Validity of five foot and ankle specific electronic patient-reported outcome (ePRO) instruments in patients undergoing elective orthopedic foot or ankle surgery

Background: Patient-reported outcomes (PROS) are widely accepted measures for evaluating outcomes of surgical interventions. As patient-reported information is stored in electronic health records, it is essential that there are valid electronic PRO (ePRO) instruments available for clinicians and researchers. The aim of this study was to evaluate the validity of electronic versions of five widely used foot and ankle specific PRO instruments. Methods: Altogether 111 consecutive elective foot/ankle surgery patients were invited face-to-face to participate in this study. Patients completed electronic versions of the Foot and Ankle Ability Measure (FAAM), the Foot and Ankle Outcome Score (FAOS), the modified Lower Extremity Function Scale (LEFS), the Manchester-Oxford Foot Questionnaire (MOXFQ), and the Visual Analogue Scale Foot and Ankle (VAS-FA) on the day of elective foot and/or ankle surgery. Construct validity, coverage, and targeting of the scales were assessed. Results: Based on general and predefined thresholds, construct validity, coverage, and targeting of the ePRO versions of the FAAM, the FAOS, the MOXFQ, and the VAS-FA were acceptable. Major issues arose with score distribution and convergent validity of the modified LEFS instrument. Conclusions: The ePRO versions of the FAAM, the FAOS, the MOXFQ and the VAS-FA provide valid scores for foot and ankle patients. However, our findings do not support the use of the modified LEFS as an electronic outcome measure for patients with orthopedic foot and/or ankle pathologies. (C) 2020 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.Peer reviewe

Gill Epithelial Cells as Tools for Toxicity Screening. Comparison between Primary Cultures, Cells in Suspension and Epithelia on Filters.

Abstract not availableJRC.(EI)-Environment Institut

Novel application of a fish gill cell line assay to assess ichthyotoxicity of harmful marine microalgae

Fish-killing microalgae can cause substantial mortalities of cultured finfish, but their killing mechanisms are not completely understood. Since use of cell lines offers significant advantages compared to working with whole organisms, a simple in vitro assay for microalgal ichthyotoxicity is described using the rainbow trout cell line RTgill-W1. We describe the application of a microplate based assay for testing the toxicity of fatty acids to gill cells in a time-dependent manner. Additionally, a modification of this assay using an insert support with permeable membranes is presented to test the toxicity of living marine microalgae. The endpoint is measurement of cell viability using alamarBlue as an indicator dye. Gill cells remained 100% viable for 60 h in the modified version of the basal growth medium, L-15/ex, without fetal bovine serum and with 1% methanol (in which fatty acids were dissolved). In contrast, gill cells survived for 3 h in microplates with insert supports upon exposure to algal seawater-based media. Toxicity of palmitic acid was less than 10%, as observed by loss of gill cell viability, during the first 12 h at all concentrations. However, the highest toxicity was observed at 48–60 h with a reduction of cell viability of 50% after exposure to 140 mg L−1. The ichthyotoxic raphidophyte Chattonella marina and dinoflagellate Karlodinium veneficum had a negative effect on gill cells, causing up to 70 and 38% loss of viability, respectively, when exposed to high algal concentrations for 2 h. These two simple and reproducible screening tests represent a sensitive and suitable alternative to whole fish ichthyotoxic bioassays for fish-killing marine microalgae