bluuebunny/crossref_metadata_2025_split huggingface dataset:
Operator experience affects the risk of obstetric anal sphincter injury in vacuum extraction deliveries
Authors: Bergendahl Sandra , Lindberg Petra , Brismar Wendel Sophia 
Published: January 2019

AbstractIntroductionDelivery by vacuum extraction is a major risk factor for obstetric anal sphincter injury. The aim of this study was to assess risk factors for obstetric anal sphincter injury in vacuum extraction in nulliparous women, specifically operator‐related factors. A secondary aim was to assess other complications of vacuum extraction that are dependent on operator experience.Material and methodsA historical cohort study of nulliparous women with a live single fetus ≥34 weeks, delivered by vacuum extraction at a teaching hospital in Sweden in 1 year (2013), using data from medical records. Risk of obstetric anal sphincter injury was assessed for obstetricians (reference), gynecologists, and residents, and adjusted for maternal, fetal, procedure‐related, and operator‐related covariates using unconditional logistic regression. Results are presented as prevalence and crude and adjusted odds ratio (aOR) with 95% CI.ResultsIn total, 323 nulliparous women delivered by vacuum extraction were included. Obstetric anal sphincter injury occurred in 57 (17.6%) women. Fifteen (11.5%) obstetric anal sphincter injuries occurred in vacuum extractions performed by obstetricians, 10 (13.5%) by gynecologists (aOR 1.84, 95% CI 0.72‐4.70), and 32 (26.9%) by residents (aOR 5.13, 95% CI 2.20‐11.95). Maternal height ≤155 cm (aOR 4.63, 95% CI 1.35‐15.9) and conversion to forceps (aOR 19.4, 95% CI 1.50‐252) increased the risk of obstetric anal sphincter injury. Operator gender, night shift work, or being a frequent operator did not affect the risk of obstetric anal sphincter injury. Postpartum hemorrhage and fetal complications did not differ between operator categories.ConclusionsThe adjusted risk of obstetric anal sphincter injury in nulliparous women was five times higher in vacuum extractions performed by residents compared with those performed by obstetricians. Vacuum extractions performed by gynecologists did not carry an increased risk of obstetric anal sphincter injury. Experience in years of training, rather than frequency of the procedure, seemed to have the highest impact on reducing obstetric anal sphincter injury in vacuum extractions, which indicates a need for increased training and supervision.
Belief in conspiracy theories and intentions to engage in everyday crime
Authors: Jolley Daniel , Douglas Karen M. , Leite Ana C. , Schrader Tanya 
Published: January 2019

Belief in conspiracy theories is associated with negative outcomes such as political disengagement, prejudice, and environmental inaction. The current studies – one cross‐sectional (N = 253) and one experimental (N = 120) – tested the hypothesis that belief in conspiracy theories would increase intentions to engage in everyday crime. Study 1 demonstrated that belief in conspiracy theories predicted everyday crime behaviours when controlling for other known predictors of everyday crime (e.g., Honesty–Humility). Study 2 demonstrated that exposure to conspiracy theories (vs. control) increased intentions to engage in everyday crime in the future, through an increased feeling of anomie. The perception that others have conspired may therefore in some contexts lead to negative action rather than inaction.
Blocking bacterial entry at the adhesion step reveals dynamic recruitment of membrane and cytosolic probes
Authors: Ciczora Yann , Janel Sébastien , Soyer Magali , Popoff Michka , Werkmeister Elisabeth , Lafont Frank 
Published: January 2019

BackgroundBacterial invasion covers two steps: adhesion and entry per se. The cell signalling response is triggered upon pathogen interaction at the cell surface. This response continues when the pathogen is internalised. It is likely that these two steps activate different molecular machineries. So far, it has not been possible to easily follow in physiological conditions these events separately. We thus developed an approach to uncouple adhesion from entry using atomic force microscopy (AFM)‐driven force and fluorescence measurements.ResultsWe report nanometric‐scale, high‐resolution, functional dynamic measurements of bacterial interaction with the host cell surface using photonic and adhesion force analyses. We describe how to achieve a precise monitoring of iterative cell–bacterium interactions to analyse host cell signalling responses to infection. By applying this method to Yersinia pseudotuberculosis, we first unveil glycosylphosphatidylinositol‐anchored protein domains recruitment to the bacterium cell surface binding site and concomitant cytoskeleton rearrangements using super‐resolution fluorescence microscopy. Second, we demonstrate the feasibility of monitoring post‐translationally modified proteins, for example, via ubiquitylation, during the first step of infection.ConclusionWe provide an approach to discriminate between cellular signalling response activated at the plasma membrane during host–pathogen interaction and that is triggered during the internalisation of the pathogen within the cell.SignificanceThis approach adds to the technological arsenal to better understand and fight against pathogens and beyond the scope of microbiology to address conceptual issues of cell surface signalling.
The development of a South African Early Learning Outcomes Measure: A South African instrument for measuring early learning program outcomes
Authors: Snelling Matthew , Dawes Andrew , Biersteker Linda , Girdwood Elizabeth , Tredoux Colin 
Published: January 2019

AbstractBackgroundAssessment of early childhood development programme effectiveness in South Africa is hampered by a lack of suitable measures that account for variations in cultural and socio‐economic backgrounds and can be administered by non‐professionals. This contribution reports the standardisation of the South African Early Learning Outcomes Measure (ELOM), an instrument designed for population level monitoring of the developmental status of children aged 50–69 months and for evaluation of early learning programmes.MethodsThe development of the ELOM was informed by South Africa's National Curriculum Framework from Birth to Four and its National Early Learning and Development Standards. ELOM items were drawn from reliable and valid instruments, particularly those used in Africa and other developing regions and were clustered in five domains: gross motor development, fine motor coordination and visual motor integration, emergent numeracy and mathematics, cognition and executive functioning, emergent literacy and language. The ELOM was standardised on a sample of 1,331 children aged 50–69 months, from five South African official languages and five socio‐economic strata. Item Response Theory techniques were used to establish reliability, validity, and differential item functioning.ResultsConfirmatory Factor Analysis established that ELOM domains are unidimensional and internally consistent. Items discriminate reliably between more and less able children and do not discriminate unfairly between children of the same ability from different language backgrounds. Socio‐economic gradients were evident in children's performance. South African Early Learning Development Standards (ELDS) based on standard scores were developed and set at the 60th percentile of the sample standard score distribution.ConclusionsThis research produced the first South African, age‐validated population‐level standardised instrument that can be administered relatively cheaply by trained non‐professionals. This will facilitate the assessment of the efficacy of early learning programmes in enabling children to reach ELDS prior to entering Grade R and track progress toward Sustainable Development Goal 4.2.
A reintroduction of environmental mite allergen control strategies for asthma treatment and the debate on their effectiveness
Authors: van Boven Frank E. , Arends Lidia R. , Braunstahl Gert‐Jan , van Wijk Roy Gerth 
Published: January 2019

SummaryAsthma affects three hundred million people worldwide. The effectiveness of house dust mite allergen control for asthma treatment is debatable. One aspect that has been little discussed in existing meta‐analyses is the possible role of environmental strategies. Here, we reintroduce the previously defined strategies for mite allergen control and discuss their importance to the debate on clinical effectiveness. The strategy of concurrent bedroom interventions is related to the combined use of a priori defined interventions, while the strategy of exposure‐based control relates to the treatment of relevant textiles after assessing exposure. The air purification strategy aims to purify the human breathing zone of airborne allergens. In Western European patient practice, the use of these strategies differs. A post hoc study of the dominant Cochrane review by Gøtzsche and Johansen (Cochrane Database of Systematic Reviews, 2008, Art. No: CD001187) appears to indicate that a majority of the underlying trials reported on the strategy of concurrent bedroom interventions, which were mainly executed in a minimal manner. Some trials have reported on the air purification strategy and may potentially alter the debate on effectiveness. No trial has reported on the strategy of exposure‐based control. We therefore hypothesize that the absence of evidence for the effectiveness of mite allergen control for asthma treatment applies to the strategy of concurrent bedroom interventions. The evidence‐based effectiveness of the exposure‐based control strategy appears to be undetermined. The results of our post hoc reanalysis urge that future meta‐analyses of mite allergen control should a priori define the environmental strategy under study. Future trials of mite allergen control are warranted to test the exposure‐based strategy as well as the sparsely tested strategy of air purification.
Comparison of the efficiency of different enemas on patients with distal ulcerative colitis
Authors: Zhang Yujie , Chen Di , Wang Fang , Li Xiaowei , Xue Xianmin , Jiang Mingzuo , Xu Bing , Chu Yi , Wang Weijie , Wu Kaichun , Mao Ren , Shen Jun , Yang Shaoqi , Liang Jie 
Published: January 2019

AbstractObjectivesRectal application of steroids and 5‐aminosalicylic acid (5‐ASA) is associated with few side effects and has a high therapeutic efficacy in left‐sided colitis. Previous studies have shown that rectal administration of both steroids and 5‐ASA is superior to one single alone. However, some reports are still controversial. Therefore, it is necessary to investigate the treatment choice and efficacy of these different enemas in distal ulcerative colitis (UC) patients.Materials and MethodsQuestionnaire survey and a retrospective study were carried out in Chinese hospitals to investigate the efficacy of 5‐ASA or hydrocortisone/dexamethasone or their combination enema in patients with distal active UC. Dextran sodium sulphate (DSS)‐induced colitis model in mice was also utilized to evaluate the effects in vivo.ResultsThe results from questionnaire survey showed that majority of physicians would prefer oral 5‐ASA with topical 5‐ASA therapy for distal UC patients. However, 43.01% of physicians would like to choose oral 5‐ASA and topical hydrocortisone/dexamethasone with or without 5‐ASA enema. A retrospective study demonstrated that 5‐ASA enema or 5‐ASA combined with hydrocortisone/dexamethasone enema therapy was superior to hydrocortisone/dexamethasone enema to decrease C‐reactive protein, erythrocyte sedimentation rate (ESR), Mayo score and induce clinical remission and clinical response. No superiority of combination therapy was further proved in DSS‐induced colitis in mice.ConclusionsAlthough 43.01% of physicians would like to choose hydrocortisone/dexamethasone with or without 5‐ASA enema for the treatment of distal UC, the combination was not superior to 5‐ASA enema. Hydrocortisone/dexamethasone enema with 5‐ASA enema is not recommended for distal active UC patients.
Description and analysis of patients and outcomes following third‐time heart transplantation: An analysis of the United Network for Organ Sharing database from 1985 to 2017
Authors: Bhalla Sameer , Dubey Gaurav K. , Basu Sanjib , Kanangat Sivadasan , Dobrescu Cosmin , Nath Dilip S. 
Published: January 2019

AbstractBackgroundFollowing second heart transplantation (HTx), some patients experience graft failure and require third‐time heart transplantation. Little data exist to guide decision‐making with regard to repeat retransplantation in older patients.MethodsWe performed a retrospective cohort analysis of patients receiving a third HTx, as identified in the United Network for Organ Sharing (UNOS) database from 1985 to 2017.ResultsThe study cohort consisted of N = 60 patients, with an average age of 29 with a standard deviation of ±18 years. Overall survival for the cohort at 1, 5, and 10 years is 83%, 64%, and 44%, respectively. The rate of third‐time HTxs has steadily increased in all age groups. Patients older than 50 years now account for 18.3% of all third‐time HTxs. Although this group demonstrated longer average previous graft survival, after third HTx they demonstrate significantly poorer survival outcomes compared to third‐time HTx recipients younger than 21 (P = 0.05). Age over 50, BMI over 30, and diabetes were all found to be independent risk factors for decreased survival following third HTx.ConclusionsWe describe trends in patients undergoing third HTx. We highlight subsets of such recipients who exhibit decreased survival.
Adaptive functioning in children with neurofibromatosis type 1: relationship to cognition, behavior, and magnetic resonance imaging
Authors: Eby Noah S , Griffith Jennifer L , Gutmann David H , Morris Stephanie M 
Published: January 2019

AimTo characterize the adaptive behavior profile of children with neurofibromatosis type 1 (NF1) and determine its relationship to neuropsychological functioning and non‐neoplastic T2‐weighted hyperintense brain lesions on brain magnetic resonance imaging (MRI).MethodIn this cross‐sectional study, we retrospectively reviewed neuropsychological reports from 104 children with NF1 (56 males, 48 females; mean age 10y 4mo; standard deviation [SD] 3y 4mo; range 3y 5mo–17y 6mo), and extracted data from a range of cognitive and behavioral measures, including the Adaptive Behavior Assessment System (ABAS). Brain MRI was retrospectively reviewed in 42 individuals.ResultsAdaptive Behavior Assessment System scores were continuously distributed and pathologically shifted by 0.79 to 1.26SD across Conceptual, Social, and Practical domains, and 46.5% of individuals had a composite score in the borderline or impaired range. Impairment in adaptive functioning was correlated with deficits in executive function (r=–9.543, p<0.001), externalizing problems (r=−0.366, p<0.001), and attention (r=−9.467, p=0.001). Cluster analysis revealed three distinct phenotypic subgroups, one of which exhibited normal cognitive ability, but impaired adaptive functioning, with persistent deficits in executive function, behavioral problems, and attention‐deficit/hyperactivity disorder symptomatology. There was no relationship between ABAS scores and the number or location of unidentified bright objects.InterpretationAdaptive functioning deficits are common among children with NF1 and are associated with impairment in other cognitive/behavioral domains, independent of general cognitive ability.What this paper adds

Deficits in adaptive behavior are common in children with neurofibromatosis type 1 (NF1).

Poor adaptive functioning is associated with impairments in executive function, externalizing behaviors, and attention, regardless of cognitive ability.

The presence or location of unidentified bright objects do not predict adaptive behavior skills in children with NF1.
Utility and safety of plasma exchange in paediatric neuroimmune disorders
Authors: Eyre Michael , Hacohen Yael , Lamb Kate , Absoud Michael , Agrawal Shakti , Gadian Jonathan , Gupta Rajat , Kneen Rachel , Milford David V , Philip Sunny , Rose Katie , Smith Martin , Spinty Stefan , Wassmer Evangeline , Lim Ming , Hemingway Cheryl 
Published: January 2019

AimOur aim was to ascertain the indications, side effects, and outcomes in children receiving therapeutic plasma exchange (TPE) for neurological disorders.MethodMedical records were retrospectively reviewed for 58 consecutive children (age ≤16y) undergoing 67 courses ofTPEacross four tertiary centres. Patient characteristics, treatment schedules, complications, and outcomes were analysed.ResultsMedian age at initiation ofTPEwas 9 years (range 1–15y). Indications included peripheral nervous system (PNS;n=18) and central nervous system (CNS;n=40) disorders. Courses comprised a median six exchanges (range 2–179) over 8 days (range 3–466). Forty‐two out of 58 (73%) children were severely disabled (bedridden) at initiation and 24 out of 58 (41%) were admitted to intensive care units. Treating clinicians’ impression of response was positive in 16 out of 18 of those withPNSdisorders versus 22 out of 40 withCNSdisorders (p=0.016). Improvements in disability (modified Rankin Scale) occurred in 13 out of 58 (22%) children by completion ofTPE(p=0.003). Complications occurred in 40 out of 67 (60%) courses, of which 16 out of 67 (24%) were line related. Potentially life‐threatening complications occurred in 2 out of 67 (3%) courses.InterpretationThis cohort study provides safety and efficacy information for clinicians and families and a basis for future prospective studies.What this paper addsDisability scores for severe neuroimmune disorders remained stable or improved during therapeutic plasma exchange treatment.Complications occurred frequently but were typically mild and correctable.
The 2017 Banting Memorial Lecture The diabetic lower limb – a forty year journey: from clinical observation to clinical science
Authors: Boulton Andrew J. M. 
Published: January 2019

AbstractA series of clinical research projects conducted over the past 40 years, all of which were informed by clinical observation or discussions with people with diabetes and staff colleagues are described in this review. A study of necrobiosis lipoidica diabeticorum confirmed that this rare skin complication occurs predominantly in young women with Type 1 diabetes and other microvascular complications. Biopsies of necrobiotic lesions showed destruction of superficial nerve fibres by inflammatory tissue, which likely causes the sensory loss in lesions that is pathognomonic of the condition. The development of corneal confocal microscopy as a new non‐invasive surrogate marker of peripheral neuropathy in diabetes is described next and several small studies of the use of this new technique in clinical research are reported. The influence of blood glucose instability on the genesis of neuropathic pain is then explained, with results suggesting that the stability of glycaemic control may be more important than the level of control achieved. Lastly, in neuropathy, studies of gustatory sweating are discussed, including the observation that sweating in the head and neck region is more common in people with end‐stage diabetic nephropathy than in those with neuropathy. The disappearance of gustatory sweating after renal transplantation suggests a metabolic cause and for those with troublesome sweating, use of the anticholinergic, anti‐muscarinic, topical cream glycopyrrolate is confirmed in a randomized control trial. In the area of diabetic foot research, distended dorsal foot veins were observed to be a clinical sign of sympathetic autonomic neuropathy: raised venous Po2 and Doppler abnormalities of blood flow are highly suggestive of arteriovenous shunting. A series of studies of the abnormalities of pressures and loads under the neuropathic diabetic foot are described: high dynamic plantar pressures are highly predictive of subsequent ulceration in the neuropathic foot. Lastly, a number of recent studies on unsteadiness and gait abnormalities when climbing and descending stairs are described. It is hoped that the art of clinical observation survives in the highly technological 21st century.
Projected number of people with diagnosed Type 2 diabetes in Germany in 2040
Authors: Tönnies T. , Röckl S. , Hoyer A. , Heidemann C. , Baumert J. , Du Y. , Scheidt‐Nave C. , Brinks R. 
Published: January 2019

AbstractAimsTo project the number of people with Type 2 diabetes in Germany between 2015 and 2040.MethodsBased on data from 65 million insurees of the German statutory health insurance, we projected the age‐specific prevalence of diabetes using mathematical relations between prevalence, incidence rate and mortality. We compared several scenarios regarding temporal trends in the incidence and mortality rate. The projected age‐specific prevalence was applied to the projected age structure of the German population between 2015 and 2040 to calculate the number of people with Type 2 diabetes.ResultsApplication of current age‐specific prevalence estimates to the projected age structure in 2040, although ignoring temporal trends in incidence and mortality, yielded an increase in the number of Type 2 diabetes cases from 6.9 million in 2015 to 8.3 million (+21%) in 2040. More realistic scenarios that account for decreasing mortality rates and different trends in the incidence rates project between 10.7 million (+54%) and 12.3 million (+77%) Type 2 diabetes cases in 2040.ConclusionsFor the first time, we projected the number of future Type 2 diabetes cases for the whole adult population in Germany. The results indicate a relative increase in the number of Type 2 diabetes cases of between 54% and 77% from 2015 to 2040. Temporal trends in the incidence rate are the main drivers of this increase. Simply applying current age‐specific prevalence to the future age structure probably underestimates the future number of Type 2 diabetes cases.
Values related to professionalism in dental education at the University of Chile: Student and faculty perceptions
Authors: Alcota Marcela , Manríquez José M. , Cornejo‐Ovalle Marco , Salinas Juan C. , Catano Victor M. , Ruiz de Gauna Pilar , González Fermín E. 
Published: January 2019

AbstractObjectiveIt is recognised that professionalism should play a central role in dental education. However, its implementation into the curricula of dental schools is still limited. Our objective was to identify the main values related to professionalism based on the perceptions of students and faculty members from the Faculty of Dentistry, University of Chile.MethodsA Dental Values Survey was validated and culturally adapted in order to guarantee the greatest possible internal validity. The adapted survey was administered to students and faculty members (416 and 225, respectively). The final survey contained 64 items rated on a Likert scale of 1‐5. Each item was categorised according to five dimensions: Altruism, Consciousness, Personal Satisfaction, Quality of Life and Professional Status. The values were compared between faculty and students and among students at different courses. A values scale was constructed by selecting the five items with the highest average score for each dimension.ResultsSurvey respondents composed 34.32% of the universe, of which 50.46% were faculty and 49.54% were students. Values associated with Altruism, Consciousness and Professional Status, were the highest rated by students and faculty. Values associated with Personal Satisfaction and Quality of Life received the lowest scores for both groups.ConclusionsTo provide the best possible attention to patients (Consciousness), and that patients have access to affordable dental care (Altruism), are the values at the top of our scale. On the other hand, to maintain financial stability and to be well paid (Quality of Life) were the less considered.