bluuebunny/crossref_metadata_2025 huggingface dataset:
The use Of Pupillary Light Reflex in Concussed Athletes
Authors: Podolak Olivia E. , Arbogast Kristy B. , Nabin Joshi B. , Ciuffreda Kenneth , Grady Matthew , Master Christina L.
Published: April 2020

Background:

Despite advancements, concussion diagnosis remains reliant on subjective symptom report and clinical assessments. Visual deficits and autonomic dysfunction have been described following concussion. Testing of the pupillary light reflex (PLR) is a simple, portable, non-invasive, and objective means of quantifying pupillary function.

Purpose:

The aim of this study was to objectively evaluate pupillary responses to a light stimulus in concussed adolescent athletes and to determine whether clinical assessments correlated with PLR responses after a diagnosed concussion when compared to pre-injury responses.

Methods:

In this prospective cohort study, PLR and clinical measures [PCSI and/or SCAT symptom scales, near point of convergence (NPC) and accommodation amplitude (AA) of both eyes] were assessed in 93 (45 female), non-concussed adolescent athletes (ages 14-18) during their pre-season. PLR was obtained in response to a brief white light stimulus using a hand-held pupillometer. During each assessment, three monocular trials were performed in each eye alternatively, with subsequent averaged responses for each eye. Seven athletes (ages 14-17) sustained a concussion and had post-injury assessments of PLR and clinical measures completed longitudinally through recovery.

Results:

All seven concussed athletes completed PLR and clinical assessments at least once post-injury (mean initial day of evaluation = 6 days post injury). Six out of the seven concussed athletes demonstrated an increase in steady state diameter of 24% (median 18%), minimum pupil diameter of 17% (median 11%) and a maximum constriction velocity of 28% (median 33%) following concussion which decreased over the course of recovery, returning to pre-injury or below pre-injury measurements. Six of seven of the concussed athletes completed NPC and AA assessments at both pre-season and post-injury timepoints. In contrast to the PLR findings, both NPC and AA measures were normal at post-injury assessments. Reported symptom scores improved throughout recovery, correlating with PLR response recovery, with both returning to pre-injury measurements.

Conclusion:

Pupil responsivity was found to be significantly enhanced after concussion compared to pre-injury measurements, waning over time during recovery, following a similar trajectory as symptom burden. NPC and AA, which have autonomic contributions and are clinical measures, were normal pre- and post-injury and did not differentiate the concussed state from the uninjured state in our series. Our preliminary results demonstrate that dynamic PLR responses may detect acute autonomic deficits that are not evident via clinical assessments. Further investigation of its potential utility as sensitive and objective biomarker in concussion diagnosis, management and sports clearance is warranted.
The Contributing Factors to Nurses’ Behavioral Intention to Use Hospital Information Technologies in Ghana
Authors: Lulin Zhou , Owusu-Marfo Joseph , Antwi Henry Asante , Xu Xinglong
Published: April 2020

Background

Medical care facilities in both developed and developing countries around the world continue to invest in hospital information technologies (HITs). Nevertheless, it has been discovered that user acceptance of these technologies is one of the imperative issues during their implementation and management in developing countries such as Ghana.

Purpose

Notably, the technology acceptance assessment of nurses is a timely one since they play a very important role in the medical sector. Based on the model of “Unified Theory of Acceptance and Use of Technology,” this study explored the factors that affect Ghanaian nurses’ acceptance of HIT. Design/Method/Approach: A descriptive nonexperimental research design was employed in this study to recruit 660 nurses (404 females and 256 males) from 3 teaching and 2 regional hospitals in Ghana. A standardized electronic platform questionnaire (based on the Unified Theory of Acceptance and Use of Technology model) was designed on smartphones and was self-administered, while the data collected were analyzed via the SmartPLS Structural Equation Modeling path analysis. The “Social Influence” ( t  = 3.656, p < .001), “Attitude towards the Use of Technology” ( t = 5.861, p < .001), and “Facilitating Conditions” ( t = 2.616, p < .001) were the main predictors of the nurses’ behavioral intention to use HIT. The effects of the aforementioned constructs explained 60.7% ( R2 = 0.607) of the variance in the nurses’ intentions to use the HIT systems.

Conclusions

Precisely, HIT systems are essential in the quality and the enhancement of nursing services provision and in the effectiveness of the performance of nursing staff. This study, therefore, offers a piece of empirical evidence for hospital administrators in developing countries especially Ghana, to assess the success probability of new HITs before and after their implementation.
For the Sake of Family and Tradition: Honour Killings in India and Pakistan
Authors: D’Lima Tanya , Solotaroff Jennifer L. , Pande Rohini Prabha
Published: April 2020

The United Nations Population Fund (UNFPA) estimates that the annual worldwide number of honour killings is as high as 5,000 women and girls, though some non-governmental organizations (NGOs) estimate as many as 20,000 honour killings annually worldwide. Despite limited statistics, research shows that honour killings occur amongst women of different ages, religions, and social status, wealth, education, and location. The limited understanding of each country context, combined with scarce data on honour killings, has contributed to the continued hidden nature of this shocking form of violence. In this article, we seek to address this gap through a descriptive analysis of honour killings in India and Pakistan. In the absence of other data, we conduct a content analysis of media-reported honour killings in these two countries to examine key similarities and differences in the motivations, types, and other characteristics of honour killings across these countries and highlight any key risk and protective factors that emerge.
Role of Women in Telangana Statehood Movement from South India: Contributions and Case Story of Belli Lalitha
Authors: Gangadhar Bongurala
Published: April 2020

The role of women in Telangana statehood movement has immense importance and has paved a way for the realization of the dreams of women who aspired for emancipation from human trafficking, dowry, domestic violence and liquor mafia. The role of Belli Lalitha in the 1990s sparked a wave of movement with her folk songs to mobilize people to demand their rights. Belli Lalitha’s journey started with ups and downs as a school dropout, married early, labourer in a cotton mill, labour activist, folk singer and political leader, but her sudden murder by the goons and political leaders changed the pace of the movement from peak level to ground. To mobilize millions of people in the final phase of the Telangana movement, the folk song tradition familiarized at grass-root level by Belli Lalitha occupies an important position.
Attitudes and experiences of health care professionals when caring for transgender men undergoing fertility preservation by egg freezing: a qualitative study
Authors: Armuand Gabriela , Dhejne Cecilia , Olofsson Jan I. , Stefenson Margareta , Rodriguez-Wallberg Kenny A.
Published: April 2020

Background:

As gender-affirming treatment may have a negative impact on fertility, reproductive health counseling to patients seeking medical or surgical gender-affirming treatment should be provided, including the option to undergo fertility preservation (FP). Experiences of transgender men undergoing FP treatments aimed at oocyte freezing have reported a negative impact of the treatments on gender dysphoria. No previous studies have investigated the experiences of health care professionals’ (HCP) when caring for transgender men undergoing such treatments.

Aim:

The aim of this study was to investigate HCP’s attitudes and experiences when meeting transgender men undergoing FP through oocyte freezing.

Methods:

Individual interviews were conducted in 2016 with 13 HCPs working at a Reproductive Medicine clinic in Sweden. Data were analyzed by thematic content analysis.

Results:

The main theme found, How to maintain professionalism, showed that HCPs experienced important challenges to their professionalism when their preconceived opinions and values about gender and transgender were confronted.

Discussion:

Our findings demonstrate the need of continuous efforts on assessing learning needs as well as addressing preconceived opinions and values of HCP. By gaining knowledge and self-confidence in the care of transgender individuals undergoing FP, a professional care for transgender people can be achieved and a safe environment can be established for the patients. This in turn may alleviate some of the distress that may arise when transgender men undergo FP.
The self-regulation of teleological thinking in natural selection learning
Authors: González Galli Leonardo , Peréz Gastón , Gómez Galindo Alma Adrianna
Published: April 2020

Background

Teleology is one of the critical aspects of students’ intuitive concepts about living beings and, specifically, their evolution. This cognitive bias imposes a substantial restriction on the process of learning such content. In this work, we rely on epistemological, psychological and pedagogical analyses to substantiate an educational proposal centered on the concepts of epistemological obstacles and metacognitive vigilance.

Results

Based on Michael Ruse’s epistemological analysis, according to which teleology in biology persists because the scientific explanation of adaptation necessarily involves appeal to the metaphor of design, and on research in cognitive psychology, especially in relation to metacognition and self-regulated learning, we argue that the primary educational aim must be to encourage students to develop metacognitive skills to regulate the use of teleological reasoning. We develop our instructional proposal based on the didactic concepts of epistemological obstacles and metacognitive vigilance (consistent with epistemological and psychological analyses).

Conclusion

We briefly discuss the instructional implications of our analysis and some possible relationships between our proposal and other lines of research in psychology and science education.
Membrane current evoked by mitochondrial Na+–Ca2+ exchange in mouse heart
Authors: Islam Mohammed M. , Takeuchi Ayako , Matsuoka Satoshi
Published: April 2020

The electrogenicity of mitochondrial Na+–Ca2+ exchange (NCXm) had been controversial and no membrane current through it had been reported. We succeeded for the first time in recording NCXm-mediated currents using mitoplasts derived from mouse ventricle. Under conditions that K+, Cl−, and Ca2+ uniporter currents were inhibited, extra-mitochondrial Na+ induced inward currents with 1 μM Ca2+ in the pipette. The half-maximum concentration of Na+ was 35.6 mM. The inward current was diminished without Ca2+ in the pipette, and was augmented with 10 μM Ca2+. The Na+-induced inward currents were largely inhibited by CGP-37157, an NCXm blocker. However, the reverse mode of NCXm, which should be detected as an outward current, was hardly induced by extra-mitochondrial application of Ca2+ with Na+ in the pipette. It was concluded that NCXm is electrogenic. This property may be advantageous for facilitating Ca2+ extrusion from mitochondria, which has large negative membrane potential.
Comparison of predictive value of NT-proBNP, sST2 and MMPs in heart failure patients with different ejection fractions
Authors: Pan Wei , Yang Donghui , Yu Peng , Yu Huizhen
Published: April 2020

Background

This study sought to compare the predictive value of NT-proBNP, sST2 and MMPs in HF with different ejection fractions from a population in southern China.

Methods

A cross-sectional study was conducted on 113 HF patients admitted to Fujian Provincial Hospital from December 2016 to March 2018.The patients were divided into three subgroups: 60 cases in HFpEF group (LVEF≥50%), 28 cases in HFmrEF group (41% ≤ LVEF≤49%) and 25 cases in HFrEF group (LVEF≤40%). ELISA method was applied to detect the concentrations of sST2, MMP-2 and MMP-9. Electrochemical luminescence immunoassay was applied to detect the concentration of plasma NT-proBNP. Univariate and multivariate Cox and logistic regression models were used to analyze the diagnostic significance of these plasma biomarkers in HF patients. Kaplan–Meier survival curves were used to assess the prognostic value of sST2 in the incidence of long-term adverse events during study.

Results

This study showed that plasma sST2 levels in HFrEF or HFmrEF patients were significantly higher than in HFpEF patients. Plasma levels of MMP-2 and MMP-9 in HFrEF patients were apparently higher than in HFpEF or HFmrEF patients. For the diagnosis of HFpEF, the AUC of NT-proBNP was higher than that of sST2, MMP-2 and MMP-9, which were 0.881, 0.717, 0.705 and 0.597, respectively. For the diagnosis of HFmrEF, the AUC of plasma sST2 was higher than that of MMP-2, MMP-9 and NT-proBNP, which were 0.799, 0.678, 0.676 and 0.793, respectively. For the diagnosis of HFrEF, the AUC of plasma NT-proBNP, sST2, MMP-2, and MMP-9 were 0.945, 0.820, 0.814, and 0.774 respectively. Spearman correlation analysis showed that plasma sST2 levels were significantly correlated with plasma MMP-2, MMP-9 and NT-proBNP levels. Further logistic regression analysis showed that except MMP-9, the biomarkers sST2 (OR = 1.960), MMP-2 (OR = 0.805) and NT-proBNP (OR = 0.002) were all independent risk factors for patients with heart failure. Survival analysis results suggested that for patients with HFmrEF, a higher level of plasma sST2 (≥ 0.332 ng/ml at admission) may predict a higher risk of endpoint events and a lower survival rate (P < 0.025).

Conclusions

The circulating biomarkers sST2, MMP-2 and NT-proBNP were all independent risk factors for patients with heart failure. The sST2 can be a useful biomarker with both diagnostic and prognostic value in patients with HFmrEF. The higher sST2 level in patients with heart failure was related to a higher incidence of combined endpoint outcome.
Multiple sclerosis in a multi-ethnic population from Northern California: a retrospective analysis, 2010–2016
Authors: Romanelli Robert J. , Huang Qiwen , Lacy Joseph , Hashemi Lobat , Wong Alana , Smith Alden
Published: April 2020

Background

Research is needed to examine differences in multiple sclerosis (MS) prevalence by race-ethnicity. The goal of this study was to quantify MS prevalence in a health care system in Northern California and examine differences in prevalence and phenotype by race-ethnicity.

Methods

We conducted a retrospective, observational cohort study of adults (2010–2016). MS prevalence estimates were standardised to distributions of gender and race-ethnicity for the underlying geographic region and stratified by gender and race-ethnicity with age adjustment. We performed a chart review of a racial-ethnic stratified sample of patients to examine disease phenotypes.

Results

1,058,102 patients were identified, of which 3286 had MS. The overall direct-standardised prevalence was 288.0 cases per 100,000 population (95% confidence interval: 276.3–299.8). Age-adjusted prevalence ranged from 677.0 per 100,000 among non-Hispanic black women to 49.7 per 100,000 among non-Hispanic Asian men. Non-Hispanic blacks compared with other groups more often had primary-progressive (10.0% vs. 0.0–4.0%) or progressive-relapsing MS (6.0% vs. 0.0–2.0%).

Conclusions

In this Northern Californian Cohort, between 2010 and 2016 the direct-standardised MS prevalence was estimated at 288.0 per 100,000 population, and increased over time. Non-Hispanic blacks, especially women, were disproportionately affected and had less common, earlier progressive MS phenotypes.
Distributed representation and one-hot representation fusion with gated network for clinical semantic textual similarity
Authors: Xiong Ying , Chen Shuai , Qin Haoming , Cao He , Shen Yedan , Wang Xiaolong , Chen Qingcai , Yan Jun , Tang Buzhou
Published: April 2020

Background

Semantic textual similarity (STS) is a fundamental natural language processing (NLP) task which can be widely used in many NLP applications such as Question Answer (QA), Information Retrieval (IR), etc. It is a typical regression problem, and almost all STS systems either use distributed representation or one-hot representation to model sentence pairs.

Methods

In this paper, we proposed a novel framework based on a gated network to fuse distributed representation and one-hot representation of sentence pairs. Some current state-of-the-art distributed representation methods, including Convolutional Neural Network (CNN), Bi-directional Long Short Term Memory networks (Bi-LSTM) and Bidirectional Encoder Representations from Transformers (BERT), were used in our framework, and a system based on this framework was developed for a shared task regarding clinical STS organized by BioCreative/OHNLP in 2018.

Results

Compared with the systems only using distributed representation or one-hot representation, our method achieved much higher Pearson correlation. Among all distributed representations, BERT performed best. The highest Person correlation of our system was 0.8541, higher than the best official one of the BioCreative/OHNLP clinical STS shared task in 2018 (0.8328) by 0.0213.

Conclusions

Distributed representation and one-hot representation are complementary to each other and can be fused by gated network.
Direct evidence for transport of RNA from the mouse brain to the germline and offspring
Authors: O’Brien Elizabeth A. , Ensbey Kathleen S. , Day Bryan W. , Baldock Paul A. , Barry Guy
Published: April 2020

Background

The traditional concept that heritability occurs exclusively from the transfer of germline-restricted genetics is being challenged by the increasing accumulation of evidence confirming the existence of experience-dependent transgenerational inheritance. However, questions remain unanswered as to how heritable information can be passed from somatic cells. Previous studies have implicated the critical involvement of RNA in heritable transgenerational effects, and the high degree of mobility and genomic impact of RNAs in all organisms is an attractive model for the efficient transfer of genetic information.

Results

We hypothesized that RNA may be transported from a somatic tissue, in this case the brain, of an adult male mouse to the germline, and subsequently to embryos. To investigate this, we injected one hemisphere of the male mouse striatum with an AAV1/9 virus expressing human pre-MIR941 (MIR941). After 2, 8 and 16 weeks following injection, we used an LNA-based qPCR system to detect the presence of virus and human MIR941 in brain, peripheral tissues and embryos, from injected male mice mated with uninjected females. Virus was never detected outside of the brain. Verification of single bands of the correct size for MIR941 was performed using Sanger sequencing while quantitation demonstrated that a small percentage (~ 1–8%) of MIR941 is transported to the germline and to embryos in about a third of the cases.

Conclusions

We show that somatic RNA can be transported to the germline and passed on to embryos, thereby providing additional evidence of a role for RNA in somatic cell-derived intergenerational effects.
Intensity of pyrethroid resistance in Anopheles gambiae before and after a mass distribution of insecticide-treated nets in Kinshasa and in 11 provinces of the Democratic Republic of Congo
Authors: Wat’senga Francis , Agossa Fiacre , Manzambi Emile Z. , Illombe Gillon , Mapangulu Tania , Muyembe Tamfum , Clark Tiffany , Niang Mame , Ntoya Ferdinand , Sadou Aboubacar , Plucinski Mateusz , Li Yikun , Messenger Louisa A. , Fornadel Christen , Oxborough Richard M. , Irish Seth R.
Published: April 2020

Background

Between 2011 and 2018, an estimated 134.8 million pyrethroid-treated long-lasting insecticidal nets (LLINs) were distributed nationwide in the Democratic Republic of Congo (DRC) for malaria control. Pyrethroid resistance has developed in DRC in recent years, but the intensity of resistance and impact on LLIN efficacy was not known. Therefore, the intensity of resistance of Anopheles gambiae sensu lato (s.l.) to permethrin and deltamethrin was monitored before and after a mass distribution of LLINs in Kinshasa in December 2016, and in 6 other sites across the country in 2017 and 11 sites in 2018.

Methods

In Kinshasa, CDC bottle bioassays using 1, 2, 5, and 10 times the diagnostic dose of permethrin and deltamethrin were conducted using An. gambiae s.l. collected as larvae and reared to adults. Bioassays were conducted in four sites in Kinshasa province 6 months before a mass distribution of deltamethrin-treated LLINs and then two, six, and 10 months after the distribution. One site in neighbouring Kongo Central province was used as a control (no mass campaign of LLIN distribution during the study). Nationwide intensity assays were conducted in six sites in 2017 using CDC bottle bioassays and in 11 sites in 2018 using WHO intensity assays. A sub-sample of An. gambiae s.l. was tested by PCR to determine species composition and frequency of kdr-1014F and 1014S alleles.

Results

In June 2016, before LLIN distribution, permethrin resistance intensity was high in Kinshasa; the mean mortality rate was 43% at the 5× concentration and 73% at the 10× concentration. Bioassays at 3 time points after LLIN distribution showed considerable variation by site and time and there was no consistent evidence for an increase in pyrethroid resistance intensity compared to the neighbouring control site. Tests of An. gambiae s.l. in 6 sites across the country in 2017 and 11 sites in 2018 showed all populations were resistant to the diagnostic doses of 3 pyrethroids. In 2018, the intensity of resistance varied by site, but was generally moderate for all three pyrethroids, with survivors at ×5 the diagnostic dose. Anopheles gambiae sensu stricto (s.s.) was the most common species identified across 11 sites in DRC, but in Kinshasa, An. gambiae s.s. (91%) and Anopheles coluzzii (8%) were sympatric.

Conclusions

Moderate or high intensity pyrethroid resistance was detected nationwide in DRC and is a serious threat to sustained malaria control with pyrethroid LLINs. Next generation nets (PBO nets or bi-treated nets) should be considered for mass distribution.
Pharmacological prevention of surgery-accelerated metastasis in an animal model of osteosarcoma
Authors: Kallis Michelle P. , Maloney Caroline , Blank Brandon , Soffer Samuel Z. , Symons Marc , Steinberg Bettie M.
Published: April 2020

Background

Osteosarcoma is a highly metastatic primary bone tumor that predominantly affects adolescents and young adults. A mainstay of treatment in osteosarcoma is removal of the primary tumor. However, surgical excision itself has been implicated in promoting tumor growth and metastasis, an effect known as surgery-accelerated metastasis. The underlying mechanisms contributing to surgery-accelerated metastasis remain poorly understood, but pro-tumorigenic alterations in macrophage function have been implicated.

Methods

The K7M2-BALB/c syngeneic murine model of osteosarcoma was used to study the effect of surgery on metastasis, macrophage phenotype, and overall survival. Pharmacological prevention of surgery-accelerated metastasis was examined utilizing gefitinib, a receptor interacting protein kinase 2 inhibitor previously shown to promote anti-tumor macrophage phenotype.

Results

Surgical excision of the primary tumor resulted in increases in lung metastatic surface nodules, overall metastatic burden and number of micrometastatic foci. This post-surgical metastatic enhancement was associated with a shift in macrophage phenotype within the lung to a more pro-tumor state. Treatment with gefitinib prevented tumor-supportive alterations in macrophage phenotype and resulted in reduced metastasis. Removal of the primary tumor coupled with gefitinib treatment resulted in enhanced median and overall survival.

Conclusions

Surgery-accelerated metastasis is mediated in part through tumor supportive alterations in macrophage phenotype. Targeted pharmacologic therapies that prevent pro-tumor changes in macrophage phenotype could be utilized perioperatively to mitigate surgery-accelerated metastasis and improve the therapeutic benefits of surgery.
Harnessing the PRECISE network as a platform to strengthen global capacity for maternal and child health research in sub-Saharan Africa
Authors:   The PRECISE Network, Flint-O’Kane Meriel , von Dadelszen Peter , Makanga Prestige Tatenda , Sevene Esperança , Roca Anna , Dukes Peter , Hinrichs-Krapels Saba , Craik Rachel , Magee Laura A. , Temmerman Marleen
Published: April 2020

It is widely acknowledged across the global health sector that research programmes need to be designed and implemented in a way that maximise opportunities for strengthening local capacity. This paper examines how the United Kingdom Research and Innovation (UKRI) Grand Challenges Research Fund (GCRF) funded PRECISE (PREgnancy Care Integrating translational Science, Everywhere) Network has been established as a platform to strengthen global capacity for research focused on the improvement of maternal, fetal and newborn health in sub-Saharan Africa.

Best practice principles outlined in an ESSENCE on Health Research report have been considered in relation to the PRECISE Network capacity-building activities described in this paper. These activities are described at the individual, programmatic and institutional levels, and successes, challenges and recommendations for future work are outlined.

The paper concludes that the PRECISE leadership have an opportunity to review and refresh activity plans for capacity building at this stage in the project to build on achievements to date.
Cord blood DNA methylation reflects cord blood C-reactive protein levels but not maternal levels: a longitudinal study and meta-analysis
Authors: Yeung Edwina H. , Guan Weihua , Zeng Xuehuo , Salas Lucas A. , Mumford Sunni L. , de Prado Bert Paula , van Meel Evelien R. , Malmberg Anni , Sunyer Jordi , Duijts Liesbeth , Felix Janine F. , Czamara Darina , Hämäläinen Esa , Binder Elisabeth B. , Räikkönen Katri , Lahti Jari , London Stephanie J. , Silver Robert M. , Schisterman Enrique F.
Published: April 2020

Background

Prenatal inflammation has been proposed as an important mediating factor in several adverse pregnancy outcomes. C-reactive protein (CRP) is an inflammatory cytokine easily measured in blood. It has clinical value due to its reliability as a biomarker for systemic inflammation and can indicate cellular injury and disease severity. Elevated levels of CRP in adulthood are associated with alterations in DNA methylation. However, no studies have prospectively investigated the relationship between maternal CRP levels and newborn DNA methylation measured by microarray in cord blood with reasonable epigenome-wide coverage. Importantly, the timing of inflammation exposure during pregnancy may also result in different effects. Thus, our objective was to evaluate this prospective association of CRP levels measured during multiple periods of pregnancy and in cord blood at delivery which was available in one cohort (i.e., Effects of Aspirin in Gestation and Reproduction trial), and also to conduct a meta-analysis with available data at one point in pregnancy from three other cohorts from the Pregnancy And Childhood Epigenetics consortium (PACE). Secondarily, the impact of maternal randomization to low dose aspirin prior to pregnancy on methylation was assessed.

Results

Maternal CRP levels were not associated with newborn DNA methylation regardless of gestational age of measurement (i.e., CRP at approximately 8, 20, and 36 weeks among 358 newborns in EAGeR). There also was no association in the meta-analyses (all p > 0.5) with a larger sample size (n = 1603) from all participating PACE cohorts with available CRP data from first trimester (< 18 weeks gestation). Randomization to aspirin was not associated with DNA methylation. On the other hand, newborn CRP levels were significantly associated with DNA methylation in the EAGeR trial, with 33 CpGs identified (FDR corrected p < 0.05) when both CRP and methylation were measured at the same time point in cord blood. The top 7 CpGs most strongly associated with CRP resided in inflammation and vascular-related genes.

Conclusions

Maternal CRP levels measured during each trimester were not associated with cord blood DNA methylation. Rather, DNA methylation was associated with CRP levels measured in cord blood, particularly in gene regions predominately associated with angiogenic and inflammatory pathways.

Trial registration

Clinicaltrials.gov, NCT00467363, Registered April 30, 2007, http://www.clinicaltrials.gov/ct2/show/NCT00467363
The combined effects of microglia activation and brain glucose hypometabolism in early-onset Alzheimer’s disease
Authors: Tondo Giacomo , Iaccarino Leonardo , Caminiti Silvia Paola , Presotto Luca , Santangelo Roberto , Iannaccone Sandro , Magnani Giuseppe , Perani Daniela
Published: April 2020

Background

Early-onset Alzheimer’s disease (EOAD) is characterized by young age of onset (< 65 years), severe neurodegeneration, and rapid disease progression, thus differing significantly from typical late-onset Alzheimer’s disease. Growing evidence suggests a primary role of neuroinflammation in AD pathogenesis. However, the role of microglia activation in EOAD remains a poorly explored field. Investigating microglial activation and its influence on the development of synaptic dysfunction and neuronal loss in EOAD may contribute to the understanding of its pathophysiology and to subject selection in clinical trials. In our study, we aimed to assess the amount of neuroinflammation and neurodegeneration and their relationship in EOAD patients, through positron emission tomography (PET) measures of microglia activation and brain metabolic changes.

Methods

We prospectively enrolled 12 EOAD patients, classified according to standard criteria, who underwent standard neurological and neuropsychological evaluation, CSF analysis, brain MRI, and both [18F]-FDG PET and [11C]-(R)-PK11195 PET. Healthy controls databases were used for statistical comparison. [18F]-FDG PET brain metabolism in single subjects and as a group was assessed by an optimized SPM voxel-wise single-subject method. [11C]-PK11195 PET binding potentials were obtained using reference regions selected with an optimized clustering procedure followed by a parametric analysis. We performed a topographic interaction analysis and correlation analysis in AD-signature metabolic dysfunctional regions and regions of microglia activation. A network connectivity analysis was performed using the interaction regions of hypometabolism and [11C]-PK11195 PET BP increases.

Results

EOAD patients showed a significant and extended microglia activation, as [11C]-PK11195 PET binding potential increases, and hypometabolism in typical AD-signature brain regions, i.e., temporo-parietal cortex, with additional variable frontal and occipital hypometabolism in the EOAD variants. There was a spatial concordance in the interaction areas and significant correlations between the two biological changes. The network analysis showed a disruption of frontal connectivity induced by the metabolic/microglia effects.

Conclusion

The severe microglia activation characterizing EOAD and contributing to neurodegeneration may be a marker of rapid disease progression. The coupling between brain glucose hypometabolism and local immune response in AD-signature regions supports their biological interaction.
Isolation of two iron-reducing facultative anaerobic electricigens and probing the application performance in eutrophication water
Authors: Zhang Xia , Zhang Hongpei , Wang Chuan , Chen Qianru , Zhao Yuqing , Zhou Qiaohong , Wu Zhenbin
Published: April 2020

Purpose

Sediment microbial fuel cell (SMFC) is a promising bioremediation technology in which microbes play an important role. Electricigens as the bio-catalysts have effect on pollution control and electricity generation. It is of great significance to screen the microorganisms with the ability of generating electricity.

Methods

The SMFC anode biofilm was used as microbiological source to study the feasibility of electricigens with iron-reducing property for eutrophication water treatment. Preliminarily, we isolated 20 facultative anaerobic pure bacteria and evaluated their cyclic voltammogram (CV) through the three-electrode system and electrochemical workstation. The power generation performance of strains was verified by air-cathode microbial fuel cells (AC-MFCs) under different single carbon sources.

Result

According to its morphological, physiological, and biochemical characteristics, along with phylogenetic analysis, the two strains (SMFC-7 and SMFC-17) with electrical characteristics were identified as Bacillus cereus. Compared with SMFC-7, SMFC-17 exhibited efficient NH4+-N and NO3−-N removal and PO43−-P accumulation from eutrophic solution with a removal rate of 79.91 ± 6.34% and 81.26 ± 1.11% and accumulation rate of 57.68 ± 4.36%, respectively.

Conclusion

The isolated bacteria SMFC-17 showed a good performance in eutrophic solution, and it might be a useful biocatalyst to enable the industrialized application of SMFC in eutrophic water treatment.
Safety and efficiency of gasless laparoscopy: a systematic review protocol
Authors: Shoman Haitham , Sandler Simone , Peters Alexander , Farooq Ameer , Gruendl Magdalen , Trinh Shauna , Little James , Woods Alex , Bolton William , Abioye Abubakar , Ljungman David
Published: April 2020

Background

Gasless laparoscopy, developed in the early 1990s, was a means to minimize the clinical and financial challenges of pneumoperitoneum and general anaesthesia. It has been used in a variety of procedures such as in general surgery and gynecology procedures including diagnostic laparoscopy. There has been increasing evidence of the utility of gasless laparoscopy in resource limited settings where diagnostic imaging is not available. In addition, it may help save costs for hospitals. The aim of this study is to conduct a systematic review of the available evidence surrounding the safety and efficiency of gasless laparoscopy compared to conventional laparoscopy and open techniques and to analyze the benefits that gasless laparoscopy has for low resource setting hospitals.

Methods

This protocol is developed by following the Preferred Reporting Items for Systematic review and Meta-Analysis–Protocols (PRISMA-P). The PRISMA statement guidelines and flowchart will be used to conduct the study itself. MEDLINE (Ovid), Embase, Web of Science, Cochrane Central, and Global Index Medicus (WHO) will be searched and the National Institutes of Health Clinical Trials database. The articles that will be found will be pooled into Covidence article manager software where all the records will be screened for eligibility and duplicates removed. A data extraction spreadsheet will be developed based on variables of interest set a priori. Reviewers will then screen all included studies based on the eligibility criteria. The GRADE tool will be used to assess the quality of the studies and the risk of bias in all the studies will be assessed using the Cochrane Risk assessment tool. The RoB II tool will assed the risk of bias in randomized control studies and the ROBINS I will be used for the non-randomized studies.

Discussion

This study will be a comprehensive review on all published articles found using this search strategy on the safety and efficiency of the use of gasless laparoscopy. The systematic review outcomes will include safety and efficiency of gasless laparoscopy compared to the use of conventional laparoscopy or laparotomy.

Trial registration

The study has been registered in PROSPERO under registration number:CRD42017078338
The great nursing brain drain and its effects on patient safety
Authors: Peters Alexandra , Palomo Rafael , Pittet Didier
Published: April 2020

The World Health Organization (WHO) has declared 2020 the “Year of the Nurse and Midwife”. On May 5th of this year, for the annual celebration of the SAVE LIVES: Clean Your Hands campaign, the WHO will focus on the critical role of nurses and midwives in promoting public health. The brain drain of healthcare workers (HCWs) leads to unequal distribution of nurses and midwives around the world, which affects the quality of care provided to patients. This phenomenon should be addressed as a global problem as it highlights staff shortages in the health system.
Testing satellite telemetry within narrow ecosystems: nocturnal movements and habitat use of bottlenose dolphins within a convoluted estuarine system
Authors: Hartel Elizabeth F. , Noke Durden Wendy , O’Corry-Crowe Greg
Published: April 2020

Background

While cetaceans have been extensively studied around the world, nocturnal movements and habitat use have been largely unaddressed for most populations. We used satellite telemetry to examine the nocturnal movements and habitat use of four bottlenose dolphins (Tursiops truncatus) from a well-studied population in a complex estuary along the east coast of Florida. This also enabled us to explore the utility of satellite tracking on an apex predator within a very narrow and convoluted ecosystem. Our objectives were to evaluate (1) nocturnal home ranges and how individual dolphins moved within them, (2) nocturnal utilization of habitats surrounding ocean inlets, (3) nocturnal movements outside of the population’s known range (i.e., the study area), and (4) nocturnal use of select environmental variables.

Results

Satellite tags were active between 129 and 140 days (136 ± 4.99) during nocturnal hours (summer/fall 2012), yielding 3.3 ± 1.4 high-quality transmissions per night. Results indicated substantial individual variation among the four tagged dolphins, with home ranges varying in length from 53.9 to 83.6 km (x̅ = 71.9 ± 12.9). Binomial tests and MaxEnt models revealed some dolphins preferred habitats surrounding inlets, seagrass habitats, and various water depths, while other dolphins avoided these areas. All dolphins, however, showed substantial movement (x̅ = 5.8 ± 7.4 km) outside of the study area, including travel into rivers/canals and the adjoining ocean (6.0–8.6% and 0.8–2.9% of locations per dolphin, respectively).

Conclusions

This study was the first to utilize satellite telemetry on Indian River Lagoon dolphins and provided the first detailed insights into the nocturnal movements and habitat use of this population. Our findings suggest that while individual dolphin home ranges may overlap, they use different foraging strategies, feed on different prey, and/or exhibit intraspecific resource partitioning. In contrast with a prior study, all tagged dolphins showed considerable movement into the adjoining ocean and freshwater sources. This suggests this population has a much larger range than previously thought, which is important to consider for future research and conservation efforts.
A simplified checklist for the visual inspection of finished pharmaceutical products: a way to empower frontline health workers in the fight against poor-quality medicines
Authors: Schiavetti B. , Wynendaele E. , Melotte V. , Van der Elst J. , De Spiegeleer B. , Ravinetto R.
Published: April 2020

Background

Substandard and falsified medicines, mainly prevalent in low and middle-income countries (LMICs), cause avoidable morbidity and mortality, and put at stake the performance of health systems. They may be prevented by an adequate implementation of pharmaceutical Quality Assurance (QA) guidelines, but unfortunately, most guidelines address upstream stakeholders and specialized staff in the supply chain. A multi-layered approach is needed, in order to empower the health workers at the point-of-care to proactively contribute to the fight against poor-quality medicines.

Visual inspection is a simple technique, suitable for field screening. The findings of a survey conducted in the Democratic Republic of the Congo (DRC) suggested that it might be a fairly good (yet partial) predictor of poor-quality, when compared to full laboratory tests.

Methods and results

Starting from the 68-questions checklist originally used in the survey in the DRC, we developed a simplified checklist, specifically designed to guide health workers at the point of care to rapidly identify suspect poor-quality medicines. We selected those medicines’ attributes the assessment of which does not require technical expertise, or access to regulatory information. Attributes were categorized according to a 3-level risk scale, to guide decision-making on suspect poor-quality medicines, based on an informed risk assessment.

The simplified checklist contains 26 binary questions (YES/NO), grouped into four themes: packaging, identification, traceability, and physical appearance. Each non-conformity corresponds to a level of risk for patients. The user is guided towards three possible actions: A) reasonably safe for dispensing; B) dispense with explanation; C) quarantine and make a risk-benefit evaluation before dispensing.

Conclusion

The simplified checklist should now be implemented in real-life setting in LMICs. If proven useful in guiding health workers at the point-of-care to take rapid, transparent, patient-centred actions when facing a suspect poor-quality medicine, it could be further extended to address specific formulations. Digitalization for linkage with pharmacovigilance programs could also be considered.
Mild spring temperature rising affects the anti-oxidation and immune functions of Asian Short-toed Larks
Authors: Zhu Na , Liu Tingting , Wang Fei , Liang Wei , Zhang Shuping
Published: April 2020

Background

Predicting the possibility of severe effects of global warming on animals is important for understanding the ecological consequences of climate change on ecosystem. Spring is the season during which birds have to physiologically prepare for the subsequent breeding period, and unusual spring temperature rising probably becomes a heat stress to the birds which have adapted to the low spring temperature. Therefore, it is necessary to understand the physiological effect of spring warming on the temperate birds.

Methods

Using the activities of blood anti-oxidative enzymes (SOD, CAT, GPx) and the concentrations of serum immunogloblins (IgA, IgY, IgM) as indicators, we compared the anti-oxidative and immune functions of Asian Short-toed Larks (Calandrella cheleensis) captured between 10 and 15 March, 2015 and housed under conditions of 21 °C and 16 °C.

Results

The SOD activities of birds in 21 °C group were significantly lower than those in 16 °C group on all the treatment days. The CAT activities of the birds in 21 °C group were significantly lower than those in 16 °C group on the 1st, 5th, 13th, 17 treatment days. The GPx activities of the birds in 21 °C group were signifthicantly lower than those in 16 °C group on the 1st, 13th and 17th, but significantly higher on the 21st treatment day. The IgA, IgY and IgM concentrations of birds in 21 °C group were significantly lower than those in 16 °C group on all the treatment days.

Conclusions

This study shows that spring temperature rising negatively influences antioxibative and humoral immune functions, which indicates that spring climate warming might reduce the fitness of the temperate passerine birds which have adapted to the low spring temperature.
Test–retest variability of microperimetry in geographic atrophy
Authors: Alibhai A. Yasin , Mehta Nihaal , Hickson-Curran Sheila , Moreira-Neto Carlos , Levine Emily S. , Reichel Elias , Duker Jay S. , Waheed Nadia K.
Published: April 2020

Purpose

Microperimetry (MP) allows for measurement of retinal sensitivity at precise locations and is now commonly employed as a clinical trial endpoint. Test–retest reliability is important when evaluating treatment effects in patients with geographic atrophy (GA). This study aimed to determine the test–retest variability of MP in patients with moderate to severe GA using the MAIA MP device.

Methods

In this prospective study, patients with a confirmed diagnosis of foveal-involving GA were enrolled. Participants performed three MP assessments of a selected eye over two visits with the Macular Integrity Assessment (MAIA) 2 instrument (Centervue, Padova, Italy) utilizing a wide 30° grid, consisting of 93 stimuli (Goldmann III) using a 4-2 representation strategy, encompassing the entire area of GA and beyond. Mean retinal sensitivity (MS) was expressed as an average threshold value (dB) for the entire field tested. Coefficients of Repeatability at a 95% level (CoR95) were calculated for Point Wise Sensitivity (PWS). Fixation stability (FS) was assessed by evaluating the area of an elliptical representation encompassing 95% of the cloud of fixation points (CFP) dataset generated by the MAIA MP, known as the bivariate contour ellipse area (BCEA).

Results

A total of 8 subjects were enrolled (21 tests), with six subjects completing 3 MP assessments. BCVA in these patients ranged from 20/100 to 20/800. The mean area of GA was 18.7 ± 12.3 mm2. The average time to complete one MP assessment was 13 min 9 s and mean BCEA@95% was 38.5 ± 19.3°2. The MS was 14.3 ± 4.5 dB. No significant increase in MS was noted between testing pairs 1&2 and 2&3. The preferred retinal locus was maintained in the same quadrant on successive tests. The mean CoR95 for PWS were similar for testing pairs 1&2 (± 3.50 dB) and 2&3 (± 3.40).

Conclusion

Microperimetry using a wide grid can be reliably performed in a reasonable amount of time in patients with moderate and severe vision loss secondary to GA. There was no learning effect seen between sequential assessments when analyzing MS or PWS. A change of approximately 4 dB in PWS provides a threshold for considering a true change in this patient cohort.
Childlessness and low fertility in context: evidence from a multilevel analysis on 20 European countries
Authors: Brini Elisa
Published: April 2020

Low fertility and childlessness have been largely interpreted as being driven by the same mechanisms, although they may be qualitatively different phenomena. The present article discusses this assumption and studies determinants of childlessness by comparing them with determinants of low fertility. Drawing on micro-level data from the European Labour Force Survey (2005–2010) and macro-level data from external data sources, it enters the debate on the micro- and macro-determinants of fertility and childlessness by analysing women who live with or without children when they are 35–39 years old. By means of a series of multilevel models, it discusses the moderating role of the institutional and normative context in the link between individual characteristics and childlessness, and it analyses the extent to which micro- and macro-level determinants of childlessness differ from factors associated with low-fertility. The results indicate that the macro-level factors associated with individual childlessness are similar to those identified in the literature on low fertility. However, interesting differences emerge in how reconciliation and family support policies relate on childlessness and low-fertility across different groups of women. Overall, these findings highlight the importance to study childlessness as a phenomenon on its own, distinguishing its determinants from determinants of (low) fertility.