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Healthcare staff members' perceptions involving episiotomy within the period of respectful maternity treatment: a new qualitative research of an obstetric training curriculum within South america.
89; 2 RCTs, 4,564 women, moderate certainty of evidence). Estimates of effect of Tenofovir 1% (RR 0.83, 95%CI0.65-1.06), Nonoxynol-9 (RR 1.15, 95%CI0.93-1.42), cellulose-sulphate (RR 1.16, 95%CI0.61-2.21), SAVVY (RR 1.34, 95%CI0.69-2.59), Carraguard (RR 0.89, 95%CI0.71-1.10), BufferGel (RR 1.02, 95%CI0.71-1.46), 0.5% PRO2000 (RR 0.88, 95%CI0.60-1.28) and 2% PRO2000 (RR 0.81, 95%CI0.58-1.12) failed to reach statistical significance; each had low certainty of evidence. CONCLUSION The long-acting intravaginal ring containing Dapivirine significantly reduced risk of HIV transmission in women by 29%. The remaining microbicides had no evident effect. This article is protected by copyright. All rights reserved.Nearly half of the animal phyla contain species that propagate asexually via agametic reproduction, often forming colonies of genetically identical modules, that is, ramets, zooids, or polyps. Clonal reproduction, colony formation, and modular organization have important consequences for many aspects of organismal biology. Theories in ecology, evolution, and development are often based on unitary and, mainly, strictly sexually reproducing organisms, and though colonial animals dominate many marine ecosystems and habitats, recognized concepts for the study of clonal species are often lacking. In this review, we present an overview of the study of colonial and clonal animals, from the historic interests in this subject to modern research in a range of topics, including immunology, stem cell biology, aging, biogeography, and ecology. We attempt to portray the fundamental questions lying behind the biology of colonial animals, focusing on how colonial animals challenge several dogmas in biology as well as the remaining puzzles still to be answered, of which there are many. © 2020 Wiley Periodicals, Inc.BACKGROUND Dental caries is a significant public health problem for low-income children with special healthcare needs (CSHCN). AIM We evaluated associations between oral health behaviours (eg diet, fluoride, dental care) and dental caries for CSHCN enrolled in Medicaid, a health insurance programme for low-income populations that provides comprehensive dental coverage for children. DESIGN We recruited 116 CSHCN ages 7-20 years from Medicaid enrolment files in Washington state, USA. Caregivers completed a 166-item questionnaire, and children received a dental screening. The outcome was dental caries, defined as total pre-cavitated, decayed, missing or filled tooth (PDMF) surfaces. We ran log-linear regression models and generated prevalence rate ratios (PRR). RESULTS The mean age of study participants was 12.4 ± 3.1 years, 41.4% were female, and 38.8% were white. The mean PDMF surfaces were 6.4 ± 9.4 (range 0-49). Only sugar-sweetened beverage intake was significantly associated with dental caries. CSHCN who consumed >4 sugar-sweetened beverages per week were significantly more likely to have dental caries than those who consumed no sugar-sweetened beverages (PRR 2.58; 95% CI 1.37, 4.85; P less then .01). CONCLUSION Sugar-sweetened beverages are an important target for future behavioural interventions aimed at preventing dental caries in low-income CSHCN. © 2020 BSPD, IAPD and John Wiley & Sons Ltd.Pre-clinical responses to fast moving infectious disease outbreaks heavily depend on choosing the best isolates for animal models that inform diagnostics, vaccines and treatments. Current approaches are driven by practical considerations (e.g. first available virus isolate) rather than a detailed analysis of the characteristics of the virus strain chosen, which can lead to animal models that are not representative of the circulating or emerging clusters. Here, we suggest a combination of epidemiological, experimental and bioinformatics considerations when choosing virus strains for animal model generation. We discuss the currently chosen SARS-CoV-2 strains for international coronavirus disease (COVID-19) models in the context of their phylogeny as well as in a novel alignment-free bioinformatics approach. Galunisertib molecular weight Unlike phylogenetic trees, which focus on individual shared mutations, this new approach assesses genome-wide co-developing functionalities and hence offers a more fluid view of the "cloud of variances" that RNA viruses are prone to accumulate. This joint approach concludes that while the current animal models cover the existing viral strains adequately, there is substantial evolutionary activity that is likely not considered by the current models. Based on insights from the non-discrete alignment-free approach and experimental observations, we suggest isolates for future animal models. This article is protected by copyright. All rights reserved.BACKGROUND & AIMS Activation of hepatic stellate cells (HSC) is a critical process involved in liver fibrosis. Several miRNAs are implicated in gene regulation during this process but their exact and respective contribution is still incompletely understood. Here we propose an integrative approach of miRNA-regulatory networks to predict new targets. METHODS miRNA regulatory networks in activated HSCs were built using lists of validated miRNAs and the CyTargetLinker tool. The resulting graphs were filtered according to public transcriptomic data and the reduced graphs were analysed through GO annotation. A miRNA network regulating the expression of TIMP3 was further studied in human liver samples, isolated hepatic cells and mouse model of liver fibrosis. RESULTS Within the up-regulated miRNAs, we identified a subnetwork of five miRNAs (miR-21-5p, miR-222-3p, miR-221-3p miR-181b-5p and miR-17-5p) that target TIMP3. We demonstrated that TIMP3 expression is inversely associated with inflammatory activity and IL1-ß expression in vivo. We further showed that IL1-ß inhibits TIMP3 expression in HSC-derived LX-2 cells. Using data from The Cancer Genome Atlas (TCGA), we showed that, in hepatocellular carcinoma (HCC), TIMP3 expression is associated with survival (P less then .001), while miR-221 (P less then .05), miR-222 (P less then .01) and miR-181b (P less then .01) are markers for a poor prognosis. CONCLUSIONS Several miRNAs targeting TIMP3 are up-regulated in activated HSCs and down-regulation of TIMP3 expression is associated with inflammatory activity in liver fibrosis and poor prognosis in HCC. The regulatory network including specific miRNAs and TIMP3 is therefore central for the evolution of chronic liver disease. © 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.Rosacea fulminans (RF) is a rare dermatological condition which occurs exclusively in women and it is characterized by a sudden onset of painful papules, pustules, cysts, and nodules on the face. A 28-year-old woman was referred to our clinic due to a painful facial eruption within the 13th week of her second pregnancy. After physical examination, the diagnosis of RF during pregnancy was established. Several treatments were used mupirocin ointment, topical zinc oxide, topical erythromycin, oral erythromycin, metronidazole gel, oral metronidazole, oral amoxiciline, and oral prednisone. Finally, the patient was started on 5% permethrin cream with complete clearing of the lesions. Nowadays, a wide range of treatments for rosacea is available topical metronidazole, oral metronidazole, topical ivermectin, oral tetracyclines, oral isotretinoin, systemic steroids, photodynamic therapy, or pulsed dye laser. However, in pregnant patients, the treatment alternatives are limited. We consider that 5% permethrin cream could be an effective, cheap, and safe treatment not only in regular patients with rosacea but also in pregnant women, representing an important alternative in the context of pregnancy when therapeutic options are limited. To our knowledge, this is the first case of rosacea treated with 5% permethrin cream in monotherapy during pregnancy. © 2020 Wiley Periodicals LLC.Anaerobic ammonium oxidation (anammox) is a novel process of deammonification that exhibits superior ecological and economic potential compared to that of traditional heterotrophic processes. Although this process has been successfully implemented in treating high-strength nitrogen-contaminated wastewater, it still faces many challenges in treating mainstream municipal wastewater. This review aims to provide an overview of the status and challenges of mainstream anammox-based processes. The different configurations and crucial factors are discussed in this review. Finally, the future needs for feasible application are stated. This article is protected by copyright. All rights reserved.The coronavirus disease 2019 (COVID-19) pandemic, which began in Wuhan, China in December 2019, has become a huge public health issue in China and worldwide, spanning across Asia, including South Korea, Europe, North America, South America, and Oceania (Phelan, Katz, & Gostin, 2020). The fatality rate is 0.2 deaths per 100,000 persons per week globally. On March 11, 2020, the World Health Organization declared COVID-19 outbreak a pandemic of international concern. This article is protected by copyright. All rights reserved.COVID-19 burdens all areas of healthcare, and the relationship between COVID-19 and liver injury is being examined. The recently published papers by Xu et al and Xie et al nicely describe liver injury resulting from COVID-191,2 . As with many papers the focus lies on patients without pre-existing liver disease, even though it has been suggested that pre-existing conditions affect COVID-19. This article is protected by copyright. All rights reserved.INTRODUCTION AND BACKGROUND Randomized controlled trials comparing open and robot-assisted radical cystectomy (RARC) have mainly focused on the extirpative portion of the procedure rather than the urinary diversion approach. There is paucity of data comparing intracorporeal (ICUD) and extracorporeal urinary diversion (ECUD) following RARC, and published data were mostly subject to selection bias. METHODS Retrospective review of the prospectively maintained International Robotic Cystectomy Consortium (IRCC) database. A total of 972 patients from 27 institutions who underwent RARC were included. Propensity score matching was utilized to match patients based on age, gender, BMI, ASA score, Charlson comorbidity index (CCI) score, prior radiation and abdominal surgery, receipt of neoadjuvant chemotherapy, and clinical staging. Matched cohorts were compared. Multivariate stepwise logistic and linear regression models were fit to evaluate variables associated with receiving ICUD, operative time, 90-d high grade comp article is protected by copyright. All rights reserved.BACKGROUND The outbreak of the coronavirus disease 2019 (Covid-19) shows a global spreading trend. Early and effective predictors of clinical outcomes is urgent needed to improve management of Covid-19 patients. OBJECTIVE The aim of the present study was to evaluate whether elevated D-dimer levels could predict mortality in patients with Covid-19. METHODS Patients with laboratory confirmed Covid-19 were retrospective enrolled in Wuhan Asia General Hospital from January 12, 2020 to March 15, 2020. D-dimer levels on admission, and death events were collected to calculate the optimum cutoff using receiver operating characteristic curve. According to the cutoff, the subjects were divided into two groups. Then the in-hospital mortality between two groups were compared to assess the predictive value of D-dimer level. RESULTS A total of 343 eligible patients were enrolled in the study. The optimum cutoff value of D-dimer to predict in-hospital mortality was 2.0 µg/ml with a sensitivity of 92.3% and a specificity of 83.
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