A Low UVB Dose, with the Potential to Trigger a Protective p53-Dependent Gene Program, Increases the Resilience of Keratinocytes against Future UVB Insults

One protein central in the response of human keratinocytes to ultraviolet B damage is p53. By transactivating genes involved in either cell cycle arrest or DNA repair, p53 has a leading role in the recovery from this damage. Considering this role, we wished to investigate whether the triggering of a p53-dependent gene program by repetitive ultraviolet B (UVB) exposure can induce an adaptive response in human skin cells. In particular, we examined two p53-target genes, p21/WAF1 and p53R2, with a crucial role in p53-induced cell cycle arrest and p53-induced DNA repair respectively. Exposure to a mild UVB dose was able to induce an adaptive response in human keratinocytes, leading to increased survival of cells that maintain their capacity to repair DNA damage upon exposure to apoptotic doses of UVB. Our study indicates that this adaptation response is only achieved if the interval between subsequent UVB insults allows sufficient time for the p53-induced protective gene program to be induced. Our results also demonstrate that small but quickly recurring UVB exposures are as harmful as one intense, continual exposure to UVB irradiation. Future research will be oriented toward investigating alternative ways to induce an adaptive response without pre-exposing the cells to UV

Variations in childbirth interventions in high-income countries: protocol for a multinational cross-sectional study

Introduction There are growing concerns about the increase in rates of commonly used childbirth interventions. When indicated, childbirth interventions are crucial for preventing maternal and perinatal morbidity and mortality, but their routine use in healthy women and children leads to avoidable maternal and neonatal harm. Establishing ideal rates of interventions can be challenging. This study aims to describe the range of variations in the use of commonly used childbirth interventions in high-income countries around the world, and in outcomes in nulliparous and multiparous women. Methods and analysis This multinational cross-sectional study will use data from births in 2013 with national population data or representative samples of the population of pregnant women in high-income countries. Data from women who gave birth to a single child from 37 weeks gestation onwards will be included and the results will be presented for nulliparous and multiparous women separately. Anonymised individual level data will be analysed. Primary outcomes are rates of commonly used childbirth interventions, including induction and/or augmentation of labour, intrapartum antibiotics, epidural and pharmacological pain relief, episiotomy in vaginal births, instrument-assisted birth (vacuum or forceps), caesarean section and use of oxytocin postpartum. Secondary outcomes are maternal and perinatal mortality, Apgar score below 7 at 5 min, postpartum haemorrhage and obstetric anal sphincter injury. Univariable and multivariable logistic regression analyses will be conducted to investigate variations among countries, adjusted for maternal age, body mass index, gestational weight gain, ethnic background, socioeconomic status and infant birth weight. The overall mean rates will be considered as a reference category, weighted for the size of the study population per country. Ethics and dissemination The Medical Ethics Review Committee of VU University Medical Center Amsterdam confirmed that an official approval of this study was not required. Results will be disseminated at national and international conferences and published in peer-reviewed journals.The study was developed during a meeting with COST-members (European Cooperation in Science and Technology). These meetings are funded by the COST Action IS1405 ‘BIRTH’ (European Cooperation in Science and Technology). There is no other external funding for this study.Peer Reviewe

Correction : variations in childbirth interventions in high-income countries : protocol for a multinational cross-sectional study

Original article can be fount at: https://www.um.edu.mt/library/oar/handle/123456789/58714Correction issued for the article Variations in childbirth interventions in highincome countries: protocol for a multinational cross-sectional study (10.1136/bmjopen-2017-017993)peer-reviewe

Economic Evaluation of Urban Track Systems: Integration of Life Cycle Costs and Socio-Economic Assessment

Urban Track is an EU funded research project (2006-2010) aiming at the development and construction of modular track systems for tram, metro and light rail with a low life cycle cost and a high performance. Systems should be safe, and produce a minimum of noise and vibrations. In total, 28 different partners have worked on the development, implementation and assessment of the innovative rail technologies. To assess the Life Cycle Costs (LCC) and Socio-Economic Costs (SEC) of the newly developed systems before and after implementation, an integrated LCC-SEC methodology has been developed. Based on European literature and discussions with partners and experts, relevant socio-economic impacts and their monetary values have been defined. For the building site noise and turnover compensation have been considered, for the detour costs of congestion, fuel, road accidents, noise, emissions, climate change and costs for the public transport company have been taken into account. The SEC-calculation tool provides a transparent overview of the socio-economic costs for a certain location or the performance of a certain system on different locations. Although the LCC-SEC calculation tool is based on monetary cost, the Socio-Economic methodology has been made suitable to incorporate qualitative and non-monetary effects, like environmental impacts, vibrations, quality of the surface or typical characteristics of the building site that have impact on the decision-making process and the desirability of the project. The before and after studies carried out, show the importance of Socio-Economic impacts in the choice for a system. Innovative systems, fast to implement, low cost in maintenance, are often more expensive leading to a higher LCC. However, the advantages are often socio-economic (hindrance for traffic or shops, noise and vibrations, carbon). By including both types of costs in the assessment a better founded choice can be made, taking different types of short and long term impacts into account