bluuebunny/crossref_metadata_2025 huggingface dataset:
Use of the Robson Ten Group Classification System to categorise operative vaginal delivery
Authors: O’Leary Bobby D. , Kane Daniel T. , Kruseman Aretz Nicholas , Geary Michael P. , Malone Fergal D. , Hehir Mark P.
Published: April 2020

Background

Operative vaginal delivery (OVD), either vacuum or forceps, can be used to expedite vaginal delivery. While rates of OVD have been reducing worldwide, rates in Ireland remain high. The Robson Ten Group Classification System (TGCS) was originally created to compare rates of caesarean delivery between healthcare units, although no similar system exists for the analysis of OVD.

Aims

We sought to examine rates of OVD using the TGCS in an effort to understand which patient groups make significant contributions to the overall rate of OVD.

Materials and Methods

This is a retrospective cohort study of all women delivering in a tertiary‐level university institution in Dublin, Ireland, from 2007 to 2016. Mode of delivery for all patients was extracted from contemporaneously recorded hospital records. Rates of OVD were analysed according to the TGCS, and the contribution of each group to the overall hospital population was calculated.

Results

There were 86 191 deliveries of women in our institution, of which 19.3% (16 673/86 191) had an OVD. Women in Group 1 (singleton, cephalic, nulliparous women at term in spontaneous labour) contributed the most to the overall rate of OVD, accounting for almost half of all OVDs (46.1% (7679/16 673)). Nulliparous women with a singleton, cephalic fetus at term who were induced (Group 2) were more likely to have an OVD than similar patients who laboured spontaneously (Group 1).

Conclusion

OVD accounts for almost one in five deliveries in our population and is predominately performed in nulliparous women. These groups may be the subject of interventions to lower rates of OVD. The Robson TGCS is a freely available tool to hospitals and birthing centres to facilitate comparison of rates of OVD on local and national levels.
Morphological description of the male reproductive tract of the Clymene dolphin (Stenella clymene, Gray, 1850)
Authors: Spinelli Lucas G. , Randi Caroline B. , Mari Renata B. , Angrimani Daniel S. R. , Carvalho Vitor Luz , de Meirelles Ana Carolina Oliveira , Vergara‐Parente Jociery E. , Guimarães Juliana P.
Published: April 2020

Stenella clymene is an endemic species of dolphin living in tropical regions in the Atlantic Ocean. Despite its wide distribution, there is still scarce information on Stenella clymene, including its reproductive biology. In this context, this work describes the morphology of the whole male reproductive tract of the Clymene dolphin. Five males (N = 5) were studied after stranding on the northeast coast of Brazil. The analysis was performed through the use of macroscopic techniques and light and scanning microscopy. The male reproductive system consists of large testes wrapped around the tunica albuginea and adhered to the epididymis; the testes are attached to the abdominal cavity by the mesorchium. The ductus deferens is convoluted in the proximal portion and rectilinear in the distal portion. The prostate was the only accessory gland found, which is submerged by the prostate compressor muscle and lined with a dense fibroelastic capsule. The penis is classified as fibroelastic, with a spiral sigmoid flexure associated with a large volume of muscle tissue. The penis is inserted into two vestigial bones or pelvic bones, which exhibit no connection with the spine. In conclusion, the macro‐ and microscopic conformation and other morphofunctional features of the male reproductive organs of Stenella clymene are in accord with the anatomy observed in other Cetartiodactyla.
Having a son or daughter with an intellectual disability transition to adulthood: A parental perspective
Authors: Codd Jon , Hewitt Olivia
Published: April 2020

Accessible Summary

Becoming an adult can be a difficult time. We wanted to find out what it is like for parents who have a son or daughter with an intellectual disability. Ten parents were interviewed. They were asked questions about being in their family, helping their son or daughter, and support services for people with an intellectual disability and their parents.

Things that mattered the most to parents: Many parents were confused about what to do when their son or daughter became eighteen years old. They were worried about the future. Independence was important. Parents found it hard sometimes helping their son or daughter to be more independent. Getting more help and talking to other parents.

Services and staff can help by: Working together in a better way to help parents. Setting up support groups for parents to talk together and learn from each other. Writing better plans with every person with an intellectual disability.

Background

Transition to adulthood is an important time for young people and may be a particularly challenging time for people with intellectual disabilities. However, there has been little research in the UK regarding the experiences of parents who have son or daughter with an intellectual disability transitioning to adulthood.

Method

The study used interpretive phenomenological analysis to explore the lived experiences of ten parents who had a son or daughter (aged 18–25 years) with an intellectual disability. Half of the sample also had a diagnosis of autism.

Results

Three superordinate themes were generated from the data: (a) Transition: The Good, the Bad and Unknown; (b) Striving for Independence; and (c) Supporting the Supporters. Parents experienced many difficulties and uncertainty related to their role, their son/daughter's independence, navigating services for their son/daughter and accessing support for themselves.

Conclusions

Increased collaboration and consistency from statutory services is required in addition to providing emotional support to parents and facilitating parent support networks.
A pattern of care analysis: Prosthetic rehabilitation of head and neck cancer patients after radiotherapy
Authors: Wiedenmann Felicitas , Liebermann Anja , Probst Florian , Troeltzsch Matthias , Balermpas Panagiotis , Guckenberger Matthias , Edelhoff Daniel , Mayinger Michael
Published: April 2020

Background

While some medical associations provide guidelines for the implant‐prosthetic rehabilitation of head and neck cancer patients, the circulation and implementation in the everyday routine of practicing dentists remain unknown.

Purpose

To analyze patterns of care for the prosthetic rehabilitation of head and neck cancer patients after radiotherapy in German speaking countries.

Materials and methods

An online survey consisting of 34 questions separated into three sections, (a) general inquiries, (b) treatment concepts, and (c) patient cases, was forwarded to university hospital departments for Prosthetic Dentistry and Oral and Maxillofacial Surgery, and members of different medical associations. Statistical differences between groups were analyzed using chi‐squared test (P < .05).

Results

From May to October 2019, 118 participants completed the survey. The majority practiced in university hospitals, had more than 5 years of work experience, and reported to be involved in <10 post radiation prosthetic rehabilitation cases per year. Rehabilitation protocols involving dental implants were implemented by oral/oral‐ and maxillofacial surgeons and prosthetic dentists, while general dentists favored implant‐free solutions. Xerostomia was recognized as a common problem for a successful prosthetic rehabilitation. The subsequent treatment choice with either fixed dental prostheses or removable dentures was divided among participants.

Conclusions

As treatment planning differed with regard to the participants' field of expertise and work environment, and most practitioners only handle a low number of cases, patients might benefit from centralization in larger institutes with a multidisciplinary structure. A high agreement between the practitioners' treatment concepts and the current state of research was observed. While the choice between a mucosa‐ or tooth‐supported, and an implant‐supported restoration depends on numerous individual factors, guidelines derived from longitudinal studies would enhance evidence‐based treatment in this field.
Modification of carbon black pigment: Cotton fabric colouring and anti‐bacterial finishing
Authors: Zhang Liping , Li Min , Wang Liangan , Wang Dong , Fu Shaohai
Published: April 2020

Functional polymer modified carbon black (CB) pigment (P‐(DMC‐co‐CHPMA)‐g‐MPTS/CB) with reactive epoxy and quaternary ammonium groups was designed and prepared via a thiol‐ene click chemistry reaction, and its dispersion ability in the aqueous phase, as well as its colouring and anti‐bacterial properties for cotton fabrics, were investigated. In considering both dispersion ability and reactive ability to cotton fabric, the mole ratio of the monomers (methacrylatoethyl trimethyl ammonium chloride [DMC] and 3‐chloro‐2‐hydroxypropyl methacrylate [CHPMA]) was discussed. Morphology and chemical properties of P‐(DMC‐co‐CHPMA)‐g‐MPTS/CB were tested by scanning electron microscopy, transmission electron microscopy, thermogravimetric analysis and X‐ray photoelectron spectroscopy, resulting in a weight content of copolymer (DMC‐co‐CHPMA) in P‐(DMC‐co‐CHPMA)‐g‐MPTS/CB ofca. 18%. P‐(DMC‐co‐CHPMA)‐g‐MPTS/CB was fixed onto cotton fabric via a nucleophilic‐substituted reaction between reactive epoxy groups on the CB surface and the hydroxyl groups of cotton fabric, which endowed good fastness to cotton fabric without either a fixing or an adhesive agent. Also, coloured cotton fabric demonstrated excellent anti‐bacterial activity towardsStaphylococcus aureusandEscherichia coliO157:H7.
Histopathology and genetic susceptibility in COVID‐19 pneumonia
Authors: von der Thüsen Jan , van der Eerden Menno
Published: April 2020

Background

The clinical features of COVID‐19 pneumonia range from a mild illness to patients with a very severe illness with acute hypoxemic respiratory failure requiring ventilation and Intensive Care Unit admission.

Aims

To provide a brief overview of the existing evidence for such differences in host response and outcome, and generate hypotheses for divergent patterns and avenues for future research, by highlighting similarities and differences in histopathological appearance between COVID‐19 and influenza as well as previous coronavirus outbreaks, and by discussing predisposition through genetics and underlying disease.

Materials and Method

We assessed the available early literature for histopathological patterns of COVID‐19 pneumonia and underlying risk factors.

Result

The histopathological spectrum of COVID‐19 pneumonia includes variable patterns of epithelial damage, vascular complications, fibrosis and inflammation. Risk factors for a fatal disease include older age, respiratory disease, diabetes mellitus, obesity and hypertension.

Discussion

While some risk factors and their potential role in COVID‐19 pneumonia are increasingly recognized, little is known about the mechanisms behind episodes of sudden deterioration or the infrequent idiosyncratic clinical demise in otherwise healthy and young subjects.

Conclusion

The answer to many of the remaining questions regarding COVID‐19 pneumonia pathogenesis may in time be provided by genotyping as well careful clinical, serological, radiological and histopathological phenotyping.
Developmental origins and homologies of the hyracoid dentition
Authors: Gomes Rodrigues Helder , Tabuce Rodolphe , Asher Robert J. , Hautier Lionel
Published: April 2020

Understanding the origins of morphological specializations in mammals is a key goal in evolutionary biology. It can be accomplished by studying dental homology, which is at the core of most evolutionary and developmental studies. Here, we focused on the evolution and development of the specialized dentition of hyraxes for which dental homologies have long been debated, and could have implications on early placental evolution. Specifically, we analysed dental mineralization sequences of the three living genera of hyraxes and 17 fossil species using X‐ray computed microtomography. Our results point out the labile position of vestigial upper teeth on jaw bones in extant species, associated with the frequently unusual premolar shape of deciduous canines over 50 Ma of hyracoid evolution. We proposed two evolutionary and developmental hypotheses to explain these original hyracoid dental characteristics. (a) The presence of a vestigial teeth on the maxilla in front of a complex deciduous canine could be interpreted as extra‐teeth reminiscent of early placental evolution or sirenians, an order phylogenetically close to hyracoids and showing five premolars. (b) These vestigial teeth could also correspond to third incisors with a position unusually shifted on the maxilla, which could be explained by the dual developmental origin of these most posterior incisors and their degenerated condition. This integrative study allows discussion on the current evolutionary and developmental paradigms associated with the mammalian dentition. It also highlights the importance of nonmodel species to understand dental homologies.
Clinical benefit of ixazomib plus lenalidomide‐dexamethasone in myeloma patients with non‐canonical NF‐κB pathway activation
Authors: Dash Ajeeta B. , Zhang Jacob , Shen Lei , Li Bin , Berg Deborah , Lin Jianchang , Avet‐Loiseau Hervé , Bahlis Nizar J. , Moreau Philippe , Richardson Paul G. , Di Bacco Alessandra
Published: April 2020

Objectives

Evaluating potential relationships between progression‐free survival (PFS) and tumor gene expression patterns and mutational status was an exploratory objective of the phase 3 TOURMALINE‐MM1 study (NCT01564537) of ixazomib‐lenalidomide‐dexamethasone (IRd) vs placebo‐Rd in 722 patients with relapsed/refractory multiple myeloma (MM).

Methods

We utilized gene expression and mutation data from screening bone marrow aspirates to identify tumors with non‐canonical nuclear factor‐κB (NF‐κB) signaling pathway activation.

Results

DNA/RNA sequencing data were available for 339 (47.0%)/399 (55.2%) patients; 49/339 (14.5%) patients had non‐canonical NF‐κB pathway gene mutations (tumor‐necrosis‐factor receptor‐associated factor 2, 3 [TRAF2, TRAF3], baculoviral‐inhibitor‐of‐apoptosis repeat‐containing 2/3 [BIRC2/3]), and PFS was significantly longer with IRd vs placebo‐Rd in these patients (hazard ratio [HR] 0.23). In patients with lower TRAF3 expression (median not reached vs 11 months, HR 0.47) and higher NF‐κB‐inducing kinase (NIK) expression (median not reached vs 14 months, HR 0.45), both associated with non‐canonical NF‐κB pathway activation, PFS was significantly longer with IRd vs placebo‐Rd. TRAF3 expression was decreased in patients harboring t(4;14) and 1q21 amplification, suggesting increased non‐canonical NF‐κB pathway activation.

Conclusions

Adding ixazomib to Rd provides clinical benefit in MM tumors with increased non‐canonical NF‐κB pathway activity. This is a potential mechanism for activity in 1q21 amplified high‐risk tumors.
Hyperglycemia‐related FAS gene and hsa‐let‐7b‐5p as markers of poor outcomes for ischaemic stroke
Authors: Chi N.‐F. , Chiou H.‐Y. , Chou S.‐Y. , Hu C.‐J. , Chen K.‐Y. , Chang C.‐F. , Hsieh Y.‐C.
Published: April 2020

Background and purpose

Hyperglycemia in acute stroke leads to poor neurological outcomes. The role of microRNA (miRNA) in hyperglycemia‐associated genes can provide new avenues for stroke prognostic applications. We aimed to identify novel genes and their regulated miRNAs that are associated with hyperglycemia‐induced unfavorable stroke outcomes and further validated in the plasma exosome. Moreover, we intended to evaluate the prognostic ability of miRNA–messenger RNA (mRNA) biomarkers in addition to using traditional risk factors.

Methods

After the integration analysis of small RNA sequencing and mRNA polymerase chain reaction array, two mRNAs and six miRNAs were selected for validation in middle cerebral artery occlusion animal models and ischaemic stroke patients. Receiver operator characteristic analysis was used to determine the performance of mRNA and miRNA expression.

Results

The increased Fas expression was associated with hyperglycemia after acute stroke onset in animal and human studies. In addition, Fas gene level was significantly higher in patients with an unfavorable outcome when compared with patients with a favorable outcome. The expression of Fas and miRNA hsa‐let‐7b‐5p in addition to traditional risk factors could increase the discrimination and predictive ability for poor prognosis. The higher exosomal Fas was further observed among patients with an unfavorable outcome, suggesting Fas signal transporting through exosome in the circulation system.

Conclusions

Combined analyses of Fas and has‐let‐7b‐5p expression in addition to traditional risk factors are favorable prognostic biomarkers for predicting poor neurological outcomes at 3 months after stroke onset in ischaemic stroke patients. Additional studies are required to address the precise role of the apoptosis pathway in unfavorable hyperglycemia‐induced stroke outcomes.
Maintenance of Relationship and Individual Functioning Gains Following Online Relationship Programs for Low‐Income Couples
Authors: Roddy McKenzie K. , Knopp Kayla , Georgia Salivar Emily , Doss Brian D.
Published: April 2020

Initial evidence suggests that gains in relationship functioning from brief, web‐based programs are maintained through one year following the intervention; however, whether these results generalize to a low‐income sample is unclear. Furthermore, previous research from in‐person couple therapy suggests there may be different shapes of maintenance slopes for behavioral versus acceptance‐based techniques. This study contacted 668 individuals who enrolled in online behavioral (ePREP) or acceptance‐based (OurRelationship) programs one year following completion of the program. Multilevel modeling was used to examine linear and quadratic rates of change in the year following the online intervention as well as total amount of change from pretreatment to 12‐month follow‐up for both relationship and individual functioning. The majority of couples who responded continued to be in a relationship with the same partner (68.3%). Examinations of relationship functioning indicated couples in both programs maintained their gains over follow‐up (i.e., no significant linear or quadratic changes), with medium‐to‐large within‐group effect sizes from pre‐ to one‐year follow‐up. There were no significant differences in relationship outcomes between OurRelationship and ePREP. Similarly, examinations of individual functioning outcomes indicated couples maintained their gains over follow‐up or continued to improve. In total, couples experienced small‐to‐medium within‐group effect sizes from pretreatment to one‐year follow‐up, with larger effects for individuals who were initially distressed. These results suggest that online programs create lasting change for low‐income couples in relationship and individual functioning, with minimal differences between behavioral and acceptance‐based orientations.
Catalytic activity of human guanylate‐binding protein 1 coupled to the release of structural restraints imposed by the C‐terminal domain
Authors: Ince Semra , Zhang Ping , Kutsch Miriam , Krenczyk Oktavian , Shydlovskyi Sergii , Herrmann Christian
Published: April 2020

Human guanylate‐binding protein 1 (hGBP‐1) shows a dimer‐induced acceleration of the GTPase activity yielding GDP as well as GMP. While the head‐to‐head dimerization of the large GTPase (LG) domain is well understood, the role of the rest of the protein, particularly of the GTPase effector domain (GED), in dimerization and GTP hydrolysis is still obscure. In this study, with truncations and point mutations on hGBP‐1 and by means of biochemical and biophysical methods, we demonstrate that the intramolecular communication between the LG domain and the GED (LG:GED) is crucial for protein dimerization and dimer‐stimulated GTP hydrolysis. In the course of GTP binding and γ‐phosphate cleavage, conformational changes within hGBP‐1 are controlled by a chain of amino acids ranging from the region near the nucleotide‐binding pocket to the distant LG:GED interface and lead to the release of the GED from the LG domain. This opening of the structure allows the protein to form GED:GED contacts within the dimer, in addition to the established LG:LG interface. After releasing the cleaved γ‐phosphate, the dimer either dissociates yielding GDP as the final product or it stays dimeric to further cleave the β‐phosphate yielding GMP. The second phosphate cleavage step, that is, the formation of GMP, is even more strongly coupled to structural changes and thus more sensitive to structural restraints imposed by the GED. Altogether, we depict a comprehensive mechanism of GTP hydrolysis catalyzed by hGBP‐1, which provides a detailed molecular understanding of the enzymatic activity connected to large structural rearrangements of the protein.

Database

Structural data are available in RCSB Protein Data Bank under the accession numbers: 1F5N, 1DG3, 2B92.
Clinging on to alpine life: Investigating factors driving the uphill range contraction and population decline of a mountain breeding bird
Authors: Ewing Steven R. , Baxter Alistair , Wilson Jeremy D. , Hayhow Daniel B. , Gordon James , Thompson Des B. A. , Whitfield D. Philip , van der Wal René
Published: April 2020

Climate change and anthropogenic nitrogen deposition are widely regarded as important drivers of environmental change in alpine habitats. However, due to the difficulties working in high‐elevation mountain systems, the impacts of these drivers on alpine breeding species have rarely been investigated. The Eurasian dotterel (Charadrius morinellus) is a migratory wader, which has been the subject of uniquely long‐term and spatially widespread monitoring effort in Scotland, where it breeds in alpine areas in dwindling numbers. Here we analyse data sets spanning three decades, to investigate whether key potential drivers of environmental change in Scottish mountains (snow lie, elevated summer temperatures and nitrogen deposition) have contributed to the population decline of dotterel. We also consider the role of rainfall on the species' wintering grounds in North Africa. We found that dotterel declines—in both density and site occupancy of breeding males—primarily occurred on low and intermediate elevation sites. High‐elevation sites mostly continued to be occupied, but males occurred at lower densities in years following snow‐rich winters, suggesting that high‐elevation snow cover displaced dotterel to lower sites. Wintering ground rainfall was positively associated with densities of breeding males two springs later. Dotterel densities were reduced at low and intermediate sites where nitrogen deposition was greatest, but not at high‐elevation sites. While climatic factors explained variation in breeding density between years, they did not seem to explain the species' uphill retreat and decline. We cannot rule out the possibility that dotterel have increasingly settled on higher sites previously unavailable due to extensive snow cover, while changes associated with nitrogen deposition may also have rendered lower lying sites less suitable for breeding. Causes of population and range changes in mountain‐breeding species are thus liable to be complex, involving multiple anthropogenic drivers of environmental change acting widely across annual and migratory life cycles.
Helicobacter pylori test‐and‐treat strategy for second‐year junior high school students aimed at the prevention of gastric cancer in Takatsuki City
Authors: Kaji Emiri , Yoden Atsushi , Otani Masano , Okuhira Takeru , Aomatsu Tomoki , Tamai Hiroshi , Ashida Akira
Published: April 2020

Background

More than 90% of gastric cancer cases are caused by Helicobacter pylori infections. To prevent gastric cancer, an H pylori test‐and‐treat strategy targeting young people has been implemented in various places in Japan. In this study, we evaluated the effectiveness of an H pylori test‐and‐treat strategy for second‐year junior high school students in Takatsuki City.

Materials and Methods

In 2014‐2017, a urine‐based H pylori test was used for initial screening. The final infection status was determined by a 13C‐urea breath test (13C‐UBT). Successful H pylori eradication was confirmed by 13C‐UBT 3 months after treatment. First‐line eradication therapy was changed from 10 mg of rabeprazole, 750 mg of amoxicillin, and 200 mg of clarithromycin twice daily for 7 days in 2014 to 20 mg of vonoprazan, 750 mg of amoxicillin, and 200 mg of clarithromycin twice daily for 7 days in 2015‐2017. Second‐line eradication therapy included 10 mg of rabeprazole, 750 mg of amoxicillin, and 250 mg of metronidazole twice daily for 7 days.

Results

In total, 8067 of 13 055 students participated this project and 206 students were diagnosed with H pylori infection. The success rate of first‐line therapy was 45.9% in 2014 and 83.8% after the revised first‐line therapy was administered. The final eradication rate was 98.5%. There were no severe side effects.

Conclusion

Our results support the use of the H pylori test‐and‐treat strategy for junior high school students as a safe approach for the prevention of gastric cancer. H pylori eradication therapy with vonoprazan could be a standard therapy in children.
Potential interaction between timing of infant complementary feeding and breastfeeding duration in determination of early childhood gut microbiota composition and BMI
Authors: Differding Moira K. , Doyon Myriam , Bouchard Luigi , Perron Patrice , Guérin Renée , Asselin Claude , Massé Eric , Hivert Marie‐France , Mueller Noel T.
Published: April 2020

Background

Introducing complementary foods other than breastmilk or formula acutely changes the infant gut microbiota composition. However, it is unknown whether the timing of introduction to complementary foods (early vs. late) in infancy is associated with early childhood gut microbiota and BMI, and if these associations depend on breastfeeding duration.

Objective

Our primary objective was to investigate whether timing of infant complentary feeding with solid foods is associated with early childhood gut microbiota composition and BMI‐z, and whether these associations differ by duration of breastfeeding.

Methods

We used data from a Canadian pre‐birth cohort followed till age 5 years. We examined timing of introduction to solid foods with the gut microbiota, determined by 16S rRNA gene sequencing of stool collected at 5 years of age, and age‐and‐sex specific BMI‐z. We conducted analyses before and after stratifying by breastfeeding duration, and adjusted for delivery mode, gestational age and birth weight.

Results

Of the 392 children in the analysis, 109 (27.8%) had early (≤4 months) solids. The association between early (vs later) solids and BMI‐z at 5 years was modified by breastfeeding status at 4 months (P = .06). Among children breastfed >4 months, early (vs later) solids were associated with differential relative abundance of 6 bacterial taxa, including lower Roseburia, and 0.30 higher BMI‐z (95% CI: 0.05, 0.55) at 5 years. In children breastfed <4 months, early solids were associated with differential relative abundance of 9 taxa, but not with child BMI‐z.

Conclusions

Early (vs. later) introduction to solid foods in infancy is associated with altered gut microbiota composition and BMI in early childhood, however these associations differ by duration of breastfeeding.
Validation of the Dutch translation of the Cardiff wound impact schedule for evaluation of the health‐related quality of life of patients with chronic wounds
Authors: van Doorn Louk P. , Sijberden Jasper P. , Brouwers Jeroen J. W. M. , Goossens Lisa Dominique , Hamming Jaap F.
Published: April 2020

The aim of this study was to validate a Dutch translation of the Cardiff wound impact schedule (CWIS), a disease‐specific instrument to measure the health‐related quality of life (HRQoL) in patients with chronic leg ulcers. To achieve this, the original instrument was translated. A total of 83 patients with chronic lower leg ulcers were included and completed the translated instrument and SF36 at baseline after assessment of their wound severity. Follow‐up was performed 1 week after inclusion. The psychometric properties of the instrument were assessed. Construct validity was positively evaluated by an expert panel. Face validity was positively evaluated in a cognitive debriefing of a pilot group. Discriminant validity was assessed by correlating 1‐year amputation risk according to the Wound, Ischaemia, foot Infection classification system with the instrument scores. Significant correlation could not be proven. Criterion validity was assessed by correlating domain scores of the instrument with domain scores of the gold standard: SF36. Moderate to high correlation was calculated for most domains of the instrument. Test‐retest reliability and internal consistency were evaluated as acceptable. In conclusion, the Dutch translation of the CWIS is a valid and reliable disease‐specific instrument to assess the HRQoL in patients with chronic lower leg ulcers.
A cross‐sectional multisite exploration of Italian paediatric nurses’ reported burnout and its relationship to perceptions of clinical safety and adverse events using the RN4CAST@IT‐Ped
Authors: Bagnasco Annamaria , Dasso Nicoletta , Rossi Silvia , Timmins Fiona , Watson Roger , Aleo Giuseppe , Catania Gianluca , Zanini Milko , Sasso Loredana
Published: April 2020

Aim

To explore Italian paediatric nurses’ reported burnout and its relationship to their perceptions of safety and adverse events.

Design

A cross‐sectional study using the RN4CAST@IT‐Ped database with a web‐based survey design.

Methods

The RN4CAST@IT‐Ped questionnaire was used to collect data in 2017. This comprised three main components: three dimensions (22 items) of the Maslach Burnout Inventory including emotional exhaustion, depersonalization and personal accomplishment. Participants also scored an overall grade of patient safety and estimated the occurrence of adverse clinical events.

Results

Nurses (N = 2,243) reported high levels of burnout. Most rated clinical safety as high. The risk of adverse events ranged from 1.3–12.4%. The degree of burnout appeared to influence the perception of safety and adverse events.

Conclusion

The association between nurses’ burnout and perceptions of higher rates of adverse events and reduced safety in clinical practice is an important finding. However, it is unclear whether this was influenced by a negative state of mind, and whether reduced safety and increased adverse events negatively influenced nurses’ well‐being, thus leading to burnout. Regardless, the association between nurses’ burnout and these quality concepts needs further exploration to examine the effect, if any, on burnout and safety, and identify supportive mechanisms for nurses.

Impact

The association between reported burnout and perception of safety and risk of adverse events in Italian paediatric nurses has been reported for the first time. Nurses reporting burnout are at greater risk of intensely negative perceptions of clinical safety and adverse events. This is an important finding as perceptions can influence practice and behaviours. Quality measures in children's clinical environments need to go beyond obvious indicators to examine nurses’ well‐being as this also influences quality and safety.
Climatic refugia boosted allopatric diversification in Western Mediterranean vipers
Authors: Martínez‐Freiría Fernando , Freitas Inês , Zuffi Marco A. L. , Golay Philippe , Ursenbacher Sylvain , Velo‐Antón Guillermo
Published: April 2020

Aim

The ecological dimension of evolutionary processes has been scarcely addressed in phylogeographic studies. We reconstruct the historical biogeography of Western Mediterranean vipers to discover the role of climate in fostering diversification.

Location

Western Mediterranean Basin.

Taxon

Vipera aspis and Vipera latastei‐monticola complex.

Methods

We used nearly range‐wide phylogeographic analyses of three mitochondrial genes followed by geographic assignment of 4,056 records to genetic units to test phylogenetic niche conservatism, under a 3D hypervolume approach, and reconstruct paleoclimatic scenarios for the diversification of main lineages during Pleistocene.

Results

Bayesian inferences from mtDNA recovered three Miocene clades and nine Pliocene lineages that diversified during the Pleistocene. Diversification was mostly restricted to southern regions of Iberian and Italian peninsulas and to the north‐western African mountains until the late Pliocene. Some lineages expanded northwards during the Pleistocene. Accordingly, genetic diversity was higher in southern regions. Ecological niche tests mostly supported allopatric diversification with niche conservatism, although niche shifts occurred with two divergence events. Palaeoclimatic models identified particular requirements for the current distribution of main lineages and distinct responses to the cooling and warming events of the Pleistocene. Areas of climatic stability during the Pleistocene were identified for main lineages; however, climatic stability was weakly correlated with haplotype diversity.

Main conclusions

In the Western Mediterranean biodiversity hotspot, palaeo‐tectonic and palaeo‐climatic factors drove diversification since the Miocene. Comparisons among patterns of diversification, haplotype diversity, and climatic stability suggest that southern Iberian and Italian peninsulas, and north‐western African mountains acted as refugia since the Pliocene, while some northern areas favoured population persistence during the Pleistocene. Climate adaptation likely played a secondary role in the diversification of some lineages.
Longitudinal control of blood pressure among a cohort of Ghanaians with hypertension: A multicenter, hospital‐based study
Authors: Sarfo Fred S. , Mobula Linda , Plange‐Rhule Jacob , Gebregziabher Mulugeta , Ansong Daniel , Sarfo‐Kantanka Osei , Arthur Lynda , Sablah Jasper , Gavor Edith , Burnham Gilbert , Ofori‐Adjei David
Published: April 2020

There are limited data on factors associated with longitudinal control of blood pressure (BP) among Ghanaians on antihypertensive treatment. We sought to evaluate associations between prospective BP control and 24 putative factors within socio‐demographic, biological, and organizational domains. This is a cohort study involving 1867 (65%) adults with hypertension and 1006 (35%) with both hypertension and diabetes mellitus at five public hospitals. Clinic BP was measured every 2 months for 18 months of follow‐up. A multivariate logistic regression analysis was fitted via generalized linear mixed models to identify factors associated with clinic BP ≥ 140/90 mm Hg at each clinic visit during follow‐up. Mean age of study participants was 58.9 ± 16.6 years and 76.8% were females. Proportions with controlled BP increased from 46.3% at baseline to 59.8% at month 18, P < .0001. Eight factors with adjusted OR (95% CI) associated prospectively with uncontrolled BP were male gender: 1.37 (1.09‐1.72), secondary education: 1.32 (1.00‐1.74), non‐adherence to antihypertensive treatment: 1.03 (1.00‐1.06), fruit intake: 0.94 (0.89‐1.00), duration of hypertension diagnosis: 1.01 (1.00‐1.02), hypertension with diabetes mellitus: 2.05 (1.72‐2.46), number of antihypertensive medications: 1.63 (1.49‐1.79), and estimated glomerular filtration rate (mL/min rise): 0.82 (0.76‐0.89). Interventions aimed at addressing modifiable factors associated with poorly controlled BP would be critical in prevention of cardiovascular diseases among Ghanaians.
HIP/PAP protects against bleomycin‐induced lung injury and inflammation and subsequent fibrosis in mice
Authors: Zheng Xiaoyan , Li Qian , Tian Hong , Li Hanchao , Lv Yifei , Wang Yanhua , He Lan , Huo Yongwei , Hao Zhiming
Published: April 2020

Hepatocarcinoma‐intestine‐pancreas/pancreatitis‐associated protein (HIP/PAP), a C‐type lectin, exerts anti‐oxidative, anti‐inflammatory, bactericidal, anti‐apoptotic, and mitogenic functions in several cell types and tissues. In this study, we explored the role of HIP/PAP in pulmonary fibrosis (PF). Expression of HIP/PAP and its murine counterpart, Reg3B, was markedly increased in fibrotic human and mouse lung tissues. Adenovirus‐mediated HIP/PAP expression markedly alleviated bleomycin (BLM)‐induced lung injury, inflammation, and fibrosis in mice. Adenovirus‐mediated HIP/PAP expression alleviated oxidative injury and lessened the decrease in pulmonary superoxide dismutase (SOD) activity in BLM‐treated mice, increased pulmonary SOD expression in normal mice, and HIP/PAP upregulated SOD expression in cultured human alveolar epithelial cells (A549) and human lung fibroblasts (HLF‐1). Moreover, in vitro experiments showed that HIP/PAP suppressed the growth of HLF‐1 and ameliorated the H2O2‐induced apoptosis of human alveolar epithelial cells (A549 and HPAEpiC) and human pulmonary microvascular endothelial cells (HPMVEC). In HLF‐1, A549, HPAEpiC, and HPMVEC cells, HIP/PAP did not affect the basal levels, but alleviated the TGF‐β1‐induced down‐regulation of the epithelial/endothelial markers E‐cadherin and vE‐cadherin and the over‐expression of mesenchymal markers, such as α‐SMA and vimentin. In conclusion, HIP/PAP was found to serve as a potent protective factor in lung injury, inflammation, and fibrosis by attenuating oxidative injury, promoting the regeneration of alveolar epithelial cells, and antagonizing the pro‐fibrotic actions of the TGF‐β1/Smad signaling pathway.
Trametinib potentiates TRAIL‐induced apoptosis via FBW7‐dependent Mcl‐1 degradation in colorectal cancer cells
Authors: Lin Lin , Ding Dapeng , Xiao Xiaoguang , Li Bing , Cao Penglong , Li Shijun
Published: April 2020

Trametinib is a MEK1/2 inhibitor and exerts anticancer activity against a variety of cancers. However, the effect of Trametinib on colorectal cancer (CRC) is not well understood. In the current study, our results demonstrate the ability of sub‐toxic doses of Trametinib to enhance TRAIL‐mediated apoptosis in CRC cells. Our findings also indicate that Trametinib and TRAIL activate caspase‐dependent apoptosis in CRC cells. Moreover, Mcl‐1 overexpression can reduce apoptosis in CRC cells treated with Trametinib with or without TRAIL. We further demonstrate that Trametinib degrades Mcl‐1 through the proteasome pathway. In addition, GSK‐3β phosphorylates Mcl‐1 at S159 and promotes Mcl‐1 degradation. The E3 ligase FBW7, known to polyubiquitinate Mcl‐1, is involved in Trametinib‐induced Mcl‐1 degradation. Taken together, these results provide the first evidence that Trametinib enhances TRAIL‐mediated apoptosis through FBW7‐dependent Mcl‐1 ubiquitination and degradation.
Salvianolic acid B inhibits ototoxic drug–induced ototoxicity by suppression of the mitochondrial apoptosis pathway
Authors: Zheng Zhiwei , Wang Yunfeng , Yu Huiqian , Li Wen , Wu Jingfang , Cai Chengfu , He Yingzi
Published: April 2020

It has been claimed that salvianolic acid B (Sal B), a natural bioactive antioxidant, exerts protective effects in various types of cells. This study aims to evaluate the antioxidant and anti‐apoptosis effects of Sal B in a cultured HEI‐OC1 cell line and in transgenic zebrafish (Brn3C: EGFP). A CCK‐8 assay, Annexin V Apoptosis Detection Kit, TUNEL and caspase‐3/7 staining, respectively, examined apoptosis and cell viability. The levels of reactive oxygen species (ROS) were evaluated by CellROX and MitoSOX Red staining. JC‐1 staining was employed to detect the mitochondrial membrane potential (ΔΨm). Western blotting was used to assess expressions of Bax and Bcl‐2. The expression pattern of p‐PI3K and p‐Akt was determined by immunofluorescent staining. We found that Sal B protected against neomycin‐ and cisplatin‐induced apoptotic features, enhanced cell viability and accompanied with decreased caspase‐3 activity in the HEI‐OC1 cells. Supplementary experiments determined that Sal B reduced ROS production (increased ΔΨm), promoted Bcl‐2 expression and down‐regulated the expression of Bax, as well as activated PI3K/AKT signalling pathways in neomycin‐ and cisplatin‐injured HEI‐OC1 cells. Moreover, Sal B markedly decreased the TUNEL signal and protected against neomycin‐ and cisplatin‐induced neuromast HC loss in the transgenic zebrafish. These results unravel a novel role for Sal B as an otoprotective agent against ototoxic drug–induced HC apoptosis, offering a potential use in the treatment of hearing loss.
Distance to Hospital‐based Intrapartum Care and Planned Home Birth in Minnesota
Authors: Parks Santangelo Elise , Osypuk Theresa , Mason Susan M.
Published: April 2020

Introduction

Loss of hospital‐based intrapartum services is associated with increases in out‐of‐hospital births, but less is known about associations with planned home birth. This study explores the impact of distance to hospital‐based intrapartum care on planned home birth.

Methods

Public‐use Minnesota birth certificate data were merged with Minnesota Hospital Annual Report data (2011‐2016) to test the relationship of miles from maternal residence to hospital‐based intrapartum care with planned home birth in Minnesota. Logistic regression models estimated the odds of a planned home birth versus hospital birth as a function of miles to hospital‐based intrapartum care.

Results

The number of hospitals offering birth services in Minnesota declined by 11% from 2011 to 2016. Moderate (>20‐50 miles) and great (>50 miles) distances to nearest hospital‐based intrapartum care were associated with increased odds of planned home birth compared with short distances (≤20 miles). Adjusted odds ratios were 3.31 (95% CI, 3.04‐3.61) and 3.89 (95% CI, 2.37‐6.37), respectively, after adjusting for maternal education, age, and race. Planned home birth was the intended birth setting in 4.3% of births among those living great distances from hospital‐based intrapartum care, compared with 1.0% among those living a short distance from hospital‐based intrapartum care.

Discussion

Better understanding of how geographical barriers affect preferred birth settings can inform efforts to reduce the impact of hospital‐based intrapartum service loss on rural women and their birth outcomes.
Airway organoids as models of human disease
Authors: van der Vaart J. , Clevers H.
Published: April 2020

Studies developing and applying organoid technology have greatly increased in volume and visibility over the past decade. Organoids are three‐dimensional structures that are established from pluripotent stem cells (PSCs) or adult tissue stem cells (ASCs). They consist of organ‐specific cell types that self‐organize through cell sorting and spatially restricted lineage commitment to generate architectural and functional characteristics of the tissue of interest. The field of respiratory development and disease has been particularly productive in this regard. Starting from human cells (PSCs or ASCs), models of the two segments of the lung, the airways and the alveoli, can be built. Such organoids allow the study of development, physiology and disease and thus bridge the gap between animal models and clinical studies. This review discusses current developments in the pulmonary organoid field, highlighting the potential and limitations of current models.
Characteristics of Schools with Youth Sports Concussion‐Related Educational Policies and Practices
Authors: DePadilla PhD Lara , Miller PhD Gabrielle F. , Everett Jones PhD, MPH, JD Sherry
Published: April 2020

BACKGROUND

School policies and practices designed to educate athletes, parents, and coaches about youth sports concussions may be a way to reduce concussion risk and improve both the recognition and management of concussions.

METHODS

Nationally representative data from the 2014 School Health Policies and Practices Study (SHPPS) were used to assess associations between school demographic characteristics (eg, school level, metropolitan status, and school type) and school policies and practices addressing youth sports concussion‐related education for athletes, parents, and coaches.

RESULTS

Overall, many schools had policies and practices that addressed youth sports concussion‐related education for athletes, parents, and coaches. There was significant variability in the adoption of policies and practices by some school demographic characteristics. Middle schools, private schools, and urban schools were less likely to adopt many of the policies and practices than high schools, public schools, and rural schools, respectively. For other school characteristics, no consistent patterns of associations emerged.

CONCLUSIONS

These findings suggest that middle, private, and urban schools, in particular, are more likely to lack youth sports concussion‐related educational policies and practices and may need information or resources about the importance of education related to preventing, recognizing, and responding to concussions.
Pityriasis lichenoides acuta (PLEVA) pemphigoides: A rare bullous variant of PLEVA
Authors: Reichel Alexandra , Grothaus Julia , Ott Hagen
Published: April 2020

Although the clinical presentations of patients with pityriasis lichenoides et varioliformis acuta (PLEVA) may vary, bullae are not usually part of the clinical spectrum. To date, only two other cases of a bullous variant of PLEVA with evidence of autoantibodies against hemidesmosomal antigens have been reported. The term PLEVA pemphigoides was suggested for this unique clinical, pathological and serological combination of both PLEVA and bullous pemphigoid.
Risk factors for motor coordination problems in preschool‐age children
Authors: Suyama Satoshi , Yagyu Kazuyori , Araki Atsuko , Miyashita Chihiro , Itoh Sachiko , Minatoya Machiko , Yamazaki Keiko , Tamura Naomi , Nakai Akio , Saito Takuya , Kishi Reiko
Published: April 2020

Background

Motor coordination problems (MCP) in children can sometimes be diagnosed as developmental coordination disorder. Early intervention for developmental coordination disorder is necessary because it often continues into adolescence, causing mental and physical complications. Few studies have investigated the prevalence of childhood MCP in the Japanese population, examining the risk factors for MCP. We therefore investigated the prenatal factors associated with MCP in preschool‐age children.

Methods

This study was based on a prospective cohort study, the Hokkaido Study on Environment and Children’s Health. Mothers of 4,851 children who reached the age of 5 years within the study‐period received questionnaires, including the Japanese version of the Developmental Coordination Disorder Questionnaire (DCDQ‐J). We examined the risk factors associated with MCP using logistic regression analysis.

Results

Of 3,402 returned DCDQ‐J questionnaires, 3,369 were answered completely. From the 3,369 children, we categorized having MCP by using two cut‐off scores: that of the DCDQ’07 and the cut‐off at the 5th percentile of a total DCDQ‐J score. Comparing children with and without MCP, we found significant differences in the education level of the mothers, annual household income during pregnancy, maternal alcohol consumption and smoking during pregnancy, and sex and age of the children at the time of completing the DCDQ‐J by both categorizations. Adjusted logistic regression analysis revealed that maternal smoking during the first trimester of pregnancy and male sex were significantly associated with MCP.

Conclusions

Our results suggest that maternal smoking during pregnancy is the main factor associated with MCP in preschool‐age children.