bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk of complicated birth at term in nulliparous and multiparous women using routinely collected maternity data in England: cohort study
Authors: Jardine Jennifer , Blotkamp Andrea , Gurol-Urganci Ipek , Knight Hannah , Harris Tina , Hawdon Jane , van der Meulen Jan , Walker Kate , Pasupathy Dharmintra 
Published: October 2020

Abstract

Objectives
To determine the rate of complicated birth at term in women classified at low risk according to the National Institute for Health and Care Excellence guideline for intrapartum care (no pre-existing medical conditions, important obstetric history, or complications during pregnancy) and to assess if the risk classification can be improved by considering parity and the number of risk factors.

Design
Cohort study using linked electronic maternity records.

Participants
276 766 women with a singleton birth at term after a trial of labour in 87 NHS hospital trusts in England between April 2015 and March 2016.

Main outcome measure
A composite outcome of complicated birth, defined as a birth with use of an instrument, caesarean delivery, anal sphincter injury, postpartum haemorrhage, or Apgar score of 7 or less at five minutes.

Results
Multiparous women without a history of caesarean section had the lowest rates of complicated birth, varying from 8.8% (4879 of 55 426 women, 95% confidence interval 8.6% to 9.0%) in those without specific risk factors to 21.8% (613 of 2811 women, 20.2% to 23.4%) in those with three or more. The rate of complicated birth was higher in nulliparous women, with corresponding rates varying from 43.4% (25  805 of 59 413 women, 43.0% to 43.8%) to 64.3% (364 of 566 women, 60.3% to 68.3%); and highest in multiparous women with previous caesarean section, with corresponding rates varying from 42.9% (3426 of 7993 women, 41.8% to 44.0%) to 66.3% (554 of 836 women, 63.0% to 69.5%).

Conclusions
Nulliparous women without risk factors have substantially higher rates of complicated birth than multiparous women without a previous caesarean section even if the latter have multiple risk factors. Grouping women first according to parity and previous mode of birth, and then within these groups according to presence of specific risk factors would provide greater and more informed choice to women, better targeting of interventions, and fewer transfers during labour than according to the presence of risk factors alone.
Menstrual cycle regularity and length across the reproductive lifespan and risk of premature mortality: prospective cohort study
Authors: Wang Yi-Xin , Arvizu Mariel , Rich-Edwards Janet W , Stuart Jennifer J , Manson JoAnn E , Missmer Stacey A , Pan An , Chavarro Jorge E 
Published: October 2020

AbstractObjectiveTo evaluate whether irregular or long menstrual cycles throughout the life course are associated with all cause and cause specific premature mortality (age <70 years).DesignProspective cohort study.SettingNurses’ Health Study II (1993-2017).Participants79 505 premenopausal women without a history of cardiovascular disease, cancer, or diabetes and who reported the usual length and regularity of their menstrual cycles at ages 14-17 years, 18-22 years, and 29-46 years.Main outcome measuresHazard ratios and 95% confidence intervals for all cause and cause specific premature mortality (death before age 70 years) were estimated from multivariable Cox proportional hazards models.ResultsDuring 24 years of follow-up, 1975 premature deaths were documented, including 894 from cancer and 172 from cardiovascular disease. Women who reported always having irregular menstrual cycles experienced higher mortality rates during follow-up than women who reported very regular cycles in the same age ranges. The crude mortality rate per 1000 person years of follow-up for women reporting very regular cycles and women reporting always irregular cycles were 1.05 and 1.23 for cycle characteristics at ages 14-17 years, 1.00 and 1.37 for cycle characteristics at ages 18-22 years, and 1.00 and 1.68 for cycle characteristics at ages 29-46 years. The corresponding multivariable adjusted hazard ratios for premature death during follow-up were 1.18 (95% confidence interval 1.02 to 1.37), 1.37 (1.09 to 1.73), and 1.39 (1.14 to 1.70), respectively. Similarly, women who reported that their usual cycle length was 40 days or more at ages 18-22 years and 29-46 years were more likely to die prematurely than women who reported a usual cycle length of 26-31 days in the same age ranges (1.34, 1.06 to 1.69; and 1.40, 1.17 to 1.68, respectively). These relations were strongest for deaths related to cardiovascular disease. The higher mortality associated with long and irregular menstrual cycles was slightly stronger among current smokers.ConclusionsIrregular and long menstrual cycles in adolescence and adulthood are associated with a greater risk of premature mortality (age <70 years). This relation is slightly stronger among women who smoke.
Efficacy of low-load blood flow restricted resistance EXercise in patients with Knee osteoarthritis scheduled for total knee replacement (EXKnee): protocol for a multicentre randomised controlled trial
Authors: Jørgensen Stian Langgård , Bohn Marie Bagger , Aagaard Per , Mechlenburg Inger 
Published: October 2020

IntroductionUp to 20% of patients undergoing total knee replacement (TKR) surgery report no or suboptimal pain relief after TKR. Moreover, despite chances of recovering to preoperative functional levels, patients receiving TKR have demonstrated persistent deficits in quadriceps strength and functional performance compared with healthy age-matched adults. We intend to examine if low-load blood flow restricted exercise (BFRE) is an effective preoperative method to increase functional capacity, lower limb muscle strength and self-reported outcomes after TKR. In addition, the study aims to investigate to which extent preoperative BFRE will protect against surgery-related atrophy 3 months after TKR.MethodsIn this multicentre, randomised controlled and assessor blinded trial, 84 patients scheduled for TKR will be randomised to receive usual care and 8 weeks of preoperative BFRE or to follow usual care-only. Data will be collected before randomisation, 3–4 days prior to TKR, 6 weeks, 3 months and 12 months after TKR. Primary outcome will be the change in 30 s chair stand test from baseline to 3-month follow-up. Key secondary outcomes will be timed up and go, 40 me fast-paced walk test, isometric knee extensor and flexor strength, patient-reported outcome and selected myofiber properties.Intention-to-treat principle and per-protocol analyses will be conducted. A one-way analysis of variance model will be used to analyse between group mean changes. Preintervention-to-postintervention comparisons will be analysed using a mixed linear model. Also, paired Student’s t-test will be performed to gain insight into the potential pretraining-to-post-training differences within the respective training or control groups and regression analysis will be used for analysation of associations between selected outcomes.Ethical approvalThe trial has been accepted by the Central Denmark Region Committee on Biomedical Research Ethics (Journal No 10-72-19-19) and the Danish Data Protection Agency (Journal No 652164). All results will be published in international peer-reviewed scientific journals regardless of positive, negative or inconclusive results.Trial registration numberNCT04081493.
ABO blood group and the risk of aortic disease: a nationwide cohort study
Authors: Zindovic Igor , Edgren Gustaf , Nozohoor Shahab , Majeed Ammar 
Published: October 2020

ObjectivesTo analyse the association between ABO blood group and aortic disease using data on blood donors and transfused patients from Sweden.DesignThis was a retrospective study using data from the Swedish portion of the Scandinavian Donations and Transfusions Database. The association between ABO blood group and aortic disease was analysed using log-linear Poisson regression models and presented as incidence rate ratios (IRRs).SettingSwedish population-based study.ParticipantsThe study cohort consisted of 1 164 561 Swedish blood donors and 961 637 transfused patients with a combined follow-up time of 29 390 649 person-years.Primary and secondary outcome measuresIRRs of aortic events (ie, aortic aneurysms and/or aortic dissections) in relation to patient blood group.ResultsA total of 20 684 aortic events occurred during the study period. Non-O donors and patients had similar incidence of aortic events when compared with blood group O donors and patients with an IRR of 0.98 (95% CI, 0.93–1.04) and 1.00 (95% CI, 0.97–1.03), respectively. There were no differences between non-O and blood group O individuals when aortic dissections and aortic aneurysms were analysed separately. Blood group B conferred a lower risk of aortic aneurysms in the patient cohort when compared with blood group O (IRR, 0.90; 95% CI, 0.85–0.96).ConclusionsIn the present study, there were no statistically significant associations between ABO blood group and the risk of aortic disease. A possible protective effect of blood group B was observed in the patient cohort but this finding requires further investigation.
Decolonising qualitative research to explore the experiences of Manitoba’s urban Indigenous population living with type 2 diabetes mellitus, obesity and bariatric surgery
Authors: Hardy Krista , Clouston Kathleen , Zmudzinski Marta , Fowler-Woods Melinda , Shingoose Geraldine , Fowler-Woods Amanda , Daeninck Felicia , Hatala Andrew , Vergis Ashley 
Published: October 2020

IntroductionObesity and type 2 diabetes mellitus (T2DM) are growing global health concerns associated with significant morbidity, mortality and healthcare expenditures. Due to histories of colonisation and contemporary marginalisation, Canada’s Indigenous populations are disproportionately burdened by obesity, T2DM and many other chronic illnesses. Culturally appropriate research on experiences and outcomes of Indigenous patients undergoing bariatric surgery in Canada is scarce. This qualitative study protocol will use a decolonising approach guided by an Indigenous Elder to explore the perspectives and experiences of urban Indigenous Manitobans with respect to T2DM, obesity and bariatric surgery. This knowledge will guide the development and implementation of culturally sensitive bariatric care.Methods and analysisSequential sharing circles (SSCs) and semistructured conversational interviews that have been purposefully designed to be culturally relevant with the guidance of an Indigenous Elder and advisory group (IAG) will be carried out in Winnipeg, Manitoba, Canada. Indigenous adults who are obese (body mass index >35 kg/m2), have T2DM and live in an urban centre will be recruited. Three groups will be investigated: (1) those who have had bariatric surgery; (2) those on the wait list for bariatric surgery and (3) those not associated with a bariatric surgery programme. Each group of 10–12 participants will be guided through a semistructured script led by an Indigenous Elder. Elder-facilitated conversational interviews will also be completed following the SSCs. All content will be audio recorded and transcribed. Thematic analysis will be used to identify emerging patterns using a constructive grounded theory approach.Ethics and disseminationThis study has received ethical approval from the University of Manitoba Health Research Ethics Board. Findings will inform the development and implementation of culturally sensitive programmes at Manitoba’s Centre for Metabolic and Bariatric Surgery. Results will be disseminated in peer-reviewed scientific journals, at obesity and Indigenous health conferences, and knowledge sharing ceremonies.
Role of community health workers in improving cost efficiency in an active case finding tuberculosis programme: an operational research study from rural Bihar, India
Authors: Garg Tushar , Bhardwaj Manish , Deo Sarang 
Published: October 2020

ObjectivesCost-efficient active case finding (ACF) approaches are needed for their large-scale adoption in national tuberculosis (TB) programmes. Our aim was to assess if community health workers’ (CHW) knowledge about families’ health status can improve the cost efficiency of the ACF programme without adversely affecting the delivery of other health services for which they are responsible.DesignQuasi-experimental design.InterventionsWe evaluated an ACF programme in the Samastipur district in Bihar, India, between July 2017 and June 2018. CHWs called Accredited Social Health Activists generated referrals of individuals at risk of TB and conducted symptom-based screening to identify patients with presumptive TB. They also helped them undergo testing and provided treatment support for confirmed TB cases.Primary and secondary outcome measuresWe compared the notification rate from the intervention region with that from a control region in the same district with similar characteristics. We analysed operational data to calculate the cost per TB case diagnosed. We used routine programmatic data from the public health system to estimate the impact on other services provided by CHWs.FindingsCHWs identified 9895 patients with presumptive TB. Of these, 5864 patients were tested for TB, and 1236 were confirmed as TB cases. Annual public case notification rate increased sharply in the intervention region from 45.8 to 105.8 per 100 000 population, whereas it decreased from 50.7 to 45.3 in the control region. There was no practically or statistically significant impact on other output indicators of the CHWs, such as institutional deliveries (−0.04%). The overall cost of the intervention was about US$134 per diagnosed case. Main cost drivers were human resources, and commodities (drugs and diagnostics), which contributed 37.4% and 32.5% of the cost, respectively.ConclusionsACF programmes that use existing CHWs in the health system are feasible, cost efficient and do not adversely affect other healthcare services delivered by CHWs.
Qualitative exploration of health professionals’ experiences of communicating positive newborn bloodspot screening results for nine conditions in England
Authors: Chudleigh Jane , Chinnery Holly , Bonham Jim R , Olander Ellinor , Moody Louise , Simpson Alan , Morris Stephen , Ulph Fiona , Bryon Mandy , Southern Kevin 
Published: October 2020

ObjectiveTo explore health professionals’ experiences of communicating positive newborn bloodspot screening (NBS) results, highlight differences, share good practice and make recommendations for future research.DesignQualitative exploratory design was employed using semi-structured interviewsSettingThree National Health Service provider organisations in EnglandParticipantsSeventeen health professionals involved in communicating positive newborn bloodspot screening results to parents for all nine conditions currently included in the newborn bloodspot screening programme in England.ResultsFindings indicated variation in approaches to communicating positive newborn bloodspot screening results to parents, largely influenced by resources available and the lack of clear guidance. Health professionals emphasised the importance of communicating results to families in a way that is sensitive to their needs. However, many challenges hindered communication including logistical considerations; difficulty contacting the family and other health professionals; language barriers; parental reactions; resource considerations; lack of training; and insufficient time.ConclusionHealth professionals invest a lot of time and energy trying to ensure communication of positive newborn bloodspot screening results to families is done well. However, there continues to be great variation in the way these results are communicated to parents and this is largely influenced by resources available but also the lack of concrete guidance. How best to support health professionals undertaking this challenging and emotive task requires further exploration. We recommend evaluation of a more cohesive approach that meets the needs of parents and staff while being sensitive to the subtleties of each condition.Trial registration numberISRCTN15330120
Protocol for a process evaluation of Family Planning Elevated: a statewide initiative to improve contraceptive access in Utah (USA)
Authors: Baayd Jami , Simmons Rebecca G 
Published: October 2020

IntroductionMany individuals in the USA do not have access to the contraceptive methods they desire. Contraceptive initiatives have emerged at the state and national levels to remove barriers to access, and many initiatives have reported success. Other initiatives may want to build on or replicate that success, but data are scarce on the details of how and why certain interventions work. This paper describes the protocol for the planned process evaluation of Family Planning Elevated (FPE), a statewide contraceptive initiative in Utah.MethodsFPE will conduct a process evaluation during the planning and implementation phases of the programme. The process evaluation will document (1) the community, state and national contexts in which the programme is implemented, (2) how FPE is implemented and (3) the mechanism by which FPE creates impact. We will collect qualitative data via interviews with FPE staff, providers and staff participating in the programme, and key stakeholders and policy-makers throughout the state. The team process evaluator will record FPE decision making and implementation activities by taking field notes during weekly FPE meetings. Quantitatively, we will collect monthly data reports from FPE-participating clinics, analytics reports from the media campaign and survey results from patients in FPE-participating clinics. The findings of the process evaluation will allow other contraceptive initiatives to learn from FPE’s efforts and replicate successful components of the programme.Ethics and disseminationThe study received approval from the University of Utah’s Institutional Review Board. Findings from the process evaluation and outcome evaluation will be published, shared with other contraceptive initiatives and presented at conferences.Trial registration numberNCT03877757.
A Community with a Shared Future
Authors: He Wenping 
Published: October 2020

Beijing has elevated Africa’s position in its foreign policy planning and increasingly regards the continent as a proving ground for its vision of humanity as a community with a shared future. The Xi Jinping administration has laid out a number of principles, for example, sincerity, pragmatism, affinity, and good faith, as well as major economic and financial initiatives — the Belt and Road Initiative and the Asian Infrastructure Investment Bank — to step up engagement with Africa in a more comprehensive and targeted manner. China’s development and governance model represents an alternative to the hitherto under-delivering Western approach that has been practiced by many African nations over the past decades. Beijing respects Africans’ political and economic choices, but also stands ready to help the continent try new development approaches and amplify its voices on the world stage. Fostering political convergence, building mutual trust, promoting local industrialization, increasing financial support for small and medium businesses, and ensuring infrastructure sustainability are the priorities for future China-African cooperation.
Autocrine Leukemia Inhibitory Factor Promotes Esophageal Squamous Cell Carcinoma Progression via Src Family Kinase-Dependent Yes-Associated Protein Activation
Authors: Kawazoe Tetsuro , Saeki Hiroshi , Oki Eiji , Oda Yoshinao , Maehara Yoshihiko , Mori Masaki , Taniguchi Koji 
Published: October 2020

Abstract

The IL6 family of cytokines, including IL6 and leukemia-inhibitory factor (LIF), are induced during inflammation and are also expressed in many types of cancer where they play an important role in tumor development. IL6 family cytokines mainly activate the JAK–STAT3 pathway via the coreceptor, gp130, and IL6 is known to activate the Src family kinase (SFK)–Yes-associated protein (YAP) pathway. The current study investigated the role of autocrine LIF in human esophageal squamous cell carcinoma (ESCC) that highly expresses LIF. LIF knockdown had various effects on cancer cells, including profound changes in gene expression, suppression of cell proliferation, migration/invasion and sphere formation, and induction of apoptosis. Similar to IL6, LIF activated the SFK–YAP pathway as well as the JAK–STAT3 pathway. LIF-induced YAP activation was more important for cancer cell proliferation than LIF-induced STAT3 activation, and concomitant YAP and STAT3 activation completely compensated for the role of LIF in human ESCC growth. We also confirmed that SFK activation and LIF expression were correlated with YAP activation in human ESCC clinical samples. Furthermore, simultaneous inhibition of the SFK–YAP and JAK–STAT3 pathways in human ESCC cells was more effective at suppressing cell proliferation than single inhibition, and autocrine LIF signaling promoted human ESCC growth in vivo. Therefore, the LIF–SFK–YAP axis may represent a new therapeutic target for human ESCC.

Implications:
Autocrine LIF signaling promotes human ESCC progression via SFK-dependent YAP activation and is a new potential target of treatment for human ESCC.
Immunosurveillance and Regression in the Context of Squamous Pulmonary Premalignancy
Authors: Krysan Kostyantyn , Tran Linh M. , Dubinett Steven M. 
Published: October 2020

AbstractSummary:In this issue of Cancer Discovery, Pennycuick and colleagues comprehensively evaluate the immune contexture of progressive and regressive lesions in squamous pulmonary premalignancy. The authors dissect the molecular features of these lesions and the potential pathways of immune escape operative in progression to invasive cancer.See related article by Pennycuick et al., p. 1489.
An observation of intergroup infanticide in grey-cheeked mangabeys (Lophocebus albigena)
Authors: Brown Michelle 
Published: October 2020

Abstract
In primates, infanticide is occasionally observed during intergroup conflicts but does not fit the predictions of the sexual selection hypothesis. I report an observation of an intergroup infanticide during a sub-group foray in grey-cheeked mangabeys (Lophocebus albigena) at the Ngogo site in Kibale National Park, Uganda. Intergroup infanticide appears to be a form of extreme and long-term food defence across primate species, and occurs in conjunction with other forms of food defence.
Do dietary carotenoids improve the escape-response performance of southern corroboree frog larvae?
Authors: McInerney Emma P. , Silla Aimee J. , Byrne Phillip G. 
Published: October 2020

AbstractDietary antioxidants can improve escape-response performance in adult vertebrates, but whether juveniles receive similar benefits remains untested. Here, we investigated the effect of two dietary carotenoids (β-carotene and lutein) on the escape-response of juvenile corroboree frogs (Pseudophryne corroboree) at two developmental points (early and late larval development). We found that burst speed was lower during late larval development compared to early larval development, particularly in the low- and high-dose lutein treatments. These findings suggest that performance decreased over time, and was reduced by lutein consumption. At each developmental point we found no treatment effect on escape-response, providing no evidence for carotenoid benefits. A previous study in corroboree frogs demonstrated that carotenoids improved adult escape-response, so our findings suggest that benefits of carotenoids in this species may be life-stage dependent. Continued investigation into how carotenoids influence escape-response at different life-stages will provide insights into mechanistic links between nutrition and behaviour.