bluuebunny/crossref_metadata_2025_split huggingface dataset:
Extravillous trophoblast invasion in placenta accreta is associated with differential local expression of angiogenic and growth factors: a cross‐sectional study
Authors: Duzyj CM , Buhimschi IA , Laky CA , Cozzini G , Zhao G , Wehrum M , Buhimschi CS 
Published: February 2018

ObjectivePlacenta accreta is clinically associated with maternal uterine scar. Our objective was to investigate the biochemical contribution of maternal scarring to hyperinvasive trophoblast. We hypothesised that trophoblast over‐invasion in placenta accreta is associated with aberrant invasion‐site signalling of growth and angiogenic factors known to be involved in wound healing and promotion of cell invasion through the epithelial to mesenchymal cellular programme.DesignCross‐sectional series.SettingYale–New Haven Hospital.PopulationWomen with histologically confirmed normal and abnormal placentation.MethodsPlacental invasion site tissue sections were immunostained for endoglin and other angiogenic regulators, and transforming growth factor β (TGFβ) proteins. Maternal serum endoglin, and the vascular endothelial growth factor (VEGF) mediators hypoxia‐inducible factor‐1α (HIF1α) and endostatin, were assessed using immunoassay.Main outcome measuresDifferences in median H‐score by immunostaining and in mean serum level by immunoassay.ResultsBy immunostaining, placenta accreta samples demonstrated intervillous endoglin shedding and increased trophoblast expression of its cleavage protein matrix metalloproteinase‐14. Absent decidual HIF1α and endostatin were observed in areas of VEGF upregulation. TGFβ1 was present in myocytes but not in collagen bundles into which accreta trophoblast invaded. Maternal serum endoglin decreased in praevia and accreta when corrected for gestational age.ConclusionAngiogenic and growth factors at the placental invasion site are altered in accreta, both by decidual absence and within myometrial scar. We postulate this promotes the invasive phenotype of placenta accreta by activating hyperinvasive trophoblast and by dysregulating placental vascular remodelling.FundingYale Department of Obstetrics, Gynecology and Reproductive Sciences funds.Tweetable abstractPlacenta accreta histology shows dysregulation of angiogenic and growth factors.
Domperidone for increasing breast milk volume in mothers expressing breast milk for their preterm infants: a systematic review and meta‐analysis
Authors: Grzeskowiak LE , Smithers LG , Amir LH , Grivell RM 
Published: February 2018

BackgroundMothers of preterm infants often struggle to produce enough breast milk to meet the nutritional needs of their infant. Galactagogues such as domperidone are often prescribed to increase breast milk supply but evidence supporting their role in clinical practice is uncertain.ObjectiveTo evaluate the efficacy and safety of domperidone for increasing breast milk volume in mothers expressing breast milk for their preterm infants.Search strategyMEDLINE, Embase and Web of Science were searched without language restrictions from first publication until January 2017. Bibliographies of articles and reviews were hand‐searched for additional reports.Selection criteriaRandomised controlled trials that compared domperidone with placebo in mothers of preterm infants (<37 weeks’ gestation) experiencing insufficient milk supply.Data collection and analysisTwo review authors independently assessed studies for inclusion, extracted data and evaluated study quality. Differences in breast milk volume and adverse events were combined using fixed effects meta‐analysis.Main resultsThe pooled analysis of five trials consisting of 194 women demonstrated a moderate increase in daily breast milk volume of 88.3 ml/day (95% CI 56.8–119.8) with the use of domperidone compared with placebo. No difference was evident with respect to maternal adverse events (odds ratio 1.05, 95% CI 0.65–1.71), with no reported cases of prolonged QTc syndrome or sudden cardiac death. Sensitivity analyses showed no important differences in the estimates of effects.ConclusionsDomperidone is well tolerated and results in a moderate short‐term increase in expressed breast milk volume among mothers of preterm infants previously identified as having insufficient breast milk supply.Tweetable abstractDomperidone leads to short‐term improvements in breast milk volume in mothers of preterm infants.
Racial/Ethnic Differential Effects of Medicaid Expansion on Health Care Access
Authors: Yue Dahai , Rasmussen Petra W. , Ponce Ninez A. 
Published: February 2018

ObjectiveTo assess racial/ethnic differential impacts of the ACA's Medicaid expansion on low‐income, nonelderly adults’ access to primary care.Data SourcesBehavioral Risk Factor Surveillance System, State Physicians Workforce Data Book, and Bureau of Labor Statistics, in 2013 and 2015.Study DesignQuasi‐experimental design with difference‐in‐differences analyses. Outcomes included health insurance coverage, having personal doctor(s), being unable to see doctors because of cost, and receiving a flu shot. We tested racial/ethnic differential impacts using the “Seemingly unrelated estimation” method. Multiple imputations and survey weights were used.Data Collection/Extraction MethodsLow‐income, nonelderly adults were identified based on age, household income, and family size.Principal FindingsAmong the low‐income, nonelderly adults, Medicaid expansion was associated with statistically significant gains in health insurance coverage, having personal doctors, and affordability. Hispanics got the fewest benefits, which significantly widened racial/ethnic disparities for the Hispanic group. Racial/ethnic disparity in having personal doctors narrowed for non‐Hispanic black and non‐Hispanic others, although not statistically significant.ConclusionMedicaid expansion improved access to primary care, but it had differential effects among racial/ethnic groups resulting in mixed effects on disparities. Further research is necessary to develop tailored policy tools for racial/ethnic groups.
Growth Capacity of a Novel Potential Probiotic Lactobacillus paracasei K5 Strain Incorporated in Industrial White Brined Cheese as an Adjunct Culture
Authors: Terpou Antonia , Bosnea Loulouda , Kanellaki Maria , Plessas Stavros , Bekatorou Argyro , Bezirtzoglou Eugenia , Koutinas Athanasios A. 
Published: February 2018

AbstractIn this study, a novel potential probiotic strain Lactobacillus paracasei K5, previously isolated from traditional Greek Feta cheese and kefir grains, was evaluated as an adjunct culture for industrial white brined cheese production. Targeting industrial applications, apart from free cell cultures, a novel ready‐to‐use freeze‐dried immobilized biocatalyst was prepared. The biocatalyst composed of L. paracasei K5 cells immobilized on delignified wheat bran prebiotic carrier and was freeze‐dried without cryoprotectants. The adjunct free or immobilized culture was added separately without prior adaptation during white brined cheese manufacture and the produced cheeses were compared with commercial white brined cheeses. Several parameters that affect the acceptability and quality of the cheeses, including microbial populations, physicochemical parameters, volatile by‐products and organoleptic characteristics, were analyzed through 70 days of storage. Results showed that the viability of the adjunct culture added either free or immobilized remained in high levels (7 to 8 log cfu/g) during maturation and storage. In addition, all white brined cheeses with the adjunct probiotic culture showed a sharp decrease in spoilage and pathogenic microorganisms such as enterobacteria, salmonella, staphylococci and coliforms during cheese maturation, especially when compared with the commercial white brined cheeses. Finally, after maturation time exceeded, all cheeses were characterized as safe for human consumption. Cheeses volatile compounds were significantly enhanced by the incorporated immobilized biocatalysts. These findings indicate the potential industrial use of freeze‐dried ready‐to‐use immobilized lactobacilli as reinforcement adjunct cultures for the production of good‐quality functional cheese products.Practical ApplicationThe launch on market of novel foods developed by the incorporation of functional ingredients provides potential benefits to consumers’ diet and new business opportunities for producers. Probiotic food products are one significant category of functional foods. Thus, this study focused on the development of a novel ready‐to‐use freeze‐dried potential probiotic biocatalyst for functional white brined cheese production. The potential industrial application of such biocatalysts is highlighted by their incorporation as adjunct cultures that resulted in good‐quality functional cheeses.
The effect of protracted X‐ray exposure on cell survival and metabolic activity of fast and slow growing fungi capable of melanogenesis
Authors: Pacelli Claudia , Bryan Ruth A. , Onofri Silvano , Selbmann Laura , Zucconi Laura , Shuryak Igor , Dadachova Ekaterina 
Published: February 2018

SummaryThe aim of this study was to analyse how protracted exposure to X‐rays delivered at low dose rates of 0.0032–0.052 kGy h−1 affects the survival and metabolic activity of two microfungi capable of melanogenesis: fast‐growing Cryptococcus neoformans (CN) and slow‐growing Cryomyces antarcticus (CA). Melanized CN and CA cells survived the protracted exposure better than non‐melanized ones, which was consistent with previous reports on the radioprotective role of melanin in these fungi after high dose rate exposures. The survival data were described by the linear quadratic dose response model. The XTT metabolic profiles were practically identical for melanized CN and CA with activity dose‐dependent increasing: no changes in the activity of the non‐melanized CN and CA were recorded by this assay. In contrast, the MTT assay, which measures the intracellular energy‐related processes, recorded an increase in activity of non‐melanized CN and CA cells, but not in their melanized counterparts. This could reflect intensive repair processes initiated by the non‐melanized cells post exposure. This study suggests that differences in radiation responses between melanized and non‐melanized fungal cells occur over a wide range of radiation dose rates.
The companion dog as a model for human aging and mortality
Authors: Hoffman Jessica M. , Creevy Kate E. , Franks Alexander , O'Neill Dan G. , Promislow Daniel E. L. 
Published: February 2018

SummaryAround the world, human populations have experienced large increases in average lifespan over the last 150 years, and while individuals are living longer, they are spending more years of life with multiple chronic morbidities. Researchers have used numerous laboratory animal models to understand the biological and environmental factors that influence aging, morbidity, and longevity. However, the most commonly studied animal species, laboratory mice and rats, do not experience environmental conditions similar to those to which humans are exposed, nor do we often diagnose them with many of the naturally occurring pathologies seen in humans. Recently, the companion dog has been proposed as a powerful model to better understand the genetic and environmental determinants of morbidity and mortality in humans. However, it is not known to what extent the age‐related dynamics of morbidity, comorbidity, and mortality are shared between humans and dogs. Here, we present the first large‐scale comparison of human and canine patterns of age‐specific morbidity and mortality. We find that many chronic conditions that commonly occur in human populations (obesity, arthritis, hypothyroidism, and diabetes), and which are associated with comorbidities, are also associated with similarly high levels of comorbidity in companion dogs. We also find significant similarities in the effect of age on disease risk in humans and dogs, with neoplastic, congenital, and metabolic causes of death showing similar age trajectories between the two species. Overall, our study suggests that the companion dog may be an ideal translational model to study the many complex facets of human morbidity and mortality.
Treating women with opioid use disorder during pregnancy in Appalachia: Initial neonatal outcomes following buprenorphine + naloxone exposure
Authors: Nguyen Linda , Lander Laura R. , O'Grady Kevin E. , Marshalek Patrick J. , Schmidt Adrienne , Kelly Audra K. , Jones Hendrée E. 
Published: February 2018

Background and ObjectivesRising concerns regarding diversion and misuse of mono‐buprenorphine for treatment of pregnant women with opioid use disorders have sparked interest in the use of buprenorphine + naloxone to reduce misuse and diversion rates. Examined the relationship of prenatal buprenorphine + naloxone exposure to neonatal outcomes.MethodsThis is a retrospective chart review of 26 mother infant dyads in comprehensive medication‐assisted treatment with buprenorphine + naloxone during pregnancy.ResultsAll neonatal birth outcome parameters were within normal ranges, albeit on the lower side of normal for gestational age and birth weight. Only 19% of neonates required morphine pharmacology for NAS.ConclusionsUse of buprenorphine + naloxone shows relative safety in pregnancy.Scientific SignificanceThese findings can help better guide prescribing practices for pregnant patients at risk for misuse or diversion of buprenorphine. (Am J Addict 2018;27:92–96)
Improving eye care services with a lean approach
Authors: Lindholm Juha‐Matti , Laine Ilkka , Hippala Heli , Ylinen Petteri , Tuuminen Raimo 
Published: February 2018

AbstractPurposeEffective provision of eye care services in government‐financed hospitals is essential to balance the discrepancy between growing demand and limited resources. We aimed to improve efficiency of the treatment protocol for Nd:YAG laser posterior capsulotomy. Predetermined quality targets were a patient‐oriented and patient‐safe approach and the development of a clinical care process with purposeful use of competences.MethodsWe utilized a lean process improvement methodology to develop a streamlined Nd:YAG laser posterior capsulotomy treatment protocol. A total of 206 patient visits were evaluated, where the lean‐oriented treatment protocol was utilized in 158 of the visits and the conventional (CONV) protocol was followed in 48 of the visits.ResultsAll baseline variables were comparable between the study groups. Compared to the CONV protocol, implementation of new operational principles shortened the total reception time per patient from 55:36 ± 30:23; 12–136 min to 44:40 ± 4:49; 37–54 min (mean ± SD; range, p = 0.040). The per hour number of patients and eyes treated in the operation room improved from 4.7 ± 1.6; 2.6–8.4 patients and 5.5 ± 2.0; 3.5–11.3 eyes to 16.3 ± 2.3; 14.3–19.4 patients (p < 0.001) and 18.0 ± 1.6; 16.8–20.4 eyes (p < 0.001). The time spent by the operating physician reduced from 8:19 ± 3:06; 3:57–14:30 min to 3:01 ± 1:00; 1:34–6:38 min in unilateral procedure (p < 0.001) and from 8:45 ± 3:55; 5:52–14:10 min to 4:40 ± 2:03; 2:38–10:14 min in bilateral procedure (p < 0.006). Furthermore, the overall patient satisfaction grade improved from 17.3 ± 1.04; 15–18 points to 17.8 ± 0.61; 15–18 points (p = 0.001).ConclusionsThe lean approach improved the treatment protocol for Nd:YAG laser posterior capsulotomy with substantial reductions in lead times without compromising patient satisfaction.
Ovarian morphology and folliculogenesis and ovulation process in the flat‐faced fruit‐eating bat Artibeus planirostris and the Argentine brown bat Eptesicus furinalis: A comparative analysis
Authors: Bueno Larissa Mayumi , Caun Dianelli Lisboa , Comelis Manuela Tosi , Beguelini Mateus Rodrigues , Taboga Sebastião Roberto , Morielle‐Versute Eliana 
Published: February 2018

Abstract
The Neotropical bat species Artibeus planirostris and Eptesicus furinalis present a different morphology of the female reproductive organs: the first presents a simplex uterus, while the second presents a bicornuate uterus, but there is no information about their ovaries. Our aim was to compare the general ovary morphology and the folliculogenesis process in these species to increase the knowledge about the reproductive diversity of tropical bats. We observed a morphological distinction between the ovaries of both species: A. planirostris presents the primordial follicles located in a cranial portion of the ovary and the interstitial gland cells are not distinctive, while in E. furinalis, the primordial follicles are located throughout the cortex, and there is an abundance of interstitial gland cells. Both species present binovular or triovular follicles. Artibeus planirostris is a monovular species, with a preferential ovulation in the left side. Some females of E. furinalis exhibited two corpora lutea in the same ovary, and others presented a corpus luteum in both right and left ovaries at the same time; thus, E. furinalis is a polyovular species. Our results express the variation between two Neotropical species, reflecting the great variation in the reproductive aspects in Chiroptera.
Radical prostatectomy and the effect of close surgical margins: results from the Shared Equal Access Regional Cancer Hospital (SEARCH) database
Authors: Herforth Christine , Stroup Sean P. , Chen Zinan , Howard Lauren E. , Freedland Stephen J. , Moreira Daniel M. , Terris Martha K. , Aronson William J. , Cooperberg Matthew R. , Amling Christopher L. , Kane Christopher J. 
Published: February 2018

ObjectiveTo evaluate biochemical recurrence (BCR) patterns amongst men undergoing radical prostatectomy (RP) with specimens having negative (NSM), positive (PSM), and close surgical margins (CSM) from the Shared Equal Access Regional Cancer Hospital (SEARCH) cohort, as PSM after RP are a significant predictor of biochemical failure and possible disease progression, with CSM representing a diagnostic challenge for surgeons.Patients and MethodsMen undergoing RP between 1988 and 2015 with known final pathological margin status were evaluated. The cohort was divided into three groups based on margin status; NSM, PSM, and CSM. CSM were defined by distance of tumour ≤1 mm from the surgical margin. BCR was defined as a prostate‐specific antigen (PSA) level of >0.2 ng/mL, two values at 0.2 ng/mL, or secondary treatment for an elevated PSA level. Predictors of BCR, metastases, and mortality were analysed using Cox proportional hazard models.ResultsOf 5515 men in the SEARCH database, 4337 (79%) men met criteria for inclusion in the analysis. Of these, 2063 (48%) had NSM, 1902 (44%) had PSM, and 372 (8%) had CSM. On multivariable analysis, relative to NSM, men with CSM had a higher risk of BCR (hazard ratio [HR] 1.51, 95% confidence interval [CI] 1.25–1.82; P < 0.001) but a decreased risk of BCR when compared to those men with PSM (HR 2.09, 95% CI 1.86–2.36; P < 0.001). Metastases, prostate cancer‐specific mortality and all‐cause mortality did not differ based on margin status alone.ConclusionsManagement of men with CSM is a diagnostic challenge, with a disease course that is not entirely benign. The evaluation of other known risk factors probably provides greater prognostic value for these men and may ultimately better select those who may benefit from adjuvant therapy.
Serine proteinases in the turnover of the cartilage extracellular matrix in the joint: implications for therapeutics
Authors: Wilkinson David J , Arques Maria del Carmen , Huesa Carmen , Rowan Andrew D 
Published: February 2018

Cartilage destruction is a key characteristic of arthritic disease, a process now widely established to be mediated by metzincins such as MMPs. Despite showing promise in preclinical trials during the 1990s, MMP inhibitors for the blockade of extracellular matrix turnover in the treatment of cancer and arthritis failed clinically, primarily due to poor selectivity for target MMPs. In recent years, roles for serine proteinases in the proteolytic cascades leading to cartilage destruction have become increasingly apparent, renewing interest in the potential for new therapeutic strategies that utilize pharmacological inhibitors against this class of proteinases. Herein, we describe key serine proteinases with likely importance in arthritic disease and highlight recent advances in this field.Linked ArticlesThis article is part of a themed section on Translating the Matrix. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v176.1/issuetoc
Facilitation of ischaemia‐induced ventricular fibrillation by catecholamines is mediated by β1 and β2 agonism in the rat heart in vitro
Authors: Wilder Catherine D E , Pavlaki Nikoleta , Dursun Tutku , Gyimah Paul , Caldwell‐Dunn Ellice , Ranieri Antonella , Lewis Hannah R , Curtis Michael J 
Published: February 2018

Background and PurposeAntiarrhythmic β‐blockers are used in patients at risk of myocardial ischaemia, but the survival benefit and mechanisms are unclear. We hypothesized that β‐blockers do not prevent ventricular fibrillation (VF) but instead inhibit the ability of catecholamines to facilitate ischaemia‐induced VF, limiting the scope of their usefulness.Experimental ApproachECGs were analysed from ischaemic Langendorff‐perfused rat hearts perfused with adrenoceptor antagonists and/or exogenous catecholamines (CATs: 313 nM noradrenaline + 75 nM adrenaline) in a blinded and randomized study. Ischaemic zone (IZ) size was deliberately made small or large.Key ResultsIn rat hearts with large IZs, ischaemia‐induced VF incidence was high in controls. Atenolol, butoxamine and trimazosin did not affect VF at concentrations with β1‐, β2‐ or α1‐ adrenoceptor specificity and selectivity (confirmed in separate rat aortae myography experiments). In hearts with small IZs and low baseline incidence of ischaemia‐induced VF, CATs, delivered to the uninvolved zone (UZ), increased ischaemia‐induced VF incidence. This effect was not mimicked by atrial pacing, hence, not due to sinus tachycardia. However, the CATs‐facilitated increase in ischaemia‐induced VF was inhibited by atenolol and butoxamine (but not trimazosin), indicative of β1‐ and β2‐ but not α1‐adrenoceptor involvement (confirmed by immunoblot analysis of downstream phosphoproteins). CATs did not facilitate VF in low‐flow globally ischaemic hearts, which have no UZ.Conclusions and ImplicationsCatecholamines facilitated ischaemia‐induced VF when risk was low, acting via β1‐ and β2‐ adrenoceptors located in the UZ. There was no scope for facilitation when VF risk was high (large IZ), which may explain why β‐blockers have equivocal effectiveness in humans.
Health spending, savings and fertility in a lifecycle‐dynastic model with longevity externalities
Authors: Yew Siew Ling , Zhang Jie 
Published: February 2018

AbstractWe investigate health spending, savings, fertility and policy implications in a lifecycle‐dynastic model with longevity externalities in annuity returns. We show that such externalities engender not only excessive health spending but also under‐saving and excessive fertility. Social security and health subsidization increase health spending and savings but reduce fertility from laissez‐faire levels. A publicly funded universal health system under labour‐income taxation raises fertility. Taxing health spending or using social security and public health together can obtain socially optimal health spending, savings, longevity and fertility. Numerical results based on US observations suggest substantial variations among these cases, especially in old‐age health spending.