Consistency of moral judgment across different dilemmas and social contexts and the relationship between the structure and content of moral judgment was studied for 40 men given hypothetical ...dilemmas. Findings demonstrate that type of dilemma may affect the structure of moral reasoning and illustrate various stages of moral reasoning. (SLD)
This study investigated two main issues: Whether people's judgments about real-life moral transgressions are affected by the role they play in them and whether self-serving biases in such judgments ...vary with level of moral development. One-hundred twenty university students took Colby and Kohlberg's (1987) test of moral judgment and made open-ended and rating-scale judgments about three real-life transgressions they considered moral in nature. As expected, participants made more exculpatory judgments about transgressions they committed than they did about transgressions others committed, but participants did not judge transgressions committed against them more harshly than they judged transgressions committed against others. The higher participants scored on Kohlberg's test the less they externalized and excused their moral transgressions. Contrary to expectation, this relation also applied to moral judgments about transgressions committed by others against others. These findings have important implications for models of moral development and social cognition.
The theory of evolution focuses on the ultimately (i.e. genetically) self-serving nature of co-operative and competitive relations among children. These relations are mediated by biases in social ...judgement. Individual differences in heritable behavioural styles are reviewed as resources of varying value in different social contexts. Discusses limitations in the a priori predictive power of evolutionary theory. (Original abstract-amended)
Introduction
Uncertainty exists regarding the impact of malpresentation on pregnancy outcomes and the optimal mode of delivery in low‐ and middle‐income countries. We sought to compare outcomes ...between cephalic and non‐cephalic pregnancies.
Material and methods
Using the NICHD Global Network's prospective, population‐based registry of pregnancy outcomes from 2010 to 2016, we studied outcomes in 436 112 singleton pregnancies. Robust Poisson regressions were used to estimate the risk of adverse outcomes associated with malpresentation. We examined rates of cesarean delivery for malpresentation and compared outcomes between cesarean and vaginal delivery by region.
Results
Across all regions, stillbirth and neonatal mortality rates were higher among deliveries with malpresentation. In adjusted analysis, malpresentation was significantly associated with stillbirth (adjusted relative risk aRR 4.0, 95% confidence interval CI 3.7‐4.5) and neonatal mortality (aRR 2.3, 95% CI 2.1‐2.6). Women with deliveries complicated by malpresentation had higher rates of morbidity and mortality. Rates of cesarean delivery for malpresentation ranged from 27% to 87% among regions. Compared with cesarean delivery, vaginal delivery for malpresentation was associated with increased maternal risk, especially postpartum hemorrhage (aRR 5.0, 95% CI; 3.6‐7.1).
Conclusions
In a cohort of deliveries in low‐ and middle‐income countries, malpresentation was associated with increased perinatal and maternal risk. Further research is needed to determine the best management of these pregnancies.
Atherosclerosis is a systemic and chronic inflammatory disease propagated by monocytes and macrophages. Yet, our knowledge on how transcriptome of these cells evolves in time and space is limited. We ...aimed at characterizing gene expression changes in site-specific macrophages and in circulating monocytes during the course of atherosclerosis.
We utilized apolipoprotein E-deficient mice undergoing one- and six-month high cholesterol diet to model early and advanced atherosclerosis. Aortic macrophages, peritoneal macrophages, and circulating monocytes from each mouse were subjected to bulk RNA-sequencing (RNA-seq). We constructed a comparative directory that profiles lesion- and disease stage-specific transcriptomic regulation of the three cell types in atherosclerosis. Lastly, the regulation of one gene, Gpnmb, whose expression positively correlated with atheroma growth, was validated using single-cell RNA-seq (scRNA-seq) of atheroma plaque from murine and human.
The convergence of gene regulation between the three investigated cell types was surprisingly low. Overall 3245 differentially expressed genes were involved in the biological modulation of aortic macrophages, among which less than 1% were commonly regulated by the remote monocytes/macrophages. Aortic macrophages regulated gene expression most actively during atheroma initiation. Through complementary interrogation of murine and human scRNA-seq datasets, we showcased the practicality of our directory, using the selected gene, Gpnmb, whose expression in aortic macrophages, and a subset of foamy macrophages in particular, strongly correlated with disease advancement during atherosclerosis initiation and progression.
Our study provides a unique toolset to explore gene regulation of macrophage-related biological processes in and outside the atheromatous plaque at early and advanced disease stages.
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•Aortic macrophages have the most active gene regulation during atheroma initiation.•Inflammatory response of aortic macrophages is prominent during atheroma progression.•Foamy macrophage marker, Gpnmb, strongly correlates with atherosclerosis advancement.•Gpnmb + foamy macrophages downregulate pro-inflammatory genes.
Because large, prospective, population-based data sets describing maternal outcomes are typically not available in low- and middle-income countries, it is difficult to monitor maternal mortality ...rates over time and to identify factors associated with maternal mortality. Early identification of risk factors is essential to develop comprehensive intervention strategies preventing pregnancy-related complications. Our objective was to describe maternal mortality rates in a large, multi-country dataset and to determine maternal, pregnancy-related, delivery and postpartum characteristics that are associated with maternal mortality.
We collected data describing all pregnancies from 2010 to 2013 among women enrolled in the multi-national Global Network for Women's and Children's Health Research Maternal and Neonatal Health Registry (MNHR). We reported the proportion of mothers who died per pregnancy and the maternal mortality ratio (MMR). Generalized linear models were used to evaluate the relationship of potential medical and social factors and maternal mortality and to develop point and interval estimates of relative risk associated with these factors. Generalized estimating equations were used to account for the correlation of outcomes within cluster to develop appropriate confidence intervals.
We recorded 277,736 pregnancies and 402 maternal deaths for an MMR of 153/100,000 live births. We observed an improvement in the total MMR from 166 in 2010 to 126 in 2013. The MMR in Latin American sites (91) was lower than the MMR in Asian (178) and African sites (125). When adjusted for study site and the other variables, no formal education (RR 3.2 1.5, 6.9), primary education only (RR 3.4 1.6, 7.5), secondary education only (RR 2.5 1.1, 5.7), lack of antenatal care (RR 1.8 1.2, 2.5), caesarean section delivery (RR 1.9 1.3, 2.8), hemorrhage (RR 3.3 2.2, 5.1), and hypertensive disorders (RR 7.4 5.2, 10.4) were associated with higher risks of death.
The MNHR identified preventable causes of maternal mortality in diverse settings in low- and middle-income countries. The MNHR can be used to monitor public health strategies and determine their association with reducing maternal mortality.
clinicaltrials.gov NCT01073475.
Abstract Objective To implement a vital statistics registry system to register pregnant women and document birth outcomes in the Global Network for Women's and Children's Health Research sites in ...Asia, Africa, and Latin America. Methods The Global Network sites began a prospective population-based pregnancy registry to identify all pregnant women and record pregnancy outcomes up to 42 days post-delivery in more than 100 defined low-resource geographic areas (clusters). Pregnant women were registered during pregnancy, with 42-day maternal and neonatal follow-up recorded—including care received during the pregnancy and postpartum periods. Recorded outcomes included stillbirth, neonatal mortality, and maternal mortality rates. Results In 2010, 72 848 pregnant women were enrolled and 6-week follow-up was obtained for 97.8%. Across sites, 40.7%, 24.8%, and 34.5% of births occurred in a hospital, health center, and home setting, respectively. The mean neonatal mortality rate was 23 per 1000 live births, ranging from 8.2 to 48.5 per 1000 live births. The mean stillbirth rate ranged from 13.7 to 54.4 per 1000 births. Conclusion The registry is an ongoing study to assess the impact of interventions and trends regarding pregnancy outcomes and measures of care to inform public health. ClinicalTrial.gov Trial Registration: NCT01073475
Maternal near miss in low‐resource areas Goldenberg, Robert L.; Saleem, Sarah; Ali, Sumera ...
International journal of gynecology and obstetrics,
September 2017, Letnik:
138, Številka:
3
Journal Article
Recenzirano
Odprti dostop
Objective
To describe the Global Network Near‐Miss Maternal Mortality System and its application in seven sites.
Methods
In a population‐based study, pregnant women eligible for enrollment in the ...Maternal and Newborn Health Registry at seven sites (Democratic Republic of the Congo; Guatemala; Belagavi and Nagpur, India; Kenya; Pakistan; and Zambia) between January 2014 and April 2016 were screened to identify those likely to have a near‐miss event. The WHO maternal near‐miss criteria were modified for low‐resource settings. The ratio of near‐miss events to maternal deaths was calculated.
Results
Among 122 707 women screened, 18 307 (15.0%) had a potential near‐miss event, of whom 4866 (26.6%; 4.0% of all women) had a near‐miss maternal event. The overall maternal mortality ratio was 155 per 100 000 live births. The ratio of near‐miss events to maternal deaths was 26 to 1. The most common factors involved in near‐miss cases were the hematologic/coagulation system, infection, and cardiovascular system.
Conclusion
By using the Global Network Near‐Miss Maternal Mortality System, large numbers of women were screened for near‐miss events, including those delivering at home or a low‐level maternity clinic. The 4.0% incidence of near‐miss maternal mortality is similar to previously reported data. The ratio of 26 near‐miss cases to 1 maternal death suggests that near miss might evaluate the impact of interventions more efficiently than maternal mortality.
The Global Network Near‐Miss Maternal Mortality System found that 4% of pregnant women experienced a near‐miss event; there were 26 events for each maternal death.
NifU is a homodimeric modular protein comprising N- and C-terminal domains and a central domain with a redox-active 2Fe−2S2+,+ cluster. It plays a crucial role as a scaffold protein for the assembly ...of the Fe−S clusters required for the maturation of nif-specific Fe−S proteins. In this work, the time course and products of in vitro NifS-mediated iron−sulfur cluster assembly on full-length NifU and truncated forms involving only the N-terminal domain or the central and C-terminal domains have been investigated using UV−vis absorption and Mössbauer spectroscopies, coupled with analytical studies. The results demonstrate sequential assembly of labile 2Fe−2S2+ and 4Fe−4S2+ clusters in the U-type N-terminal scaffolding domain and the assembly of 4Fe−4S2+ clusters in the Nfu-type C-terminal scaffolding domain. Both scaffolding domains of NifU are shown to be competent for in vitro maturation of nitrogenase component proteins, as evidenced by rapid transfer of 4Fe−4S2+ clusters preassembled on either the N- or C-terminal domains to the apo nitrogenase Fe protein. Mutagenesis studies indicate that a conserved aspartate (Asp37) plays a critical role in mediating cluster transfer. The assembly and transfer of clusters on NifU are compared with results reported for U- and Nfu-type scaffold proteins, and the need for two functional Fe−S cluster scaffolding domains on NifU is discussed.
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