Video support for prehospital stroke consultation: implications for system design and clinical implementation from prehospital simulations.

Background: Video consultations between hospital-based neurologists and Emergency Medical Services (EMS) have potential to increase precision of decisions regarding stroke patient assessment, management and transport. In this study we explored the use of real-time video streaming for neurologist-EMS consultation from the ambulance, using highly realistic full-scale prehospital simulations including role-play between on-scene EMS teams, simulated patients (actors), and neurologists specialized in stroke and reperfusion located at the remote regional stroke center.

Methods: Video streams from three angles were used for collaborative assessment of stroke using the National Institutes of Health Stroke Scale (NIHSS) to assess symptoms affecting patient's legs, arms, language, and facial expressions.

Delayed clearance of the pro-carcinogen benzo[a]pyrene in PLHC-1 cells when co-exposed to the antifungal drug clotrimazole and effects on the CYP1A biomarker.

Cytochrome P450 1 A (CYP1A) is a key enzyme in the metabolism of the polycyclic aromatic hydrocarbon (PAH) benzo[a]pyrene (BaP) in animals, and a biomarker for environmental PAH exposure. The common antimycotic imidazole drug clotrimazole (CLO) has been detected in the aquatic environment and likely co-exists with BaP. Like BaP, CLO can bind to CYP1A enzymes and can act as a CYP1A inhibitor.

Methotrexate Safety and Efficacy in Combination Therapies in Patients With Early Rheumatoid Arthritis: A Post Hoc Analysis of a Randomized Controlled Trial.

Objective: We investigated methotrexate safety and the influence of dose on efficacy outcomes in combination with three different biologic treatments and with active conventional treatment (ACT) in early rheumatoid arthritis (RA).

Methods: This post hoc analysis included 812 treatment-naïve patients with early RA who were randomized (1:1:1:1) in the NORD-STAR trial to receive methotrexate in combination with ACT, certolizumab-pegol, abatacept, or tocilizumab. Methotrexate safety, doses, and dose effects on Clinical Disease Activity Index (CDAI) remission were assessed after 24 weeks of treatment.

Carpal fractures: epidemiology, classification and treatment of 6542 fractures from the Swedish Fracture Registry.

This study describes the age and sex distribution, trauma mechanism, treatment and influence of patient-reported outcomes of 6542 carpal fractures from the Swedish Fracture Registry (SFR). The most commonly fractured carpal bone was the scaphoid (60%), followed by the triquetrum (25%), hamate (5%) and trapezium (4%). The mean age at injury was 41 years, and 69% of patients were male.

Compressed spike-triggered averaging in iterative decomposition of surface EMG.

Background And Objective: Analysis of motor unit activity is important for assessing and treating diseases or injuries affecting natural movement. State-of-the-art decomposition translates high-density surface electromyography (HDsEMG) into motor unit activity. However, current decomposition methods offer far from complete separation of all motor units.

Patterns of change of multisite pain over 1 year of follow-up and related risk factors.

Background: Multisite musculoskeletal pain is common and disabling. This study aimed to prospectively investigate the distribution of musculoskeletal pain anatomically, and explore risk factors for increases/reductions in the number of painful sites.

Methods: Using data from participants working in 45 occupational groups in 18 countries, we explored changes in reporting pain at 10 anatomical sites on two occasions 14 months apart.

Consensus document for the selection of lung transplant candidates: An update from the International Society for Heart and Lung Transplantation.

Tens of thousands of patients with advanced lung diseases may be eligible to be considered as potential candidates for lung transplant around the world each year. The timing of referral, evaluation, determination of candidacy, and listing of candidates continues to pose challenges and even ethical dilemmas. To address these challenges, the International Society for Heart and Lung Transplantation appointed an international group of members to review the literature, to consider recent advances in the management of advanced lung diseases, and to update prior consensus documents on the selection of lung transplant candidates.

Learning regularized representations of categorically labelled surface EMG enables simultaneous and proportional myoelectric control.

Background: Processing the surface electromyogram (sEMG) to decode movement intent is a promising approach for natural control of upper extremity prostheses. To this end, this paper introduces and evaluates a new framework which allows for simultaneous and proportional myoelectric control over multiple degrees of freedom (DoFs) in real-time. The framework uses multitask neural networks and domain-informed regularization in order to automatically find nonlinear mappings from the forearm sEMG envelope to multivariate and continuous encodings of concurrent hand- and wrist kinematics, despite only requiring categorical movement instruction stimuli signals for calibration.

Placental and Cord Blood Telomere Length in Relation to Maternal Nutritional Status.

Background: The uterine environment may be important for the chromosomal telomere length (TL) at birth, which, in turn, influences disease susceptibility throughout life. However, little is known about the importance of specific nutritional factors.

Objectives: We assessed the impact of multiple maternal nutritional factors on TL in placenta and cord blood.

Blood Lead Levels and Risk of Atherosclerosis in the Carotid Artery: Results from a Swedish Cohort.

Background: Lead exposure has been associated with increased incidence of adverse clinical cardiovascular outcomes. Atherosclerosis has been suggested as one of the underlying mechanisms, and findings from experimental studies support this, but human data are scarce.

Objectives: Our objective was to determine the association between environmental lead exposure based on blood lead (B-Pb) concentrations and the prevalence of atherosclerotic plaque in the carotid artery.

Placing children and adolescents at the centre of the Sustainable Development Goals will deliver for current and future generations.

Child health is taking the back seat in development strategies. In summarising a newly released collaborative report, this paper calls for a novel conceptual model where child health takes centre stage in relation to the 2030 Agenda and the Sustainable Development Goals. It lays out five principles by which renewed effort and focus would yield the most benefit for children and adolescents.

Cellular senescence: at the nexus between ageing and diabetes.

Ageing and diabetes lead to similar organ dysfunction that is driven by parallel molecular mechanisms, one of which is cellular senescence. The abundance of senescent cells in various tissues increases with age, obesity and diabetes. Senescent cells have been directly implicated in the generation of insulin resistance.

The benefits of collaboration: the Nordic Arthroplasty Register Association.

The Nordic Arthroplasty Register Association (NARA) was established in 2007 by arthroplasty register representatives from Sweden, Norway and Denmark with the overall aim to improve the quality of research and thereby enhance the possibility for quality improvement with arthroplasty surgery. Finland joined the NARA collaboration in 2010.NARA minimal hip, knee and shoulder datasets were created with variables that all countries can deliver.

Exploring telomere length in mother-newborn pairs in relation to exposure to multiple toxic metals and potential modifying effects by nutritional factors.

Background: The uterine environment may influence telomere length at birth, which is essential for cellular function, aging, and disease susceptibility over the lifespan. However, little is known about the impact of toxic chemicals on early-life telomeres. Therefore, we assessed the potential impact of multiple toxic metals on relative telomere length (rTL) in the maternal blood, cord blood, and placenta, as well as the potential modifying effects of pro-oxidants.

Inorganic arsenic in food products on the Swedish market and a risk-based intake assessment.

Inorganic arsenic (iAs) and total arsenic (tAs) were determined in common food from the Swedish market. Special focus was on rice, fish and shellfish products. For the speciation of iAs the European standard EN:16802 based on anion exchange chromatography coupled to ICP-MS was used.

Correction to: Students' understanding of teamwork and professional roles after interprofessional simulation-a qualitative analysis.

[This corrects the article DOI: 10.1186/s41077-017-0041-6.].

Reach out and grasp the opportunity: reconstructive hand surgery in tetraplegia.

Reconstructive upper extremity surgeries in tetraplegia are technically challenging because of the many complicated real-time decisions that need to be made, e.g. extent of release of donor muscle-tendon complex, routing of donor muscles, tissue preparation and optimization, tensioning of muscle-tendon units, balancing joints and suturing tendon-to-tendon attachments.

Pre- and postnatal environmental boron exposure and infant growth: Results from a mother-child cohort in northern Argentina.

Background: Experimental studies show developmental toxicity of boron and we recently found impaired weight and length in newborns of mothers exposed to boron through drinking water during pregnancy.

Objectives: To evaluate potential impact of pre- and postnatal boron exposure on infant anthropometry.

Methods: In our mother-child cohort (n = 177) in Argentinean Andes, where drinking water concentrations of boron, lithium and arsenic have been found to vary considerably, we collected maternal blood and urine during and after pregnancy, placenta, breast milk, as well as infant urine and blood during the first 6 months of life.

Evaluating the Risk Assessment Approach of the REACH Legislation: A Case Study.

Risk assessments based on occupational exposure to chemicals have increased since REACH (European regulation on Registration, Evaluation, Authorization, and restriction of Chemicals) came into force. The European Chemicals Agency (ECHA) recommends that chemical exposure could be calculated using exposure models and that parameters used to calculate the exposure scenario (ES) should be communicated in extended safety data sheets (e-SDS) as workplace instructions which downstream users are obligated to follow. We aimed to evaluate REACH's risk assessment approach using the Stoffenmanager® 6.

Blood Lead Levels and Decreased Kidney Function in a Population-Based Cohort.

Background: Environmental lead exposure has been associated with decreased kidney function, but evidence from large prospective cohort studies examining low exposure levels is scarce. We assessed the association of low levels of lead exposure with kidney function and kidney disease.

Study Design: Prospective population-based cohort.

Students' understanding of teamwork and professional roles after interprofessional simulation-a qualitative analysis.

Background: This study explores how interprofessional simulation-based education (IPSE) can contribute to a change in students' understanding of teamwork and professional roles. A series of 1-day training sessions was arranged involving undergraduate nursing and medical students. Scenarios were designed for practicing teamwork principles and interprofessional communication skills by endorsing active participation by all team members.

Cadmium, Carotid Atherosclerosis, and Incidence of Ischemic Stroke.

Background: Exposure to cadmium has been associated with carotid plaques, inflammation in carotid plaques, and increased risk of ischemic stroke. This study examined the separate and interacting effects of blood cadmium levels and carotid plaques on the risk of incident ischemic stroke.

Methods And Results: Cadmium levels were measured in 4156 subjects (39.

Urine neutrophil gelatinase-associated lipocalin and other biomarkers in infants with urinary tract infection and in febrile controls.

Background: Urine biomarkers are commonly used in the evaluation of acute kidney injury, and are gaining attention as tools for studying urinary tract infections (UTIs). We analyzed neutrophil gelatinase-associated lipocalin (NGAL) and seven other urine biomarkers to evaluate their usefulness in the diagnosis of UTI in infants.

Methods: Eight urine biomarkers were analyzed in 108 infants with UTI.