bluuebunny/crossref_metadata_2025_split huggingface dataset:
Best Practice Operative Strategies and Surgical Techniques for Preventing Caesarean Section Surgical Site Infections: A Systematic Review of Reviews and Meta-Analyses
Authors: Martin E.K. , Beckmann M.M. , Barnsbee L.N. , Halton K.A. , Merollini K. , Graves N. 
Published: May 2019

(BJOG. 2018;125:956–964)
The risk of surgical site infection (SSI) following cesarean section has been estimated to be as high as 9%. This is a problem for both women and health service providers and may lead to pain, depression, persistent seroma, and delay returning to normal activities. Currently, available evidence for perioperative strategies and surgical techniques have been reported individually. One recent systematic review has already become outdated due to new evidence. This study aimed to identify a suite of perioperative strategies and surgical techniques to reduce SSI risk after cesarean section, while including guidance for decision-making clinicians.
Reducing Maternal Mortality in the United States
Authors: Lu M.C. 
Published: May 2019

(JAMA. 2018;320(12):1237–1238)
Between 2000 and 2014, while many other countries saw decreases in maternal mortality, the rate in the United States more than doubled (9.8 to 21.5 maternal deaths per 100,000 live births). In addition, large ethnic/racial, geographic, and socioeconomic disparities exist, with African American women almost 3 times more likely than white women to die of complications related to pregnancy.
Association of Paternal Age With Perinatal Outcomes Between 2007 and 2016 in the United States: Population-based Cohort Study
Authors: Khandwala Y.S. , Baker V.L. , Shaw G.M. , Stevenson D.K. , Lu Y. , Eisenberg M.L. 
Published: May 2019

(BMJ. 2018;363:k4372)
As maternal age rises in the United States, the age of fathers is also increasing, with the percentage of births to fathers over age 40 doubling since the 1970s. While the effects of increased maternal age have been studied extensively, there is a lack of conclusive research regarding the effects of increased paternal age on pregnancy outcomes. There have been suggested links between the high number of male germ cell divisions in aging fathers and autism, genetic abnormalities and other adverse outcomes, although previous studies have not been adequately powered. This retrospective population-based cohort analysis aimed to examine associations between paternal age and maternal and neonatal health in the United States.
The Language of First-Trimester Nonviable Pregnancy: Patient-reported Preferences and Clarity
Authors: Clement E.G. , Horvath S. , McAllister A. , Koelper N.C. , Sammel M.D. , Schreiber C.A. 
Published: May 2019

(Obstet Gynecol. 2019;133:149–154)
There is no consensus on terminology regarding first-trimester pregnancy loss (<10 wk of gestation) in the literature. Consequently, the terms miscarriage, spontaneous abortion, and early pregnancy loss are often used interchangeably. It is quite possible that this variability in terminology has contributed to previously reported patient dissatisfaction with health care provider communication during the time of loss diagnosis. To gain insight into the patient experience and address this area for improvement, the authors of the present study surveyed women experiencing first-trimester pregnancy loss in a multisite, randomized trial.
Association Between Oxygen Saturation Targeting and Death or Disability in Extremely Preterm Infants in the Neonatal Oxygenation Prospective Meta-Analysis Collaboration
Authors: Askie L.M. , Darlow B.A. , Finer N. , Schmidt B. , Stenson B. , Tarnow-Mordi W. , Davis P.G. , Carlo W.A. , Brocklehurst P. , Davies L.C. , Das A. , Rich W. , Gantz M.G. , Roberts R.S. , Whyte R.K. , Costantini L. , Poets C. , Asztalos E. , Battin M. , Halliday H.L. , Marlow N. , Tin W. , King A. , Juszczak E. , Morley C.J. , Doyle L.W. , Gebski V. , Hunter K.E. , Simes R.J. 
Published: May 2019

(JAMA. 2018;319(21):2190–2201)
Oxygen saturation is almost universally measured by pulse oximetry (SpO2) in neonatal intensive care units. While a lower SpO2 target (≤90%) may reduce retinopathy of prematurity (ROP), it also may impair neurodevelopment or increase the risk of death. On the other hand, higher oxygen levels (SpO2 target >90%) may increase the risk of adverse pulmonary sequelae. In 2003, 5 investigators planning separate randomized prospective clinical trials using similar study designs agreed to provide data after completion for a meta-analysis. This article detailed the results of the meta-analysis.
Effect of High-dose Folic Acid Supplementation in Pregnancy on Preeclampsia (FACT): Double-blind, Phase III, Randomized Controlled, International, Multicenter Trial
Authors: Wen S.W. , White R.R. , Rybak N. , Gaudet L.M. , Robson S. , Hague W. , Simms-Stewart D. , Carroli G. , Smith G. , Fraser W.D. , Wells G. , Davidge S.T. , Kingdom J. , Coyle D. , Fergusson D. , Corsi D.J. , Champagne J. , Sabri E. , Ramsay T. , Mol B.W.J. , Oudijk M.A. , Walker M.C. 
Published: May 2019

(BMJ. 2018;362:k3478)
Preeclampsia is a leading cause of perinatal morbidity and mortality, and causes >35,000 maternal deaths worldwide each year. While studies of the association between folic acid supplementation and the incidence of preeclampsia have yielded inconsistent results, a potential protective effect has been shown. Worldwide, folic acid supplementation has been recommended during the preconception period through the first trimester for the prevention of neural tube defects. Preeclampsia, however, has 2 stages: 1 in the late first trimester and another in the third trimester. This study aims to evaluate the effect of daily high-dose (4.0 mg) folic acid supplementation beyond the first trimester on the risk of preeclampsia in women with identified risk factors.
Haemodynamic Stability After Paracervical Block: A Randomized, Controlled, Double-blind Study Comparing Bupivacaine-Adrenaline With Bupivacaine
Authors: Sjoeen G.H. , Falk R.S. , Hauge T.H. , Langesaeter E. 
Published: May 2019

(Acta Anaesthesiol Scand. 2018. Doi:10.1111/aas.13259)
For gynecologic procedures involving the cervix or uterus, long-acting local anesthetics like bupivacaine, administered via paracervical block, can provide a significant reduction in postoperative pain scores. Adrenaline can be added to local anesthetics to reduce toxicity potential. However, there are few data available regarding the frequency and magnitude of hemodynamic changes in patients when adrenaline is added to local anesthetics. In this randomized controlled trial, the authors examined hemodynamic stability after paracervical block in healthy patients given bupivacaine with and without adrenaline.
Association Between Intrapartum Epidural Use and Maternal Postpartum Depression Presenting for Medical Care: A Population-based, Matched Cohort Study
Authors: Wu Y. , McArthur E. , Dixon S. , Dirk J.S. , Welk B.K. 
Published: May 2019

(Int J Obstet Anesth. 2018;35:10–16)
Postpartum depression (PPD) occurs commonly, with a prevalence of 6% to 22% reported in the medical literature. This disorder can adversely affect both the mother and infant with the most severe cases leading to self-harm, suicide and rarely even infanticide. However, many women suffering from PPD do not seek help from medical professionals, so the disorder is underreported. In fact, there are some initiatives underway that recommend mandatory screening for PPD. Over the past few years, there have been several studies published that evaluated the association between the use of epidural labor analgesia and the development of PPD. The results have been conflicting, however, with some reporting a decreased risk in women who received epidural analgesia and others reporting no effect or an increased risk. This current retrospective, population-based, matched cohort study aimed to determine whether intrapartum epidural use was associated with postpartum women seeking care for PPD while accounting for maternal and neonatal characteristics that could also affect the development of PPD.
Exploring Student Beliefs and Attitudes About Learning Spanish in a Doctor of Physical Therapy Curriculum
Authors: Millar Daniel , Pechak Celia 
Published: May 2019

Introduction.
Health professions education programs have incorporated Spanish language training in their curriculum to address the needs of a growing Spanish-speaking patient population with limited English proficiency. The purpose of this study was to explore Doctor of Physical Therapy (DPT) student beliefs and attitudes about learning Spanish to contribute to the body of knowledge related to effective language training approaches in health professions programs.

Methods.
Selected participants were students in their fifth semester in the DPT Program at the University of Texas at El Paso. Sixteen participants completed an online survey that asked their demographics, overall self-assessment of Spanish proficiency when entering the DPT Program and perceived percentages of improvement, and ranked level of agreement with each of the 13 statements concerning beliefs and attitudes about learning Spanish. Descriptive statistics were used to report data from the survey. Eleven subjects also participated in either a beginner or an intermediate focus group to further discuss their responses to the 13 statements in the survey. Verbatim transcripts were generated from each of the focus groups, and investigators completed content analysis to identify themes.

Results.
While participants in the beginner group reported more improved proficiency relative to baseline, the intermediate group participants anticipate greater improvements in proficiency by the end of the DPT Program. Though distinct themes emerged from each focus group, subjects in each group reported that improvements in their Spanish proficiency were facilitated by these shared themes: (1) constructive learning environment; (2) demographic relevance; and (3) therapeutic relationships. Both groups also identified a need for more formal, integrated Spanish learning opportunities.

Discussion and Conclusion.
Shared themes underscore the importance of fostering self-efficacy, using engaging learning techniques, and promoting cultural competency when learning a foreign language. These recommendations may help guide the design or enhancement of Spanish language training models in health professions curriculum.
Approach to infection and disease due to adenoviruses in solid organ transplantation
Authors: Florescu Diana F. , Stohs Erica J. 
Published: May 2019

Purpose of review
Adenoviruses are an important cause of morbidity and mortality of solid organ transplant patients and remain a clinical challenge with regard to diagnosis and treatment. In this review, we provide an approach to identification and classification of adenovirus infection and disease, highlight risk factors, and outline management options for adenovirus disease in solid organ transplant patients.

Recent findings
Additional clinical data and pathologic findings of adenovirus disease in different organs and transplant recipients are known. Unlike hematopoietic cell transplant recipients, adenovirus blood PCR surveillance and preemptive therapy is not supported in solid organ transplantation. Strategies for management of adenovirus disease continue to evolve with newer antivirals, such as brincidofovir and adjunctive immunotherapies, but more studies are needed to support their use.

Summary
Distinguishing between adenovirus infection and disease is an important aspect in adenovirus management as treatment is warranted only in symptomatic solid organ transplant patients. Supportive care and decreasing immunosuppression remain the mainstays of management. Cidofovir remains the antiviral of choice for severe or disseminated disease. Given its significant nephrotoxic effect, administration of probenecid and isotonic saline precidofovir and postcidofovir infusion is recommended.
Clinical Effectiveness and Safety of Treatment With Anti–Tumor Necrosis Factor α Drugs in a Cohort of Colombian Patients With Rheumatoid Arthritis
Authors: Santos-Moreno Pedro , Sánchez-Vanegas Guillermo 
Published: May 2019

Objective
To compare the clinical response at 24 months and evaluate the adverse events (AEs) of patients with rheumatoid arthritis (RA) treated with etanercept 50 (injectable solution 50 mg prefilled syringe), etanercept 25 (lyophilized 25 mg), infliximab, adalimumab, or golimumab.

Methods
A cohort study was carried out in patients with RA, in treatment with etanercept (injectable solution 50 mg prefilled syringe or lyophilized 25 mg), infliximab, adalimumab, or golimumab. Duration of study: follow-up was carried out for 24 months. The difference of initial and final 28-joint Disease Activity Score, remission incidence, difference of initial and final Health Assessment Questionnaire score, disability recovery, and AE rate were evaluated.

Results
The study enrolled 435 patients (108 adalimumab, 107 infliximab, 92 etanercept 25 mg, 81 etanercept 50 mg, and 47 golimumab). For etanercept 50, the median difference between basal and at the end of follow-up 28-joint Disease Activity Score was 1.7. For golimumab, it was 1.4; for adalimumab, it was 1.1; for etanercept 25, it was 1.02; and for infliximab, it was 0.96 (p = 0.001). The median difference between basal and final Health Assessment Questionnaire ranged was 1.66 for etanercept 50, 1.34 for etanercept 25, 1.3 for golimumab, 1.24 for adalimumab, and 1.07 for infliximab (p = 0.0005). Comparatively, etanercept 50 presented the highest cumulative incidence (77%; 95% confidence interval [CI], 67%–86%) and remission incidence (64 cases per 100 person-months; 95% CI, 4.9–8.1 cases per 100 person-months) and the lowest AE rate (8.6 per 100 person-years; 95% CI, 5.3–15 per 100 person-years).

Conclusions
In patients with RA treated with anti–tumor necrosis factor α drugs, the highest incidence of remission and the lowest rate of AEs were documented for the cohort exposed to etanercept 50 mg.
Efficient differentiation and polarization of primary cultured neurons on poly(lactic acid) scaffolds with microgrooved structures
Authors: Otomo Asako , Ueda Mahoko Takahashi , Fujie Toshinori , Hasebe Arihiro , Okamura Yosuke , Takeoka Shinji , Hadano Shinji , Nakagawa So 
Published: May 2019

AbstractSynthetic biodegradable polymers including poly(lactic acid) (PLA) are attractive cell culture substrates because their surfaces can be micropatterned to support cell adhesion. The cell adhesion properties of a scaffold mainly depend on its surface chemical and structural features; however, it remains unclear how these characteristics affect the growth and differentiation of cultured cells or their gene expression. In this study, we fabricated two differently structured PLA nanosheets: flat and microgrooved. We assessed the growth and differentiation of mouse primary cultured cortical neurons on these two types of nanosheets after pre-coating with poly-D-lysine and vitronectin. Interestingly, prominent neurite bundles were formed along the grooves on the microgrooved nanosheets, whereas thin and randomly extended neurites were only observed on the flat nanosheets. Comparative RNA sequencing analyses revealed that the expression of genes related to postsynaptic density, dendritic shafts, and asymmetric synapses was significantly and consistently up-regulated in cells cultured on the microgrooved nanosheets when compared with those cultured on the flat nanosheets. These results indicate that microgrooved PLA nanosheets can provide a powerful means of establishing a culture system for the efficient and reproducible differentiation of neurons, which will facilitate future investigations of the molecular mechanisms underlying the pathogenesis of neurological disorders.
Chromatin-enriched RNAs mark active and repressive cis-regulation: an analysis of nuclear RNA-seq
Authors: Sun Xiangying , Wang Zhezhen , Perez-Cervantes Carlos , Ruthenburg Alex , Moskowitz Ivan , Gribskov Michael , Yang Xinan Holly 
Published: May 2019

AbstractLong noncoding RNAs (lncRNAs) localize in the cell nucleus and influence gene expression through a variety of molecular mechanisms. RNA sequencing of two biochemical fractions of nuclei reveals a unique class of lncRNAs, termed chromatin-enriched nuclear RNAs (cheRNAs) that are tightly bound to chromatin and putatively function to cis-activate gene expression. Until now, a rigorous analytic pipeline for nuclear RNA-seq has been lacking. In this study, we survey four computational strategies for nuclear RNA-seq data analysis and show that a new pipeline, Tuxedo, outperforms other approaches. Tuxedo not only assembles a more complete transcriptome, but also identifies cheRNA with higher accuracy. We have used Tuxedo to analyze gold-standard K562 cell datasets and further characterize the genomic features of intergenic cheRNA (icheRNA) and their similarity to those of enhancer RNA (eRNA). Moreover, we quantify the transcriptional correlation of icheRNA and adjacent genes, and suggest that icheRNA may be the cis-acting transcriptional regulator that is more positively associated with neighboring gene expression than eRNA predicted by state-of-art method or CAGE signal. We also explore two novel genomic associations, suggesting cheRNA may have diverse functions. A possible new role of H3K9me3 modification coincident with icheRNA may be associated with active enhancer derived from ancient mobile elements, while a potential cis-repressive function of antisense cheRNA (as-cheRNA) is likely to be involved in transiently modulating cell type-specific cis-regulation.Author SummaryChromatin-enriched nuclear RNA (cheRNA) is a class of gene regulatory non-coding RNAs. CheRNA provides a powerful way to profile the nuclear transcriptional landscape, especially to profile the noncoding transcriptome. The computational framework presented here provides a reliable approach to identifying cheRNA, and for studying cell-type specific gene regulation. We found that intergenic cheRNA, including intergenic cheRNA with high levels of H3K9me3 (a mark associated with closed/repressed chromatin), may act as a transcriptional activator. In contrast, antisense cheRNA, which originates from the complementary strand of the protein-coding gene, may interact with diverse chromatin modulators to repress local transcription. With our new pipeline, one future challenge will be refining the functional mechanisms of these noncoding RNA classes through exploring their regulatory roles, which are involved in diverse molecular and cellular processes in human and other organisms.
TheSynchytrium endobioticumAvrSen1 triggers a Hypersensitive Response in Sen1 potatoes while natural variants evade detection
Authors: van de Vossenberg Bart T.L.H. , Prodhomme Charlotte , van Arkel Gert , van Gent-Pelzer Marga P.E. , Bergervoet Marjan , Brankovics Balázs , Przetakiewicz Jarosław , Visser Richard G.F , van der Lee Theo A.J. , Vossen Jack H. 
Published: May 2019

AbstractSynchytrium endobioticumis an obligate biotrophic fungus of the phylum Chytridiomycota. It causes potato wart disease, has a world-wide quarantine status and is included on the HHS and USDA Select Agent list.S. endobioticumisolates are grouped in pathotypes based on their ability to evade host-resistance in a set of differential potato varieties. So far, thirty-nine pathotypes are reported. A single dominant gene (Sen1) governs pathotype 1 resistance and we anticipated that the underlying molecular model would involve a pathogen effector (AvrSen1) that is recognized by the host. TheS. endobioticumspecific secretome of fourteen isolates representing six different pathotypes was screened for effectors specifically present in pathotype 1(D1) isolates but absent in others. We identified a singleAvrSen1candidate. Expression of this candidate in potatoSen1plants showed a specific hypersensitive response, which co-segregated with theSen1resistance in potato populations. No HR was obtained with truncated genes found in pathotypes that evaded recognition bySen1. These findings established that our candidate gene was indeedAvrsen1.TheS. endobioticum AvrSen1is a single copy gene and encodes a 376 amino acid protein without predicted function or functional domains, and is the first effector gene identified in Chytridiomycota, an extremely diverse yet underrepresented basal lineage of fungi.Author SummaryPlant pathogens can have a great social and economic impact, and are a continuous threat to food security. A clear example isSynchytrium endobioticum, the fungus causing potato wart disease. The impact of the pathogen, lack of effective chemical control agents and the longevity of resting spores produced by the pathogen led to a world-wide quarantine status forS. endobioticum. Strict phytosanitary measures and the use of resistance potato varieties are currently the only way to prevent the spread of the disease. The emergence of new pathotypes that overcome resistance urged to study the underlying molecular mechanisms ofS. endobioticumrecognition by the plant. Here we describe the identification of the first effector (AvrSen1) ofS. endobioticumthat is recognized by theSen1resistance gene product. Also, we report the loss ofAvrSen1in other pathotypes thus avoiding recognition by the plant and triggering immune responses. AvrSen1 represents the first effector to be identified in the basal fungal lineage Chytridiomycota. The discovery of AvrSen1 provides an important tool to manage potato wart disease. Moreover, knowledge about Chytridiomycota effectors will shed light on other (pathogenic) interactions and the co-evolution of Chytridiomycota species with their hosts.
The effects of soft skill integration on quality of college life of diploma business students
Authors: Tan Cheng_Yoke , Kanesan Abdullah Abdul Ghani , Ali Abdul Jalil 
Published: May 2019

PurposeThe purpose of this study was to examine the effects of soft skill integration in the curriculum on quality of college life of diploma business students in Malaysian private higher educational institutions.Design/methodology/approachDescriptive quantitative survey research was used to assess the views and relationship between variables from 429 business students in Peninsular Malaysia. The adapted self-administered questionnaires were distributed through stratified random sampling method. Descriptive analysis, correlation and regression analysis were used in the findings.FindingsThe results advocated significant influence from soft skill integration on quality of college life. Soft skill integration in critical thinking and problem solving especially has significant positive influence on quality of college life in all the aspects from academic, social and also facilities.Research limitations/implicationsGeneralizability of the research as it was conducted in the northern region of Peninsular Malaysia only. It was also limited by subjectivity bias of the students who responded to the questionnaire.Practical implicationsThe implication of this study was that it serves as an evidence-based information of soft skill integration and effects on college quality. In this way, it provides an empirical reference to the authorities for better guidelines, evaluation, control and development in the curriculum, delivery approaches, co-curriculum, campus environment or facilities.Social implicationsLocal education in particular is closely linked to the neighboring community and also dependent on the socio-economic needs of the state or region. According to Kayrooz and Parker (2010), greater engagement with local issues and higher local autonomy for spending could lead to greater effectiveness and efficiencies.Originality/valueThe study was a pioneering research in the context of Malaysian private higher education, guided by Devadasonet al.’s (2010) soft skill integration study in Malaysian public higher education, plus Sirgyet al.’s (2007) study on quality of college life.