple sclerosis (MS). The aim of this study was to assess the association between lipoprotein subfractions and inflammatory status in early stages of multiple sclerosis.

Methods

Polyacrylamide gel electrophoresis Lipoprint© System was used for lipoprotein profile analysis in 19 newly diagnosed MS patients, and in matched 19 healthy controls. Serum levels of interleukin (IL) 1β, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10, IL-12 (p70), IL-13, IL-17, granulocyte colony-stimulating factor (G-CSF), granulocyte-macrophage colony-stimulating factor, interferon-γ and TNF-α were measured by multiplex bead assay.

Results

Concentrations of the measured cytokines and lipoprotein subclasses were comparable between MS patients and controls. Male, but not female MS patients had significantly higher total HDL-C and small HDL-C subfraction than healthy controls. Large HDL-C negatively correlated with all measured cytokines except IL-17 in MS but not in controls. Intermediate HDL-C subfractions correlated positively with all measured cytokines except G-CSF in MS females but not in MS males or controls.

Conclusion

Our results of higher HDL-C and mainly its small HDL-C subfraction suggest that male MS patients are at higher risk of atherosclerosis and the subtle dyslipidemia is present in early stages of the disease. The correlations between specific HDL-C subfractions and the inflammatory cytokines demonstrate mutual links between systemic inflammation and lipid metabolism in MS.

Trial registration

ClinicalTrials.gov, Identifier: NCT 03052595 Registered on Feb 14, 2017.
Cross-cultural adaptation and psychometric evaluation of the Yoruba version of the Back beliefs questionnaire among patients with chronic low-back pain
Authors: Mbada C. E. , Adeniyi O. A. , Idowu O. A. , Fatoye C. T. , Odole A. C. , Fatoye F.
Published: March 2020

Purpose

To translate, culturally adapt and conduct a psychometric evaluation of the Yoruba version of the Back Beliefs Questionnaire (BBQ) among patients with chronic low-back pain.

Methods

The English version of the BBQ was translated into the Yoruba language through a process of forward-backward translation, reconciliation and harmonization of the reconciled items sequentially. Thereafter, Cronbach’s Alpha, Intra-Class Correlation (ICC), Bland-Altman’s analysis were used to determine the internal consistency, test-retest reliability and limits of agreement of the Yoruba version of the BBQ (BBQ-Y). Other psychometric properties of the BBQ-Y explored comprised acceptability, standard error of measurement (SEM), minimal detectable change (MDC), convergent validity and floor and ceiling effects. While 119 respondents participated in the validity testing, only 51 of them were involved in the reliability testing of the BBQ-Y. Data were analysed using descriptive and inferential statistics. Alpha level was set at p < 0.05.

Results

The mean age of the respondents all the respondents was 56.8 ± 8.5 years. The BBQ-Y had excellent acceptability with a global Cronbach Alpha score of 0.71. The SEM and MDC of the BBQ-Y were 2.3 and 6.4. The BBQ-Y ICC score for test-retest was 0.89, while the Bland-Altman analysis showing limits of agreements for the test-retest reliability were − 6.84 and 5.70. The convergent validity of the BBQ-Y showed a weak correlation (r = 0.273, p = 0.001) with pain intensity using the visual analogue scale.

Conclusion

This is the first study to culturally adapt the BBY-Y and determined its psychometric properties. The BBQ-Y has adequate psychometric properties and it is an appropriate outcome measure for use among Yoruba speaking patients with chronic low-back pain.
Co-infections of human herpesviruses (CMV, HHV-6, HHV-7 and EBV) in non-transplant acute leukemia patients undergoing chemotherapy
Authors: Handous Imene , Achour Bechir , Marzouk Manel , Rouis Sana , Hazgui Olfa , Brini Ines , Khelif Abderrahim , Hannachi Naila , Boukadida Jalel
Published: March 2020

Background

Human herpesviruses (HHVs) remain latent after primary infection and can be reactivated in response to immunosuppression and chemotherapy. Little is known about their incidence, potential relationships, risk factors and clinical impact in non-transplant leukemia patients.

This study investigated prospectively incidence, risk factors, clinical impact and possible association of HHVs-(1–7) infections in patients with newly diagnosed acute leukemia.

Methods

Study design involved longitudinal sampling before chemotherapy and in different phases of chemotherapy: post-induction, post-remission, and post-salvage during 2016–2018. A total of 734 plasma samples from 95 patients were analyzed by a qualitative, multiplex PCR for HHVs detection and a quantitative real-time PCR was used for cytomegalovirus (CMV) quantification. HHVs-(1–6) IgG and IgM antibodies were tested using immunoassays. Risk factors were analyzed by binary logistic regression and relationships between viruses were analyzed using the Chi-square or Fisher’s exact test as appropriate.

Results

The overall seroprevalences of HHV-(1–6) IgG were high (> 80%). At least one herpes viral agent was detected in 60 patients (63.3%). CMV was the most commonly detected virus in the different phases of chemotherapy (19.4%), followed by HHV-6 (9.7%), HHV-7 (5.2%) and EBV (2.7%). HSV-1/2 and VZV DNA were not detected. Twenty-seven patients (28.4%) had more than one virus detected in the follow-up, with 23 who were co-infected. CMV/HHV-6 was the most frequent co-infection (69.5%, 16/23). HHV-6 infection (p = 0.008) was identified as a risk factor for CMV infection while salvage treatment (p = 0.04) and CMV infection (p = 0.007) were found to be independent risk factors for HHV-6 infection. CMV co-infection was associated with severe lymphopenia with an absolute lymphocyte count (ALC) (< 500/μL) (p = 0.009), rash (p = 0.011), pneumonia (p = 0.016) and opportunistic infections [bacteremia, p < 0.001 and invasive fungal infection, (p = 0.024)] more frequently than CMV mono-viral infections.

Conclusions

Our data suggest that co-infection with HHVs, especially CMV and HHV-6, may contribute to the development of serious clinical manifestations with profound lymphopenia, pneumonia rash and increased risk for bacterial and fungal co-infections. These findings may suggest the synergistic effect of HHVs associated infection.
Correction to: Protocol and baseline data for a prospective open-label explorative randomized singlecenter comparative study to determine the effects of various intravenous iron preparations on markers of oxidative stress and kidney injury in chronic kidney disease (IRON-CKD)
Authors: Ziedan Ahmed , Kassianides Xenophon , Bhandari Sunil
Published: March 2020

After publication of our article [1], the database of IRON-CKD has undergone vigorous inspection – the authors have therefore re-examined database.
Correction to: Core Rehabilitation Outcome Set for Single Sided Deafness (CROSSSD) study: protocol for an international consensus on outcome measures for single sided deafness interventions using a modified Delphi survey
Authors: Katiri Roulla , Hall Deborah A. , Buggy Nora , Hogan Nicholas , Horobin Adele , van de Heyning Paul , Firszt Jill B. , Bruce Iain A. , Kitterick Pádraig T.
Published: March 2020

Following the publication of our article [1], the authors have notified us of a typo in the third bullet point of the Consensus Criteria section.
Gene family information facilitates variant interpretation and identification of disease-associated genes in neurodevelopmental disorders
Authors:   EuroEPINOMICS-RES Consortium, Lal Dennis , May Patrick , Perez-Palma Eduardo , Samocha Kaitlin E. , Kosmicki Jack A. , Robinson Elise B. , Møller Rikke S. , Krause Roland , Nürnberg Peter , Weckhuysen Sarah , De Jonghe Peter , Guerrini Renzo , Niestroj Lisa M. , Du Juliana , Marini Carla , Ware James S. , Kurki Mitja , Gormley Padhraig , Tang Sha , Wu Sitao , Biskup Saskia , Poduri Annapurna , Neubauer Bernd A. , Koeleman Bobby P. C. , Helbig Katherine L. , Weber Yvonne G. , Helbig Ingo , Majithia Amit R. , Palotie Aarno , Daly Mark J.
Published: March 2020

Background

Classifying pathogenicity of missense variants represents a major challenge in clinical practice during the diagnoses of rare and genetic heterogeneous neurodevelopmental disorders (NDDs). While orthologous gene conservation is commonly employed in variant annotation, approximately 80% of known disease-associated genes belong to gene families. The use of gene family information for disease gene discovery and variant interpretation has not yet been investigated on a genome-wide scale. We empirically evaluate whether paralog-conserved or non-conserved sites in human gene families are important in NDDs.

Methods

Gene family information was collected from Ensembl. Paralog-conserved sites were defined based on paralog sequence alignments; 10,068 NDD patients and 2078 controls were statistically evaluated for de novo variant burden in gene families.

Results

We demonstrate that disease-associated missense variants are enriched at paralog-conserved sites across all disease groups and inheritance models tested. We developed a gene family de novo enrichment framework that identified 43 exome-wide enriched gene families including 98 de novo variant carrying genes in NDD patients of which 28 represent novel candidate genes for NDD which are brain expressed and under evolutionary constraint.

Conclusion

This study represents the first method to incorporate gene family information into a statistical framework to interpret variant data for NDDs and to discover new NDD-associated genes.
Correction to: Atrial myxoma with cerebellar signs: a case report
Authors: Shrestha Suraj , Raut Akash , Jayswal Amar , Yadav Randhir Sagar , Poudel Chandra Mani
Published: March 2020

In the publication of this article [1], there is an error in the name of one of the contributing authors.
Mesenchymal stem cells ameliorate myocardial fibrosis in diabetic cardiomyopathy via the secretion of prostaglandin E2
Authors: Jin Liyuan , Zhang Jinying , Deng Zihui , Liu Jiejie , Han Weidong , Chen Guanghui , Si Yiling , Ye Ping
Published: March 2020

Background

Diabetic cardiomyopathy (DCM) is a cardiac complication of long-term uncontrolled diabetes and is characterized by myocardial fibrosis and abnormal cardiac function. Mesenchymal stem cells (MSCs) are multipotent cells with immunoregulatory and secretory functions in diabetes and heart diseases. However, very few studies have focused on the effect and the underlying mechanism of MSCs on myocardial fibrosis in DCM. Therefore, we aimed to explore the therapeutic potential of MSCs in myocardial fibrosis and its underlying mechanism in vivo and in vitro.

Methods

A DCM rat model was induced using a high-fat diet (HFD) combined with a low-dose streptozotocin (STZ) injection. After four infusions of MSCs, rat serum and heart tissues were collected, and the levels of blood glucose and lipid, cardiac structure, and function, and the degree of myocardial fibrosis including the expression levels of pro-fibrotic factor and collagen were analyzed using biochemical methods, echocardiography, histopathology, polymerase chain reaction (PCR), and enzyme-linked immunosorbent assay (ELISA). We infused prostaglandin E2 (PGE2)-deficient MSCs to DCM rats in vivo and established a system mimicking diabetic myocardial fibrosis in vitro by inducing cardiac fibroblasts with high glucose (HG) and coculturing them with MSCs or PGE2-deficient MSCs to further explore the underlying mechanism of amelioration of myocardial fibrosis by MSCs.

Results

Metabolic abnormalities, myocardial fibrosis, and cardiac dysfunction in DCM rats were significantly ameliorated after treatment with MSCs. Moreover, the levels of TGF-β, collagen I, collagen III, and collagen accumulation were markedly decreased after MSC infusion compared to those in DCM hearts. However, PGE2-deficient MSCs had decreased ability to alleviate cardiac fibrosis and dysfunction. In addition, in vitro study revealed that the concentration of PGE2 in the MSC group was enhanced, while the proliferation and collagen secretion of cardiac fibroblasts were reduced after MSC treatment. However, MSCs had little effect on alleviating fibrosis when the fibroblasts were pretreated with cyclooxygenase-2 (COX-2) inhibitors, which also inhibited PGE2 secretion. This phenomenon could be reversed by adding PGE2.

Conclusions

Our results indicated that MSC infusion could ameliorate cardiac fibrosis and dysfunction in DCM rats. The underlying mechanisms might involve the function of PGE2 secreted by MSCs.
Dynorphin activation of kappa opioid receptor promotes microglial polarization toward M2 phenotype via TLR4/NF-κB pathway
Authors: Liu Lin , Xu Yingtong , Dai Hongmei , Tan Shan , Mao Xiao , Chen Zhiheng
Published: March 2020

Background

Microglia-mediated neuroinflammation is associated with epilepsy. Switching microglial polarization from the pro-inflammatory M1 phenotype to the anti-inflammatory M2 phenotype represents a novel therapeutic strategy for mitigating epileptogenesis. We previously found that dynorphins protected against epilepsy via activation of kappa opioid receptor (KOR). Here, this study aims to investigate the role and the mechanism of dynorphin in regulating microglial polarization.

Methods

A pilocarpine-induced rat model of epilepsy was established and lipopolysaccharide (LPS)-activated BV-2 microglial cells were used as an inflammatory model to explore the mechanism of dynorphin regulating microglial polarization.

Results

Overexpression of the dynorphin precursor protein prodynorphin (PDYN) alleviated the pilocarpine-induced neuronal apoptosis, promoted microglial polarization to the M2 phenotype, and inhibited pilocarpine-induced Toll-like receptor 4 (TLR4)/nuclear factor-kappa B (NF-κB) pathway in the hippocampi of epileptic rats. Dynorphin activation of KOR promoted microglial M2 polarization via inhibiting TLR4/NF-κB pathway in LPS-stimulated BV-2 microglial cells. Moreover, dynorphin/KOR regulated microglial M2 polarization inhibited apoptosis of the primary mouse hippocampal neurons.

Conclusion

In conclusion, dynorphin activation of KOR promotes microglia polarization toward M2 phenotype via inhibiting TLR4/NF-κB pathway.
Adverse drug reactions associated with amitriptyline — protocol for a systematic multiple-indication review and meta-analysis
Authors: Brueckle Maria-Sophie , Thomas Elizabeth T. , Seide Svenja E. , Pilz Maximilian , Gonzalez-Gonzalez Ana Isabel , Nguyen Truc Sophia , Harder Sebastian , Glasziou Paul P. , Gerlach Ferdinand M. , Muth Christiane
Published: March 2020

Background

Unwanted anticholinergic effects are both underestimated and frequently overlooked. Failure to identify adverse drug reactions (ADRs) can lead to prescribing cascades and the unnecessary use of over-the-counter products. The objective of this systematic review and meta-analysis is to explore and quantify the frequency and severity of ADRs associated with amitriptyline vs. placebo in randomized controlled trials (RCTs) involving adults with any indication, as well as healthy individuals.

Methods

A systematic search in six electronic databases, forward/backward searches, manual searches, and searches for Food and Drug Administration (FDA) and European Medicines Agency (EMA) approval studies, will be performed. Placebo-controlled RCTs evaluating amitriptyline in any dosage, regardless of indication and without restrictions on the time and language of publication, will be included, as will healthy individuals. Studies of topical amitriptyline, combination therapies, or including < 100 participants, will be excluded. Two investigators will screen the studies independently, assess methodological quality, and extract data on design, population, intervention, and outcomes ((non-)anticholinergic ADRs, e.g., symptoms, test results, and adverse drug events (ADEs) such as falls). The primary outcome will be the frequency of anticholinergic ADRs as a binary outcome (absolute number of patients with/without anticholinergic ADRs) in amitriptyline vs. placebo groups. Anticholinergic ADRs will be defined by an experienced clinical pharmacologist, based on literature and data from Martindale: The Complete Drug Reference. Secondary outcomes will be frequency and severity of (non-)anticholinergic ADRs and ADEs. The information will be synthesized in meta-analyses and narratives. We intend to assess heterogeneity using meta-regression (for indication, outcome, and time points) and I2 statistics. Binary outcomes will be expressed as odds ratios, and continuous outcomes as standardized mean differences. Effect measures will be provided using 95% confidence intervals. We plan sensitivity analyses to assess methodological quality, outcome reporting etc., and subgroup analyses on age, dosage, and duration of treatment.

Discussion

We will quantify the frequency of anticholinergic and other ADRs/ADEs in adults taking amitriptyline for any indication by comparing rates for amitriptyline vs. placebo, hence, preventing bias from disease symptoms and nocebo effects. As no standardized instrument exists to measure it, our overall estimate of anticholinergic ADRs may have limitations.

Systematic review registration

Submitted to PROSPERO; assignment is in progress.
A blockchain-based smart home gateway architecture for preventing data forgery
Authors: Lee Younghun , Rathore Shailendra , Park Jin Ho , Park Jong Hyuk
Published: March 2020

With the advancement of Information and Communication Technology (ICT) and the proliferation of sensor technologies, the Internet of Things (IoT) is now being widely used in smart home for the purposes of efficient resource management and pervasive sensing. In smart homes, various IoT devices are connected to each other, and these connections are centered on gateways. The role of gateways in the smart homes is significant, however, its centralized structure presents multiple security vulnerabilities such as integrity, certification, and availability. To address these security vulnerabilities, in this paper, we propose a blockchain-based smart home gateway network that counters possible attacks on the gateway of smart homes. The network consists of three layers including device, gateway, and cloud layers. The blockchain technology is employed at the gateway layer wherein data is stored and exchanged in the form blocks of blockchain to support decentralization and overcome the problem from traditional centralized architecture. The blockchain ensures the integrity of the data inside and outside of the smart home and provides availability through authentication and efficient communication between network members. We implemented the proposed network on the Ethereum blockchain technology and evaluated in terms of standard security measures including security response time and accuracy. The evaluation results demonstrate that the proposed security solutions outperforms over the existing solutions.