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Introduction While there is growing interest in applying patient-reported measures (PRMs) in clinical routine, limited collective evidence of the impact of PRMs hinder their widespread use in specific contexts, such as maternity care. Our objective was to synthesize existing emperical evidence on the impact of implementing PRMs in routine maternity care. Material and methods We followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines (version 2020). We electronically searched six databases for the literature on the implementation of PRMs in maternity care. A multi-level (woman, clinical, organizational, national and societal) analytic framework for analyzing and synthesizing emperically proven impacts of PRMs was developed. Quality was assessed using the Mixed Method Appraisal Tool. The GRADE-CERQual approach was used to assess the confidence in the review findings and arguments. The protocol was registered in PROSPERO (CRD42021234501). Results Overall, 4971 articles were screened. The emperical evidence, collected from 11 relevant studies, showed that the use of PRMs in routine maternity care could produce positive effects on clinical process (assessment and detection of health problems, clinical visit preparation, resource use, woman–professional communication, decision-making, woman–professional relationship, and care quality), and health behavior and outcomes (women's health and wellbeing, quality of life, health behavior, experiences and satisfaction with healthcare services), awareness, engagement and self-management of own health, and disclosure of health issues. The confidence in the review findings was low to moderate due to a limited number of studies, inadequate data and methodological limitations of included studies. Conclusions The limited emperical evidence available suggested that the use of PRMs may have positive effects at the individual health level and clinical process level. However, the evidence was not strong enough to provide policy recommendations on the use of PRMs in routine maternity care. This review revealed limitations of currently available research, such as lack of generalizability and narrow scopes in investigating impact. Efforts are needed to improve the quality of research on the use of PRMs in routine maternity care by widening the study population, including different types of PRMs, and considering the effects of PRMs at different levels and domains of healthcare.

Soil invertebrates are among the least understood metazoans on Earth. Thus far, the lack of taxonomically broad and dense genomic resources has made it hard to thoroughly investigate their evolution and ecology. With MetaInvert we provide draft genome assemblies for 232 soil invertebrate species, representing 14 common groups and 94 families. We show that this data substantially extends the taxonomic scope of DNA- or RNA-based taxonomic identification. Moreover, we demonstrate that theories of genome evolution cannot be generalised across evolutionarily distinct invertebrate groups. The soil invertebrate genomes presented here will support the management of soil biodiversity through molecular monitoring of community composition and function, and the discovery of evolutionary adaptations to the challenges of soil conditions.

Background: The United States ranks poorly when compared with other developed nations with regard to its maternal mortality ratio (MMR), defined as the number of maternal deaths per 100,000 live births. Meanwhile, Finland consistently ranks as one of the safest places to be pregnant and give birth. The U.S. MMR more than doubled between 1987 and 2016, increasing from 7.2 deaths per 100,000 to 16.9, and has continued to increase. The Finnish MMR in 2017 was reported as 3 deaths per 100,000 live births, compared with the United States' 19 deaths for that same year. This article provides a comprehensive outline of Finland's structure of perinatal care, as well as a review of statistics concerning trends in the country's mortality and morbidity risk factors and a comparison with similar parameters in the United States. Methods: The Finnish maternal healthcare system was observed through the shadowing of healthcare providers during various pre- and postpartum patient encounters. Further discussion was supplemented by literature review. Results: Although trends among Finnish mothers for more than the past 30 years indicate increased prevalence of mortality and morbidity risk factors, including C-section rates, maternal mortality remains consistently low. Observational data depict the Finnish perinatal care system as a decentralized community-based network of primary health facilities that emphasizes both physical and psychosocial well-being in the care of its expectant mothers. Conclusion: We suggest that the Finnish perinatal system of care may provide a good template from which the United States can model future efforts to decrease maternal mortality.

Soil microbial diversity affects ecosystem functioning and global biogeochemical cycles. Soil bacterial communities catalyze a diversity of biogeochemical reactions and have thus sparked considerable scientific interest. One driver of bacterial community dynamics in natural ecosystems has so far been largely neglected: the predator-prey interactions between bacterial viruses (bacteriophages) and bacteria. To generate ground level knowledge on environmental drivers of these particular predator-prey dynamics we propose an activity-based ecological framework to simultaneous capture community dynamics of bacteria and bacteriophages in soils. An ecological framework and specifically the analyses of community dynamics across latitudinal and altitudinal gradients have been widely used in ecology to understand community-wide responses of innumerable taxa to environmental change, in particular to climate. Here, we tested the hypothesis that the activity of bacteria and bacteriophages co-decline across an elevational gradient. We used metatranscriptomics to investigate bacterial and bacteriophage activity patterns at 5 sites across 400 elevational meters in the Swiss Alps in 2015 and 2017. We found that metabolic activity (transcription levels) of bacteria declined significantly with increasing elevation, but activity of bacteriophages did not. We showed that bacteriophages are consistently active in soil along the entire gradient. Bacteriophage activity pattern, however, is divergent from that of their putative bacterial prey. Future efforts will be necessary to link the environment-activity relationship to predator-prey dynamics, to understand the magnitude of viral contributions to mobilize bacterial cell carbon when infection causes bacterial cell death, a process that may represent an overlooked component of soil biogeochemical cycles.

Metagenomics - shotgun sequencing of all DNA fragments from a community DNA extract - is routinely used to describe the composition, structure and function of microorganism communities. Advances in DNA sequencing and the availability of genome databases increasingly allow the use of shotgun metagenomics on eukaryotic communities. Metagenomics offers major advances in the recovery of biomass relationships in a sample, in comparison to taxonomic marker gene based approaches (metabarcoding). However, little is known about the factors which influence metagenomics data from eukaryotic communities, such as differences among organism groups, the properties of reference genomes and genome assemblies.We evaluated how shotgun metagenomics records composition and biomass in artificial soil invertebrate communities. We generated mock communities of controlled biomass ratios from 28 species from all major soil mesofauna groups: mites, springtails, nematodes, tardigrades and potworms. We shotgun-sequenced these communities and taxonomically assigned them with a database of over 270 soil invertebrate genomes.We recovered 90% of the species, and observed relatively high false positive detection rates. We found strong differences in reads assigned to different taxa, with some groups (e.g. springtails) consistently attracting more hits than others (e.g. enchytraeids). Original biomass could be predicted from read counts after considering these taxon-specific differences. Species with larger genomes, and with more complete assemblies consistently attracted more reads than species with smaller genomes. The GC content of the genome assemblies had no effect on the biomass-read relationships.The results show considerable differences in taxon recovery and taxon specificity of biomass recovery from metagenomic sequence data. The properties of reference genomes and genome assemblies also influence biomass recovery, and they should be considered in metagenomic studies of eukaryotes. We provide a roadmap for investigating factors which influence metagenomics-based eukaryotic community reconstructions. Understanding these factors is timely as accessibility of DNA sequencing, and momentum for reference genomes projects show a future where the taxonomic assignment of DNA from any community sample becomes a reality.

BackgroundIn Germany, there are neither guidelines provided by the medical associations nor a public discussion about general practitioners (GPs) treating their family members. Only few studies on this topic from the primary care setting exist. The aim of this study is to describe GPs’ treatment of family members and to generate empirical data on the most common reasons for this.MethodsIn June 2018 we conducted a postal survey among GPs in the North Rhine region of Germany. The questionnaire was developed in a stepwise process including initial expert panels, interviews with GPs, item construction workshops, cognitive pre-tests and pilot testing with 40 questionnaires. The final questionnaire addressed: type and frequency of treatment, documentation and place of treatment, engagement as the official GP as well as reasons for and against the treatment. For data evaluation, descriptive and explorative statistical analyses were conducted.ResultsOverall, 393 questionnaires were returned (response rate 39.8%). 96.7% of the GPs had treated at least one family member during the last 12 months. Services that were provided frequently (more than three times in the last 12 months) included the prescription or dispensing of medication (partner 45%, children 37%, parents 43%, partner’s parents 26%), physical examinations (partner 18%, children 24%, parents 25%, partner’s parents 15%), and the arrangement or provision of laboratory tests (partner 14%, children 7%, parents 16%, partner’s parents 9%). Less than one third of the study participants always treated their relatives in their office. Male GPs more often provided care to family members (except children) registered in their practice. Senior male GPs treated their relatives more often than junior female GPs. Family members were most commonly treated for practical reasons.ConclusionThe subject of GPs treating their relatives is of high everyday relevance, since nearly all GPs are involved in the treatment of their family members. Frequent at-home treatments and low documentation rates may indicate risks due to deviating from the professional routine.

Background\ud Childhood maltreatment, including neglect, can affect an individual's mental health. However, there is a gap in current literature investigating the long-term, dynamic effects of childhood neglect on adult affective symptoms (AS).\ud \ud Method\ud Data were used from the National Child Development Study (a British 1958 birth cohort). Childhood neglect was prospectively measured at ages 7 and 11. Five distinct trajectories of AS have been derived previously, using data from the Malaise Inventory Scale (at ages 23, 33, 42 and 50): ‘no symptoms’, ‘persistent mild/moderate symptoms’, ‘low and increasing symptoms’, ‘high and increasing symptoms’ and ‘high and decreasing symptoms’ (John et al., 2019). Multinomial logistic regressions were used to explore whether childhood neglect was associated with AS trajectory membership, while adjusting for a number of covariates.\ud \ud Results\ud Results revealed that childhood neglect was significantly associated with ‘high and decreasing’, ‘high and increasing’ and ‘persistent mild/moderate’ AS trajectories from young adulthood through midlife. There was no association with the ‘low and increasing’ AS trajectory. When testing for at age specific effects, neglect experienced at age 7 only, or at age 11 only, was predictive of ‘high and decreasing symptoms’ trajectory, whereas neglect experienced at both ages was predictive of ‘persistent mild/moderate symptoms’ trajectory.\ud \ud Conclusions\ud Childhood neglect has negative long-lasting effects on trajectories of adult mental health. This finding has important implications for early intervention for individuals who have experienced childhood neglect.

Dipyrrolyldiketone ligands (dpkH) are used with Ti(OiPr)4 to afford monomeric titanium(IV) complexes displaying the general formula C2-[Ti(dpk)2(OiPr)2]. The dpkH ligands employed consist of two dipyrrolyldiketone compounds (2H and 3H) and three diphenyl-substituted analogues (4H–6H). The behavior of these octahedral [Ti(dpk)2(OiPr)2] species in solution was investigated by 1H NMR at variable temperatures. Dynamic phenomena were evidenced, and the activation parameters associated with these processes (ΔH⧧, ΔS⧧, and ΔG⧧) were retrieved. [Ti(dpk)2(OiPr)2] complexes are precursors for the formation of high-nuclearity aggregates whose structures depend on the substituents on the diketone backbone. The crystal structures of monomeric ([Ti(1)2(OiPr)2]; 1 is the 1,3-diphenyl-1,3-propanedionato ligand) and [Ti(2)2(OEt)2]), dimeric ([Ti2(1)4(μ2-O)2]), and tetrameric ([Ti4(4)8(μ2-O)4]) species have been established, and the origin of this structural diversity is discussed. The solid-state optical properties of several complexes were determined and interpreted with the help of DFT calculations. Finally, the dinuclear complex [Ti(6)2(μ2-O)2] was synthesized, where ligand 6 incorporates six long alkyl chains (C16H33). This complex shows rich mesomorphic properties, with an original room-temperature plastic crystal phase followed by a hexagonal columnar liquid-crystalline phase.

Various bio-applications of mesoporous materials (e.g., the immobilization of enzymes or the delivery of biomolecules such as siRNA) require large pores for the successful adsorption of the rather large molecules of interest and protecting the fragile cargo from external forces such as degradation. We describe the facile synthesis of functionalized mesoporous silica nanoparticles with large pores (LP-MSNs) providing high loading capacity for the immobilization of two differently-sized enzymes. The synthesis procedure yields homogeneous core–shell particles of about 100 nm in size with large mesopores (about 7 nm in diameter) and an azide-functionality inside the pores. The LP-MSNs were synthesized employing a co-condensation approach with the rather large micellar template cetyltrimethylammonium p-toluenesulfonate (CTATos). Due to the azide functionality, the LP-MSNs are suitable for bio-orthogonal click chemistry reactions within the porous network. Two different acetylene-functionalized enzymes (sp-carbonic anhydrase (CA) and sp-horseradish peroxidase (HRP)) were immobilized in the pores of the obtained LP-MSNs by a copper-catalyzed 1,3-dipolar cycloaddition reaction. The covalent attachment of the enzymes within the mesopores allowed us to investigate the catalytic performance of the enzyme–silica systems. The enzymes are stable after bioconjugation with the silica support and show high catalytic activity over several cycles for the colorimetric reaction of guaiacol (2-methoxyphenol) in case of LP-MSN–HRP and the hydrolysis of 4-nitrophenyl acetate (NPA) by LP-MSN–CA.

Background: Microencapsulation is one of the most common techniques for the delivery of macromolecules;however, it can cause various stability problems, such as degradation or loss of bioactivity of the loaded molecules. For this reason, several techniques were investigated to load insulin into pre-formed porous microparticles (MPs). Objective: The high loading of insulin is a prerequisite of its delivery in sufficient concentration;hence we examined insulin loading in mesoporous silica (SBA15-NH2) as a model for uniformly porous microparticles using different loading methods and factors. Method: The MPs were characterized with respect to their morphology, porosity and pore diameter while insulin adsorption into the porous substrates was investigated using immersion and freeze-drying at different pH and initial peptide concentrations. MPs were further coated with Chitosan as a technique for pore blocking. Results: The results showed that the extent of insulin adsorption by freeze-drying varied depending on substrate affinity to insulin and pH where it could achieve the highest loading capacity at a pH near its isoelectric point. A significant increase in drug loading along with slower drug release was observed with Chitosan coated SBA15-NH2 MPs. In addition, the structural integrity of insulin was maintained after loading into the MPs, as confirmed by gel electrophoresis and fluorescent spectroscopy together with the in vivo study which in turn confirmed the preservation of insulin bioactivity in lowering blood glucose after oral administration. Conclusion: The present work displays the various factors that can control insulin loading in mesoporous silica MPs and their effects in enhancing the efficiency of insulin oral delivery using such substrates.

Rotary pump technology used in left ventricular assist devices (LVADs) dampens the pulsatility of the native heart and damages the blood, contributing to frequent occurrence of adverse events, including stroke, bleeding, and infection. Based on a disruptive technology that uses an undulating membrane inspired by the swimming movement of marine animals, CorWave is developing a unique blood pump, whose aim is to reproduce the native heart’s pulsatility while minimizing alterations to the blood. Extensive simulations of the device have been conducted in silico with in vitro testing to confirm hydraulic capacity to generate pulsatility with low blood trauma. The pump is currently being evaluated in vivo.

Mesoporous silica nanoparticles (MSNs) attract increasing interest in the field of gene and drug delivery due to their versatile features as a multifunctional drug delivery platform. Here, we describe poly(amidoamine) (PAMAM) dendron-functionalized MSNs that fulfill key prerequisites for a controllable intracellular drug release. In addition to high loading capacity, they offer 1) low cytotoxicity, showing no impact on the metabolism of endothelial cells, 2) specific cancer cell targeting due to receptor-mediated cell uptake, 3) a redox-driven cleavage of disulfide bridges allowing for stimuli-responsive cargo release, and most importantly, 4) a specific internal trigger based on the high buffering capacity of PAMAM dendrons to provide endosomal escape.

The mesoporous framework of MCM-41 can be modified with various metal-organic reagents, enabling the introduction of functional groups to the surface of the silica material. We demonstrate the direct organic functionalization of mesoporous silica with easily accessible lithiated aromatic compounds. Detailed C-13 solid-state NMR studies revealed that the choice of the lithiation agent is of key importance for the organo-functionalization;the lithiation of 4-bromo arenes with tert-butyllithium is highly favorable compared to the lithiation with n-butyllithium. Based on the availability of numerous reagents, remarkably reduced cost for the synthesis, and the unique features of these novel functionalized inorganic organic hybrid materials, lithiated aromatic compounds are promising candidates for the post synthesis modification of mesoporous silica materials. We describe the synthesis and immobilization of heteroatom-bearing compounds such as esters, ethers and a heteroarene (e.g., 4-bromoanisole, 4-bromobenzaldehyde dimethylacetal and 2-bromothiophene). The high specific surface areas, the well-defined pore size distribution and the typical 2D hexagonal array of the porous channels were retained during the synthesis of the inorganic-organic hybrid materials. Additionally, we achieved a high loading of organic moieties in these novel mesoporous hosts. (C) 2015 ELSEVIER. All rights reserved.

Background Safety restraint system (SRS) use is known to improve maternal and fetal outcomes in pregnant women. Factors associated with seatbelt use in females of childbearing age are largely unstudied despite global public health endeavors to increase use. We sought to define its use and uncover risk factors for not using a restraint system in this vulnerable patient cohort. Materials and methods A retrospective chart review of all female patients aged 15-35 y presenting from 2007 to 2017 was performed using our institutional level 1 trauma database. Age, pregnancy, insurance status (commercial or private, Medicaid plan, and uninsured), race, and Injury Severity Score (ISS) were examined in unmatched data. A matched cohort was created to evaluate the impact of pregnancy on SRS use based on ISS, age, race, and insurance status with blinding to belt use during matching (two nonpregnant to one pregnant). Differences in restraint use were then examined using Mann–Whitney U and Chi-square tests. Results A total of 779 patients met inclusion criteria, of which 140 were pregnant. In unmatched data, there was no difference in belt use with regard to age, race, or insurance type. Overall belt use was 59%. Twenty-five percent of patients were uninsured, and 39% used a Medicaid plan. Pregnant patients were statistically more likely to wear belts (71% versus 57%, P = 0.003). In ISS-matched data, this difference was not upheld (63% pregnant belt use versus 58%, P = 0.615). Conclusions Pregnancy did not induce improved safety behavior in our population. More study is needed to confirm our findings. Overall SRS use in our urban population is very poor, lags behind the national average, and requires additional public health attention.

Research-led teaching is designed to give students the opportunity to engage with their learning process and develop the skills needed to build their professional identity through active participation in the scientific cognitive process. Here in particular, social workers need research-oriented behavior, hermeneutic competencies and reflexivity in order to master the imminent requirements of case comprehension and case processing in a professional way.

Der Beitrag stellt forschungsgeleitete Lehre aus lerntheoretischer Perspektive als ein relevantes Lehrformat fur den berufsbegleitenden BA-Studiengang der Sozialen Arbeit vor. Es wird besprochen, wie geeignet das Format ist, die Herausbildung professioneller Handlungskompetenzen zu unterstutzen. Neben der Diskussion uber die besonderen Anforderungen an forschungsgeleitete Lehre im Online-Format gibt der Beitrag einen konkreten Einblick in die Lehrpraxis des Blended Learning-Bachelorstudiengangs Soziale Arbeit an der Fachhochschule Potsdam und zeigt, wie forschungsgeleitete Lehre in der als Prasenzmodul konzipierten Werkstatt umgesetzt wird.

Highly mesoporous nanosized carbon spheres (MCS) equipped with an active lipid bilayer demonstrate pronounced molecular release behavior, and excellent potential for drug delivery applications. We report a facile synthesis route for the creation of colloidal MCS with a bimodal pore size distribution, featuring a high BET surface area combined with high pore volume. Bimodal mesoporosity was achieved by a simultaneous co-assembly of a polymer resin (resol), tetraethyl orthosilicate (TEOS) and a block copolymer (Pluronic F127). The spherical geometry originates from casting the precursor mixture into a macroporous silica hard template, having a mean pore size of 60 nm, followed by thermopolymerization and final carbonization at 900 °C in nitrogen atmosphere. The final bimodal mesoporous MCS were obtained after removal of inorganic compounds by etching with hydrofluoric acid. Colloidal suspensions of MCS were prepared by oxidation with ammonium persulfate. MCS were loaded with calcein as a model drug. Efficient sealing of the MCS was achieved with a supported lipid bilayer (SLB). The SLB acts as a diffusion barrier against the uncontrolled release of encapsulated dye molecules until the release is triggered via the addition of a surface active agent. The high surface area and pore volume and the excellent release characteristics make the SLB-coated MCS a promising release-on-demand system.

Après une discussion critique du concept de Langue-Culture d’Origine et son rapport avec d’autres concepts désignant le rapport des sujets aux langues, nous présentons le projet "Images (de l’enseignement) du Portugais à l’Étranger", qui vise à rendre compte des images de la langue portugaise (qu’elle soit considérée LM, LE ou LCO) dans différents contextes. Dans cette étude, nous présenterons et discuterons les images recueillies auprès d’un public d’enfants "lusodescendants" en Allemagne à travers le recueil de leurs dessins, en classe de Langue Culture d’Origine, sous l’instruction "dessine-toi en train de parler les langues que tu connais". Les résultats permettent de cerner et de discuter le profil linguistique et socio-affectif de ce public et de présenter des implications pour une Didactique des LCO en rapport avec les approches plurielles des langues-cultures. After critically discussing the concept of Heritage Language and considering the relationship between that concept and others designating the relationship individuals maintain with their languages, we will present the research project "Images of Portuguese (language, teaching and learning)". This project aims at detecting and analysing images of Portuguese and the practices used in its teaching and learning worldwide (whether it is a Mother Tongue, a Foreign Language or a Heritage Language), in different contexts. In this study, we will present and discuss the social representations “luso-descendent speaker” children living in Germany possess. These social representations were collected through drawings in the Portuguese Heritage Language classroom, under the instruction “draw yourself while speaking the languages you know”. The results allow us to determine and to discuss the linguistic and socio-affective profiles of these children as well as to present some implications in terms of Heritage Language Education when related to multilingual approaches to languages and cultures.

Histone deacetylase inhibitors are a new and promising drug family with a strong anticancer activity and potent modulation of connexin expression. The restoration of connexins in cancer cells has been suggested as a possible mechanism to control tumor progression. The aim of this study was to investigate the effects of 4-phenylbutyrate (4-PB) on the growth of human pancreatic cell lines in vitro and in vivo with a focus on connexin modulation. The proliferation of tumor cells was determined using an MTT assay, and the effect of 4-PB in vivo was studied in a chimeric mouse model. The expression and localization of connexin 43 (Cx43) were assessed by Western blot, immunofluorescence microscopy, and immunohistochemistry. Antitumoral activity was assessed by immunohistochemistry for Ki-67 and histone H4. Treatment with 4-PB resulted in the significant in vitro and in vivo growth inhibition of pancreatic tumor cells. The reduction of the xenograft tumor volume was associated with the inhibition of histone deacetylation and decrease in cell proliferation. Treatment with 4-PB caused a significant increase in the Cx43 expression in T3M4 cells (up to 2.8-fold). The newly synthesized Cx43 was localized in the cytoplasm but not on the cell membrane. Treatment with 4-PB inhibited the proliferation of human pancreatic tumor cells in vitro and in vivo and increased the expression of Cx43. Therefore, 4-PB might be useful in the therapy of pancreatic cancer.