Concepts and Dimensions in Continuous Midwifery Care Models Based on the Experiences and Expectations of Stakeholders: A Meta-Synthesis

Context: Pregnant women’s have access to different models of care especially to those who provide continuous care and this is one of the recommendations of the world health organization (WHO) for promoting maternal health. Moreover, to provide adequate services in care models, the experiences and perceptions of mothers, providers of prenatal care, and other stakeholders should be taken into consideration. Objectives: A systematic meta-synthesis was carried out to inquire into the findings of some qualitative studies aimed to explore the concept and dimensions of continuous midwifery care including experiences, perspectives and perceptions of engaged people. Data Sources: This study was the first step of an action research designed to develop a midwifery model of care. Qualitative research articles published between 2005 and 2015 on experiences, attitudes, expectations and opinions of stakeholders in models of midwifery care were collected from Google scholar, Elsevier, and PubMed databases. Study Selection: Following the various stages of the scrutiny of the abstracts and contents of the collected articles, five faculty members finally selected 21 qualitative research articles as eligible for inclusion in the meta-synthesis. Results: The findings of meta-synthesis showed that continuous midwifery care for pregnantwomenas a highly important process revolves around at least five basic themes: continuity of care, compliance with needs satisfaction levels, regulation of care environment, and the philosophy of providing continuous care. Conclusions: Given the importance of access to healthcare as a right for pregnant women and given the key role of continuous midwifery care in health promotion and maternal satisfaction, it is suggested based on the results of the study that rigorous local and national research in this area to be carried out so that adequate models of continuous midwifery care can be designed and implemented based on the findings

Assessing the percent of necrosis after neoadjuvant chemotherapy with 24hr infusional cisplatin/3 days doxorubicin intermittent with ifosfamide-doxorubicin for osteosarcoma

Introduction: osteosarcoma is the most common primary bone tumor in children and young adults and appropriate chemotherapy can increase limb sparing and overall survival. Yet, the toxicity of chemotherapy regimens including MTX can be life threatening. Therefore; we tried another chemotherapy regimen for these patients. Method and materials: we investigated 15 patients aged 15 to 40 years old and used continuous infusion of cisplatin, doxorubicin intermittently with ifosfamide, doxorubicin as neoadjuvant chemotherapy. Percent of necrosis and toxicities was recorded for each patient. Results: Out of 15 patients investigated, 13 were males and 2 females. Tumor necrosis≥ 90% (defined as good necrosis) was observed in 60% of patients. 26.7% of the patients showed leucopenia grade three or four, 26.7% had anemia grade three or four, and 20% showed thrombocytopenia grade three or four. Conclusion: The above chemotherapy regimen can cause as good necrosis as the chemotherapy regimens including high dose of MTX with reduced toxicity and less nursing cares and laboratory tests. Of course small sample size limits extension of our result to all patients but trying this regimen is recommended in more patients to see more reliable results

The influences of vitamin D and omega-3 co-supplementation on clinical, metabolic and genetic parameters in women with polycystic ovary syndrome

Objective: The aim of this study was to evaluate the effect of the co-administration of vitamin D and omega-3fatty acid on clinical, metabolic and genetic parameters in women with polycystic ovary syndrome (PCOS). Methods: This randomized, double-blinded, placebo-controlled clinical trial was conducted on 60 subjects, aged 18–40 years old with PCOS. Subjects were randomly allocated to take either 50,000 IU vitamin D every 2 weeks plus 2000 mg/day omega-3 fatty acid from fish oil (n=30) or placebo (n=30) for 12 weeks. Gene expression analysis of inflammatory cytokines was conducted on peripheral blood mononuclear cells (PBMCs) of PCOS women using RT-PCR method. Results: Vitamin D and omega -3 fatty acid co-supplementation significantly decreased serum total testosterone levels (−0.2 ± 0.5 vs.+0.1 ± 0.4 ng/mL, P=0.02) compared with the placebo. In addition, vitamin D and omega-3 fatty acid co-supplementation resulted in a significant improvement in beck depression inventory (−1.4 ± 1.6 vs. −0.5 ± 0.6, P=0.01), general health questionnaire scores (−4.5 ± 4.3 vs. −1.9 ± 2.3, P=0.005) and depression anxiety and stress scale scores (−5.0 ± 5.1 vs. −2.3 ± 3.5, P=0.01) compared with the placebo. Additionally, vitamin D and omega-3 fatty acid co-administration significantly decreased serum high-sensitivity C-reactive protein (hs-CRP) (−1.2 ± 1.9 vs.+0.1 ± 0.7 mg/L, P=0.001) and malondialdehyde (MDA) levels (−0.4 ± 0.4 vs.+0.2 ± 0.6 μmol/L, P<0.001), and significantly increased plasma total antioxidant capacity (TAC) levels (+ 114.6 ± 122.2 vs. -2.4 ± 168.2 mmol/L, P=0.003) compared with the placebo. Results of RT-PCR demonstrated that vitamin D and omega-3 fatty acid co-supplementation significantly downregulated gene expression of interleukin-1 (IL-1) (P=0.03), and upregulated vascular endothelial growth factor (VEGF) (P=0.004) in PBMCs of subjects with PCOS, when compared with placebo. Conclusions: Overall, the co-administration of vitamin D and omega-3 fatty acid for 12 weeks had beneficial effects on mental health parameters, serum total testosterone, hs-CRP, plasma TAC and MDA levels, and gene expression of IL-1 and VEGF among women with PCOS

A randomized double-blinded, placebo-controlled trial investigating the effect of fish oil supplementation on gene expression related to insulin action, blood lipids, and inflammation in gestational diabetes mellitus-fish oil supplementation and gestational diabetes

Gestational diabetes mellitus (GDM) is a common complication of pregnancy, and it is mostly associated with postpartum diabetes, insulin resistance, and dyslipidemia. Fish oil (omega-3) supplementation has been shown to reduce the risk of different chronic diseases such as cardiovascular disease, type 2 diabetes, and cancers, though the evidence of its impact on gestational diabetes is scarce. Our goal in this study was to determine the effect of fish oil administration on gene expression related to insulin action, blood lipids, and inflammation in women with GDM. Participants with GDM (n = 40), aged 18�40 years, were randomized to take either 1000 mg fish oil capsules, containing 180 mg eicosapentaenoic acid and 120 mg docosahexaenoic acid (n = 20), or placebo (n = 20) twice a day for 6 weeks. Gene expression related to insulin, lipids, and inflammation was quantified in peripheral blood mononuclear cells (PBMCs) of GDM women using Reverse Transcription Polymerase Chain Reaction (RT-PCR) method. Results of RT-PCR indicated that omega-3 supplementation upregulated gene expression of peroxisome proliferator-activated receptor gamma (PPAR-γ) (P = 0.04) in PBMCs of patients with GDM, compared with the placebo. In addition, gene expression of the low-density lipoprotein receptor (LDLR) (P < 0.001), interleukin-1 (IL-1) (P = 0.007), and tumor necrosis factor alpha (TNF-α) (P = 0.01) was downregulated in PBMCs of women with GDM, following omega-3 supplementation. No significant effect of omega-3 supplementation was indicated on gene expression of IL-8 in PBMCs of patients with GDM. Overall, fish oil supplementation for 6 weeks in women with GDM significantly improved gene expression of PPAR-γ, IL-1, and TNF-α, but not gene expression of IL-8. © 2018 by the authors. Licensee MDPI, Basel, Switzerland

Molecular survey of aminoglycoside-resistant Acinetobacter baumannii isolated from tertiary hospitals in Qazvin, Iran

Aminoglycoside-modifying enzymes (AMEs) and 16S rRNA methylases (16S RMTase) are two main resistance mechanisms against aminoglycosides. This study aimed to evaluate the frequency of AMEs and 16S rRNA methylase genes among aminoglycoside nonsusceptible Acinetobacter baumannii isolates and to assess their clonal relationship using repetitive extragenic palindromic-PCR (rep-PCR). In this cross-sectional study, a total of 192 A. baumannii isolates were collected from the patients hospitalized in Qazvin, Iran (January 2016 to January 2018). Identification of isolates was performed by standard laboratory methods and API 20E strips. Antimicrobial susceptibility was determined by Kirby–Bauer method followed by examination of the genes encoding the AMEs and 16S RMTase by PCR and sequencing methods. The clonal relationship of isolates was carried out by rep-PCR. In total, 98.4% of isolates were nonsusceptible to aminoglycosides, 98.4%, 97.9% and 83.9% of isolates were found to be non-susceptible against gentamicin, tobramycin and amikacin, respectively. The frequencies of aph(30 )-VI, aac(60 )-Ib, aac(3)-II, aph(30 )-Ia and armA genes were 59.3%, 39.2%, 39.2%, 31.7% and 69.8%, respectively, either alone or in combination. Rep-PCR results showed that the aminoglycoside non-susceptible isolates belonged to three distinct clones: A (79.4%), B (17.5%) and C (3.2%). The findings of this study showed a high frequency for AMEs with the emergence of armA genes among the aminoglycoside non-susceptible A. baumannii isolates. Rational administration of aminoglycosides as well as using an appropriate infection control policy may reduce the presence of resistance to antibiotics in medical centres

Altered localisation of the copper efflux transporters ATP7A and ATP7B associated with cisplatin resistance in human ovarian carcinoma cells

Metals in Catalysis, Biomimetics & Inorganic Material

The Nekton Maldives taxonomic workshop: Exploring the biodiversity of shallow, mesophotic and deep-sea communities in Maldives

This is the final version. Available from Pensoft Publishers via the DOI in this record. The Nekton Maldives Taxonomic Workshop took place at the Maniyafushi Research Station in the Maldives between 12 and 23 February 2023. This workshop had two primary objectives. Firstly, it aimed to identify species from biological samples and underwater imagery collected during the Nekton Maldives Mission in 2022. Secondly, it sought to facilitate training and knowledge exchange sessions between early career researchers from the Maldives and international taxonomists. These sessions were designed to share knowledge and introduce fundamental taxonomy concepts and enhance practical identification skills for common reef benthic groups and major zooplankton taxonomic groups. A total of 24 people from 10 different countries were directly or indirectly involved with the workshop comprising nine taxonomic experts, eleven trainees and four organisers. Collectively, we identified 278 biological specimens including potentially undescribed species of hydroids, black corals, sponges and octocorals, 318 morphotypes for underwater footage and zooplankton composition congruent with previous reports from the Indian Ocean Region. Next steps will involve depositing the specimens into a more a permanent facility to facilitate the process of specimen description and knowledge transfer.Nekton FoundationMaldives Marine Research Institut

Combined inhibition of DNA methylation and histone acetylation enhances gene re-expression and drug sensitivity in vivo

Histone deacetylation and DNA methylation have a central role in the control of gene expression in tumours, including transcriptional repression of tumour suppressor genes and genes involved in sensitivity to chemotherapy. Treatment of cisplatin-resistant cell lines with an inhibitor of DNA methyltransferases, 2-deoxy-5′azacytidine (decitabine), results in partial reversal of DNA methylation, re-expression of epigenetically silenced genes including hMLH1 and sensitisation to cisplatin both in vitro and in vivo. We have investigated whether the combination of decitabine and a clinically relevant inhibitor of histone deacetylase activity (belinostat, PXD101) can further increase the re-expression of genes epigenetically silenced by DNA methylation and enhance chemo-sensitisation in vivo at well-tolerated doses. The cisplatin-resistant human ovarian cell line A2780/cp70 has the hMLH1 gene methylated and is resistant to cisplatin both in vitro and when grown as a xenograft in mice. Treatment of A2780/cp70 with decitabine and belinostat results in a marked increase in expression of epigenetically silenced MLH1 and MAGE-A1 both in vitro and in vivo when compared with decitabine alone. The combination greatly enhanced the effects of decitabine alone on the cisplatin sensitivity of xenografts. As the dose of decitabine that can be given to patients and hence the maximum pharmacodynamic effect as a demethylating agent is limited by toxicity and eventual re-methylation of genes, we suggest that the combination of decitabine and belinostat could have a role in the efficacy of chemotherapy in tumours that have acquired drug resistance due to DNA methylation and gene silencing

A Study of the Learnability of Relational Properties: Model Counting Meets Machine Learning (MCML)

This paper introduces the MCML approach for empirically studying the learnability of relational properties that can be expressed in the well-known software design language Alloy. A key novelty of MCML is quantification of the performance of and semantic differences among trained machine learning (ML) models, specifically decision trees, with respect to entire (bounded) input spaces, and not just for given training and test datasets (as is the common practice). MCML reduces the quantification problems to the classic complexity theory problem of model counting, and employs state-of-the-art model counters. The results show that relatively simple ML models can achieve surprisingly high performance (accuracy and F1-score) when evaluated in the common setting of using training and test datasets - even when the training dataset is much smaller than the test dataset - indicating the seeming simplicity of learning relational properties. However, MCML metrics based on model counting show that the performance can degrade substantially when tested against the entire (bounded) input space, indicating the high complexity of precisely learning these properties, and the usefulness of model counting in quantifying the true performance