Women are increasingly turning to mobile health platforms to receive health information and support in pregnancy, yet the content of these platforms vary. Although there is great potential to ...influence health behaviors, little research has assessed the quality of these platforms or their ability to change behavior. In recent years, validated tools to assess app quality have become available.
To identify and assess the quality and ongoing popularity of the top 10 freely available pregnancy apps in Australia using validated tools.
A systematic search on app stores to identify apps was performed. A Google Play search used subject terms pregnancy, parenting, and childbirth; the iTunes search used alternative categories medical and health and fitness. The top 250 apps from each store were cross-referenced, and the top 100 found in both Google Play and iTunes were screened for eligibility. Apps that provided health information or advice for pregnancy were included. Excluded apps focused on nonhealth information (eg, baby names). The top 10 pregnancy apps were assessed using the Mobile App Rating Scale (MARS). A comparative analysis was conducted at 2 time points over 2 years to assess the ongoing popularity of the apps. The MARS score was compared to the download and star rating data collected from iTunes and Google Play in 2017 and 2019. Health behaviors including breastfeeding, healthy pregnancy weight, and maternal awareness of fetal movements were reviewed for apparent impact on the user's knowledge, attitudes, and behavior change intentions using the MARS perceived impact section and the Coventry, Aberdeen, and London-Refined (CALO-RE) taxonomy.
A total of 2052 free apps were screened for eligibility, 1397 were excluded, and 655 were reviewed and scored. The top 10 apps were selected using download numbers and star ratings. All 10 apps were suboptimal in quality, practicality, and functionality. It was not possible to identify a primary purpose for all apps, and there was overlap in purpose for many. The mean overall MARS app quality score across all 10 apps was 3.01 (range 1.97-4.40) in 2017 and 3.40 (range 2.27-4.44) in 2019. A minority of apps scored well for perceived impact on health behavior using the MARS tool. Using the CALO-RE 40 item taxonomy, the number of behavior change techniques used was low. The mean number of behavior change techniques for breastfeeding was 5 (range 2-11), for pregnancy weight was 4 (range 2-12), and for maternal awareness of fetal movements was 5 (range 2-8).
This review provides valuable information to clinicians and consumers about the quality of apps currently available for pregnancy in Australia. Consideration is needed regarding the regulation of information and the potential opportunity to incorporate behavior change techniques to improve maternal and fetal outcomes.
A major agronomic problem in the southeastern USA is low yield of late-planted soybean Glycine max (L.) Merr.. This problem is aggravated by the adverse effect of waterlogging on crop growth. Our ...objectives were to identify soybean growth stages sensitive to waterlogging, identify yield components and physiological parameters explaining yield losses induced by waterlogging; and determine the extent of yield losses induced by waterlogging under natural field conditions. Greenhouse and field studies were conducted during 1993 and 1994 near Baton Rouge, LA, (30 degree N Lat) on a Commerce silt loam. Waterlogging tolerance was assessed in cultivar Centennial (Maturity Group VI) at three vegetative and five reproductive growth stages by maintaining the water level at the soil surface in a greenhouse study. Using the same cultivar, we evaluated the effect of drainage in the field for late-planted soybean. Rain episodes determined the timing of waterlogging; redox potential and oxygen concentration of the soil were used to quantify the intensity of waterlogging stress. Results of the greenhouse study indicated that the early vegetative period (V2) and the early reproductive stages (R1, R3, and R5) were most sensitive to waterlogging. Three to 5 cm of rain per day falling on poorly drained soil was sufficient to reduce crop growth rate, resulting in a yield decline from 2453 to 1550 kg ha-1. Yield loss in both field and greenhouse studies was induced primarily by decreased pod production resulting from fewer pods per reproductive node. In conclusion, waterlogging was determined to be an important stress for late-planted soybean in high rainfall areas such as the Gulf Coast Region
There is limited guidance available to clinicians regarding the management of antithrombotic therapy during epistaxis, whilst there has been an increase in the use of anticoagulation and antiplatelet ...therapy. In addition, the introduction of direct oral anticoagulants (DOACs), such as dabigatran and rivaroxaban, over the last decade has significantly increased the complexity of managing the anticoagulated epistaxis patient. We undertook a systemic literature review investigating potential management strategies for each class of anti-thrombotic therapy during epistaxis. A PubMED and Cochrane Library search was performed on 10/03/16 using, but not limited to, the search terms epistaxis, nosebleed, nose bleeding, nasal haemorrhage, nasal bleeding AND each of the following search terms: antithrombotic, anticoagulant, antiplatelet, aspirin, clopidogrel, warfarin, dabigatran, rivaroxaban, apixaban and tranexamic acid. This yielded 3815 results, of which 29 were considered relevant. Other sources such as national and international guidelines related to the management of anti-thrombotics were also utilised. We present the findings related to the management of each class of anti-thrombotic therapy during epistaxis. Overall we found a lack of evidence regarding this topic and further high quality research is needed. This is an area growing in complexity and the support of colleagues in Haematology and Cardiology is increasingly important.
Plant culture in oxygen concentrations below ambient is known to stimulate vegetative growth, but apart from reports on increased leaf number and weight, little is known about development at ...subambient oxygen concentrations. Arabidopsis thaliana (L.) Heynh. (cv. Columbia) plants were grown full term in pre-mixed atmospheres with oxygen partial pressures of 2.5, 5.1, 10.1, 16.2, and 21.3 kPa O2, 0.035 kPa CO2 and the balance nitrogen under continuous light. Fully expanded leaves were harvested and processed for light and transmission electron microscopy or for starch quantification. Growth in subambient oxygen concentrations caused changes in leaf anatomy (increased thickness, stomatal density and starch content) that have also been described for plants grown under carbon dioxide enrichment. However, at the lowest oxygen treatment (2.5 kPa), developmental changes occurred that could not be explained by changes in carbon budget caused by suppressed photorespiration, resulting in very thick leaves and a dwarf morphology. This study establishes the leaf parameters that change during growth under low O2, and identifies the lower concentration at which O2 limitation on transport and biosynthetic pathways detrimentally affects leaf development. Grant numbers: NAG5-3756, NAG2-1020, NAG2-1375.
Essentials
The once‐daily dosing of tinzaparin provides an advantage over other low molecular weight heparins.
The recommended age‐dependent doses of tinzaparin in children have not previously been ...validated.
Once‐daily administration of tinzaparin is a safe and effective treatment of childhood thrombosis.
Recommended doses are appropriate but monitoring may be required due to inter‐individual variation.
Summary
Background
The recommended starting doses of tinzaparin for the treatment of thrombosis in children have not previously been validated. There are few data to support the efficacy and safety of once‐daily tinzaparin dosing in children with thrombosis.
Objectives
To investigate the use of tinzaparin for the treatment of childhood thrombosis, and to evaluate the age‐dependent dosing recommendations and define outcomes in terms of efficacy and safety.
Methods
This was a retrospective cohort study of children aged 0 to < 16 years treated for thrombosis at a large teaching hospital in the UK between 2008 and 2015. Medical records were reviewed to evaluate tinzaparin dosing, anti‐activated factor X (FXa) levels, and patient outcomes.
Results
Seventy‐nine children were identified as having received tinzaparin. Dosing information was available for 57. Younger children required higher doses to reach a therapeutic level. The therapeutic dose requirement varied within age groups, supporting the use of anti‐FXa monitoring. Over a median follow‐up of 35 months, there were 13 (16%) bleeding episodes (two major; seven clinically relevant but non‐major; and four minor). There were two (3%) recurrent episodes of thrombosis. Children were treated for a median duration of 3 months, and the majority (86%) remained on tinzaparin for the duration of their anticoagulant therapy.
Conclusion
Once‐daily tinzaparin is a safe and effective treatment for childhood thrombosis, with rates of recurrence and bleeding similar to those for other anticoagulants used in children. The recommended starting doses are appropriate, but anti‐FXa monitoring may be required, owing to interindividual variability in the therapeutic dose requirement.
Tissue factor expression on monocytes is implicated in the pathophysiology of sepsis-induced coagulopathy. How tissue factor is expressed by monocyte subsets (classical, intermediate and ...non-classical) is unknown.
Monocytic tissue factor surface expression was investigated during three conditions. Primary human monocytes and microvascular endothelial cell co-cultures were used for in vitro studies. Volunteers received a bolus of lipopolysaccharide (2 ng/kg) to induce endotoxemia. Patients with sepsis, or controls with critical illness unrelated to sepsis, were recruited from four intensive care units.
Contact with endothelium and stimulation with lipopolysaccharide reduced the proportion of intermediate monocytes. Lipopolysaccharide increased tissue factor surface expression on classical and non-classical monocytes. Endotoxemia induced profound, transient monocytopenia, along with activation of coagulation pathways. In the remaining circulating monocytes, tissue factor was up-regulated in intermediate monocytes, though approximately 60 % of individuals (responders) up-regulated tissue factor across all monocyte subsets. In critically ill patients, tissue factor expression on intermediate and non-classical monocytes was significantly higher in patients with established sepsis than among non-septic patients. Upon recovery of sepsis, expression of tissue factor increased significantly in classical monocytes.
Tissue factor expression in monocyte subsets varies significantly during health, endotoxemia and sepsis.
•There are three monocyte subsets: classical (CD14++, CD16-), intermediate (CD14++, CD16+) and non-classical (CD14+, CD16+).•Classical and non-classical tissue factor (TF) expression is induced by LPS stimulation.•Only a proportion of individuals increased monocyte TF surface expression post endotoxaemia.•Individuals with sepsis had higher intermediate and non-classical TF surface expression than those without sepsis•On recovery from sepsis, classical monocytes increased TF surface expression.
We present the result of an experiment to measure the electric dipole moment (EDM) of the neutron at the Paul Scherrer Institute using Ramsey's method of separated oscillating magnetic fields with ...ultracold neutrons. Our measurement stands in the long history of EDM experiments probing physics violating time-reversal invariance. The salient features of this experiment were the use of a ^{199}Hg comagnetometer and an array of optically pumped cesium vapor magnetometers to cancel and correct for magnetic-field changes. The statistical analysis was performed on blinded datasets by two separate groups, while the estimation of systematic effects profited from an unprecedented knowledge of the magnetic field. The measured value of the neutron EDM is d_{n}=(0.0±1.1_{stat}±0.2_{sys})×10^{-26} e.cm.
Waterlogging is a serious environmental stress on winter wheat (Triticum aestivum L.) grown in the Gulf Coast region. We hypothesized that waterlogging tolerance differs in currently available lines ...and cultivars and that suitability of physiological parameters to distinguish yield responses could be evaluated. Three types of studies were conducted: a 2-yr greenhouse study of eight cultivars, a 4-yr irrigated field study of 20 cultivars and breeding lines, and a 3-yr field study of six cultivars under rain-excluding shelters which allowed comparison of performance under waterlogged and well-drained conditions. In the rainshelter study, waterlogging caused a 45% decrease in grain weight, resulting from a 45% decrease in number of kernels and a 5% decrease in kernel weight. Cultivars differed for grain yield under waterlogged conditions in the field (P = 0.1), and Coker 9877 and line LA 862A16-3-3-X yielded 32 and 33% above the mean, respectively. Greenhouse measures of photosynthesis under waterlogging were weakly predictive of yield (r2 = 0.61) and correlated to measures under well-drained conditions (r2 = 0.87). Yield was well correlated with biomass (r2 = 0.84) and root mineral content (Fe + Mn + P) (r2 = 0.94). Waterlogged yields X cultivar did not correlate with yield under well-drained conditions (r2 = 0.14) and the same differential response to waterlogging was shown for biomass and root mineral content. The negative correlation between root mineral content and yield was attributed to processes involved in the formation of a mineral plaque on the surface of the wheat roots. This emphasizes the need to explore differences in root function when selecting wheat lines for enhanced waterlogging tolerance.
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