bluuebunny/crossref_metadata_2025 huggingface dataset:
Socioeconomic status and uptake of reproductive carrier screening in Australia
Authors: Robson Stephen J. , Caramins Melody , Saad Mirette , Suthers Graeme
Published: August 2020

Reproductive carrier screening enables the early identification of genetic conditions that may impact the long‐term health of a child, including cystic fibrosis, fragile X syndrome, and spinal muscular atrophy. We used unique data from the major providers of pathology services in Australia to profile women who intend on becoming, or who are, pregnant and access basic to advanced testing for genetic conditions. We found a strong socioeconomic gradient in the uptake of reproductive carrier screening, with women living in the most advantaged postcodes across Australia significantly being more likely to have reproductive carrier screening than those living in the most disadvantaged areas. These results highlight the need to minimise social and financial barriers that are currently limiting access.
Gratitude as a protective factor against anxiety and depression among Chinese adolescents: The mediating role of coping flexibility
Authors: Sun Peizhen , Sun Yudi , Jiang Hongyan , Jia Ru , Li Zhiyuan
Published: August 2020

Gratitude is a crucial element of mental health and wellbeing. But the underlying mechanism by which gratitude is negatively associated with anxiety and depression has been underinvestigated. The current study aimed to examine the associations among gratitude, anxiety, and depression in Chinese adolescents, with a focus on coping flexibility as an individual factor mediating their associations. To do this, 492 middle‐school students in China were surveyed. Subsequently, a mediation model based on the broaden‐and‐build theory, transactional theory of coping, and previous studies was tested. Results demonstrated that the total effects of gratitude on both anxiety and depression were significant. Moreover, coping flexibility significantly mediated the influence of gratitude on both anxiety and depression. Therefore, improving gratitude and enhancing coping flexibility may protect Chinese adolescents from anxiety and depression.
Th2 cell markers in peripheral blood increase during an acute asthma exacerbation
Authors: Shrestha Palikhe Nami , Wu Yingqi , Konrad Emily , Gandhi Vivek Dipak , Rowe Brian H. , Vliagoftis Harissios , Cameron Lisa
Published: August 2020

Background

Allergic asthma is characterized by type 2 inflammation. We have shown the presence of increased type 2 inflammation in patients with severe asthma and those with frequent exacerbations. However, it is not known whether increased type 2 inflammation drives asthma exacerbations. This study aims to determine Th2 immune parameters in patients presenting to the emergency department (ED) with an acute asthma exacerbation and correlate these parameters with clinical and physiological measures of asthma.

Methods

Sixteen adults presenting to the ED with acute asthma exacerbations were recruited after giving informed consent. Ten patients returned 2 weeks later for follow‐up. Physiological parameters, asthma control (ACQ6), asthma quality of life (AQLQ) questionnaires, and venous blood were collected during both visits. An immune cell profiling was performed by whole blood flow cytometry: CD4+ T cells, Th2 cells (CD4+CRTh2+ T cells and % of CD4+ T cells expressing CRTh2), eosinophils and innate lymphoid cells (ILC2).

Results

During exacerbation, peripheral blood Th2 cell numbers correlated with ACQ6 and AQLQ scores, while ILC2 and eosinophil numbers did not. Subjects had higher % of CD4+ T cells expressing CRTh2 and worse FEV1 during exacerbation compared with the follow‐up. The decrease in the % of CD4+ T cells expressing CRTh2 seen during the follow‐up visit correlated with the improvement in lung function.

Conclusions

These data suggest that Th2 cells in peripheral blood may be a sensitive measure of increasing symptoms in patients with asthma exacerbations and may serve as a biomarker of an asthma exacerbation.
Retinal vessel architecture in retinopathy of prematurity and healthy controls using swept‐source optical coherence tomography angiography
Authors: Rezar‐Dreindl Sandra , Eibenberger Katharina , Told Reinhard , Neumayer Thomas , Steiner Irene , Sacu Stefan , Schmidt‐Erfurth Ursula , Stifter Eva
Published: August 2020

Purpose

To determine microvascular changes in children with a history of retinopathy of prematurity (ROP) and in a control group of full‐term children.

Methods

In a cross‐sectional study, 30 eyes of 15 children aged 6–8 years with a history of ROP were evaluated with swept‐source optical coherence tomography angiography (SS‐OCTA). Twenty‐eight eyes of 22 age‐matched full‐term children served as a healthy control group. The foveal avascular zone (FAZ), vessel density (VD) and choroidal vascular flow area (VFA) were evaluated on OCTA and correlated with central retinal thickness (CRT), visual acuity (VA), birth weight (BW), gestational age (GA) and ROP stages.

Results

Twenty‐two eyes of 14 children with a history of ROP (stage 1–3) and 25 eyes of 19 full‐term children were available for evaluation. In the ROP group, the gestational age was 27 ± 2 weeks and birth weight was 781 ± 164 g. In the ROP group, CRT was higher in the central ETDRS segment (mean difference [95% CI]: 32.8 µm [18.7; 47.0], p = 0.0002) compared to the controls. Smaller mean FAZ area (−0.12 [−0.19; −0.04], p = 0.004) and perimeter (−662 [−1228; −96], p = 0.03) was found in comparison to the control group. An oval shape of the FAZ was observed among patients with a history of ROP. The mean central VD of the superficial plexus was 28 ± 8/23 ± 8% and of the deep plexus 7 ± 7/3 ± 5% (ROP group/control group; p > 0.05). No statistically significant difference was found regarding the choroidal VFA. Only weak correlation of FAZ and VD with function was observed.

Conclusions

Swept‐source optical coherence tomography angiography imaging revealed significant microvascular anomalies in children with a history of ROP indicating disturbance of early morphological development of the central retina.
Prevalence of Charles Bonnet syndrome in patients with glaucoma: a systematic review with meta‐analyses
Authors: Subhi Yousif , Schmidt Diana Chabané , Bach‐Holm Daniella , Kolko Miriam , Singh Amardeep
Published: August 2020

Glaucoma is a widespread sight‐threatening condition often only recognized when very pronounced. It is initially characterized by peripheral visual field losses, while advanced stages also affect the central vision. Some of these patients may experience visual hallucinations, the Charles Bonnet syndrome (CBS). In this systematic review and meta‐analysis, we provide an overview of the literature dealing with the prevalence of CBS in patients with glaucoma. We searched the databases PubMed/MEDLINE, Embase, Web of Science, the Cochrane Central and PsycInfo on 22 March 2020. Eight studies (n = 827 patients) were identified and included for a qualitative and quantitative analysis. No studies included a representative sample of patients with only glaucoma. In patients with glaucoma in different stages and with ocular comorbidities, prevalence of CBS was 2.8% (CI95%: 0.7–6.1%). Among patients with glaucoma where all had bilateral low visual acuity, prevalence of CBS was 13.5% (CI95%: 8.4–19.6%). In patients with glaucoma who visited vision rehabilitation clinics, presumably due to an extensive vision impairment, prevalence of CBS was 20.1% (CI95%: 16.8–23.6%). Risk factors of CBS besides low vision were high age, female gender, reduced contrast sensitivity and not living alone. Taken together, we find that CBS may not be rare in patients with advanced glaucoma with and without ocular comorbidities. However, limitations of the current literature should be highlighted and careful approach towards conclusions is important. More studies are needed to better understand the prevalence and risk factors among different populations of patients with glaucoma.
Cluster non‐Gaussian functional data
Authors: Zhong Qingzhi , Lin Huazhen , Li Yi
Published: August 2020

Gaussian distributions have been commonly assumed when clustering functional data. When the normality condition fails, biased results will follow. Additional challenges occur as the number of the clusters is often unknown a priori. This paper focuses on clustering non‐Gaussian functional data without the prior information of the number of clusters. We introduce a semiparametric mixed normal transformation model to accommodate non‐Gaussian functional data, and propose a penalized approach to simultaneously estimate the parameters, transformation function, and the number of clusters. The estimators are shown to be consistent and asymptotically normal. The practical utility of the methods is confirmed via simulations as well as an application of the analysis of Alzheimer's disease study. The proposed method yields much less classification error than the existing methods. Data used in preparation of this paper were obtained from the Alzheimer's Disease Neuroimaging Initiative database.
p53 is associated with high‐risk and pinpointsTP53missense mutations in mantle cell lymphoma
Authors: Rodrigues Joana M. , Hassan May , Freiburghaus Catja , Eskelund Christian W. , Geisler Christian , Räty Riikka , Kolstad Arne , Sundström Christer , Glimelius Ingrid , Grønbæk Kirsten , Kwiecinska Anna , Porwit Anna , Jerkeman Mats , Ek Sara
Published: August 2020

Survival for patients diagnosed with mantle cell lymphoma (MCL) has improved drastically in recent years. However, patients carrying mutations in tumour protein p53 (TP53) do not benefit from modern chemotherapy‐based treatments and have poor prognosis. Thus, there is a clinical need to identify missense mutations through routine analysis to enable patient stratification. Sequencing is not widely implemented in clinical practice for MCL, and immunohistochemistry (IHC) is a feasible alternative to identify high‐risk patients. The aim of the present study was to investigate the accuracy of p53 as a tool to identify patients withTP53missense mutations and the prognostic impact of overexpression and mutations in a Swedish population‐based cohort. In total, 317 cases were investigated using IHC and 255 cases were sequenced, enabling analysis of p53 andTP53status among 137 cases divided over the two‐cohort investigated. The accuracy of predicting missense mutations from protein expression was 82%, with sensitivity at 82% and specificity at 100% in paired samples. We further show the impact of p53 expression andTP53mutations on survival (hazard ratio of 3·1 in univariate analysis for both), and the association to risk factors, such as high MCL International Prognostic Index, blastoid morphology and proliferation, in a population‐based setting.
The well‐being of people with learning disabilities
Authors: Nind Melanie
Published: August 2020

Accessible summary

The papers this time are all about the well‐being of people with learning disabilities.

Some papers are about emotional well‐being, such as feeling secure, dealing with stress and anger, coping when someone dies, having a good life and planning for death.

Some papers are about physical well‐being, particularly keeping healthy and what some medicines can do to us. One paper is about having the money needed to keep well and live a good life.

There is now an easy read guide to what the journal is about and how to judge papers for the journal. You can follow us on Twitter too, @BJLD_Wiley.
US national treatment admissions with opioids and benzodiazepines
Authors: Arfken Cynthia L. , Owens Darlene D. , Greenwald Mark K.
Published: August 2020

Introduction and Aims

Opioids and benzodiazepines (O/BZD) are increasingly involved in drug overdose deaths in the USA. Expanding treatment capacity may reduce these deaths. Knowledge about co‐occurring O/BZD admissions compared to opioid admissions (opioid) is needed to plan this expansion.

Design and Methods

US treatment admissions to specialty facilities for 2011–2017 were analysed for trends and 2017 for group differences. Due to 1.9 million admissions in 2017, comparisons between O/BZD and opioid admissions were summarised as effect sizes. Additional analysis compared the administratively pre‐coded category ‘other opiates and synthetics’ to other opiates and synthetics/benzodiazepines admissions to control for possible similarity in drug source. Differences within O/BZD admissions by primary drug were explored.

Results

Although opioid admissions showed a steady increase over time (25.9% to 38.2%), O/BZD admissions showed increases until decline in 2017 (3.2% to 4.0%). In 2017 no factor reached moderate effect size (≥0.2) in group comparisons or within the O/BZD admissions. Heroin was self‐reported in 70% of both O/BZD and opioid admissions.

Discussion and Conclusions

No meaningful US national differences on data routinely collected were found for O/BZD compared to opioid admissions including the subgroup with other opiates and synthetics only. Efforts to expand existing opioid treatment in specialty treatments may help reduce opioid and O/BZD deaths. However, the analysis could not address whether changes in treatment would improve outcomes.
E‐cigarette use and cigarette smoking initiation among Australian women who have never smoked
Authors: Melka Alemu , Chojenta Catherine , Holliday Elizabeth , Loxton Deborah
Published: August 2020

Introduction and Aim

Evidence regarding the association between e‐cigarette use and subsequent initiation of smoking mostly relates to the US population. In Australia, no studies are available investigating the association between the uses of e‐cigarettes and smoking initiation among young adults who have never smoked. This study aimed to determine the association between lifetime e‐cigarette use and subsequent initiation of cigarette smoking among tobacco‐naïve Australian women aged 20–27.

Design and Methods

The current study used data (n = 5398) from the third (2015) and fourth (2016) surveys collected from a cohort of Australian women born in 1989–1995 who participated in the Australian Longitudinal Study on Women's Health. Multivariable logistic regression was used to identify the association between lifetime e‐cigarette use at the baseline survey and initiation of cigarette smoking (smoked 100 cigarettes or more in the last year) at the follow up adjusting for possible confounders. Effects were expressed as odds ratios with 95% confidence interval.

Results

The mean (± SD) age of the study participants at baseline (third survey) was 22.5 (±1.7). Ever e‐cigarette use at baseline was positively associated with smoking initiation at follow up (adjusted odds ratio 3.71; 95% confidence interval 2.33, 5.93). History of depression, binge drinking and higher childhood adversity score were also risk factors for subsequent smoking initiation in the follow up.

Discussion and Conclusions

This study identified a strong association between e‐cigarette use and subsequent initiation of smoking. Enforcing the existing restriction of sale and supply of e‐liquid containing nicotine is essential to prevent never smokers from nicotine addiction via e‐cigarettes.
Approaches to screening for hyperglycaemia in pregnant women during and after the COVID‐19 pandemic
Authors: Meek C. L. , Lindsay R. S. , Scott E. M. , Aiken C. E. , Myers J. , Reynolds R. M. , Simmons D. , Yamamoto J. M. , McCance D. R. , Murphy H. R.
Published: August 2020

Aim

To evaluate the diagnostic and prognostic performance of alternative diagnostic strategies to oral glucose tolerance tests, including random plasma glucose, fasting plasma glucose and HbA1c, during the COVID‐19 pandemic.

Methods

Retrospective service data (Cambridge, UK; 17 736 consecutive singleton pregnancies, 2004–2008; 826 consecutive gestational diabetes pregnancies, 2014–2019) and 361 women with ≥1 gestational diabetes risk factor (OPHELIA prospective observational study, UK) were included. Pregnancy outcomes included gestational diabetes (National Institute of Health and Clinical Excellence or International Association of Diabetes and Pregnancy Study Groups criteria), diabetes in pregnancy (WHO criteria), Caesarean section, large‐for‐gestational age infant, neonatal hypoglycaemia and neonatal intensive care unit admission. Receiver‐operating characteristic curves and unadjusted logistic regression were used to compare random plasma glucose, fasting plasma glucose and HbA1c performance.

Results

Gestational diabetes diagnosis was significantly associated with random plasma glucose at 12 weeks [area under the receiver‐operating characteristic curve for both criteria 0.81 (95% CI 0.79–0.83)], fasting plasma glucose [National Institute of Health and Clinical Excellence: area under the receiver‐operating characteristic curve 0.75 (95% CI 0.65–0.85); International Association of Diabetes and Pregnancy Study Groups: area under the receiver‐operating characteristic curve 0.92 (95% CI 0.85–0.98)] and HbA1c at 28 weeks' gestation [National Institute of Health and Clinical Excellence: 0.83 (95% CI 0.75–0.90); International Association of Diabetes and Pregnancy Study Groups: 0.84 (95% CI 0.77–0.91)]. Each measure predicts some, but not all, pregnancy outcomes studied. At 12 weeks, ~5% of women would be identified using random plasma glucose ≥8.5 mmol/l (sensitivity 42%; specificity 96%) and at 28 weeks using HbA1c ≥39 mmol/mol (sensitivity 26%; specificity 96%) or fasting plasma glucose ≥5.2–5.4 mmol/l (sensitivity 18–41%; specificity 97–98%).

Conclusions

Random plasma glucose at 12 weeks, and fasting plasma glucose or HbA1c at 28 weeks identify women with hyperglycaemia at risk of suboptimal pregnancy outcomes. These opportunistic laboratory tests perform adequately for risk stratification when oral glucose tolerance testing is not available.
NOT ALL BANKS ARE EQUAL: COOPERATIVE BANKING AND INCOME INEQUALITY
Authors: Minetti Raoul , Murro Pierluigi , Peruzzi Valentina
Published: August 2020

This paper studies the role of different types of credit institutions in income inequality. By analyzing Italian local (provincial) credit markets over the 2001–2011 period, we find that cooperative banks mitigate income inequality in local communities more than their commercial counterparts. The results also suggest that it is the specific nature and orientation of cooperative banks, more than their relationship lending technologies, that improve income distribution. The impact of cooperative banking on inequality appears however to be partly channeled by a reduced dynamism of local economies, especially lower migratory flows and business turnover. (JEL G21, G38, O15)
Quality of life in patients of chronic lymphocytic leukemia using the EORTC QLQ‐C30 and QLQ‐CLL17 questionnaire
Authors: Youron Padma , Singh Charanpreet , Jindal Nishant , Malhotra Pankaj , Khadwal Alka , Jain Arihant , Prakash Gaurav , Varma Neelam , Varma Subhash , Lad Deepesh P.
Published: August 2020

Introduction

The quality of life (QoL) analysis is likely to differ by region, ethnicity, and questionnaires in comparison with age‐matched healthy controls.

Methods

The EORTC QLQ‐C30 and QLQ‐CLL17 questionnaire validated in regional languages were administered to 127 consecutive CLL and 100 age‐matched, healthy controls at a single center from 2018 to 2019.

Results

All groups of CLL patients either on wait and watch (W&W) or on treatment had significantly impaired QoL in all functional domains including global health compared to controls (P < .0001). CLL patients had significantly higher symptom scores than controls in most domains (P < .0001, 0.03 for diarrhea). There was no difference in the QoL by age or gender. Lower socioeconomic status patients had higher financial difficulty (P = .02). Patients on CIT had the worst global health (OR 12.21 compared to patients on W&W) (P = .03). Patients on ibrutinib had less worries/fears about health and functioning than patients who were on CIT (P = .04).

Conclusions

Quality of life is severely affected in CLL patients on W&W. Global health status and worries about future health and functioning were major concerns. Socioeconomic status but not age or gender impacted QoL. Patients on ibrutinib had better QoL than on CIT.
Single UM171‐expanded cord blood transplant can cure severe idiopathic aplastic anemia in absence of suitable donors
Authors: Claveau Jean‐Sébastien , Cohen Sandra , Ahmad Imran , Delisle Jean‐Sébastien , Kiss Thomas , Lachance Silvy , Sauvageau Guy , Busque Lambert , Brito Rose‐Marie , Bambace Nadia , Bernard Léa , Roy Denis Claude , Roy Jean
Published: August 2020

Haplo‐identical donors have been increasingly used as an alternative source of stem cells in patients with severe aplastic anemia in need of an allogeneic transplantation but lack a matched donor. Single cord blood (CB) transplant also offers a curative option for this disease, but few adult patients have been reported due to low number of progenitor cells leading to prolonged cytopenias and a high risk of infections. CB stem cell expansion may theoretically solve these pitfalls but has not been used previously in non‐malignant diseases, likely due to fear of graft rejection and lack of availability of expanded CBs outside clinical trials. We report the first case of an adult patient with severe aplastic anemia who was successfully transplanted with a UM171‐expanded CB graft. After a conditioning of rabbit antithymocyte globulin, fludarabine, cyclophosphamide, and total body irradiation, a UM171 expanded graft of 3.29 × 106 CD34 + cells/kg (a 51‐fold increase) was infused. Full donor chimerism was observed on day + 14, with neutrophil and platelet engraftment on days + 23 and + 27. There was no severe infection or graft‐vs‐host disease. UM171‐expanded grafts offer a valuable option for patients with aplastic anemia in need of transplantation but have no suitable donor.
Structural and spectroscopic characterization of a HdrA‐like subunit from Hyphomicrobium denitrificans
Authors: Ernst Corvin , Kayastha Kanwal , Koch Tobias , Venceslau Sofia S. , Pereira Inês A. C. , Demmer Ulrike , Ermler Ulrich , Dahl Christiane
Published: August 2020

Many bacteria and archaea employ a novel pathway of sulfur oxidation involving an enzyme complex that is related to the heterodisulfide reductase (Hdr or HdrABC) of methanogens. As a first step in the biochemical characterization of Hdr‐like proteins from sulfur oxidizers (sHdr), we structurally analyzed the recombinant sHdrA protein from the Alphaproteobacterium Hyphomicrobium denitrificans at 1.4 Å resolution. The sHdrA core structure is similar to that of methanogenic HdrA (mHdrA) which binds the electron‐bifurcating flavin adenine dinucleotide (FAD), the heart of the HdrABC‐[NiFe]‐hydrogenase catalyzed reaction. Each sHdrA homodimer carries two FADs and two [4Fe–4S] clusters being linked by electron conductivity. Redox titrations monitored by electron paramagnetic resonance and visible spectroscopy revealed a redox potential between −203 and −188 mV for the [4Fe–4S] center. The potentials for the FADH•/FADH− and FAD/FADH• pairs reside between −174 and −156 mV and between −81 and −19 mV, respectively. The resulting stable semiquinone FADH• species already detectable in the visible and electron paramagnetic resonance spectra of the as‐isolated state of sHdrA is incompatible with basic principles of flavin‐based electron bifurcation such that the sHdr complex does not apply this new mode of energy coupling. The inverted one‐electron FAD redox potentials of sHdr and mHdr are clearly reflected in the different FAD‐polypeptide interactions. According to this finding and the assumption that the sHdr complex forms an asymmetric HdrAA′B1C1B2C2 hexamer, we tentatively propose a mechanism that links protein‐bound sulfane oxidation to sulfite on HdrB1 with NAD+ reduction via lipoamide disulfide reduction on HdrB2. The FAD of HdrA thereby serves as an electron storage unit.

Database

Structural data are available in PDB database under the accession number 6TJR.
“Promotion tournament 2.0”: Why local cadres expand health‐care provision in China
Authors: Zhang Yuxi
Published: August 2020

Previous research has attributed the delayed welfare development in China to the government's traditional obsession with GDP growth target as the principal criteria for cadre promotion. Yet why has health‐care provision significantly expanded since the 2000s? This article argues that as central policies adjusted to incorporate health care as a priority, the cadre assessment system subsequently made it a “hard target,” and thus the competition for office has compelled local cadres to implement health‐care expansion. Apart from the importance of local leaders in policy change as the literature suggests, this article elaborates on the pivotal role of technical bureaucrats by innovatively introducing the “promotion tournament 2.0” model, which emphasizes the knowledge–power coalition between these political actors. By investigating the case of health‐care expansion, this article illustrates the local politics of policy change with various forms of data collected from semi‐structured interviews, newspaper archives, political documents, and official statistics.
Exploring the experiences of having Guillain‐Barré Syndrome: A qualitative interview study
Authors: Akanuwe Joseph N. A. , Laparidou Despina , Curtis Ffion , Jackson Jennifer , Hodgson Timothy L. , Siriwardena Aloysius Niroshan
Published: August 2020

Background

Guillain‐Barré syndrome (GBS) is a rare inflammatory disorder affecting the peripheral nerves. Although typically there is full neurological recovery, some people continue to experience residual physical, psychological or social problems longer term. Evidence describing the experiences of people with GBS is limited.

Objective

We aimed to explore the experiences of people with GBS in the UK.

Design

We used qualitative (face‐to‐face and telephone) interviews to explore experiences of people with GBS. Audio‐recorded data were transcribed verbatim and analysed using the Framework Method supported by NVivo 11.

Setting and Participants

We purposively recruited a sample of 16 volunteers with a prior diagnosis of GBS of varying age, sex, ethnicity, location, marital status, time since diagnosis and length of hospital stay to maximize differences in experience. Interviewees were required to have been discharged from hospital, able to give informed consent, able to speak and understand English and currently resident in the United Kingdom.

Results

The key themes arising from the analysis were as follows: the importance of early diagnosis; the experiences of inpatient care; the importance of active support for recovery; the need for communication throughout the course of the illness; the need for greater awareness, knowledge and provision of information by health‐care staff; and path to achieving function.

Conclusion

This is the first qualitative study exploring experiences of people with GBS in the UK through their whole illness journey from onset to recovery. The findings contribute to our understanding of the experiences and support needs of people recovering from GBS.
Development and validation of an instrument of occupational low back pain prevention behaviours of nurse
Authors: Kazemi Seyedeh‐Somayeh , Tavafian Sedigheh‐Sadat , Hidarnia Alireza , Montazeri Ali
Published: August 2020

Aim

To develop and test the psychometric properties of occupational low back pain prevention behaviours questionnaire in nursing personnel.

Design

A qualitative and quantitative research design to develop and validate an instrument.

Methods

A qualitative study was conducted from May ‐ October 2017 with 20 participants to generate an item pool. Then, content and face validity was carried out. Next, the questionnaire was distributed among a sample of nurses. In all, 150 nurses participated (mean age 34.1; SD 7.66 years) in the study. Exploratory factor analysis used to determine the factor structure of the questionnaire. Item‐scale correlation matrix was provided to examine the construct validity. Internal consistency (Cronbach's alpha) was estimated to assess reliability and intraclass correlation coefficient was calculated to examine stability.

Results

Six factors with 30 items emerged from the exploratory factor analysis that jointly accounted for 67.9% of the variance observed. Item‐scale correlation matrix showed satisfactory results lending support to construct validity of the questionnaire. The Cronbach's alpha coefficient for the whole scale showed excellent internal consistency (0.92), although this was not true for the knowledge subscale. The intraclass correlation coefficient with a 2‐week interval also indicated that the questionnaire had satisfactory stability (0.97).

Conclusion

This study provides initial support for reliability and validity of the Occupational Low Back Pain Prevention Behaviour Questionnaire.

Impact

This study offers an instrument to assess low back pain preventive behaviours among nurses. The instrument is useful for nursing personnel and could be used in hospitals and healthcare settings to implement appropriate interventions.
Hospital‐based intervention to enhance hypertension diagnosis in Kalasin hospital, Thailand, 2017‐2019: A pre‐post pilot intervention study
Authors: Yueayai Khanuengnij , Moran Andrew E. , Pratipanwat Piyanut , Chaisongkram Siwaboon , Anosri Ladda , Thitichai Phanthanee
Published: August 2020

In Thailand 5.9 million individuals ≥15 years old have undiagnosed hypertension. The intervention to reduce undiagnosed hypertension was piloted and aimed to compare pre‐ and post‐intervention hypertension diagnosis rate and follow‐up rate. A hospital‐based pre‐ and post‐intervention study was piloted in a general hospital in Thailand. The intervention included an electronic pop‐up alert when raised blood pressure was observed and a follow‐up protocol. The follow‐up protocol entered patient information in a follow‐up book that scheduled an appointment to recheck blood pressure. Statistical analyses compared the rate of hypertension diagnosis and follow‐up between the pre‐ and post‐intervention periods, adjusted for differences in baseline characteristics. A post‐intervention, self‐report survey among nurses and nurse‐aids explored perceptions about raised blood pressure management and solicited suggestions to improve the intervention. 574 raised blood pressure patients visited the hospital in the pre‐intervention period; 27.4% returned for follow‐‐up; and hypertension diagnosis rate was 1.4%. Among 686 post‐intervention raised blood pressure patients, overall hypertension diagnosis rate improved to 6.1%. In per‐protocol patients, 81.9% were booked to follow‐‐up, hypertension diagnosis rate was 18.6%, and the adjusted odds ratio of hypertension diagnosis was 4.5 times higher compared with the pre‐intervention period. By self‐report, 20% of health workers had no time to provide the follow‐up book due to work overload, yet >57% reported that information technology improved detection of raised blood pressure and improved follow‐up. The interventions significantly increased the hypertension diagnosis rate and follow‐up among raised blood pressure patients in a single hospital but may benefit from incorporating an information technology‐assisted follow‐up protocol.
Arterial stiffness in black adults from Angola and Brazil
Authors: Cruz Vitória P. D. , Gonzaga Carla W. O. , da Silva Victor B. , da Cruz André F. P. , da Silva Amilcar B. Tomé , Capingana Daniel P. , Magalhães Pedro , Zaniqueli Divanei A. , Guimarães André L. S. , Cunha Roberto Sá , Mill José Geraldo , Baldo Marcelo P.
Published: August 2020

Ethnicity is an important determinant of blood pressure levels, being black individuals affected more than any other ethnic group. Arterial stiffening, an independent risk factor for hypertension, is also influenced by ethnicity. However, whether black individuals from different continents would have different patterns of arterial stiffening is still unknown. Thus, the authors aimed to compare pulse wave velocity (PWV) in black subjects living in Angola and Brazil. A total of 677 black individuals from two independent cross‐sectional studies conducted in Brazil and Angola were included in this analysis. Carotid‐to‐femoral PWV was measured following the same protocols for both studies, as well as clinical and anthropometric variables. Adjusted PWV was higher in Brazilian blacks than in Angolans, regardless of sex (men from Brazil: 10.7 ± 1.8 vs men from Angola: 9.9 ± 1.8 m/s, P < .001; women from Brazil: 10.3 ± 1.5 vs women from Angola: 9.2 ± 1.3 m/s, P < .001). Although the cf‐PWV was higher in Brazilian blacks, the age‐related increase in cf‐PWV was higher in Angolan men compared to Brazilians, but not in women. SBP showed the strongest association with cf‐PWV, regardless of sex and country. However, age was associated with cf‐PWV in all groups, except in Brazilian men. Our results clearly show a difference in PWV between two black populations, and highlight for sex differences in the hemodynamic parameters that might affect blood pressure levels in these populations.
BMP2 signalling activation enhances bone metastases of non‐small cell lung cancer
Authors: Huang Fei , Cao Yaqiang , Wu Gui , Chen Junying , CaihongWang  , Lin Wanzun , Lan Ruilong , Wu Bing , Xie Xianhe , Hong Jinsheng , Fu Lengxi
Published: August 2020

Distant metastases occur when non‐small cell lung cancer (NSCLC) is at late stages. Bone metastasis is one of the most frequent metastases of NSCLC and leads to poor prognosis. It has been reported that high expression of BMP2 in NSCLC correlates with poor survival, but whether BMP2 contributes to NSCLC bone metastasis remains largely unknown. The activation of BMP signalling is found in metastatic bone tumours of mice Lewis lung carcinoma and predicts poor survival in human NSCLC. BMP2 signalling activation can enhance bone metastasis of Lewis lung carcinoma. Moreover, BMP2 secreted by stroma fibroblasts can promote the migration and invasion of NSCLC cells. Besides, in combination with pre‐osteoblast and LLCs, BMP2 could enhance the differentiation of macrophages into osteoclasts to play roles in the osteolytic mechanism of NSCLC bone metastasis. Interestingly, NSCLC cells can also enrich BMP2 to pre‐osteoblasts to function in the osteoblastic mechanism. Our results firstly demonstrate the detailed mechanisms about what roles BMP2 signalling play in enhancing NSCLC bone metastases. These findings provide a new potential therapy choice for preventing bone metastases of NSCLC via the inhibition of BMP2 signalling.
Calculators Estimating the Likelihood of Vaginal Birth After Cesarean: Uses and Perceptions
Authors: Thornton Patrick D. , Liese Kylea , Adlam Kirby , Erbe Katherine , McFarlin Barbara L.
Published: August 2020

Introduction

A calculator estimating likelihood of vaginal birth after cesarean (VBAC) has been promoted by the Society for Maternal‐Fetal Medicine, but little is known about how it is used and perceived in practice. Cutoffs for prohibiting labor after cesarean are discouraged by the calculator's developers, but such uses may be widespread. The purpose of this study was to determine how calculators predicting VBAC are used and perceived in midwifery practices.

Methods

Certified nurse‐midwives and certified midwives currently providing care for labor after cesarean were surveyed between January 17, 2019, and February 7, 2019. Quantitative and text data were collected regarding the uses and perceptions of calculators among midwives and their colleagues. We compared these findings with midwives’ perceptions of their ability to accommodate patient wishes for labor after cesarean. We used descriptive content analysis to evaluate themes occurring in text responses.

Results

There were 1305 valid responses. A requirement to use calculator scores for patient counseling was reported by 527 (40.4%) of responding midwives. Over 1 in 5 midwives reported that scores were used to discourage or prohibit labor after cesarean. Almost half reported some or strong disagreement with physician colleagues regarding calculator use. Interprofessional agreement and disagreement centered on how scores are used to direct clinical care or restrict patient options. Calculator scores were used in more than twice as many midwives’ practices to discourage rather than encourage labor after cesarean. Descriptive analysis of text revealed 4 themes regarding calculators: inconsistent use, information counseling, informed consent, and influence patient management or options.

Discussion

Calculators predicting likelihood of VBAC success are widely used in midwifery settings and are more often used to discourage than to encourage labor after cesarean. Midwives reported both directive and nondirective counseling based on calculator scores.
In vitro evaluation of aspiration of hyaluronic acid filler with a new saline flashing method
Authors: Kogan Inna , Korolik Pavel , Cartier Hugues , Adhoute Hertsel , Liberzon Alexander
Published: August 2020

Aims

In vitro evaluation of aspiration of viscous hyaluronic acid (HA) fillers through dermatologic needles, with and without a new solution for safe aspiration with a saline flashing procedure. The final objective is to be able to offer an easy‐to‐use device for a practitioner who injects fillers under and into the skin blindly. This device aims to protect him from an immediate and reproducible intravascular venous or arterial injection whatever the type of product used and independently of its rheological properties or the diameter of the needle used.

Materials and Methods

We performed in vitro aspiration experiment using syringes and commonly used needle sizes (27G, 29G). We measured the time to observe a blood being aspirated through the needle with HA filler. Intervals longer than 10 seconds were considered as false results. We added a new approach of flashing a saline solution through the needle with a filler prior to aspiration. Saline solution pressurized by a syringe plunger opens a fluid path in the needle and enables the successful and efficient aspiration in 1‐2 seconds through smallest needle size for 6 commercial HA fillers.

Conclusion

The saline flashing of the dermatological needles with HA fillers appeared to be a feasible and efficient solution for the 100% safe aspiration safety test.

Results

Aspiration was possible only in few trials with HA fillers for the 27G and all false for 29G needle, respectively. The aspiration with the novel saline flashing procedure is successful for 100% of cases with the two commonly used HA fillers and all needle sizes. The time to aspiration is also significantly shorter with the saline flashing.
A woman with primary ovarian insufficiency had two live births resulting from intrauterine inseminations during 10 years of ovarian follicle monitoring
Authors: Maruyama Tetsuo
Published: August 2020

Women with primary ovarian insufficiency rarely ovulate and even more rarely achieve a spontaneous pregnancy. A patient with primary ovarian insufficiency who had only 13 follicle development cycles during 13 years, but had 2 live births resulting from intrauterine inseminations is reported. She was diagnosed with primary ovarian insufficiency at 19 years of age and started infertility treatment at 23 years of age. During 10 of the 13 years that she was not pregnant and not breastfeeding, she underwent cyclic estrogen and progestin therapy with biweekly monitoring of follicle development. She delivered the first and second child at 30 and 37 years of age, respectively. This case report suggests that continuous follicle monitoring may increase the probability of having a child in a subset of patients with primary ovarian insufficiency and desired fertility, although the validity and efficacy of such management has not been established.
Levels of serum Hoxb3 and sFlt‐1 in pre‐eclamptic patients and their effects on pregnancy outcomes
Authors: Zhou Jun , Guo Xiaohui , Sun Yuan , Ma Li , Zhe Ruilian
Published: August 2020

Aim

We aimed to explore a new approach and theoretical basis for the diagnosis, treatment and prognosis of pre‐eclampsia.

Methods

In total, 103 pre‐eclamptic patients (study group: SG) and 100 healthy pregnant women (control group: CG) were enrolled. Reverse transcription quantitative polymerase chain reaction (RT‐qPCR) was used to detect the expression level of serum Hoxb3. Enzyme‐linked immunosorbent assay was used to detect the content of serum sFlt‐1. Pregnancy outcomes in the two groups were recorded, and the correlations of the levels of Hoxb3 and sFlt‐1 with the pregnancy outcomes were analyzed.

Results

The relative expression of serum Hoxb3 mRNA in the CG was significantly higher than that in the SG, whereas the content of serum sFlt‐1 in the CG was significantly lower than that in the SG. Compared with the CG, the SG had a significantly lower number of spontaneous deliveries, higher number of cesarean deliveries and significantly higher number of uneventful perinatal births. The incidences of intrauterine growth restriction, intrauterine distress, premature infants and neonatal deaths in perinatal infants in the SG were significantly higher than those in the CG. According to the analysis of receiver operating characteristic curves, the areas under the curves of Hoxb3, sFlt‐1 and their combined detection for diagnosing pre‐eclampsia were 0.799, 0.856 and 0.930, respectively. The areas under the curves for predicting poor perinatal outcomes were 0.724, 0.828 and 0.871, respectively.

Conclusion

In conclusion, Hoxb3 and sFlt‐1 have certain reference significance for the risk evaluation of pre‐eclampsia and the adverse pregnancy outcomes of pre‐eclampsia women.
Ultrasound measurement of fetal arterial pulse pressure using phased‐tracking methods: A phantom study and clinical experience with antenatal corticosteroid therapy
Authors: Muromoto Jin , Murotsuki Jun , Miyashita Susumu , Hasegawa Hideyuki , Taki Hirofumi , Kanai Hiroshi , Yaegashi Nobuo
Published: August 2020

Aim

This study aimed to compare the accuracy of fetal pulse pressure estimated with a vascular simulator with that obtained by a manometer (reference) and evaluate the pulse pressure in normal human fetuses and fetuses whose mothers received corticosteroids.

Methods

Fetal pulse pressure was estimated as the product of blood flow velocity and pulse wave velocity, based on the water hammer equation. Ultrasonic raw radiofrequency signals for blood flow velocity were captured from the fetal descending aortas at the diaphragm level, and pulse wave velocity was simultaneously measured from different directions using the phased‐tracking method. First, the precision and accuracy of pulse pressure in the estimated method were verified by a circulatory phantom simulator, which reproduced fetal blood flow using a pulsating pump. Then, the pulse pressure of 98 normal human fetuses after 17 weeks of gestation and the fetal pulse pressure in 21 mothers who received antenatal corticosteroids for fetal maturation were measured.

Results

A significant correlation between the estimated pulse pressure values and the actual values was found in the phantom simulation (r = 0.99, P < 0.01). The estimated pulse pressure was significantly correlated with gestational age in normal fetuses (r = 0.74, P < 0.01). In steroid‐treated pregnant women, fetal pulse pressure was observed to increase significantly on the second day of administration (P < 0.01).

Conclusion

A noninvasive and accurate estimation model of fetal pulse pressure could be established using phased‐tracking method, and this method has the potential to improve the assessment of human fetal hemodynamics.
Investigation on the metabolic characteristics of isobavachin in Psoralea corylifolia L. (Bu-gu-zhi) and its potential inhibition against human cytochrome P450s and UDP-glucuronosyltransferases
Authors: Xing Han , Yang Jing , Ren Kaidi , Qin Zifei , Wang Peile , Zhang Xiaojian , Yao Zhihong , Gonzalez Frank J , Yao Xinsheng
Published: August 2020

Objectives

Isobavachin is a phenolic with anti-osteoporosis activity. This study aimed to explore its metabolic fates in vivo and in vitro, and to investigate the potential drug–drug interactions involving CYPs and UGTs.

Methods

Metabolites of isobavachin in mice were first identified and characterized. Oxidation and glucuronidation study were performed using liver and intestine microsomes. Reaction phenotyping, activity correlation analysis and relative activity factor approaches were employed to identify the main CYPs and UGTs involved in isobavachin metabolism. Through kinetic modelling, inhibition mechanisms towards CYPs and UGTs were also explored.

Key findings

Two glucuronides (G1 - G2) and three oxidated metabolites (M1 - M3) were identified in mice. Additionally, isobavachin underwent efficient oxidation and glucuronidation by human liver microsomes and HIM with CLint values from 5.53 to 148.79 μl/min per mg. CYP1A2, 2C19 contributed 11.3% and 17.1% to hepatic metabolism of isobavachin, respectively, with CLint values from 8.75 to 77.33 μl/min per mg. UGT1As displayed CLint values from 10.73 to 202.62 μl/min per mg for glucuronidation. Besides, significant correlation analysis also proved that CYP1A2, 2C19 and UGT1A1, 1A9 were main contributors for the metabolism of isobavachin. Furthermore, mice may be the appropriate animal model for predicting its metabolism in human. Moreover, isobavachin exhibited broad inhibition against CYP2B6, 2C9, 2C19, UGT1A1, 1A9, 2B7 with Ki values from 0.05 to 3.05 μm.

Conclusions

CYP1A2, 2C19 and UGT1As play an important role in isobavachin metabolism. Isobavachin demonstrated broad-spectrum inhibition of CYPs and UGTs.
Blood mineral profile of the critically endangered Western Derby eland (Taurotragus derbianus derbianus) in two conservation breeding reserves in Senegal
Authors: Stoklasová Lucie , Váhala Jiří , Hejcmanová Pavla
Published: August 2020

For many nondomestic species, nutritional requirements and the challenges faced in their current habitats are unknown. This is the case of small semi‐captive population of the critically endangered Western Derby eland held in two wildlife reserves (the Bandia and the Fathala) in Senegal. The aim of this study was to determine the mineral profile (Ca, P, Mg, Cu, Fe, Zn, Se, K, S) in blood serum and to identify potential mineral deficiencies. Serum data (11 individuals) were compared to other Tragelaphineae, where it was lower in almost all elements. Considerably low concentrations were recorded for Cu, Fe and Zn. Animals in the Bandia reserve had higher serum levels of Fe and K compared to the Fathala reserve and a higher serum level of S in the Fathala reserve compared to the Bandia reserve. Recorded mineral levels may reflect most likely the limited mineral background in the local environment. The knowledge of adequate nutritional requirements and health status of these animals is relevant for the conservation breeding programme. No other serum mineral reference values exist for Western Derby eland, neither for free‐ranging nor captive animals. Therefore, the knowledge of reference intervals for minerals in serum may serve for monitoring of the population's health.