Johansensantos6537

Background Mutations of the thyroid hormone (TH)-specific cell membrane transporter, monocarboxylate transporter 8 (MCT8), produce an X-chromosome-linked syndrome of TH deficiency in the brain and excess in peripheral tissues. The clinical consequences include brain hypothyroidism causing severe psychoneuromotor abnormalities (no speech, truncal hypotonia, and spastic quadriplegia) and hypermetabolism (poor weight gain, tachycardia, and increased metabolism, associated with high serum levels of the active TH, T3). Treatment in infancy and childhood with TH analogues that reduce serum triiodothyronine (T3) corrects hypermetabolism, but has no effect on the psychoneuromotor deficits. Studies of brain from a 30-week-old MCT8-deficient embryo indicated that brain abnormalities were already present during fetal life. Methods A carrier woman with an affected male child (MCT8 A252fs268*), pregnant with a second affected male embryo, elected to carry the pregnancy to term. We treated the fetus with weekly 500 μg intrntreated brother. Conclusions This is the first demonstration that prenatal treatment improved the neuromotor and neurocognitive function in MCT8 deficiency. Earlier treatment with TH analogues that concentrate in the fetus when given to the mother may further rescue the phenotype.

Correct diagnosis of stroke and its subtypes is pivotal in early stages for optimum treatment.

The aim of this systematic review and meta-analysis is to summarize the published evidence on the potential of blood biomarkers in the diagnosis and differentiation of stroke subtypes.

A literature search was conducted for papers published until 20 April 2020 in PubMed, EMBASE, Cochrane Library, TRIP, and Google Scholar databases to search for eligible studies investigating the role of blood biomarkers in diagnosing stroke. Quality assessment was done using modified Quality Assessment of Diagnostic Accuracy Studies questionnaire. Pooled standardized mean difference and 95% confidence intervals were calculated. Presence of heterogeneity among the included studies was investigated using the Cochran's

statistic and



metric tests. If



was < 50% then a fixed-effect model was applied else a random-effect model was applied. Risk of bias was assessed using funnel plots and between-study heterogeneity waspotential of brain natriuretic peptide, matrix metalloproteinase-9, D-dimer, and glial fibrillary acidic protein as diagnostic biomarkers for stroke within 24 h. Results of our meta-analysis might serve as a platform for conducting further targeted proteomics studies and phase-III clinical trials.

CRD42019139659.

This meta-analysis highlights the potential of brain natriuretic peptide, matrix metalloproteinase-9, D-dimer, and glial fibrillary acidic protein as diagnostic biomarkers for stroke within 24 h. Results of our meta-analysis might serve as a platform for conducting further targeted proteomics studies and phase-III clinical trials.PROSPERO Registration ID CRD42019139659.Background Many e-health services were launched after countries relaxed their telehealth regulations to combat the coronavirus disease 2019 (COVID-19) pandemic. e-Health technologies that support person-centered health care are crucial for the patient's needs. In this systematic review, we examined how e-health applications are used to support person-centered health care at the time of COVID-19. Methodology Literature was systematically searched without language restriction and publication status between January 1 and May 25, 2020, to describe e-health's support on the person-centered health care to control the COVID-19 pandemic. PubMed, ScienceDirect, and CINAHL, MedRxiv, and Web of Science were used. Two researchers independently assessed the eligibility of each retrieved record. All included studies were subsequently rescreened by the researchers. The systematic review was conducted in accordance with preferred reporting items for systematic reviews and meta-analyses guidelines. Results We identified 60 articles and selected 8 studies that met the inclusion criteria. Most of the studies used e-health technologies to facilitate clinical decision support and team care. Patient's engagement and access to health care from their homes were enhanced using telehealth and mobile health. Electronic health records were used to avail reliable data to health care providers and health authorities to make evidence-based decisions. Conclusion Although there are limited studies to evaluate the effectiveness of e-health technologies for person-centered health care, the reviewed studies indicated e-health's potentials to improve the quality of health care and personalized health systems during COVID-19 pandemic. Further research should be done to better understand applications of e-health to improve the quality of health care and patients' outcomes and evaluate its cost-effectiveness.Background Observational studies have demonstrated that variation in normal range thyroid function is associated with major cardiovascular risk factors, including dyslipidemia, hypertension, type 2 diabetes (T2D), and obesity. As observational studies are prone to residual confounding, reverse causality, and selection bias, we used a Mendelian randomization (MR) approach to investigate whether these associations are causal or not. Methods Two-sample MR analysis using data from the largest available genome-wide association studies on normal range thyrotropin (TSH) and free thyroxine (fT4) levels, serum lipid levels, blood pressure measurements, T2D, and obesity traits (body mass index [BMI] and waist/hip ratio). Results A one standard deviation (SD) increase in genetically predicted TSH levels was associated with a 0.037 SD increase in total cholesterol levels (p = 3.0 × 10-4). After excluding pleiotropic instruments, we also observed significant associations between TSH levels and low-density lipoprotein levels (β = 0.026 SD, p = 1.9 × 10-3), pulse pressure (β = -0.477 mmHg, p = 7.5 × 10-10), and T2D risk (odds ratio = 0.95, p = 2.5 × 10-3). While we found no evidence of causal associations between TSH or fT4 levels and obesity traits, we found that a one SD increase in genetically predicted BMI was associated with a 0.075 SD decrease in fT4 levels (p = 3.6 × 10-4). Conclusions Variation in normal range thyroid function affects serum cholesterol levels, blood pressure, and T2D risk.Background Compared with singletons, a twin pregnancy is associated with a larger thyroid hormone demand and an increased stimulation of gestational thyroid function due to higher concentrations of human chorionic gonadotropin. However, such effects have been sparsely quantified. The aim of this study was to evaluate thyroid function and thyroid function test abnormalities in twin pregnancies during early and late pregnancy compared with singletons. Methods We included 1208 twin pregnancies and 46,834 singleton pregnancies with thyroid function tests available. Thyroid function test abnormalities were defined using population-based reference ranges. The analyses were adjusted for potential confounders including maternal age and body mass index. Results Compared with singletons, a twin pregnancy was associated with a lower thyrotropin (TSH) (β = -0.46 [95% confidence interval, CI -0.49 to -0.44], p  less then  0.001) and a higher free thyroxine (fT4) (β = 0.91 [CI 0.69-1.16], p  less then  0.001) during early risk of (subclinical) hyperthyroidism, as well as a higher risk of isolated hypothyroxinemia. During late pregnancy, a twin pregnancy was associated with a higher TSH concentration and a higher risk of subclinical hypothyroidism, as well as a persistently higher risk of isolated hypothyroxinemia and subclinical hyperthyroidism. The study was approved by Chinese Clinical Trial Registry (registration no. ChiCTR1800014394).

Type 2 diabetes and its high-risk stage, prediabetes, are often undiagnosed. Early detection of these conditions is of importance to avoid organ complications due to the metabolic disturbances associated with diabetes. Diabetes screening can detect persons unaware of diabetes risk and the elevated glucose levels can potentially be reversed through lifestyle modification and medication. There are mainly two approaches to diabetes screening opportunistic facility-based screening at health facilities and community screening.

To determine the difference in population reach and participant characteristics between community- and facility-based screening for detection of type 2 diabetes and persons at high risk of developing diabetes.

Finnish diabetes risk score (FINDRISC) is a risk assessment tool used by two diabetes projects to conduct community- and facility-based screenings in disadvantaged suburbs of Stockholm. In this study, descriptive and limited inferential statistics were carried out analyzing data and screening initiatives to achieve a gender balance.

Community-based screening and facility-based screening were complementary methods in reaching different population groups at high risk of developing type 2 diabetes. Community screening in particular reached more hard-to-reach groups with unfavorable risk profiles, making it a critical strategy for T2D prevention. More men should be recruited to intervention studies and screening initiatives to achieve a gender balance.White-tailed deer (WTD) are abundant mammals widely distributed across the United States. As a result, WTD are considered to be excellent sentinels for detecting arboviral activity in certain geographic areas. Evidence of West Nile virus (WNV) antibody in WTD has been reported previously in several states. However, WNV infection in WTD has not been reported from Texas, where the incidence of human West Nile (WN) cases is among the highest in the United States. Therefore, the aim of this study was to determine the prevalence of WNV antibody in WTD in central Texas. Sera samples (n = 644) were collected from deer during the fall and winter in western Travis County, Texas from 2014 to 2018 and tested for WNV immunoglobulin G (IgG) antibody by an indirect enzyme-linked immunosorbent assay (ELISA). ELISA antibody-positive samples were further tested for WNV and St. Louis encephalitis virus (SLEV) antibodies by an 80% plaque-reduction neutralization tests (PRNT80). Overall, 9% (n = 58) and 0.31% (n = 2) of the deer samples had serological evidence of WNV and SLEV infections, respectively. WNV seroprevalence differed significantly by age (p  less then  0.05), but there was no significant difference between sex. Interestingly, 3.1% (n = 20) of the samples were positive for Flavivirus IgG antibody by ELISA, but negative for SLEV and WNV antibodies, suggesting that other Flaviviruses may be circulating among WTD in Texas. Finally, these results supported WNV infection among WTD and highlight their potential role as sentinels for the detection of WNV in Texas and warrant further studies to determine the role WTD play in the maintenance and transmission of WNV.

Previous studies from Ethiopia detected disease clustering using broader geographic settings, but limited information exists on the spatial distribution of the disease using residential locations. An assessment of predictors of spatial variations of TB at community level could fill the knowledge gaps, and helps in devising tailored interventions to improve TB control.

To assess the pattern of spatial distribution of pulmonary tuberculosis (PTB) based on geographic locations of individual cases in the Dale district and Yirga Alem town in southern Ethiopia.

The socio-demographic characteristics of PTB cases were collected using a structured questionnaire, and spatial information was collected using geographic position systems. We carried out Getis and Ord (Gi*) statistics and scan statistics to explore the pattern of spatial clusters of PTB cases, and geographically weighted regression (GWR) was used to assess the spatial heterogeneities in relationship between predictor variables and PTB case notification rates (CNRs).