bluuebunny/crossref_metadata_2025_split huggingface dataset:
Contribution of the second stage of labour to pelvic floor dysfunction: a prospective cohort comparison of nulliparous women
Authors: Rogers RG , Leeman LM , Borders N , Qualls C , Fullilove AM , Teaf D , Hall RJ , Bedrick E , Albers LL 
Published: February 2014

ObjectiveMaternal expulsive efforts are thought to damage the pelvic floor. We aimed to compare pelvic floor function and anatomy between women who delivered vaginally (VB) versus those with caesarean delivery (CD) prior to the second stage of labour.DesignProspective cohort.SettingUniversity Hospital Midwifery practice.PopulationNulliparas.MethodsPregnant nulliparas were recruited during pregnancy and women who underwent CD prior to the 2nd stage of labour at birth were recruited immediately postpartum. Both groups were followed prospectively to 6 months postpartum.Main outcome measuresPOPQ, perineal ultrasound (U/S) and Paper Towel Test (PTT), an objective measure of stress incontinence; Incontinence Severity Index (ISI), Pelvic Floor Impact Questionnaire (PFIQ‐7), Wexner Fecal Incontinence Scale (W) and Female Sexual Function Index (FSFI).Results336/448 (75%) VB and 138/224 (62%) CD followed up. The VB group was younger (23.9 ± 4.9 versus 26.6 ± 6.1 years, P < 0.001) and less overweight/obese (38 versus 56%, P < 0.001); baseline functional measures were similar (all P > 0.05). At follow‐up, urinary incontinence (UI) (55 versus 46% ISI > 0, P = 0.10), fecal incontinence (FI) (8 versus 13% FI on W, P = 0.12), sexual activity rates (88 versus 92%, P = 0.18) and PFIQ‐seven scores were similar. Positive PTT tests (17 versus 6%, P = 0.002) and ≥ Stage 2 prolapse (22 versus 15%, P = 0.03) were higher with VB; differences were limited to points Aa and Ba. U/S findings were not different between groups. Stepwise multivariate analyses controlling for age, body mass index, and non‐Hispanic White race for prolapse of points Aa and Ba did not alter conclusions (all P < 0.004).ConclusionsVB resulted in prolapse changes and objective UI but not in increased self‐report pelvic floor dysfunction at 6 months postpartum compared with women who delivered by CD prior to the second stage of labour. The second stage of labour had a modest effect on postpartum pelvic floor function.
Response to first‐line chemotherapy of docetaxel combined with platinum predicting the prognosis and subsequent treatment of patients with non‐small cell lung cancer
Authors: Liu Hongbing , Wu Ying , Wang Zhaofeng , Song Yong 
Published: February 2014

AbstractBackgroundThe aim of this study was to confirm the association between the response to docetaxel combined with platinum as first‐line chemotherapy and prognosis and subsequent treatment for patients with non‐small cell lung cancer (NSCLC).MethodsThis study enrolled 224 patients with NSCLC diagnosed at our institution between January 2001 and August 2012. All patients received more than two cycles of docetaxel combined with platinum as first‐line chemotherapy and were reassessed after two cycles. The association between the response to first‐line treatment and prognosis and subsequent treatment were statistically analyzed.ResultsAmong the 224 patients, 70 (31.25%) achieved partial response (PR), 90 (40.18%) stable disease (SD), and 64 (28.57%) progressive disease (PD). The overall survival (OS) of NSCLC patients with PR, SD and PR+SD was significantly longer than those with PD (P = 0.043; P = 0.000; P = 0.001). However, no significant difference was observed in OS between patients with PR and SD (P = 0.174). Cox regression analysis found treatment response was an independent prognostic factor (hazard ratio = 1.615, 95% confidence interval: 1.121–2.327). Two independent non‐parametric sample tests showed that patients with a good response to first‐line treatment had received further treatment cycles and treatment lines (P = 0.000; P = 0.000).ConclusionsOur study demonstrated that the response to docetaxel in combination with platinum as a first‐line chemotherapy was an independent prognostic factor for patients with NSCLC. In addition, patients with a good response to first‐line treatment had received further treatment cycles and treatment lines.
The Association between Use of Serotonergic Antidepressants and Perioperative Bleeding during Total Hip Arthroplasty – A Cohort Study
Authors: Dall Michael , Primdahl Annie , Damborg Frank , Nymark Tine , Hallas Jesper 
Published: February 2014

AbstractIn vitro studies have shown that selective serotonin reuptake inhibitors inhibit platelet aggregation. It is well documented that SSRIs cause serious gastrointestinal bleeding, but studies on other bleeding manifestations have been equivocal. Our objective was to determine a possible association between use of serotonergic antidepressants (SA) and perioperative bleeding during hip replacements. We conducted a retrospective study between 1 January 2007 and 30 June 2012 among patients that underwent a primary unilateral uncemented total hip arthroplasty (THA). Information was collected on the observed blood loss and the need for blood transfusions among this group. We compared the blood loss between users of SA, users of non‐serotonergic antidepressants (NSA) and non‐users, while adjusting for potential confounders using multivariate linear regression. We indentified 1318 patients that underwent a THA in the study period. The average volume of surgical bleeding was 350 ml. The adjusted incremental blood loss associated with use of SA and NSA was 93, 95% confidence interval (38–147) ml and −50 (−125 to 25) ml compared with non‐use. Only 48 subjects (3.6%) had transfusions. Use of SA was associated with an increased blood loss compared with non‐users. The hypothesis that SA impairs haemostasis is supported by these results.
Hypoallergenic derivatives of Fel d 1 obtained by rational reassembly for allergy vaccination and tolerance induction
Authors: Curin M. , Weber M. , Thalhamer T. , Swoboda I. , Focke‐Tejkl M. , Blatt K. , Valent P. , Marth K. , Garmatiuk T. , Grönlund H. , Thalhamer J. , Spitzauer S. , Valenta R. 
Published: February 2014

SummaryBackground and objectiveThe major cat allergen Fel d 1 represents one of the most important respiratory allergens. Aim of this study was to engineer recombinant Fel d 1 derivatives with reduced IgE reactivity and preserved T cell epitopes for vaccination and tolerance induction.MethodsSeven recombinant mosaic proteins were generated by reassembly of non‐IgE‐reactive peptides of Fel d 1 which contained the sequence elements for induction of allergen‐specific blocking IgG antibodies and T cell epitopes. Mosaic proteins were expressed in Escherichia coli using codon‐optimized synthetic genes and compared with Fel d 1 regarding structural fold by circular dichroism, IgE‐binding capacity, activation of allergic patients' basophils and ability to induce allergen‐specific blocking IgG antibodies upon immunization.ResultsAlthough each of the mosaic proteins had lost the alpha‐helical fold typical for Fel d 1, a strong reduction in IgE reactivity as well as allergenic activity in basophil activation assays was only obtained for three constructs, two reassembled fragments (Fel d 1 MB, Fel d 1 MC) and a fusion of the latter two (Fel d 1 MF) in which the cysteines of Fel d 1 MC were replaced by serines. Immunization of rabbits with Fel d 1 MB, MC and MF induced high levels of IgG antibodies that inhibited IgE reactivity of cat‐allergic patients to Fel d 1 in a comparable manner as IgG induced with the wild‐type allergen.ConclusionsWe report the development of hypoallergenic reassembled Fel d 1 proteins suitable for vaccination and tolerance induction in cat‐allergic patients.
Cytomegalovirus drives Vδ2neg γδ T cell inflation in many healthy virus carriers with increasing age
Authors: Alejenef A , Pachnio A , Halawi M , Christmas S E , Moss P A H , Khan N 
Published: February 2014

SummaryCytomegalovirus (CMV) usually causes lifelong asymptomatic infection, but over time can distort immune profiles. Recent reports describe selective expansion of Vδ2neg γδ T cells in healthy and immunocompromised CMV carriers. Having shown previously that virus-specific CD8+ and CD4+ T cell responses are increased significantly in elderly CMV carriers, probably driven by chronic stimulation, we hypothesized that Vδ2neg γδ T cells may also be expanded with age. Our results show that Vδ2neg γδ T cells are increased significantly in CMV-seropositive healthy individuals compared to CMV-seronegative controls in all age groups. The differences were most significant in older age groups (P &lt; 0·0001). Furthermore, while Vδ2neg γδ T- cells comprise both naive and memory cells in CMV-seronegative donors, highly differentiated effector memory cells are the dominant phenotype in CMV carriers, with naive cells reduced significantly in numbers in CMV-seropositive elderly. Although phenotypically resembling conventional CMV-specific T cells, Vδ2neg γδ T cells do not correlate with changes in magnitude of CMV-specific CD4+ or CD8+ T cell frequencies within those individuals, and do not possess ex-vivo immediate effector function as shown by CMV-specific CD4+ and CD8+ T cells. However, after short-term culture, Vδ2neg γδ T cells demonstrate effector T cell functions, suggesting additional requirements for activation. In summary, Vδ2neg γδ T cells are expanded in many older CMV carriers, demonstrating a further level of lymphocyte subset skewing by CMV in healthy individuals. As others have reported shared reactivity of Vδ2neg γδ T cells towards tumour cells, the composition of γδ T cell subsets may also have implications for risk of developing cancer in elderly people.
Response to pneumococcal vaccination in mannose-binding lectin-deficient adults with recurrent respiratory tract infections
Authors: van Kessel D A , Hoffman T W , van Velzen-Blad H , Zanen P , Rijkers G T , Grutters J C 
Published: February 2014

Summary
Mannose-binding lectin (MBL)-deficiency is associated with an increased susceptibility to pneumococcal infections and other forms of disease. Pneumococcal vaccination is recommended in MBL-deficient patients with recurrent respiratory tract infections (RRTI). The response to pneumococcal vaccination in MBL-deficient individuals has not yet been studied in detail. An impaired response to pneumococcal polysaccharides in MBL-deficient patients might explain the association between MBL deficiency and pneumococcal infections. This study investigates the antibody response to pneumococcal vaccination in MBL-deficient adult patients with RRTI. Furthermore, we investigated whether there was a difference in clinical presentation between MBL-deficient and -sufficient patients with RRTI. Eighteen MBL-deficient and 63 MBL-sufficient adult patients with RRTI were all vaccinated with the 23-valent pneumococcal polysaccharide vaccine and antibodies to 14 pneumococcal serotypes were measured on a Luminex platform. There were no differences observed in the response to pneumococcal vaccination between MBL-sufficient and -deficient patients. Forty-three MBL-sufficient patients could be classified as responders to pneumococcal vaccination and 20 as low responders, compared to 15 responders and three low responders in the MBL-deficient patients. We found no clear difference in clinical, radiological, lung function and medication parameters between MBL-sufficient and -deficient patients. In conclusion, our study suggests that MBL-deficient adults with RRTI have a response to a pneumococcal capsular polysaccharide vaccine comparable with MBL-sufficient patients. Moreover, we did not find a clear clinical role of MBL deficiency in adults with RRTI. As MBL deficiency is associated with an increased susceptibility to pneumococcal infections, pneumococcal vaccination might be protective in MBL-deficient patients with RRTI.
Quantifying Ecological Life Support: The Biological Efficacy of Alternative Supplementation Strategies for Imperiled Amphibian Populations
Authors: Kissel Amanda M. , Palen Wendy J. , Govindarajulu Purnima , Bishop Christine A. 
Published: February 2014

AbstractGlobal biodiversity loss has prompted diverse efforts to stem or reverse declines for many species. Such efforts are often implemented before the efficacy of alternative management actions is quantified. Here, we use matrix models to compare the effectiveness of two supplementation strategies, head‐starting early life stages and captive breeding for reintroduction, at reducing extinction risk of declining amphibians. We use the imperiled Oregon spotted frog (Rana pretiosa) as a case study and find that when supplementation occurs after metamorphosis, captive breeding is more effective at reducing extinction risk than head‐starting, but the difference declines with increasing supplementation effort. We also find that captive breeding with release as larvae yields similar reductions in extinction risk, and is two orders of magnitude more effective at reducing extinction probabilities than head‐starting the same stage. Our results highlight that even basic demographic data can be leveraged to assess tradeoffs among alternative supplementation strategies.
Radiographic diagnosis of craniodorsal coxofemoral luxation in standing equids
Authors: Amitrano F. N. , Gutierrez‐Nibeyro S. D. , Joslyn S. K. 
Published: February 2014

SummaryRadiographic evaluation of the pelvis in standing horses has been used to diagnose fractures of the pelvis, head and greater trochanter of the femur, and luxations of the coxofemoral joint. Coxofemoral luxation injuries are more common in smaller horse breeds and donkeys, but, due to their size, the standing ventrodorsal projection is not possible, as there is insufficient space to place the radiography equipment under the animal's abdomen. The objective of the study was to report the advantages and limitations of the use of an oblique radiographic projection to diagnose unilateral craniodorsal coxofemoral luxation in 3 ponies and a donkey performed with the animals standing under light sedation. All cases had severe unilateral hindlimb lameness and asymmetry of the gluteal region; 2 also had concurrent intermittent upward fixation of the patella. A standing dorsolateral 20–30° ventral oblique radiograph of the affected coxofemoral joint was performed in all cases to obtain a definitive diagnosis. Radiography of the coxofemoral joint in standing ponies and donkeys can be carried out to identify craniodorsal coxofemoral luxation avoiding the need for general anaesthesia.
Protecting the Rights of Indigenous and Multicultural Children and Preserving their Cultures in Fostering and Adoption
Authors: Anderson Mark 
Published: February 2014

This article examines transracial/cultural placement of children for fostering and adoption as discussed within the context of expert evidence in applications for permanent placement. Transracial/cultural placement raises the issues of attachment and identity. The undesirability of the child being raised apart from the natural biological family's culture and ethnicity, the undesirability of disrupting secure attachments, and the significance of birth parents' parenting capacity are placed in stark contrast. The benefits of contact in reducing sense of abandonment and loss of parental care and culture of origin are also examined. The best practice for transracial placements depends upon the cultural prominence determined to be in the child's best interests. Placements favored are those where attachment is secure and parenting capacity is judged superior. The child's best interests may generally be considered by the courts in the short to medium term to be enhanced by placement with the person(s) with whom the child has the strongest attachments. The longer term issue is more problematic and not determined with confidence.Keypoints
Cultural preservation of children's birth culture in out‐of‐home placements for fostering and adoption
Placement of children—issues for attachment and identity
Best practice and cultural dominance in placement where ethnically and racially diverse environments of origin of placement and child
Best interests principle Considerations for secure attachment and parenting capacity
What's in a Name? Defining and Granting a Legal Status to Grandparents Who are Informal Primary Caregivers of their Grandchildren
Authors: Meara Kathleen 
Published: February 2014

The number of grandparents raising their grandchildren informally is increasing in the United States. Without legal recognition, grandparents face problems consenting for their grandchild's educational and medical needs and receiving government financial assistance. Although many of these grandparents live on a fixed or limited income, current government programs are either not applicable or insufficient to provide financial support for grandparents raising grandchildren. Some states have attempted to provide a legal status for grandparents who are primary caregivers, but state solutions are both inadequate and varied. This Note proposes that all states adopt a de facto custodianship statute to create a legal status for grandparents informally raising their grandchildren so they can provide for the child's needs and receive financial assistance. The statute will protect the parental presumption by setting a high standard for de facto custodians and will preserve a temporary opportunity for the child's parents to reassume their parental duties. If the court finds that a grandparent has met the de facto custodian standard, then the grandparents will have legal standing to seek custody of the child.Keypoints
2.5 million grandparents in the United States are primary caregivers for their grandchildren.
Current forms of legal recognition for grandparents raising grandchildren do not allow grandparents to consent in all medical and educational settings.
A model statute is proposed for all states to adopt that would allow grandparents legal recognition to adequately care for their grandchildren.
Model statute is constitutional because it gives preference to parents and requires grandparents to prove by clear and convincing evidence their ability to seek legal recognition.
Structural and functional effects of two stabilizing substitutions, D137L and G126R, in the middle part of α‐tropomyosin molecule
Authors: Matyushenko Alexander M. , Artemova Natalia V. , Shchepkin Daniil V. , Kopylova Galina V. , Bershitsky Sergey Y. , Tsaturyan Andrey K. , Sluchanko Nikolai N. , Levitsky Dmitrii I. 
Published: February 2014

Tropomyosin (Tm) is an α‐helical coiled‐coil protein that binds along the length of actin filament and plays an essential role in the regulation of muscle contraction. There are two highly conserved non‐canonical residues in the middle part of the Tm molecule, Asp137 and Gly126, which are thought to impart conformational instability (flexibility) to this region of Tm which is considered crucial for its regulatory functions. It was shown previously that replacement of these residues by canonical ones (Leu substitution for Asp137 and Arg substitution for Gly126) results in stabilization of the coiled‐coil in the middle of Tm and affects its regulatory function. Here we employed various methods to compare structural and functional features of Tm mutants carrying stabilizing substitutions Arg137Leu and Gly126Arg. Moreover, we for the first time analyzed the properties of Tm carrying both these substitutions within the same molecule. The results show that both substitutions similarly stabilize the Tm coiled‐coil structure, and their combined action leads to further significant stabilization of the Tm molecule. This stabilization not only enhances maximal sliding velocity of regulated actin filaments in the in vitro motility assay at high Ca2+ concentrations but also increases Ca2+ sensitivity of the actin–myosin interaction underlying this sliding. We propose that the effects of these substitutions on the Ca2+‐regulated actin–myosin interaction can be accounted for not only by decreased flexibility of actin‐bound Tm but also by their influence on the interactions between the middle part of Tm and certain sites of the myosin head.
Integrins αvβ6, α6β4 and α3β1 are down‐regulated in cholangiolocellular carcinoma but not cholangiocarcinoma
Authors: Soejima Yurie , Inoue Masafumi , Takahashi Yoshihisa , Uozaki Hiroshi , Sawabe Motoji , Fukusato Toshio 
Published: February 2014

AimThe aim of this study was to evaluate integrin expression and immunolocalization of the extracellular matrix proteins in cholangiolocellular carcinoma (CoCC).MethodsTissue specimens of 23 CoCC, 28 cholangiocarcinomas (CCC), 42 hepatocellular carcinomas (HCC) and 11 classical type combined hepatocellular cholangiocarcinomas (CHC) were immunostained for β6, β4 and α3 integrins, fibronectin and laminin. ITGB6, B4 and A3 mRNA levels in six HCC cell lines, five CCC cell lines and two CHC cell lines were quantified by quantitative reverse transcription polymerase chain reaction.ResultsLittle or no positivity for β6, β4 and α3 integrins was shown in 91%, 91% and 52% of CoCC and 100%, 98% and 81% of HCC, respectively, according to immunostaining, whereas intense positive staining for these integrins was demonstrated in 64%, 96% and 75% of CCC, respectively. There was a close correlation between β4 and α3 integrin expression and intracytoplasmic laminin in CoCC, CCC and HCC, but not between β6 expression and its ligand, fibronectin. Integrin mRNA levels were increased in four of five CCC cell lines, but nearly undetectable in five of six HCC cell lines and one CHC cell line. Tubular differentiation of a CHC cell line cultured in collagen gel matrix induced upregulation of these integrins.ConclusionOur results first indicated downregulation of αvβ6, α6β4 and α3β1 integrins in CoCC, in contrast to its high expression in CCC, suggesting a diagnostic value of integrins in the differential diagnosis of CoCC and CCC, as well as a useful inducible marker of the intermediate features of CoCC.
Loss of FBXW7 expression is associated with poor prognosis in intrahepatic cholangiocarcinoma
Authors: Enkhbold Chinbold , Utsunomiya Tohru , Morine Yuji , Imura Satoru , Ikemoto Tetsuya , Arakawa Yusuke , Kanamoto Mami , Iwahashi Shuichi , Saito Yu , Ishikawa Daichi , Shimada Mitsuo 
Published: February 2014

AimFBXW7 acts as a tumor suppressor gene by targeting several oncogenic regulators of proliferation, growth and apoptosis for proteasomal degradation. However, the significance of this protein is not yet well understood in intrahepatic cholangiocarcinoma (IHCC). In this study, we aimed to investigate the correlation between FBXW7 expression and clinicopathological variables in IHCC patients.MethodsThirty‐one patients with IHCC who underwent hepatic resection were enrolled. FBXW7 expression in tumor tissue was determined by immunohistochemistry and patients were divided into two groups, the FBXW7 high expression group (n = 11) and the FBXW7 low expression group (n = 20). We then compared clinicopathological variables including prognosis between the high and low expression groups in tumor tissue.ResultsFBXW7 expression was significantly correlated with staging (P = 0.006), and tended to correlate with lymph node metastasis. The FBXW7 low expression group had significantly poorer prognosis compared with the FBXW7 high expression group (P = 0.020); 3‐year survival rates were 29.4% and 72.7%, respectively. Furthermore, the disease‐free survival rate in the FBXW7 low expression group was significantly worse than in the FBXW7 high expression group (P = 0.022). On multivariate analysis, intrahepatic metastasis (P = 0.006) was a significant independent prognostic factor for disease‐free survival, and FBXW7 low expression tended to be an independent prognostic factor for both overall (P = 0.067) and disease‐free survival (P = 0.083).ConclusionOur results confirmed that low expression of FBXW7 in IHCC correlates with tumor progression and poor prognosis in IHCC.