bluuebunny/crossref_metadata_2025 huggingface dataset:
Monozygotic multiple pregnancies after transfer of single in vitro produced equine embryos
Authors: Dijkstra A. , Cuervo‐Arango J. , Stout T. A. E. , Claes A.
Published: June 2019

Background

Monozygotic multiple pregnancy is rare in horses, but may be more common after transfer of an in vitro produced (IVP) embryo.

Objectives

To determine the occurrence, incidence, characteristics and outcome of monozygotic siblings arising from in vivo and IVP equine embryos.

Study design

Retrospective case series.

Methods

A total of 496 fresh in vivo and 410 frozen‐thawed IVP blastocysts, produced by intracytoplasmic sperm injection (ICSI) of in vitro matured oocytes from Warmblood mares, were transferred into recipient mares. The likelihoods of pregnancy and multiple pregnancy were calculated, and the clinical features and outcome of any multiple pregnancy were recorded.

Results

The likelihood of pregnancy after transfer of a single IVP or in vivo embryo was 62% (254/410) and 83% (413/496) respectively. The incidence of multiple pregnancy was 1.6% (4/254) and 0% (0/413) for IVP and in vivo blastocysts, respectively. More specifically, three IVP blastocysts yielded twin embryo propers/fetuses, and one IVP conceptus developed three distinct embryonic bodies. Interestingly, only one embryonic vesicle was detected at all ultrasonographic examinations prior to embryo proper development. Multiple embryonic bodies only became apparent at later scans to check for an embryo proper and heartbeat, or when the recipient mare aborted. Two twin pregnancies aborted spontaneously at 3 and 9 months, respectively, while the heartbeat was lost from all three embryos in the triplet pregnancy before day 35 of gestation. Twin reduction by per rectum compression of one fetal thorax was attempted at day 50 of gestation in the fourth case; however, both fetuses were lost.

Main limitations

Small number of cases.

Conclusions

In vitro embryo production resulted in a higher incidence of multiple monozygotic pregnancy, which could only be diagnosed after development of the embryo proper and is likely to result in pregnancy loss later in gestation if left untreated.
Does transpersonal trust moderate the association between chronic conditions and general practitioner visits in the oldest old? Results of the AgeCoDe and AgeQualiDe study
Authors: Hajek André , Brettschneider Christian , Eisele Marion , Lühmann Dagmar , Mamone Silke , Wiese Birgitt , Weyerer Siegfried , Werle Jochen , Fuchs Angela , Pentzek Michael , Stein Janine , Luck Tobias , Weeg Dagmar , Mösch Edelgard , Heser Kathrin , Wagner Michael , Scherer Martin , Maier Wolfgang , Riedel‐Heller Steffi G , König Hans‐Helmut ,   the AgeCoDe and AgeQualiDe Study Group
Published: June 2019

Aim

The purpose of this study was to investigate whether transpersonal trust (TPT) moderates the relationship between chronic conditions and general practitioner (GP) visits among the oldest old in Germany.

Methods

The multicenter prospective cohort Study on Needs, health service use, costs and health‐related quality of life in a large sample of oldest old primary care patients (85+) (AgeQualiDe) was carried out. Individuals were recruited through GP offices at six study centers in Germany (follow‐up wave 7). Primary care patients were aged ≥85 years (n= 861, mean age 89.0 years; range 85–100 years). The self‐reported number of outpatient visits to the GP was used as the outcome measure. To explore religious and spiritual beliefs, the short form of the Transpersonal Trust scale was used. The presence or absence of 36 chronic conditions was recorded by the GP.

Results

Multiple Poisson regressions showed that GP visits were positively associated with the number of chronic conditions (incidence rate ratio 1.03,P< 0.05). TPT moderated the relationship between chronic conditions and GP visits (incidence rate ratio 1.01,P< 0.05). The association between chronic conditions and GP visits was significantly more pronounced when TPT was high.

Conclusion

Our findings highlight the importance of TPT in the relationship between chronic conditions and GP visits. Future longitudinal studies are required to clarify this subject further.Geriatr Gerontol Int 2019; 19: 705–710.
Emodin, as a mitochondrial uncoupler, induces strong decreases in adenosine triphosphate (ATP) levels and proliferation of B16F10 cells, owing to their poor glycolytic reserve
Authors: Sugiyama Yuma , Shudo Toshiyuki , Hosokawa Sho , Watanabe Aki , Nakano Masaki , Kakizuka Akira
Published: June 2019

Many types of cancer cells show a characteristic increase in glycolysis, which is called the “Warburg effect.” By screening plant extracts, we identified one that decreases cellular adenosine triphosphate (ATP) levels and suppresses proliferation of malignant melanoma B16F10 cells, but not of noncancerous MEF cells. We showed that its active ingredient is emodin, which showed strong antiproliferative effects on B16F10 cells both in vitro and in vivo. Moreover, we also found that emodin can function as a mitochondrial uncoupler. Consistently, three known mitochondrial uncouplers also displayed potent antiproliferative effects and preferential cellular ATP reduction in B16F10 cells, but not in MEF cells. These uncouplers provoked comparable mitochondrial uncoupling in both cell types, but they manifested dramatically different cellular effects. Namely in MEF cells, these uncouplers induced three to fivefold increases in glycolysis from the basal state, and this compensatory activation appeared to be responsible for the maintenance of cellular ATP levels. In contrast, B16F10 cells treated with the uncouplers showed less than a twofold enhancement of glycolysis, which was not sufficient to compensate for the decrease of ATP production. Together, these results raise the possibility that uncouplers could be effective therapeutic agents specifically for cancer cells with prominent “Warburg effect.”
B‐cell lymphoma‐2‐associated transcription factor 1 is overexpressed and contributes to sorafenib resistance in hepatocellular carcinoma
Authors: Yu Shijun , Wang Xiao , Dou Ning , Zhou Jun , Gao Yong , Li Yandong
Published: June 2019

Aim

B‐cell lymphoma‐2‐associated transcription factor 1 (BCLAF1) is involved in various biological processes including tumorigenesis, but its function and expression in hepatocellular carcinoma (HCC) is little known, and its clinical value in HCC has not yet been defined.

Methods

The protein level of BCLAF1 in HCC specimens and paired adjacent normal tissues was examined by immunohistochemical staining. The effects of BCLAF1 on autophagy in HCC cells were detected by confocal microscopy, transmission electron microscopy, and western blot analysis. Cell proliferation and tumorigenicity assays were carried out in vitro and in vivo. Flow cytometry assay was used to determine the apoptosis level of HCC cells. The correlation of BCLAF1 and sorafenib resistance in HCC was analyzed by the Kaplan–Meier survival method.

Results

High expression of BCLAF1 was found in HCC tissues compared with adjacent normal tissues, and higher BCLAF1 expression was correlated with higher tumor–node–metastasis stage, worse differentiation, and worse prognosis of HCC patients. BCLAF1 could induce autophagy in HCC cells in response to starvation and BCLAF1‐mediated autophagy could enhance cell proliferation and impede cell apoptosis under stress conditions. Animal experiments indicated that BCLAF1 promoted tumorigenicity of HCC cells in vivo. More importantly, high expression of BCLAF1 might contribute to sorafenib resistance in HCC patients.

Conclusions

BCLAF1 is a potential oncogene in HCC by inducing autophagy to maintain tumor cell growth in response to stress conditions, and it could serve as a potential biomarker for predicting the prognosis of HCC patients and screening patients who are suitable for sorafenib therapy.
SATB2 in neuroendocrine neoplasms: strong expression is restricted to well‐differentiated tumours of lower gastrointestinal tract origin and is most frequent in Merkel cell carcinoma among poorly differentiated carcinomas
Authors: Bellizzi Andrew M
Published: June 2019

Aims

Special AT‐rich sequence‐binding protein 2 (SATB2) is a transcriptional regulator with critical roles in brain, craniofacial and skeletal development. It has emerged as a key marker of lower gastrointestinal (GI) tract columnar epithelial and osteoblastic differentiation. Transcription factor immunohistochemistry is useful in assigning site of origin in well‐differentiated neuroendocrine tumours (NETs), and has had a limited role in poorly differentiated neuroendocrine carcinomas (NECs). This study sought to evaluate the role of SATB2 in assigning site of origin in neuroendocrine epithelial neoplasms.

Methods and results

Tissue microarrays were constructed from the following: 317 NETs (37 thyroid, 46 lung, 16 stomach, 12 duodenum, 70 pancreas, 106 jejunoileum, 24 appendix, and six rectosigmoid), 44 phaeochromocytomas/paragangliomas, and 79 NECs (29 Merkel cell, 30 lung, and 20 extrapulmonary visceral); nine appendiceal and 19 rectal NETs were examined in whole sections. SATB2 immunohistochemistry was scored for extent (%) and intensity (0–3+), with an H‐score being calculated. SATB2 was expressed by 96% of rectosigmoid NETs, 79% of appendiceal NETs, and only 7% of other well‐differentiated neoplasms (P < 0.0001). Expression in lower GI tract NETs (median H‐score of 255) was stronger than in other positive tumours (median H‐score of 7) (P < 0.0001). Any SATB2 expression was 86% sensitive/93% specific for lower GI tract origin. SATB2 was expressed by 79% of Merkel cell carcinomas (median H‐score of 300), 33% of lung NECs (median H‐score of 23), and 60% of extrapulmonary visceral NECs (median H‐score of 110), with stronger expression in Merkel cell carcinoma (P < 0.001). At an H‐score cutoff of ≥150, SATB2 was 69% sensitive/90% specific for Merkel cell carcinoma.

Conclusions

SATB2 is frequently and strongly expressed by lower GI tract NETs; we have adopted it as our rectal NET marker. Relatively frequent and strong expression in Merkel cell carcinoma may have value in assigning NEC site of origin.
Loss of succinate dehydrogenase B immunohistochemical expression distinguishes pulmonary chondromas from hamartomas
Authors: Chatzopoulos Kyriakos , Fritchie Karen J , Aubry Marie‐Christine , Carney J Aiden , Folpe Andrew L , Boland Jennifer M
Published: June 2019

Aims

Pulmonary chondromas, which are rare cartilaginous neoplasms that often arise in the setting of Carney triad, are morphologically similar to pulmonary hamartomas, which are much more common. There is evidence that succinate dehydrogenase (SDH) deficiency drives neoplasia in patients with Carney triad, and SDHB immunohistochemistry can be used as a surrogate marker to detect SDH deficiency. The aim of this study was to investigate the utility of SDHB immunohistochemistry in distinguishing pulmonary chondromas from hamartomas.

Methods and results

Immunohistochemistry for SDHB (clone 21A11AE7) was performed on histological sections from six cases of pulmonary chondroma and 33 cases of pulmonary hamartoma. SDHB expression was retained in all 33 pulmonary hamartomas, and lost in the majority of evaluable chondromas (five of six). Of the five patients with chondromas showing SDHB loss, four had definitive Carney triad. Most patients with pulmonary hamartomas were older males with small solitary masses, whereas chondromas often presented as multiple masses in young females.

Conclusion

Loss of SDHB immunohistochemical expression can be useful for differentiating pulmonary chondromas from hamartomas, and potentially identifying patients with Carney triad.
Parental empowerment—Lesbian, gay, bisexual, trans or queer parents' perceptions of maternity and child healthcare
Authors: Kerppola Jenni , Halme Nina , Perälä Marja‐Leena , Maija‐Pietilä Anna
Published: June 2019

Aim

Describe empowerment in maternity and child healthcare from the perspective of self‐identified lesbian, gay, bisexual, trans, or queer (LGBTQ) parents in Finland.

Background

Parental empowerment is a core aspect of maternity and child healthcare. However, knowledge about LGBTQ parents' perceptions about empowerment is still lacking.

Method

Qualitative design, 22 parents participating. The interviews were conducted in between July and September 2016 and analysed using inductive content analysis.

Findings

Three core categories emerged as follows: (a) recognition and acknowledgment, particularly being treated as a parent, irrespective of any biological or legal ties to a child; (b) cooperation and interaction, such as working together, respecting parents' autonomy, and supporting parents' full involvement; (c) equitable care, such as parents' trust in services, but also a health‐care professional's knowledge of a family's special needs.

Conclusion

Empowerment was perceived as the parents' sense of being visible and recognized as a parent. This recognition requires education and structures that are inclusive of all families. In addition, the language used by professionals was a key indicator for promoting positive feelings of comfort and safety for all families.
Taking the pulse of Timor‐Leste’s cardiac needs: a 10‐year descriptive time‐trend analysis
Authors: Paratz Elizabeth D. , Mock Nicki , Gutman Sarah J. , Horton Ari , Creati Louise , Appelbe Alan , Eggleton Simon , Kushwaha Virag , da Silva Almeida Inez T. , Monteiro Andre , Bayley Noel
Published: June 2019

Background

Timor‐Leste is one of the poorest countries in the world. The East Timor Hearts Fund is a charitable organisation involving Australian cardiologists providing outreach screening and access to cardiac interventions.

Aims

To assess ten years of clinical volume, demographics and patient outcomes. Our intention was to identify existing limitations to facilitate planning for further capacity building over the next decade.

Methods

The East Timor Hearts Fund database was sectioned into 2‐year intervals (2009/2010, 2011/2012, 2013/2014, 2015/2016 and 2017/2018). Demographics and clinical outcomes of patients were compared, with subgroup analysis of adult (>18 years old), paediatric and interventional patients.

Results

Over 10 years, 2050 patient encounters have occurred; 1119 (54.6%) encounters occurred in 2017/2018; 73.6% of patients were assessed in the capital Dili. Rheumatic and congenital cardiac diseases remain very common (39.1% of adult new patients and 74.2% of paediatric new patients), with 1.4% of new patients exhibiting both pathologies. The number of new patients with rheumatic or congenital heart disease tripled in 2017/2018 compared to 2009/2010 (99 vs 34 patients, P < 0.0001). Paediatric case volume increased over 10‐fold over 10 years (288 new patients in 2017/2018 vs 24 in 2009/2010, P < 0.0001), with corresponding increase in proportion of paediatric interventions (59.4% in 2017/2018 vs 25.0% in 2009/2010, P = 0.027). For patients undergoing intervention (n = 87), post‐procedural complications and mortality are extremely low (3.4% and 1.1%, respectively), with all eligible patients attending at least one post‐procedure appointment.

Conclusion

Demand for cardiac services in Timor‐Leste is rising exponentially, with inequitable geographic coverage. Rheumatic and congenital cardiac diseases remain priorities for assessment, and paediatric case volume is increasing. Patients undergoing intervention experience good medical outcomes.
Associations between common respiratory viruses and invasive group A streptococcal infection: A time‐series analysis
Authors: de Gier Brechje , Vlaminckx Bart J. M. , Woudt Sjoukje H. S. , van Sorge Nina M. , van Asten Liselotte
Published: June 2019

Background

Invasive infections by group A Streptococcus (iGAS, Streptococcus pyogenes) have a winter seasonality which largely coincides with the season for influenza and other respiratory viruses. Influenza superinfections with GAS have been described to occur regularly and to show a severe clinical picture with high mortality. We aimed to study the extent to which influenza A and B viruses (IAV and IBV), respiratory syncytial virus (RSV) and rhinovirus circulation contribute to iGAS incidence and severity.

Methods

Time‐series regression models were built to explore the temporal associations between weekly laboratory counts of IAV, IBV, RSV and rhinovirus as independent variables and weekly counts of GAS disease notifications or laboratory GAS cultures as dependent variables.

Results

The weekly number of IAV detections showed a significant temporal association with the number of notifications of streptococcal toxic shock syndrome (STSS), a severe complication of iGAS. Depending on the season, up to 40% of all notified STSS cases was attributable to IAV circulation. Besides STSS, none of the other iGAS manifestations were associated with a respiratory virus.

Conclusions

Our study found an ecological temporal association between IAV and STSS, the most severe complication of iGAS. Future studies are needed to confirm this association and assess the possible preventability of STSS by influenza vaccination, especially in the age group 60 years and older.
The experience of partners supporting adolescents and young adults with cancer
Authors: Davies Jane , Hannigan Ben , Kelly Daniel
Published: June 2019

Aims

In a larger study where the aim was to investigate choice and control in decision making, the role of partners was significant. Reported here are the experiences of those partners of young people with cancer.

Design

A qualitative, exploratory case study approach was used.

Methods

In the larger study, 22 participants were recruited including five adolescents and young adults with cancer, two sets of parents/carers and three individual parents, five healthcare professionals linked to the adolescent or young adult with cancer and five friends or partners. Data were collected between February 2014 and February 2015 and included interviews, non‐participant observation and documentary analysis.

Results

Three themes were identified relating to partner experience derived from partner and patient interview data: “practical support”, “putting your partner first” and “acting as a confidante/ally”.

Conclusion

These findings reveal new knowledge of partner experience when adolescents and young adults have cancer. Richer in‐depth understandings of partner experience are required to improve the care of adolescents and young adults with cancer and those around them.

Impact

These findings will inform the development of guidance and further research which will enhance the knowledge of partner experience for those involved in cancer care in the adolescent and young adult age group.
Nursing interventions in adult psychiatric outpatient care. Making nursing visible using the Nursing Interventions Classification
Authors: Ameel Maria , Kontio Raija , Junttila Kristiina
Published: June 2019

Aim

To describe and to clarify the work of nurses in psychiatric outpatient care using a standardized nursing terminology and to describe the potential benefits and challenges in the use of the terminology.

Design

A qualitative study of ethnographically grounded fieldwork in four adult outpatient units located in three major cities in Finland.

Methods

A two‐phase ethnographically oriented study, consisting of observations and focus group interviews in four psychiatric outpatient care units (in January–March 2018). During this process, the identified nursing interventions were mapped into the Nursing Interventions Classification.

Results

We identified 93 different nursing interventions, covering all seven domains. Categories describing potential benefits and challenges were as follows: giving words to nurses’ work and the challenge of overlapping interventions.

Conclusion

Our findings indicate that the Nursing Interventions Classification is a suitable means to describe nursing in the psychiatric outpatient care setting. Our findings support the theory that describing nurses’ work using a nursing terminology can make nursing visible and further empower nurses and help them to structure their work. The lack of other professionals, especially physicians, has led to nurses taking over new tasks officially and unofficially and we suggest that the issue needs to be studied further.

Impact

Nurses’ role in the psychiatric outpatient care has been described as invisible and difficult to describe. Our findings suggest that a nursing terminology can make nursing visible, not only from the perspective of patient health records but is also a way to conceptualize nurses’ work.
Molecular mechanisms of ferroptosis and its role in cancer therapy
Authors: Xu Tao , Ding Wei , Ji Xiaoyu , Ao Xiang , Liu Ying , Yu Wanpeng , Wang Jianxun
Published: June 2019

Ferroptosis is a newly defined programmed cell death process with the hallmark of the accumulation of iron‐dependent lipid peroxides. The term was first coined in 2012 by the Stockwell Lab, who described a unique type of cell death induced by the small molecules erastin or RSL3. Ferroptosis is distinct from other already established programmed cell death and has unique morphological and bioenergetic features. The physiological role of ferroptosis during development has not been well characterized. However, ferroptosis shows great potentials during the cancer therapy. Great progress has been made in exploring the mechanisms of ferroptosis. In this review, we focus on the molecular mechanisms of ferroptosis, the small molecules functioning in ferroptosis initiation and ferroptosis sensitivity in different cancers. We are also concerned with the new arising questions in this particular research area that remains unanswered.
Phytosterols and their oxidative products in infant formula
Authors: Kilvington Alice , Maldonado‐Pereira Lisaura , Torres‐Palacios Cristobal , Medina‐Meza Ilce
Published: June 2019

Infant formulations are enriched with vegetable oils that confer not only calories, but also peculiar chemical attributes. Vegetable oils are particularly rich in phytosterols, a class of triterpene molecules analogous to cholesterol, but with different and largely unknown biological effects. The preparation and sterilization of infant formula provide opportune physicochemical conditions for oxidative reactions to occur. Oxidation of phytosterols during the preparation of infant formula can led to oxidized derivatives, known as phytosterol oxidation products [POPs], which harmful effects can be exacerbated given the wide variety of infant formulas characterized by their exclusivity of milk surrogates, required to fulfill specific needs in the nutritional development of a baby. In this review, the state‐of‐the‐art regarding phytosterols and their presence in infant formulation is revised, stressing the need of further investigation in the field of food processing. Reconsidering infant formula manufacturing in the context of phytosterols oxidation will lead to several opportunities for food engineers and technologists in the food safety.

Practical applications

Phytosterols are plant‐based bioactive lipids with health benefits. Therefore, they have been implemented as a supplement in infant formula through the addition of vegetable oils. Processing, packaging, and storage contribute to the oxidative process of these compounds. A surveillance of the entire food chain is needed to reduce the oxidative load in the final product.
Clustered ANFIS weighing models for sweet lime (Citrus limetta) using computer vision system
Authors: Phate Vikas R. , Malmathanraj Ramanathan , Palanisamy Ponnusamy
Published: June 2019

In the present research work, a clustered adaptive neuro‐fuzzy inference system (ANFIS) is used to develop the model of relationship between the weight with 1D and 2D features of the Indian sweet lime fruit extracted through the developed computer vision system. Initially, three clustering methods are used to classify the input data into a homogeneous group. Then, the self‐learning proficiency of an artificial neural network and the ability of fuzzy theory to deal with the uncertainty and nonlinearity are utilized by developing the ANFIS model. Finally, the clustered data is combined with the ANFIS models trained by two different learning methods are analyzed. The goodness‐of‐fit indicators close to unity and the lower values of the error performance metrics implies the adequacy, robustness, and superiority of the proposed method. Moreover, the lower value of Theil's coefficient for uncertainty (UII) signifies the credibility of the model to predict the weight of a sweet lime fruit.

Practical applications

The presented improved approach of clustered ANFIS modeling for weighing sweet lime fruit will be fruitful to the researchers, farmers, and engineers. In order to, design and develop the real time weight‐based grading, sorting, and packaging machine's knowledge about the fruit weight‐size relation is a basic requirement. Use of this proposed approach (computer vision linked with the clustered ANFIS model) will greatly reduce the handling of the fruit as well as the workload that are responsible for the qualitative and quantitative losses of fruits on bulk industrial scale. Also, this weighing model using 1D and 2D features will be more beneficial, faster, and economically viable substitute to the on‐field manual method used in agriculture specially during the sorting, grading, and packaging of sweet lime.
Comparison of anticoagulants and risk factors for bleeding following endoscopic sphincterotomy among anticoagulant users: Results from a large multicenter retrospective study
Authors: Muro Shinichiro , Kato Hironari , Ishida Etsuji , Ueki Toru , Fujii Masakuni , Harada Ryo , Seki Hiroyuki , Hirao Ken , Wato Masaki , Akimoto Yutaka , Takatani Masahiro , Tsugeno Hirofumi , Miyaike Jiro , Toyokawa Tatsuya , Nishimura Mamoru , Yunoki Naoko , Okada Hiroyuki
Published: June 2019

Background and Aim

Bleeding is an inevitable and often severe complication after endoscopic sphincterotomy (EST). We aimed to investigate the factors associated with post‐EST bleeding in patients treated with anticoagulants.

Methods

The data of patients who underwent EST at 15 hospitals between July 2015 and June 2017 were extracted. We investigated the incidence of post‐EST bleeding and risk factors for bleeding in patients treated with anticoagulants.

Results

One hundred forty‐nine patients undergoing EST who met the inclusion criteria were included in this study. The total‐EST bleeding (bleeding occurring during or after EST) rate did not differ between the heparin replacement (8.0%, 6/75) and continuation (16.6%, 2/12; P = 0.37) groups of warfarin users. The total‐EST‐bleeding rate in the heparin replacement group (12.9%, 4/31) was significantly higher than that in the continuation group (0%, 0/31; P = 0.016) in direct oral anticoagulant (DOAC) users. The rate of total‐EST bleeding with continuation of DOAC (0%, 0/31) was significantly lower with continuation of warfarin (16.6%, 2/12; P = 0.021). During‐EST bleeding (bleeding occurring during EST) (P = 0.0083) and precut (P = 0.033) were significant risk factors for post‐EST bleeding in all 149 patients. Heparin replacement was only a significant risk factor for total‐EST bleeding (P = 0.033) in DOAC users.

Conclusion

Heparin replacement was a significant risk factor for post‐EST bleeding in DOAC users; however, there was no significant difference between the bleeding rate of heparin replacement and that of continuation groups in patients taking warfarin. During EST and precut were significant risk factors for post‐EST bleeding in all patients treated with anticoagulants.
Measurement of Maternal Mindful Awareness of Fetal Movement
Authors: Kantrowitz‐Gordon Ira , Cunningham Emma , Reynolds Nicole
Published: June 2019

Introduction

Decreased fetal movement is a common concern late in pregnancy that may be associated with increased fetal morbidity and mortality. Limited research suggests a relationship between maternal psychological factors and perception of fetal movement. The goal of this study was to test the reliability and external validity of a novel self‐report instrument for maternal mindful awareness of fetal movement.

Methods

Pregnant women who were at 20 weeks’ gestation or later and feeling regular fetal movement (N = 497) were recruited online through a commercial pregnancy website to complete an internet survey from April to May 2016. The online survey included demographic and pregnancy characteristics, psychological and mindfulness measures, and investigator‐developed items on mindful awareness of fetal movement. Reliability and validity of the instrument were tested with exploratory factor analysis, correlations with psychological variables, and hierarchical linear regression.

Results

Exploratory factor analysis of mindful awareness of fetal movement items using principal components analysis showed a 2‐factor structure, noticing and distracted, with internal consistency of α equal to .69 and .57, respectively. Hierarchical multiple regression analysis showed that noticing was associated with increased gestational age, mindfulness (observing facet), and maternal‐fetal attachment. Distracted was associated with increased education level and prenatal anxiety and with decreased mindfulness (nonjudging facet).

Discussion

There was moderate internal consistency in the items measuring mindful awareness of fetal movement. Findings suggest relationships between mindful awareness of fetal movement and state mindfulness, maternal‐fetal attachment, and prenatal anxiety. More research is needed to further develop items for a mindful awareness of fetal movement scale suitable for research and clinical practice.
Oestrogen and androgen receptor activation contribute to the masculinisation of oxytocin receptors in the bed nucleus of the stria terminalis of rats
Authors: Worley Nicholas B. , Dumais Kelly M. , Yuan Jingting C. , Newman Laura E. , Alonso Andrea G. , Gillespie Tessa C. , Hobbs Nicholas J. , Breedlove S. Marc , Jordan Cynthia L. , Bredewold Remco , Veenema Alexa H.
Published: June 2019

Oxytocin (OT) often regulates social behaviours in sex‐specific ways, and this may be a result of sex differences in the brain OT system. Adult male rats show higher OT receptor (OTR) binding in the posterior bed nucleus of the stria terminalis (pBNST) than adult female rats. In the present study, we investigated the mechanisms that lead to this sex difference. First, we found that male rats have higher OTR mRNA expression in the pBNST than females at postnatal day (P) 35 and P60, which demonstrates the presence of the sex difference in OTR binding density at message level. Second, the sex difference in OTR binding density in the pBNST was absent at P0 and P3, but was present by P5. Third, systemic administration of the oestrogen receptor (ER) antagonist fulvestrant at P0 and P1 dose‐dependently reduced OTR binding density in the pBNST of 5‐week‐old male rats, but did not eliminate the sex difference in OTR binding density. Fourth, pBNST‐OTR binding density was lower in androgen receptor (AR) deficient genetic male rats compared to wild‐type males, but higher compared to wild‐type females. Finally, systemic administration of the histone deacetylase inhibitor valproic acid at P0 and P1 did not alter pBNST‐OTR binding density in 5‐week‐old male and female rats. Interestingly, neonatal ER antagonism, AR deficiency, and neonatal valproic acid treatment each eliminated the sex difference in pBNST size. Overall, we demonstrate a role for neonatal ER and AR activation in setting up the sex difference in OTR binding density in the pBNST, which may underlie sexual differentiation of the pBNST and social behaviour.
Prophylactic use of tranexamic acid reduces blood loss and transfusion requirements in patients undergoing cesarean section: A meta‐analysis
Authors: Wang Yongjun , Liu Siyuan , He Li
Published: June 2019

Aim

Tranexamic acid (TXA) has been used to treat peripartum hemorrhage, while preoperative use of TXA in cesarean section (CS) remains controversial. To assess the effectiveness and safety of prophylactic application of TXA, a meta‐analysis was performed.

Methods

Electronic databases (MEDLINE [PubMed], Cochrane central register of controlled trials and Embase) were searched up to November 2018. The relevant data and quality of included trail were analyzed by RevMan 5.3. The study was registered at PROSPERO (CRD42018111165).

Results

Twenty‐one randomized controlled trials with a total of 3852 patients were included. Only one research reported thromboembolic events. Compared with control groups, the intra‐operative blood loss (mean difference [MD] −155.23 mL, 95% confidence interval [CI] −195.64 − 114.81; P<0.01), postoperative blood loss (MD −26.67 mL, 95% CI −32.98 to −20.36; P<0.01), total blood loss (MD −184.88 mL, 95% CI −218.83 to −150.94; P<0.01), transfusion requirements (relative risk [RR] 0.29, 95% CI 0.18−0.49, P<0.01), massive hemorrhage (RR 0.39, 95% CI 0.30 to 0.51; P<0.01) and additional uterotonic agents use (RR 0.40, 95% CI 0.30−0.55, P<0.01) were markedly reduced in TXA‐treated patients. Besides, TXA yielded a significant reduction in hemoglobin drop (MD −0.80 g/dL, 95% CI −1.07 to −0.53; P<0.01) and hematocrit drop (MD −2.05, 95% CI −3.09 to −1.01; P<0.01) compared with control groups.

Conclusion

Prophylactic application of TXA can decrease perioperative blood loss and transfusion requirements in patients undergoing CS. More high‐quality researches are needed to determine optimal dose of the drug.
HIV Diagnoses and Viral Suppression Among US Women in Rural and Nonrural Areas, 2010–2017
Authors: Nwangwu‐Ike Ndidi , Saduvala Neeraja , Watson Meg , Panneer Nivedha , Oster Alexandra M.
Published: June 2019

Background

Women in rural areas face challenges to HIV diagnosis and care, including limited access to testing and treatment facilities. Recent declines in HIV diagnosis rates among women in the United States are encouraging. However, few studies have addressed how HIV diagnosis and care differ by rurality.

Methods

We analyzed National HIV Surveillance System data for women aged ≥13 years with diagnosed HIV infection. We examined diagnoses in the United States during 2010–2017. Then, for women living with diagnosed HIV in 40 jurisdictions with complete laboratory reporting, we assessed viral suppression (viral load <200 copies/mL). Analyses were stratified by rural‐urban category: rural (population <50,000), metropolitan (population 50,000‐499,000), and metropolitan statistical areas (MSA, population ≥500,000).

Results

Among 64,004 women who received a diagnosis of HIV infection during 2010‐2017, 4.2% resided in a rural area, 15% resided in a metropolitan area, and 80% resided in an MSA. Rural women had the highest percentage of stage 3 infection (acquired immune deficiency syndrome) at diagnosis (rural 30%, metropolitan 27%, MSA 25%). Of 190,735 women living with diagnosed HIV, viral suppression was lower in rural areas (rural 55%, metropolitan 59%, MSA 58%).

Conclusions

During 2010‐2017, most HIV diagnoses occurred among women residing in nonrural areas. However, women in rural areas had slightly higher levels of late diagnosis and lower levels of viral suppression, which might have resulted from differences in access to testing and treatment services. Interventions are needed to increase HIV testing, care, and viral suppression among women in rural areas.
The functional trait spectrum of European temperate grasslands
Authors: Ladouceur Emma , Bonomi Costantino , Bruelheide Helge , Klimešová Jitka , Burrascano Sabina , Poschlod Peter , Tudela‐Isanta Maria , Iannetta Pietro , Mondoni Andrea , Amiaud Bernard , Cerabolini Bruno E. L. , Cornelissen Johannes Hans C. , Craine Joseph , Louault Frédérique , Minden Vanessa , Öllerer Kinga , Onipchenko Vladimir , Soudzilovskaia Nadejda A. , Jiménez‐Alfaro Borja
Published: June 2019

Questions

What is the functional trait variation of European temperate grasslands and how does this reflect global patterns of plant form and function? Do habitat specialists show trait differentiation across habitat types?

Location

Europe.

Methods

We compiled 18 regeneration and non‐regeneration traits for a continental species pool consisting of 645 species frequent in five grassland types. These grassland types are widely distributed in Europe but differentiated by altitude, soil bedrock and traditional long‐term management and disturbance regimes. We evaluated the multivariate trait space of this entire species pool and compared multi‐trait variation and mean trait values of habitat specialists grouped by grassland type.

Results

The first dimension of the trait space accounted for 23% of variation and reflected a gradient between fast‐growing and slow‐growing plants. Plant height and SLA contributed to both the first and second ordination axes. Regeneration traits mainly contributed to the second and following dimensions to explain 56% of variation across the first five axes. Habitat specialists showed functional differences between grassland types mainly through non‐regeneration traits.

Conclusions

The trait spectrum of plants dominating European temperate grasslands is primarily explained by growth strategies which are analogous to the trait variation observed at the global scale, and secondly by regeneration strategies. Functional differentiation of habitat specialists across grassland types is mainly related to environmental filtering linked with altitude and disturbance. This filtering pattern is mainly observed in non‐regeneration traits, while most regeneration traits demonstrate multiple strategies within the same habitat type.
Cardiovascular morbidity and mortality is increased post‐liver transplantation even in recipients with no pre‐existing risk factors
Authors: De Luca Laura , Kalafateli Maria , Bianchi Simone , Alasaker Norah , Buzzetti Elena , Rodríguez‐Perálvarez Manuel , Thorburn Douglas , O'Beirne James , Patch David , Leandro Gioacchino , Westbrook Rachel , Tsochatzis Emmanuel A.
Published: June 2019

Background/aims

Post‐liver transplant (LT) metabolic syndrome (PTMS) and cardiovascular (CVS) mortality are becoming increasingly prevalent following sustained improvements in post‐LT survival. We investigated the prevalence and predictors of PTMS and CVS complications in a cohort of consecutive LT recipients.

Methods

We reviewed prospectively collected data of patients (n = 928) who underwent LT (1995‐2013) and survived at least 1‐year post‐LT or died before that due to a major CVS complication.

Results

Median follow‐up was 85 months (IQR = 106). The prevalence of PTMS was 22.4% and it developed de novo in 183 recipients (19.7%). A total of 187 (20.2%) patients developed at least one CVS event post‐LT within a median of 49 months (IQR = 85). Overall mortality rate was 22.6% (n = 210). Causes of death were CVS events (n = 45, 21.4%), malignancies (21%), liver‐related deaths (20%) and infections (6.7%). Independent predictors of major CVS events were: documented CVS disease pre‐LT (Hazard Ratio (HR) = 3.330; 95% CI = 1.620‐6.840), DM (HR = 1.120; 95% CI 1.030‐1.220), hypertension (HR = 1.140; 95% CI 1.030‐1.270), dyslipidaemia (HR = 1.140; 95% CI 1.050‐1.240) and creatinine levels at 1 year (HR = 1.010; 95% CI = 1.005‐1.013). Among LT recipients without pre‐LT CVS disease or MS components (n = 432), 85 recipients developed ≥1 CVS events (19.7%) with independent predictors being DM (HR = 1.150; 95% CI = 1.010‐1.320), creatinine levels at 1 year (HR = 1.020; 95% CI = 1.010‐1.030) and hypertension (HR = 1.190; 95% CI = 1.040‐1.360).

Conclusions

Post‐LT patients are at increased risk of CVS morbidity even in the absence of pre‐existing metabolic risk factors. Renal sparing immunosuppressive protocols might reduce CVS events post‐LT.
Reintroducing beavers Castor fiber to Britain: a disease risk analysis
Authors: Girling Simon J. , Naylor Adam , Fraser Mary , Campbell‐Palmer Róisín
Published: June 2019

Eurasian beavers Castor fiber are potential hosts for a range of infectious diseases and parasites, including those typical of common European rodents. A number of infectious organisms are potentially zoonotic and may be notifiable under animal health legislation. The official trial beaver reintroductions to Scotland, the retrospectively licensed releases in England, and the increasingly obvious presence of large numbers of unlicensed illegally released animals have highlighted potential disease risks.

We aimed to conduct a disease risk analysis, based on peer reviewed publications, for selection and health screening of Eurasian beavers prior to release into the wild in Britain.

Adapted from the International Union for the Conservation of Nature’s ‘Guidelines for Disease Risk Analysis’, a four‐step process was used to formulate a disease risk analysis: 1) problem description; 2) hazard identification based on literature review; 3) risk assessment, which resulted in categorisation of pathogens into low, medium, and high risk; and 4) risk management: identification of mitigating measures, followed by risk re‐evaluation in light of the reported effectiveness of the mitigation measures.

The highest‐risk pathogens identified in the literature review process included: parasites, specifically Cryptosporidium parvum, Echinococcus multilocularis, Eimeria spp., Fasciola hepatica, Giardia spp., Trichinella britovi; bacteria, specifically Escherichia coli, Franciscella tularensis, Mycobacterium avium, Salmonella spp., Yersinia spp.; a fungus Chrysosporium parvum (Emmonsia parva); and terrestrial rabies virus. Most could be mitigated by sourcing beavers from Britain. The rest could be mitigated by pre‐release testing procedures that are already established.

The risk of introducing significant disease to humans, domestic animals, or wildlife by releasing into the wild in Britain a beaver that was captive‐bred in Britain or a wild beaver from Scotland, based on the current evidence of disease incidence, and assuming the use of robust, peer reviewed, pre‐release health screening techniques, can be viewed as low.
From ‘them’ to ‘us’: bridging group boundaries through team inclusiveness
Authors: Eppich Walter J , Schmutz Jan B
Published: June 2019

To promote a sense of ‘team’ across group and hierarchical boundaries, the authors promote strategies of (a) perspective‐taking, (b) inclusive leadership and language, (c) reflection and (d) increased contact between intergroup members.
The apelinergic system: a perspective on challenges and opportunities in cardiovascular and metabolic disorders
Authors: Marsault Eric , Llorens‐Cortes Catherine , Iturrioz Xavier , Chun Hyung J. , Lesur Olivier , Oudit Gavin Y. , Auger‐Messier Mannix
Published: June 2019

The apelinergic pathway has been generating increasing interest in the past few years for its potential as a therapeutic target in several conditions associated with the cardiovascular and metabolic systems. Indeed, preclinical and, more recently, clinical evidence both point to this G protein–coupled receptor as a target of interest in the treatment of not only cardiovascular disorders such as heart failure, pulmonary arterial hypertension, atherosclerosis, or septic shock, but also of additional conditions such as water retention/hyponatremic disorders, type 2 diabetes, and preeclampsia. While it is a peculiar system with its two classes of endogenous ligand, the apelins and Elabela, its intricacies are a matter of continuing investigation to finely pinpoint its potential and how it enables crosstalk between the vasculature and organ systems of interest. In this perspective article, we first review the current knowledge on the role of the apelinergic pathway in the above systems, as well as the associated therapeutic indications and existing pharmacological tools. We also offer a perspective on the challenges and potential ahead to advance the apelinergic system as a target for therapeutic intervention in several key areas.
A cone‐beam computed tomography analysis of angulation and inclination of whole tooth and clinical crown in adults with normal occlusion
Authors: Wang Honghong , Zhao Ning , Li Peilun , Shen Gang
Published: June 2019

Objectives

To identify the mesiodistal angulation and faciolingual inclination of whole tooth and clinical crown in Chinese young adults with normal occlusion, by examining CBCT digitalized images.

Setting and Sample Population

Forty‐two volunteers, who presented with normal occlusion and without previous orthodontic treatment, were selected for this study.

Materials and Methods

The subjects were advised to take dental CBCT and the digital images of the dentition were obtained. The widely recognized University of Southern California (USC) root vector analysis was adopted to detect the angulation and inclination of the whole tooth, as well as of the clinical crown.

Results

No statistically significant difference was detected between male and female subjects. The fluctuations of the angulation and the inclination of the whole tooth from anterior to posterior in both arches manifested distinctive trends. The changes in maxillary dentition seem relatively marked, whereas those in mandibular dentition show less obvious, demonstrating moderate fluctuation both in angulation or inclination. The angulation and inclination of clinical crown are obtained and are shown positively correlated with that of each whole tooth.

Conclusions

The normal range of the mesiodistal angulation and faciolingual inclination of whole tooth and clinical crown in Chinese adults with normal occlusion are identified. This study could establish clinical standards for designing 3D dental data‐based orthodontic appliances for Chinese, and for providing the guidance for orthodontic treatment.
Presence of the anther gland is a key feature in pollination of the early‐branching papilionoidsDipteryx alataandPterodon pubescens(Leguminosae)
Authors: Leite V. G. , Mansano V. F. , Pansarin E. R. , Teixeira S. P.
Published: June 2019

The presence of glandular appendages in the anthers is a rare condition in angiosperms. In Leguminosae it occurs in species of the Mimosoid clade and in early‐branching clades of papilionoids such as Dipterygeae. In Dipterygeae such appendages surprisingly exhibit a secretory cavity instead of secretory emergences as is the case for the Mimosoid clade. Thus, the objective of this study was to elucidate the function of anther glands inDipteryx alataandPterodon pubescens, species in the Dipterygeae clade that exhibit a pollen release mechanism that is intermediate between the explosive and valvular types.

Flower buds and flowers were processed for surface, anatomical, histochemical and ultrastructural analyses.

Anther glands consist of a cavity secreting sticky substances (oleoresins and polysaccharides) that play a key role during the flower's lifespan by aggregating pollen grains and attaching them to the floral visitor's body. Other floral features that are important for understanding the pollen release mechanism that is intermediate between the valvular and the explosive types are: (i) keel petals intertwined with tector trichomes; (ii) glandular appendages in the abaxial and lateral sepals and in petals composed of secretory ducts; and (iii) a continuous secretion process of the anther glands followed by an asynchronous dehiscence of anthers.

The well‐adapted papilionoid flag blossom with anther glands and keel petals intertwined with trichomes provided the foundation for a successful canalisation toward a pollen release mechanism intermediate between the explosive and valvular types inside early‐branching papilionoids.
Anger Mediates the Effects of Fear on Support for the Far Right—A Rejoinder
Authors: Vasilopoulos Pavlos , Marcus George E. , Valentino Nicholas , Foucault Martial
Published: June 2019

We are grateful to John Jost for carefully engaging with our work and presenting a different interpretation of our findings on the effects of fear and anger stemming from the November 13, 2015, Paris attacks on the propensity to vote for the far right. Jost advances a model that holds that anger mediates the effect of fear on support for the far right. In this rejoinder, we respond to the issues he raises regarding our model specification, consider his alternative suggestion, and offer some conclusions about how to resolve this debate empirically. We hope this exchange advances the literature on the impact of various societal threats on voting for the far right.