bluuebunny/crossref_metadata_2025 huggingface dataset:
Perinatal and maternal morbidity and mortality among term singletons following midcavity operative vaginal delivery versus caesarean delivery
Authors: Muraca GM , Skoll A , Lisonkova S , Sabr Y , Brant R , Cundiff GW , Joseph KS
Published: July 2017

Objective

To quantify severe perinatal and maternal morbidity/mortality associated with midcavity operative vaginal delivery compared with caesarean delivery.

Design

Population‐based, retrospective cohort study.

Setting

British Columbia, Canada.

Population

Term, singleton deliveries (2004–2014) by attempted midcavity operative vaginal delivery or caesarean delivery in the second stage of labour, stratified by indication for operative delivery (n = 10 901 deliveries; 5057 indicated for dystocia, 5844 for fetal distress).

Methods

Multinomial propensity scores and mulitvariable log‐binomial regression models were used to estimate adjusted rate ratios (ARR) and 95% confidence intervals (95% CI).

Main outcome measures

Composite severe perinatal morbidity/mortality (e.g. convulsions, severe birth trauma and perinatal death) and severe maternal morbidity (e.g. severe postpartum haemorrhage, shock, sepsis and cardiac complications).

Results

Among deliveries with dystocia, attempted midcavity operative vaginal delivery was associated with higher rates of severe perinatal morbidity/mortality compared with caesarean delivery (forceps ARR 2.11, 95% CI 1.46–3.07; vacuum ARR 2.71, 95% CI 1.49–3.15; sequential ARR 4.68, 95% CI 3.33–6.58). Rates of severe maternal morbidity/mortality were also higher following midcavity operative vaginal delivery (forceps ARR 1.57, 95% CI 1.05–2.36; vacuum ARR 2.29, 95% CI 1.57–3.36). Among deliveries with fetal distress, there were significant increases in severe perinatal morbidity/mortality following attempted midcavity vacuum (ARR 1.28, 95% CI 1.04–1.61) and in severe maternal morbidity following attempted midcavity forceps delivery (ARR 2.34, 95% CI 1.54–3.56).

Conclusion

Attempted midcavity operative vaginal delivery is associated with higher rates of severe perinatal morbidity/mortality and severe maternal morbidity, though these effects differ by indication and instrument.

Tweetable abstract

Perinatal and maternal morbidity is increased following midcavity operative vaginal delivery.
Neuromuscular Blockade of Fazadinium Bromide (AH 8165) in Renal Failure Patients
Authors: CAMU F. , D'HOLLANDER A.
Published: July 2017

Fazadinium bromide (AH 8165) is a new non‐depolarizing neuromuscular blocking agent with rapid onset of action and intermediate duration of effect. The characteristics of the neuromuscular blockade induced were compared in normal and renal failure patients by monitoring the mechanical responses of thumb adductor muscle to ulnar nerve stimulation.

The data suggest that renal failure, even in anephric patients, does not influence the depth of neuromuscular relaxation when judged from the identical dose‐effect curves in both groups of patients. Moreover, the duration of the neuromuscular block was not significantly increased in end‐stage kidney failure patients, whether the initial or late phases of the spontaneous recovery of neuromuscular transmission were considered, and this occurred over the entire therapeutic range. However, additional incremental injections of fazadinium bromide should be used cautiously, as evidence appeared of prolonged duration of action.

This agent, fazadinium bromide, may therefore present useful advantages to other non‐depolarizing neuromuscular blocking agents as to clinical safety and effects in patients with renal insufficiency.
Sperm morphology: assessment, pathophysiology, clinical relevance, and state of the art in 2017
Authors: Gatimel N. , Moreau J. , Parinaud J. , Léandri R. D.
Published: July 2017

For over 30 years, sperm morphology assessment has been one of the most common tests in evaluation of fertility. This review examines the clinical relevance of sperm morphology assessment in the diagnosis of infertility and in assisted reproductive technology, as well as its analytical reliability. Publications on the pathophysiology, the analytical reliability of the test and its clinical relevance in diagnosis and in Assisted Reproductive Technology (ART) were evaluated. This review compared and discussed study methodologies and results, including patient characteristics, preparation, smear staining methods and classification systems. The assessment of the percentage of some abnormalities such as for example thin head, amorphous head, or bent or asymmetrical neck is of little clinical use, and their pathophysiology is not well explained as most are physiological traits. Some studies have highlighted correlations between the percentage of normal forms and functional sperm abnormalities, as well as correlations with ability to conceive in vivo and, in some situations, with the success of intra‐uterine insemination (IUI) or conventional IVF. However, except in the case of some specific sperm defects (easy to detect with 99 or 100% of spermatozoa affected) and which are often linked to genetic disorders (globozoospermia, macrocephaly, decapitated sperm syndrome and fibrous sheath dysplasia), sperm morphology assessment has very poor sensitivity and specificity in the diagnosis of infertility. Moreover, there is very little evidence that indices of multiple sperm defects [sperm deformity index (SDI), teratozoospermia index (TZI), and multiple abnormalities index (MAI)] are relevant. Above all, many publications report a major lack of analytical reliability of this test, mainly in assessment of the details of sperm abnormalities. Many questions arise concerning how and when sperm morphology should be assessed, and how to interpret the thresholds of normal forms. Questions are raised on the real clinical impact of this test.
Copy number variants of Ras/MAPK pathway genes in patients with isolated cryptorchidism
Authors: Rodríguez F. , Vallejos C. , Giraudo F. , Unanue N. , Hernández M. I. , Godoy P. , Célis S. , Martín‐Arenas R. , Palomares‐Bralo M. , Heath K. E. , López M. T. , Cassorla F.
Published: July 2017

Cryptorchidism is the most common congenital disorder in boys, but the cause for most cases remains unknown. Patients with Noonan Syndrome are characterized by a typical face, growth retardation, congenital heart defects, learning disabilities and cryptorchidism. Copy number variations of Ras/MAPK pathway genes are unusual in patients with several clinical features of Noonan Syndrome; however, they have not been studied in patients with only one feature of this condition, such as cryptorchidism. Our aim was to determine whether patients with isolated cryptorchidism exhibit Ras/MAPK pathway gene copy number variations (CNVs). Fifty‐nine patients with isolated cryptorchidism and negative for mutations in genes associated with Noonan Syndrome were recruited. Determination of Ras/MAPK pathway gene CNVs was performed by Comparative Genome Hybridization array. A CNV was identified in two individuals, a ~175 kb microduplication at 3p25.2, partially including RAF1. A similar RAF1 microduplication has been observed in a patient with testicular aplasia. This suggests that some patients with isolated cryptorchidism may harbor Ras/MAPK pathway gene CNVs.
Fitness plus American Society of Anesthesiologists grade improve outcome prediction after endovascular aneurysm repair
Authors: Boult Margaret , Cowled Prue , Barnes Mary , Fitridge Robert A.
Published: July 2017

Background

Although the American Society of Anesthesiologists (ASA) grade was established for statistical purposes, it is often used prognostically. However, older patients undergoing elective surgery are typically ASA III, which limits patient stratification. We look at the prognostic effect on early complications and survival of using ASA and self‐reported physical fitness to stratify patients undergoing endovascular repair of abdominal aortic aneurysms.

Methods

Data were extracted from a trial database. All patients were assigned a fitness level (A (fit) or B (unfit)) based on their self‐reported ability to walk briskly for 1 km or climb two flights of stairs. Fitness was used to stratify ASA III patients, with fitter patients assigned ASA IIIA and less fit patients ASA IIIB. Outcomes assessed included survival, reinterventions, endoleak, all early and late complications and early operative complications.

Results

A combined ASA/fitness scale (II, IIIA, IIIB and IV) correlated with 1‐ and 3‐year survival (1‐year P = 0.001, 3‐year P = 0.001) and early and late complications (P = 0.001 and P = 0.05). On its own, ASA predicted early complications (P = 0.0004) and survival (1‐year P = 0.01, 3‐year P = 0.01). Fitness alone was predictive for survival (1‐year P = 0.001, 3‐year P = 0.001) and late complications (P = 0.009).

Conclusion

This study shows that even a superficial assessment of fitness is reflected in surgical outcomes, with fitter ASA III patients showing survival patterns similar to ASA II patients. Physicians should be alert to differences in fitness between patients in the ASA III group, despite similarities based on preexisting severe systemic disease.
A Flow Cytometry‐based Method for the Screening of Nanomaterial‐induced Reactive Oxygen Species Production in Leukocytes Subpopulations in Whole Blood
Authors: Kermanizadeh Ali , Jantzen Kim , Brown David M. , Møller Peter , Loft Steffen
Published: July 2017

To date, the use and translation of nanomedicine from the laboratory to the clinic has been relatively slow. Among other issues, one of the reasons for this tardiness is the lack of the availability of quick and reliable toxicity tools for the screening of nanomaterials (NMs). In this investigation, we apply a flow cytometry‐based method for the detection of nanomaterial‐induced oxidative stress by measurement of reactive oxygen species production in specific leukocyte subpopulations in human whole blood. The screening of a panel of relevant nanomedical‐associated materials (liposomes, silica, iron oxide and functionalized single‐walled carbon nanotubes) demonstrated that only the carbon nanotubes induced oxidative stress in human circulating leukocytes. In summary, we apply and corroborate a flow cytometry‐based method for the simple and effective measurement of NM‐induced oxidative stress in human blood subpopulations after realistic and relevant exposure scenarios which is extremely useful in future toxicological applications.
Civic Science for Public Use: Mind in the Making and Vroom
Authors: Galinsky Ellen , Bezos Jackie , McClelland Megan , Carlson Stephanie M. , Zelazo Philip D.
Published: July 2017

Mind in the Making and Vroom are partner initiatives that exemplify a unique “civic science” approach to “bringing developmental science into the world.” Mind in the Making offers families and professionals working with children 0–8 access to developmental research, by engaging them in an active process of professional development and community outreach. Vroom is an outreach and communication initiative that brings “brain building basics” to communities, inviting parents to participate in the science of early learning through partnerships with trusted entities. These initiatives use collaborative, iterative processes in disseminating findings and implications of child development research. Preliminary evidence shows early promise of these initiatives to help promote engaged learning and life skills based on executive function in adults and children.
Whole genome SNP genotyping in a family segregating developmental dysplasia of the hip detected runs of homozygosity on chromosomes 15q13.3 and 19p13.2
Authors: Basit Sulman , Alharby Essa , Albalawi Alia M. , Khoshhal Khalid I.
Published: July 2017

Developmental dysplasia of the hip (DDH) is one of the most prevalent developmental orthopedic diseases worldwide. DDH is a spectrum of anatomical abnormalities of the hip joint and is characterized by premature arthritis in later life. Sporadic cases have been reported more frequently; however, some studies have reported families segregating DDH. Studies have suggested that the genetic factors play a significant role in the development of DDH. In order to detect genetic defect underlying DDH, we performed Sanger sequencing of all DDH associated genes, whole genome SNP genotyping and exome sequencing in a Saudi family with four individuals having DDH. Sanger sequencing of all known genes did not identify any pathogenic variant. Genotype data analysis using HomozygosityMapper identified shared homozygous regions on chromosome 15q13.3 and chromosome 19p13.2 flanked by rs17228178‐rs1534200 and rs466123‐rs2112461, respectively. These data were also analyzed by cnvpartition software for identification of DDH associated copy number variations (CNV). A shared copy number gain of approximately 15 kb on chr6p21.32 (chr6:33 053 906–33 069 893) was discovered in all affected individuals. Partial gain of this region has also been found in unaffected sibling of this family. Exome data did not reveal any candidate sequence variant. Whole genome sequencing is required to identify deep intronic variants in the shared homozygous regions. Identification of genetic variants involved in pathogenesis of DDH may open up interesting perspectives into the function of the gene(s) in hip joint development.
Microclimate variability in alpine ecosystems as stepping stones for non‐native plant establishment above their current elevational limit
Authors: Lembrechts Jonas J. , Lenoir Jonathan , Nuñez Martin A. , Pauchard Aníbal , Geron Charly , Bussé Gilles , Milbau Ann , Nijs Ivan
Published: July 2017

Alpine environments are currently relatively free from non‐native plant species, although their presence and abundance have recently been on the rise. It is however still unclear whether the observed low invasion levels in these areas are due to an inherent resistance of the alpine zone to invasions or whether an exponential increase in invasion is just a matter of time. Using a seed‐addition experiment on north‐ and south‐facing slopes (cf. microclimatic gradient) on two mountains in subarctic Sweden, we tested the establishment of six non‐native species at an elevation above their current distribution limits and under experimentally enhanced anthropogenic pressures (disturbance, added nutrients and increased propagule pressure). We found a large microclimatic variability in cumulative growing degree days (GDD) (range = 500.77°C, SD = 120.70°C) due to both physiographic (e.g. aspect) and biophysical (e.g. vegetation cover) features, the latter being altered by the experimental disturbance. Non‐native species establishment and biomass production were positively correlated with GDD along the studied microclimatic gradient. However, even though establishment on the north‐facing slopes caught up with that on the south‐facing slopes throughout the growing season, biomass production was limited on the north‐facing slopes due to a shorter growing season. On top of this microclimatic effect, all experimentally imposed anthropogenic factors enhanced non‐native species success. The observed microclimatic effect indicates a potential for non‐native species to use warm microsites as stepping stones for their establishment towards the cold end of the gradient. Combined with anthropogenic pressures this result suggests an increasing risk for plant invasion in cold ecosystems, as such stepping stones in alpine ecosystems are likely to be more common in a future that will combine a warming climate with persistent anthropogenic pressures.
Effect of vigabatrin on seizure control and safety profile in different subgroups of children with epilepsy
Authors: Jackson Michele C. , Jafarpour Saba , Klehm Jacquelyn , Thome‐Souza Sigride , Coughlin Francesca , Kapur Kush , Loddenkemper Tobias
Published: July 2017

Objective

To evaluate the efficacy and safety of vigabatrin in pediatric epilepsy.

Methods

We retrospectively reviewed patients with epilepsy treated with vigabatrin over a 2‐year period at a pediatric tertiary center. We assessed the relationship between seizure frequency, etiology, vigabatrin dose, adverse events, medication discontinuation reasons, and electroencephalography (EEG) characteristics.

Results

One hundred three patients followed at Boston Children's Hospital were treated with vigabatrin and had complete medical records. Within the follow‐up interval, 69 (67%) of 103 patients had discontinued vigabatrin therapy. Two patients (1.9%) died during therapy for unknown reasons. Median age at vigabatrin initiation was 8 months (interquartile range [IQR] 5–15). Median starting dose was 48.1 mg/kg per day (IQR 29.8–52.3) with a median target of 100 mg/kg (IQR 81.9–107.9). Median treatment duration was 12.1 months (n = 89, IQR 5.0–22.9) overall, and 13.3 months (IQR 5.2–23.2) for patients who discontinued vigabatrin. The most common reasons for discontinuation were controlled seizures in 31 (43.7%) of 71 and unsatisfactory therapeutic effect in 23 (32.4%) of 71. Median percent seizure reduction from baseline to first follow‐up was 83.3% (IQR 27.4–99.8) and 96.7% (IQR 43.3–100) to last follow‐up. Twenty‐four (38.7%) of 62 patients with a follow‐up posttreatment remained seizure‐free. Four patients who had initially achieved seizure freedom relapsed. Patients with structural/metabolic etiology had greater median percent seizure reduction at first follow‐up than patients with genetic etiology (98.7% vs. 61.4%, respectively, p = 0.001). Hypsarrhythmia resolved after therapy in 18 of 20 (90%, 95% confidence interval [CI] 70–97) patients with pretreatment hypsarrhythmia, and 2 patients presented with hypsarrhythmia posttreatment. Risk of having hypsarrhythmia was reduced by 32% (95% CI 14.9–49.1) posttreatment.

Significance

Vigabatrin is efficacious in all seizure types and resolved hypsarrhythmia in most patients. In this series with a median treatment duration of 12.1 months, vigabatrin had a good safety profile with a low rate of discontinuation due to nonophthalmologic and ophthalmologic adverse effects.
Commemorating the Reformation in 2017
Authors: Kässmann Margot
Published: July 2017

This article argues that the commemoration of the Reformation is not just a time to look back historically, but an occasion to reflect where reform and reformation is needed today in church and society. It is clear that in 2017 we cannot but celebrate in an ecumenical dimension, with a concern for religious dialogue, and in a global context.
Reformation and Mutual Accountability: A Common Agenda for the Reformation and the Ecumenical Movement Today?
Authors: Tveit Olav Fykse
Published: July 2017

This article argues that commemorating the Reformation properly means doing so in a spirit of mutual accountability to others in God's world from whom we learn, through affirming the gifts we have received and shared, and through constructive critique. Mutual accountability involves dialogue about how we deal with the differences and divisions that have developed, and how we are stewards of this legacy.
Putting the Protest Back into Protestant
Authors: Helmer Christine
Published: July 2017

When Martin Luther nailed his 95 Theses to the door of the Wittenberg Castle Church on 31 October 1517, he did so in protest at abuses in Catholic theology and practice. Contemporary times, too, call for protest. The first “protest” concerns the revitalization of education and an increased commitment to intellectual excellence. The second “protest” concerns a recovery of Luther as a figure of protest. While scholars have tamed Luther's dangerous doctrines, the popular imagination still perceives him as an urban legend who spoke truth to power. An expansive notion of scholarship on Luther is required in order to approach a Luther who continues to inspire people around the world. The third “protest” is a critical protest of Luther's religious intolerance, specifically his anti‐Judaism. Christian theologians must acknowledge Luther's anti‐Judaism as central to his theology and radically revise this legacy to promote justice in inter‐religious relations.
Reformation Revisited: Women's Voices in the Reformation
Authors: Stjerna Kirsi
Published: July 2017

Considering the 16th‐century Reformation from the perspective of women is ecumenically promising. Following the tracks of women who embraced the Protestant faith, and learning from their theological orientations, leads to a major rewriting of the Reformation histories; it also provides valuable sources for the reassessment of the Protestant theological traditions. Even if women's place was seen as being at home, in relishing the holy calling of motherhood, women were impassioned to expand their vocations through their own experiences and aspirations. Some of them participated in theological discourse via letters. First‐hand knowledge of the scriptures and observations on injustice empowered women to use a public voice. Compassion emerges as a common theme in the theologies the women themselves considered “Christian.” The 16th‐century reforming women assist us in naming the sins of sexism and misogyny, and direct our attention to the matter of gender.
The Encounter between Eastern Orthodoxy and Lutheranism: A Historical and Theological Assessment
Authors: Asproulis Nikolaos
Published: July 2017

After the fall of the Byzantine Empire in 1453 and the following centuries of Ottoman occupation, especially in Eastern Europe and the Balkans, a series of unpredictable and difficult factors prevented Eastern Orthodoxy from engaging in a creative dialogue with the emerging Reformation of Martin Luther (1517), an event that decisively changed the course of Western history by triggering a chain of events at all levels of life. In spite of this, Luther and other Lutheran leaders initiated a continuing relationship and frank dialogue with various Orthodox churches, especially the Ecumenical Patriarchate. This encounter culminated in an official bilateral dialogue during the second half of the 20th century. In addition to the intensive formal efforts made by both traditions to find their way toward Christian unity, the long process of direct and indirect dialogue between theologians of both traditions points to a fundamental common doctrinal background shared by both church families.
The Reformation of Jan Hus as Inspiration for Transformative Ecumenism
Authors: Chang Yoon‐Jae
Published: July 2017

While 2017 marks the 500th anniversary of the Lutheran Reformation, this article argues that reflection on the Reformation should begin by remembering that the Lutheran Reformation was only one of several reformations. Noting both the achievements and the limits of Luther's Reformation, the article proposes commemorating Jan Hus and the Czech Reformation, which took place a hundred years before Luther. Unlike Luther's Reformation, which focused on the doctrinal issue of “justification by faith,” the Czech Reformation focused on the issue of the Lord's supper and practised a “social Holy Communion” beyond the boundaries of the church. The article concludes that the Czech Reformation provides a fresh vision and inspiration for the contemporary ecumenical movement in Korea and around the world, transcending a perspective that sees ecumenism as being focused on a fellowship of churches.
The (Holy and Great) Council of the Orthodox Churches: An Ecumenical Perspective
Authors: Heller Dagmar
Published: July 2017

From 19 to 26 June 2016, the first Pan‐Orthodox Council for more than a thousand years took place in Crete, although the Orthodox churches of Russia, Georgia, Bulgaria, and Antioch, for various reasons, did not participate. This article offers an assessment, from an ecumenical perspective, of the preparation and results of the council, and especially the document agreed in Crete concerning the “Relations of the Orthodox Church with the Rest of the Christian World.”
Water availability affects seasonal CO2‐induced photosynthetic enhancement in herbaceous species in a periodically dry woodland
Authors: Pathare Varsha S. , Crous Kristine Y. , Cooke Julia , Creek Danielle , Ghannoum Oula , Ellsworth David S.
Published: July 2017

Elevated atmospheric CO2 (eCO2) is expected to reduce the impacts of drought and increase photosynthetic rates via two key mechanisms: first, through decreased stomatal conductance (gs) and increased soil water content (VSWC) and second, through increased leaf internal CO2 (Ci) and decreased stomatal limitations (Slim). It is unclear if such findings from temperate grassland studies similarly pertain to warmer ecosystems with periodic water deficits. We tested these mechanisms in three important C3 herbaceous species in a periodically dry Eucalyptus woodland and investigated how eCO2‐induced photosynthetic enhancement varied with seasonal water availability, over a 3 year period. Leaf photosynthesis increased by 10%–50% with a 150 μmol mol−1 increase in atmospheric CO2 across seasons. This eCO2‐induced increase in photosynthesis was a function of seasonal water availability, given by recent precipitation and mean daily VSWC. The highest photosynthetic enhancement by eCO2 (>30%) was observed during the most water‐limited period, for example, with VSWC <0.07 in this sandy surface soil. Under eCO2 there was neither a significant decrease in gs in the three herbaceous species, nor increases in VSWC, indicating no “water‐savings effect” of eCO2. Periods of low VSWC showed lower gs (less than ≈ 0.12 mol m−2 s−1), higher relative Slim (>30%) and decreased Ci under the ambient CO2 concentration (aCO2), with leaf photosynthesis strongly carboxylation‐limited. The alleviation of Slim by eCO2 was facilitated by increasing Ci, thus yielding a larger photosynthetic enhancement during dry periods. We demonstrated that water availability, but not eCO2, controls gs and hence the magnitude of photosynthetic enhancement in the understory herbaceous plants. Thus, eCO2 has the potential to alter vegetation functioning in a periodically dry woodland understory through changes in stomatal limitation to photosynthesis, not by the “water‐savings effect” usually invoked in grasslands.
Can a Time Fractional‐Derivative Model Capture Scale‐Dependent Dispersion in Saturated Soils?
Authors: Garrard Rhiannon M. , Zhang Yong , Wei Song , Sun HongGuang , Qian Jiazhong
Published: July 2017

Time nonlocal transport models such as the time fractional advection‐dispersion equation (t‐fADE) were proposed to capture well‐documented non‐Fickian dynamics for conservative solutes transport in heterogeneous media, with the underlying assumption that the time nonlocality (which means that the current concentration change is affected by previous concentration load) embedded in the physical models can release the effective dispersion coefficient from scale dependency. This assumption, however, has never been systematically examined using real data. This study fills this historical knowledge gap by capturing non‐Fickian transport (likely due to solute retention) documented in the literature (Huang et al. 1995) and observed in our laboratory from small to intermediate spatial scale using the promising, tempered t‐fADE model. Fitting exercises show that the effective dispersion coefficient in the t‐fADE, although differing subtly from the dispersion coefficient in the standard advection‐dispersion equation, increases nonlinearly with the travel distance (varying from 0.5 to 12 m) for both heterogeneous and macroscopically homogeneous sand columns. Further analysis reveals that, while solute retention in relatively immobile zones can be efficiently captured by the time nonlocal parameters in the t‐fADE, the motion‐independent solute movement in the mobile zone is affected by the spatial evolution of local velocities in the host medium, resulting in a scale‐dependent dispersion coefficient. The same result may be found for the other standard time nonlocal transport models that separate solute retention and jumps (i.e., displacement). Therefore, the t‐fADE with a constant dispersion coefficient cannot capture scale‐dependent dispersion in saturated porous media, challenging the application for stochastic hydrogeology methods in quantifying real‐world, preasymptotic transport. Hence improvements on time nonlocal models using, for example, the novel subordination approach are necessary to incorporate the spatial evolution of local velocities without adding cumbersome parameters.
Clinical and prognostic significance of a reverse dipping pattern on ambulatory monitoring: An updated review
Authors: Cuspidi Cesare , Sala Carla , Tadic Marijana , Gherbesi Elisa , De Giorgi Antonio , Grassi Guido , Mancia Giuseppe
Published: July 2017

Reverse or inverted dipping (ie, the phenomenon characterized by higher nighttime compared with daytime blood pressure values) is an alteration of circadian blood pressure rhythm frequently documented in hypertension, type 2 diabetes mellitus, chronic kidney disease, and sleep apnea syndrome, and generally regarded as a harmful condition. Available literature on the clinical and prognostic implications of reverse dipping is scanty. The present article will review a number of relevant issues concerning reverse dipping, in particular: (1) its possible mechanisms; (2) prevalence and clinical correlates, (3) concomitant cardiac and extracardiac subclinical organ damage; (4) association with acute and chronic cardiovascular diseases; (5) prognostic value in predicting cardiovascular events and mortality; and (6) therapeutic interventions aimed at reverting this abnormal circadian blood pressure rhythm.
Inhibitory effects of cinnamon, clove and celak extracts on growth of Aspergillus flavus and its aflatoxins after spraying on pistachio nuts before cold storage
Authors: Khorasani Sepideh , Azizi Mohammad Hossein , Barzegar Mohsen , Hamidi‐Esfahani Zohreh , Kalbasi‐Ashtari Ahmad
Published: July 2017

The essential oils of clove, cinnamon and celak extracted, diluted (at 3, 5, 7 and 9%), and UV‐sterilized. HPLC analysis showed that the clove, cinnamon and celak extracts had respectively eugenol (12.15 mg/g), cinamaldehyde (25.74 mg/g), and combination of thymol (14.49 mg/g) and carvacrol (1.17 mg/g). The Ohadi, Akbari, Ahmad‐Aghaei (AA) and Kalleh‐Ghouchi (CG) pistachio mixed with each dilution and extract (5% ratio) separately, sprayed with 1 ml of Aspergillus flavus (Af) spores (108 CFU/mL), and cold‐stored (1°C and 75% RH) 9 months. The aflatoxins of KG pistachio without herbal extract exceeded 1000 ppb after 3 months. However, the phenols of each extract with 9% concentration could inhibit 100% Af in each contaminated pistachio variety and destruct its aflatoxins efficiently even after 14 days of cold‐storage. The contaminated and extract‐sprayed Ohadi pistachio nuts had smallest size and weight among pistachios and its total aflatoxin < 35 ng/g (global standard) after 9 months of cold‐storage.

Practical applications

While pistachio with pleasant taste has a high international demand, it is a susceptible nut to Aspergillus flavus. This fungus contaminates high volume of even low moisture (∼5%) pistachio packages in less than 3 months during storage or transportation at high relative humidity. A. flavus produces different kinds of carcinogenic aflatoxins (as secondary metabolites) which threaten human health even at global and maximum acceptable level of 15 ng/g of pistachio. Since applying of the chemical disinfectants (even permissible ones) on pistachio kernels may leave residue with undesirable side‐effects on human health and natural environment, medicinal plants have been considered for their powerful antimicrobial activities. This study showed that separate spraying of three herbal plant extracts including cinnamon, clove and celak on pistachio kernels could inhibit entirely (100%) the growth of toxigenic fungi and destruct the produced aflatoxin when the nuts should be stored for more than 1 month.
Use of ultrasound shear‐wave elastography to evaluate change in cervical stiffness during pregnancy
Authors: Ono Tetsuo , Katsura Daisuke , Yamada Kazutaka , Hayashi Kaori , Ishiko Akiko , Tsuji Shunichiro , Kimura Fuminori , Takahashi Kentaro , Murakami Takashi
Published: July 2017

Aim

The aim of this study was to evaluate the usefulness of shear‐wave elastography (SWE) for measuring change in cervical stiffness during pregnancy, with regions of interest (ROI) designed for easy identification.

Methods

A total of 280 women were enrolled in this study. SWE was performed at a routine prenatal visit. A measurement area was chosen at the anterior part of the cervix, and a circular ROI 5 mm in diameter was set at two points, 5–10 mm (lower point) and 15–20 mm (upper point) from the external cervical os. The generalized estimating equation was used to estimate the correlation between stiffness and gestational age, using generalized linear models.

Results

There were significant negative correlations between stiffness and gestational age. The estimated regression equations of the lower and upper points were Y = −0.049X + 3.675 (P < 0.05) and Y = −0.060X + 4.170 (P < 0.05), respectively. The stiffness at the upper point behaved statistically significantly differently to that at the lower point. Softening of the cervix at the upper point was significantly different between single pregnancies and twin pregnancies (P < 0.05), but no marked difference was noted between primiparous and multiparous women.

Conclusion

Cervical elastography using SWE was useful for measuring change in cervical stiffness during pregnancy, and the upper area of the cervix may be a more relevant assessment point for cervical softening than the lower area.
Effect of lidocaine spray during colposcopy‐directed cervical biopsy: A randomized controlled trial
Authors: Wongluecha Tanyalak , Tantipalakorn Charuwan , Charoenkwan Kittipat , Srisomboon Jatupol
Published: July 2017

Aim

We aimed to examine the effect of lidocaine spray in reducing pain during colposcopy‐directed cervical biopsy (CDB).

Methods

Two hundred women with abnormal cervical screening test results and abnormal colposcopic findings that required a CDB during April to December 2015 were enrolled. The participants were randomly assigned into one of two groups. For group 1 (lidocaine group), 10% lidocaine spray was applied thoroughly to the ectocervix. For group 2, no anesthesia was given. The primary outcome of this study was the biopsy pain score.

Results

Of the 200 women enrolled, 100 were randomly assigned to group 1 and 100 were in group 2. The baseline, biopsy, and postprocedure pain scores were comparable between the study groups. The mean difference between the biopsy and the baseline pain scores and the mean difference of the postprocedure pain scores from baseline were statistically significantly higher in the no‐anesthesia group (group 2), P = 0.01 and P = 0.02, respectively. However, the degree of pain was minimal in both groups. There were no complications observed in any participants.

Conclusion

Lidocaine spray reduces pain during colposcopy‐directed cervical biopsy; however, the clinically meaningful effect of such a procedure cannot be demonstrated in this study.
Bile acid levels and risk of adverse perinatal outcomes in intrahepatic cholestasis of pregnancy: A meta‐analysis
Authors: Cui Donghua , Zhong Yongxing , Zhang Lin , Du Hechun
Published: July 2017

Aim

We aimed to determine the association between maternal total bile acid (TBA) levels and the risks of adverse perinatal outcomes in pregnant women with intrahepatic cholestasis of pregnancy (ICP) based on a meta‐analysis study.

Methods

We searched PubMed for articles published from 2000 to 2015 with a focus on ICP and restriction to the English language. The main perinatal outcomes were preterm birth (PTB), meconium‐stained amniotic fluid (MSAF), asphyxia, or respiratory distress syndrome (RDS). Relative risk (RR) with 95% confidence intervals (CI) was the summary statistic. We used a random‐ or fixed‐effects model to calculate the pooled RR according to the heterogeneity test. Subgroup analyses were performed by region and study design.

Results

Nine eligible related citations fulfilled the inclusion criteria and were included in this study. Compared with pregnant women with a serum TBA < 40 μmol/L, severe ICP (TBA ≥ 40 μmol/L) was associated with a significantly increased risk of adverse fetal outcomes (pooled RR, 1.96; 95%CI, 1.63–2.35), PTB (pooled RR, 2.23; 95%CI, 1.51–3.29), MSAF (pooled RR, 2.27; 95%CI, 1.81–2.85), and asphyxia or RDS (pooled RR, 1.67; 95%CI, 1.18–2.36). Sensitivity analysis suggested that the study design difference may be a major source of heterogeneity. No publication bias was demonstrated by Begg's test (P > 0.05).

Conclusion

This meta‐analysis indicates that maternal elevated bile acid levels are significantly associated with increased risks of overall adverse perinatal outcomes, PTB, MSAF, and asphyxia or RDS. Serum TBA levels seem to be a useful predictor for the risk of adverse perinatal outcomes.
Chronic histiocytic intervillositis in three consecutive pregnancies in a single patient: Differing clinical results and pathology according to treatment used
Authors: Ozawa Nobuaki , Yamaguchi Koushi , Shibata Megumi , Sugibayashi Rika , Yagi Hiroya , Sago Haruhiko , Matsuoka Kentaro
Published: July 2017

Chronic histiocytic intervillositis (CHI) is an extremely rare pathological condition but is strongly associated with severe obstetric complications and has a high recurrence rate. The management of this condition has not yet been established. We describe herein the occurrence of CHI in the late second–third trimester in each of three consecutive pregnancies in a single patient with four previous consecutive early miscarriages. In this patient, each of the three complicated pregnancies was managed with one of the following, respectively: low‐dose aspirin; heparin plus low‐dose aspirin; and prednisolone plus low‐dose aspirin. CHI was histologically confirmed in all three pregnancies, but the clinical results and pathology (e.g. extent of histiocytic infiltration) in each pregnancy clearly differed with treatment. Both combination treatments eventuated in a live birth. Immunosuppressive therapy seemed to produce better clinical results by restricting the extent of the affected areas. The elevated alkaline phosphatase associated with the CHI was assumed to have no clinical prognostic value.
The Association of School Climate, Depression Literacy, and Mental Health Stigma Among High School Students
Authors: Townsend Lisa , Musci Rashelle , Stuart Elizabeth , Ruble Anne , Beaudry Mary B. , Schweizer Barbara , Owen Megan , Goode Carly , Johnson Sarah L. , Bradshaw Catherine , Wilcox Holly , Swartz Karen
Published: July 2017

ABSTRACT

BACKGROUND

Although school climate is linked with youth educational, socioemotional, behavioral, and health outcomes, there has been limited research on the association between school climate and mental health education efforts. We explored whether school climate was associated with students' depression literacy and mental health stigma beliefs.

METHODS

Data were combined from 2 studies: the Maryland Safe Supportive Schools Project and a randomized controlled trial of the Adolescent Depression Awareness Program. Five high schools participated in both studies, allowing examination of depression literacy and stigma measures from 500 9th and 10th graders. Multilevel models examined the relationship between school‐level school climate characteristics and student‐level depression literacy and mental health stigma scores.

RESULTS

Overall school climate was positively associated with depression literacy (odds ratio [OR] = 2.78, p < .001) and negatively associated with stigma (Est. = −3.822, p = .001). Subscales of engagement (OR = 5.30, p < .001) and environment were positively associated with depression literacy (OR = 2.01, p < .001) and negatively associated with stigma (Est. = −6.610, p < .001), (Est. = −2.742, p < .001).

CONCLUSIONS

Positive school climate was associated with greater odds of depression literacy and endorsement of fewer stigmatizing beliefs among students. Our findings raise awareness regarding aspects of the school environment that may facilitate or inhibit students' recognition of depression and subsequent treatment‐seeking.
Children With Type 1 Diabetes Mellitus: Self‐Management Experiences in School
Authors: Sparapani Valéria de Cássia , Liberatore Raphael D.R. , Damião Elaine B.C. , de Oliveira Dantas Isa R. , de Camargo Rosangela A.A. , Nascimento Lucila C.
Published: July 2017

BACKGROUND

Children with type 1 diabetes mellitus (T1DM) need to perform self‐management activities at school and in other environments. Learning about their experiences at school is crucial to assist them in this challenging task.

METHODS

Qualitative interviews were conducted with children with T1DM, aged between 7 and 12. A scenario was created and puppets were used during the interviews to help the participating children to communicate about school, daily routines, and experiences in diabetes management. Data were collected over a period of 1 year and analyzed according to content analysis procedures.

RESULTS

Nineteen children, 13 boys and 6 girls, at the mean age of 9.8 ± 1.8 years and mean time since diagnosis of 3.3 years, participated in the study. Three themes were identified: lack of information on T1DM, diabetes self‐care at school, and support received by the children.

CONCLUSIONS

The study provides useful information to understand the children's experiences in managing the disease at school. The partnership between school staff, health teams, children with T1DM, and their families need to be enhanced to promote appropriate strategies that improve the management of diabetes in this setting.
Academic Performance in Primary School Children With Common Emotional and Behavioral Problems
Authors: Mundy Lisa K. , Canterford Louise , Tucker Dawn , Bayer Jordana , Romaniuk Helena , Sawyer Susan , Lietz Petra , Redmond Gerry , Proimos Jenny , Allen Nicholas , Patton George
Published: July 2017

ABSTRACT

BACKGROUND

Many emotional and behavioral problems first emerge in primary school and are the forerunners of mental health problems occurring in adolescence. However, the extent that these problems may be associated with academic failure has been explored less. We aimed to quantify the association between emotional and behavioral problems with academic performance.

METHODS

A stratified random sample of 8‐ to 9‐year‐olds (N = 1239) were recruited from schools in Australia. Data linkage was performed with a national assessment of academic performance to assess reading and numeracy. Parent report assessed emotional and behavioral problems with students dichotomized into “borderline/abnormal” and “normal” categories.

RESULTS

One in 5 grade 3 students fell in the “borderline/abnormal” category. Boys with total difficulties (β = ‐47.8, 95% CI: ‐62.8 to ‐32.8), conduct problems, and peer problems scored lower on reading. Numeracy scores were lower in boys with total difficulties (β = ‐37.7, 95% CI: ‐53.9 to ‐21.5) and emotional symptoms. Children with hyperactivity/inattention scored lower in numeracy. Girls with peer problems scored lower in numeracy.

CONCLUSIONS

Boys with emotional and behavioral problems in mid‐primary school were 12 months behind their peers. Children with emotional and behavioral problems are at high risk for academic failure, and this risk is evident in mid‐primary school.
Big Data for Good: Insights from Emerging Markets*
Authors: Chandy Rajesh , Hassan Magda , Mukherji Prokriti
Published: July 2017

This paper examines how innovations involving big data are helping to solve some of the greatest challenges facing the world today. Focusing primarily on the developing world, this paper explores how the large volumes of digital information, increasingly available in these contexts, can help decision‐makers better address problems as big as poverty, illness, conflict, migration, corruption, natural disasters, climate change, and pollution, among other areas. This paper argues that the information vacuum that still exists in many developing countries makes the potential for impact from big data much greater in these contexts. Through a series of case studies, the authors demonstrate how big data can be used to address pressing social and environmental challenges in developing countries. The authors present research questions that could not have been addressed in the absence of dramatic recent increases in data volume, variety, and velocity. They then extrapolate from these questions, and discuss the nature of the technological changes that now allow decision‐makers in developing countries to leapfrog from data poverty to big data, and permit innovative solutions to the aforementioned challenges. The authors emphasize the importance of looking beyond the current focus, in the literature, on storing, analyzing, and creating commercial value from big data. Instead, they point to the importance of innovativeness in identifying, integrating, disseminating, and applying new sources of data to execute actions that in turn generate product, service, process, and business model innovations that are impactful due to big data. The authors argue that academic researchers have an important role to play in helping the world harness the potential for big data innovations, through validation, visualization, and verification of such data.
Water use segregation among plants with contrasting root depth and distribution along gypsum hills
Authors: Palacio Sara , Montserrat‐Martí Gabriel , Ferrio Juan Pedro
Published: July 2017

Aims

Plant communities growing along gypsum hills in NE Spain show a distinct zonation that may depend on water table depth, salt and nutrient availability gradients between hilltops and saline depressions. We analysed the main sources of water used by woody species in these communities. Specifically, we assessed whether hydrological niche segregation occurred among dominant woody species with different root depth and plant location along gypsum hills during spring and summer.

Location

Miocene gypsum formations of NE Spain, Middle‐Ebro depression.

Methods

We analysed the oxygen and hydrogen isotope composition of the xylem water of ten dominant woody species growing along gypsum hills and compared it to water extracted from the top 20 cm of the soil, gypsum crystallization water and groundwater, both in spring and summer. Bayesian isotope mixing models were used to estimate the proportion of each water source used by different species.

Results

There was a clear segregation in the sources of water used by dominant woody species from plant communities co‐existing on gypsum hills, and such segregation responded to their rooting depth and position along the hill. Shallow‐rooted plants growing out of saline depressions exploited superficial free soil water and gypsum crystallization water, and had limited access to groundwater, particularly during summer. In contrast, deep‐rooted plants and shallow‐rooted plants from saline depressions thrived preferentially on the water table. Such differences were noticeable in spring, but became sharper during summer.

Conclusions

Woody species from gypsum hills have different hydrological niches. Niche segregation is mainly related to the depth of the root system of plants and to their position along gypsum hills, which determine proximity to the water table. It is accentuated during summer, highlighting the role of summer drought as a structuring factor in gypsum plant communities. The segregation of the water sources used by plants is related to a suite of phenological, functional and anatomical features, indicating adaptation of plant species to their respective hydrological niches.