Plos One
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The incidence of stillbirth in Sweden has essentially remained constant since the 1980's, and despite thorough investigation, many cases remain unexplained. It has been suggested that a proportion of stillbirth cases is caused by heart disease, mainly channelopathies. The aim of this study was to analyze DNA from 290 stillbirth cases without chromosomal abnormalities for pathogenic single nucleotide variants (SNVs) in 70 genes associated with cardiac channelopathies and cardiomyopathies. ⋯ Regarding identified putative pathogenic variants in genes associated with channelopathies, the prevalence was significantly higher in the stillbirth cohort (n = 23, 7.93%) than the corresponding prevalence of the same variants in the non-Finnish European population of the Exome Aggregation Consortium (2.70%, p<0.001) and SweGen, (2.30%, p<0.001). Our results give further support to the hypothesis that cardiac channelopathies might contribute to stillbirth. Screening for pathogenic SNVs in genes associated with heart disease might be a valuable complement for stillbirth cases where today's conventional investigation does not reveal the underlying cause of fetal demise.
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Patients with acute-on-chronic liver failure (ACLF) precipitated by hepatic injury and extrahepatic insults had distinct clinical phenotypes, and prognosis. This study aimed to validate prognostic models for ACLF and to explore their discriminative abilities in ACLF population categorized by the etiologies of precipitating events. ⋯ The CLIF-SOFA and simpler CLIF-C OF are reliable measures of mortality risk in ACLF patients precipitated by either hepatic or extrahepatic insults. Both validated models could be used to stratify the risk of death and improve management of ACLF.
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Professional sporting organisations invest considerable resources collecting and analysing data in order to better understand the factors that influence performance. Recent advances in non-invasive technologies, such as global positioning systems (GPS), mean that large volumes of data are now readily available to coaches and sport scientists. However analysing such data can be challenging, particularly when sample sizes are small and data sets contain multiple highly correlated variables, as is often the case in a sporting context. Multicollinearity in particular, if not treated appropriately, can be problematic and might lead to erroneous conclusions. In this paper we present a novel 'leave one variable out' (LOVO) partial least squares correlation analysis (PLSCA) methodology, designed to overcome the problem of multicollinearity, and show how this can be used to identify the training load (TL) variables that influence most 'end fitness' in young rugby league players. ⋯ The LOVO PLSCA technique appears to be a useful tool for evaluating the relative importance of predictor variables in data sets that exhibit considerable multicollinearity. When used as a filtering tool, LOVO PLSCA produced a MLR model that demonstrated a significant relationship between 'end fitness' and the predictor variable 'accumulated distance at very-high speed' when 'starting fitness' was included as a covariate. As such, LOVO PLSCA may be a useful tool for sport scientists and coaches seeking to analyse data sets obtained using GPS and MEMS technologies.
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The aims of this study were to 1) evaluate the impact of eight common chronic conditions and multimorbidity on preference-based health-related quality of life (HRQoL), and 2) estimate the minimally important difference (MID) in the general population of Hong Kong (HK). ⋯ The findings suggest that having more chronic conditions is strongly associated with a lower HRQoL. Healthcare reforms to address foreseeable challenges arising as more patients live with chronic conditions and multimorbidity could improve the HRQoL of HK citizens.
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As a result of global migration, health professionals in destination countries are increasingly being called upon to provide care for women and girls who have experienced female genital mutilation/cutting (FGM/C). There is considerable evidence to suggest that their care experiences are sub-optimal. This systematic review sought to illuminate possible reasons for this by exploring the views, experiences, barriers and facilitators to providing FGM-related healthcare in high income countries, from health professionals' perspectives. ⋯ FGM/C is a complex and culturally shaped phenomenon. In order to work effectively across cultural divides, there is a need for provider training, clear guidelines, care pathways and specialist FGM/C centres to support mainstream services.