Plos One
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Administrative claims and electronic health records are valuable resources for evaluating pharmaceutical effects during pregnancy. However, direct measures of gestational age are generally not available. Establishing a reliable approach to infer the duration and outcome of a pregnancy could improve pharmacovigilance activities. ⋯ In Optum validation sensitivity analysis, a total of 73% of algorithm estimated starts for live births were in agreement with fertility procedure estimated starts within two weeks in either direction; ectopic pregnancy 77%, stillbirth 47%, and abortion 36%. An algorithm to infer live birth and ectopic pregnancy episodes and outcomes can be applied to multiple observational databases with acceptable accuracy for further epidemiologic research. Less accuracy was found for start date estimations in stillbirth and abortion outcomes in our sensitivity analysis, which may be expected given the nature of the outcomes.
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Sepsis is characterized by an intense systemic inflammatory response activating a cascade of proinflammatory events resulting in leukocyte dysregulation and host tissue damage. The lung is particularly susceptible to systemic inflammation, leading to acute lung injury. Key to inflammation-induced lung damage is the excessive migration of neutrophils across the vascular endothelium. ⋯ Administration of the PKCδ inhibitor decreased platelet and neutrophil influx, and was lung protective. Thus, PKCδ inhibition modulated platelet activity both locally and systemically, decreased neutrophil influx into the lung, and was lung protective. We demonstrate for the first time that PKCδ plays an important role in platelet activation and platelet-neutrophil interaction during sepsis.
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The lifecycle perspective reminds us that the roots of adult ill-health may start in-utero or in early childhood. Nutritional and infectious disease insults in early life, the critical first 1000 days, are associated with stunting in childhood, and subsequent short adult stature. There is limited or no opportunity for stunted children above 2 years of age to experience catch-up growth. Some previous research has shown short maternal height to lead to adverse birth outcomes. In this paper, we document the association between maternal height and caesarean section, and between maternal height and neonatal mortality in 34 sub-Saharan African countries. We also explore the appropriate height cut-offs to use. Our paper contributes arguments to support a focus on preventing non-communicable risk factors, namely early childhood under-nutrition, as part of the fight to reduce caesarean section rates and other adverse maternal and newborn health outcomes, particularly neonatal mortality. We focus on the Sub-Saharan Africa region because it carries the highest burden of maternal and neonatal ill-health. ⋯ Short stature is associated with an increased prevalence of caesarean section and neonatal mortality, particularly on the newborn's first days. These results are even more striking because we know that caesarean section rates tend to be higher among wealthier and more educated women, who are often taller and that the same patterns may hold for neonatal survival; in such cases, adjusting for wealth, education and urban residence would attenuate these associations. Caesarean sections can be lifesaving operations; however, they cost the health system and families more, and are associated with worse health outcomes. We suggest that our findings be used to argue for policies targeting stunting in infant girls and potential catch-up growth in adolescence and early adulthood, aiming to increase their adult height and thus decrease their subsequent risk of experiencing caesarean section and adverse birth outcomes.
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The aim of the study was to estimate the prevalence of underweight and overweight or obesity and their socio-demographic and lifestyle factors in a female adult population in Myanmar. ⋯ A dual burden of both underweight and overweight or obesity among female adults was found in Myanmar. Sociodemographic and health risk behaviour factors were identified for underweight and overweight or obesity that can guide public health interventions to address both of these conditions.
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Dot-probe studies consistently show that high trait anxious individuals have an attentional bias towards threatening faces. However, little is known about the influence of perceptual confounds of specific emotional expressions on this effect. Teeth-exposure was recently recognized as an important factor for the occurrence of attentional bias towards angry faces in a closely related paradigm (the face-in-the-crowd paradigm). ⋯ For angry faces with non-exposed teeth, we found the expected positive correlation (r = .441) of trait anxiety with the attentional bias score (reaction times for probes replacing the neutral face minus reaction times for probes replacing the angry face). However, we found no influence of trait anxiety on attentional bias towards angry faces with exposed teeth. These results suggest that natural low-level stimulus confounds of emotional faces like exposed teeth can affect the manifestation of anxiety-related attentional biases towards angry faces in the dot-probe task.