Background: The intrapartum period is critical for reducing maternal and perinatal morbidity and mortality. The WHO's Safe Childbirth Checklist (SCC) was designed as a reminder of the most critical, evidence-based practices (EBPs) to improve quality care and reduce preventable complications and deaths.
Objective: To assess the impact of SCC on birth attendant behavior and maternal and newborn health outcomes.
Br J Hosp Med (Lond)
December 2024
Malignant pleural effusion (MPE) is a common complication of malignancy and is regularly seen on the general medicine take. Diagnosis of MPE is indicative of advanced or metastatic disease and carries a poor prognosis, with median survival ranging from 3 to 12 months. Despite recent advancements in systemic anti-cancer treatment, the goal of management in MPE remains the palliation of symptoms.
View Article and Find Full Text PDFAims: To assess the utility of reanalysing GCK variants of uncertain significance (VUS) as an intervention to improve the detection of monogenic diabetes.
Methods: We examined GCK VUS in a local cohort of individuals with suspected monogenic diabetes and re-curated each variant against the recent ClinGen GCK-specific variant classification guidelines.
Results: Variant reanalysis achieved a new 'likely pathogenic' classification (i.
Sphingosine-1-phosphate (S1P) is a signaling lysolipid critical to heart development, immunity, and hearing. Accordingly, mutations in the S1P transporter SPNS2 are associated with reduced white cell count and hearing defects. SPNS2 also exports the S1P-mimicking FTY720-P (Fingolimod) and thereby is central to the pharmacokinetics of this drug when treating multiple sclerosis.
View Article and Find Full Text PDFSleepiness-related errors are a leading cause of driving accidents, requiring drivers to effectively monitor sleepiness levels. However, there are inter-individual differences in driving performance after sleep loss, with some showing poor driving performance while others show minimal impairment. This research explored if there are differences in self-reported sleepiness and driving performance in healthy drivers who exhibited vulnerability or resistance to objective driving impairment following extended wakefulness.
View Article and Find Full Text PDFSolvent toxicity limits -butanol fermentation titer, increasing the cost and energy consumption for subsequent separation processes and making biobased production more expensive and energy-intensive than petrochemical approaches. Amphiphilic solvents such as -butanol partition into the cell membrane of fermenting microorganisms, thinning the transverse structure, and eventually causing a loss of membrane potential and cell death. In this work, we demonstrate the deleterious effects of -butanol partitioning upon the lateral dimension of the membrane structure, called membrane domains or lipid rafts.
View Article and Find Full Text PDFAntimicrobial resistance is considered a global One Health threat. Controlling selection pressure by reducing antibiotic use in livestock is a significant component of the response to this threat. The science concerning use and resistance is complicated and affected by time from antibiotic exposure, changing bacterial fitness, and varies by drug and pathogen.
View Article and Find Full Text PDFImportance: Driving is a complex occupation requiring the interplay of high-level cognitive, physical, sensory, and behavioral skills for safe performance. Occupational therapists need to routinely address driving with adults as an occupational performance area. Further research is needed to determine whether performance-based assessment tools can support occupational therapists in screening client driving potential.
View Article and Find Full Text PDFBackground: Development of a paediatric palliative care child and family centred outcome measure is a priority for health care professionals, researchers and advocates. It is methodologically challenging to develop a measure relevant for such a heterogenous population with complex needs. Involving children in measuring development is vital.
View Article and Find Full Text PDFPurpose: We set out to develop a publicly available tool that could accurately diagnose spinal muscular atrophy (SMA) in exome, genome or panel sequencing datasets aligned to a GRCh37, GRCh38, or T2T reference genome.
Methods: The SMA Finder algorithm detects the most common genetic causes of SMA by evaluating reads that overlap the c.840 position of the SMN1 and SMN2 paralogs.
Cell entry of severe acute respiratory coronavirus-2 (SARS-CoV-2) and other CoVs can occur via two distinct routes. Following receptor binding by the spike glycoprotein, membrane fusion can be triggered by spike cleavage either at the cell surface in a transmembrane serine protease 2 (TMPRSS2)-dependent manner or within endosomes in a cathepsin-dependent manner. Cellular sialoglycans have been proposed to aid in CoV attachment and entry, although their functional contributions to each entry pathway are unknown.
View Article and Find Full Text PDFBackground: Few evidence-based resources exist to support generalist occupational therapists address driving in practice. This pilot study aimed to evaluate whether a driving clinical decision pathway can assist generalist occupational therapists to address driving with clients.
Methods: Using a before (Timepoint-1) and after (Timepoint-2) design, data were collected at a multi-site outpatient community rehabilitation service.
Representativeness is an important component of generalizability. Few studies have rigorously examined the representativeness of randomized trials or observational studies of pain or musculoskeletal conditions with regards to a wide range of factors beyond age, sex, race, and ethnicity. We conducted the first study of a pain condition that uses individual-level data to directly compare the enrolled study sample to the population from which it was drawn.
View Article and Find Full Text PDFConnexins are essential for intercellular communication through gap junctions and the maintenance of cellular and tissue homeostasis. Connexin 43 (Cx43) is the most ubiquitously expressed connexin. As well as regulating homeostasis, Cx43 hemichannels and gap junctions play important roles in inflammation and the immune response.
View Article and Find Full Text PDFObjective: To examine recent changes in the birth prevalence of cerebral palsy in Australia; to examine the functional mobility of children with cerebral palsy by residential remoteness.
Study Design: Population-based register study; analysis of Australian Cerebral Palsy Register (ACPR) data.
Setting, Participants: Children with cerebral palsy born in Australia, 1995-2016, and included in the ACPR at the time of the most recent state/territory data provision (31 July 2022).
Objective: This study examined the unique and interactive effects of PA volume and within-person fluctuations in PA volume (i.e., intraindividual variability in PA volume; PA-var) on preschoolers' ( = 141; 47.
View Article and Find Full Text PDFObjectives: Fetal growth restriction (FGR) is commonly associated with placental dysfunction, increasing perinatal morbidity and mortality. Visualizing placental vessels in utero would be advantageous for identifying functional FGR cause and determining proper management strategies. We aimed to utilize high-sensitivity ultrasound microvessel imaging (HUMI) for quantifying placental vessel density (VD) in pregnancies diagnosed with FGR.
View Article and Find Full Text PDFPurpose: To characterize the diagnostic and clinical outcomes of a cohort of critically ill infants and children with suspected mitochondrial disorders (MD) undergoing ultrarapid genomic testing as part of a national program.
Methods: Ultrarapid genomic sequencing was performed in 454 families (genome sequencing: n = 290, exome sequencing +/- mitochondrial DNA sequencing: n = 164). In 91 individuals, MD was considered, prompting analysis using an MD virtual gene panel.
Epidemiological evidence of familial predispositions to myeloid malignancies and myeloproliferative neoplasms (MPN) has long been recognised, but recent studies have added to knowledge of specific germline variants in multiple genes that contribute to the familial risk. These variants may be common risk alleles in the general population but have low penetrance and cause sporadic MPN, such as the JAK2 46/1 haplotype, the variant most strongly associated with MPN. Association studies are increasingly identifying other MPN susceptibility genes such as TERT, MECOM, and SH2B3, while some common variants in DDX41 and RUNX1 appear to lead to a spectrum of myeloid malignancies.
View Article and Find Full Text PDFObjective: The purpose of this study was to investigate the technical feasibility of integrating the quantitative maps available from SyntheticMR into the head and neck adaptive radiation oncology workflow. While SyntheticMR has been investigated for diagnostic applications, no studies have investigated its feasibility and potential for MR-Simulation or MR-Linac workflow. Demonstrating the feasibility of using this technique will facilitate rapid quantitative biomarker extraction which can be leveraged to guide adaptive radiation therapy decision making.
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