bluuebunny/crossref_metadata_2025 huggingface dataset:
12. Case Management
Authors: Macgregor Lucilla , Peacey Charlotte , Ridsdale Georgina
Published: August 2020

This chapter considers the way in which the court ‘actively manages’ cases. All disputed cases are subject to a level of court management and enforcement of its directions orders. The chapter provides an understanding of the time at which active case management commonly occurs. It explains the ethos of case management, allocation (to track), and case management directions through the tracks. It discusses the ways in which the court will seek to ensure that its orders for the management of a case are complied with.
15. Part 36 Offers and Offers to Settle Outside Part 36
Authors: Macgregor Lucilla , Peacey Charlotte , Ridsdale Georgina
Published: August 2020

Offers to settle are a common occurrence prior to the resolution dispute or the start of trial. There does not appear to be a limit on the number of offers that can be made, although credibility and common sense would indicate that offers to settle should be made purposefully, but not irrationally. This chapter discusses the main features of Part 36 of the Civil Procedure Rules (CPR) and its Practice Direction in relation to commercial and personal injury claims; practical suggestions on dealing with Part 36 offers; and advising the client. It considers recent cases that demonstrate how the courts apply and interpret CPR Part 36. This chapter will also discuss the relative merits of global offers, and other offers that do not have the ‘protections’ or procedures associated with Part 36 offers.
Soy and isoflavone consumption and subsequent risk of prostate cancer mortality: the Japan Public Health Center-based Prospective Study
Authors: Sawada Norie , Iwasaki Motoki , Yamaji Taiki , Shimazu Taichi , Inoue Manami , Tsugane Shoichiro ,   for the Japan Public Health Center-based Prospective Study Group
Published: August 2020

Background

Although many epidemiological studies have reported the preventive effects of soy products and isoflavones on prostate cancer, our previous studies reported that the association between soy and isoflavones and prostate cancer incidence differed according to stage. It is more important to identify modifiable risk factors related to lethal prostate cancer. Here, we investigated the association between soy, soy products and isoflavones intake and prostate cancer mortality, in a prospective study in Japan.

Methods

We conducted a population-based prospective study in 43 580 Japanese men with no history of cancer or cardiovascular disease (aged 45-74 years). Participants completed a validated questionnaire which included 138 food items. We followed participants from 1995 to 2016. Hazard ratios (HRs) and 95% confidence intervals (CIs) of prostate cancer mortality were calculated according to quintiles of soy products and isoflavones intake, using Cox hazard proportional hazards regression.

Results

During 16.9 years follow-up, we registered 221 deaths from prostate cancer. Isoflavones and soy products intake was associated with an increased risk of prostate cancer death, with multivariate HRQ5 vs. Q1=1.39, 95% CI = 0.87-2.20, p for trend = 0.04 for isoflavones and multivariate HRQ5 vs. Q1=1.76, 95% CI = 1.10-2.82, p for trend = 0.04 for soy food.

Conclusions

Our study suggested that high intake of soy and isoflavones might increase the risk of prostate cancer mortality.
Hib Vaccines: Their Impact on Haemophilus influenzae Type b Disease
Authors: Gilsdorf Janet R
Published: August 2020

Haemophilus influenzae serotype b (Hib) is an important cause of serious, invasive infections, particularly in young children. Since 1985, a series of vaccines composed of the type b capsular polysaccharide polyribosylribitol phosphate (PRP), followed by PRP conjugated to various proteins, have been licensed for use in the United States and worldwide. The conjugated vaccines offer increased immunogenicity and prolonged durability of immune protection compared to the plain PRP vaccine and increasingly are combined with other childhood vaccines for decreased cost and increased ease of vaccination. Hib vaccines have a very favorable safety profile, have been found to be either cost-saving or cost-effective by many public health agencies, and, in most countries, are initiated during early infancy as part of routine childhood immunization programs. As a result of widespread use of the vaccines, the incidence of Hib infections, and their associated morbidity and mortality, has fallen dramatically across the globe. Yet, many children remain unimmunized or underimmunized against Hib, particularly in limited-resource countries. Future efforts to further reduce the disease burden of Hib infections remain a high priority.
Native Human Antibody to Shr Promotes Mice Survival After Intraperitoneal Challenge With Invasive Group A Streptococcus
Authors: Chatterjee Nilanjana , Huang Ya-Shu , Lyles Kristin V , Morgan Julie E , Kauvar Lawrence M , Greer Susanna F , Eichenbaum Zehava
Published: August 2020

Background

A vaccine against group A Streptococcus (GAS) has been actively pursued for decades. The surface receptor Shr is vital in GAS heme uptake and provides an effective target for active and passive immunization. Here, we isolated human monoclonal antibodies (mAbs) against Shr and evaluated their efficacy and mechanism.

Methods

We used a single B-lymphocyte screen to discover the mAbs TRL186 and TRL96. Interactions of the mAbs with whole cells, proteins, and peptides were investigated. Growth assays and cultured phagocytes were used to study the mAbs’ impact on heme uptake and bacterial killing. Efficacy was tested in prophylactic and therapeutic vaccination using intraperitoneal mAb administration and GAS challenge

Results

Both TRL186 and TRL96 interact with whole GAS cells, recognizing the NTR and NEAT1 domains of Shr, respectively. Both mAbs promoted killing by phagocytes in vitro, but prophylactic administration of only TRL186 increased mice survival. TRL186 improved survival also in a therapeutic mode. TRL186 but not TRL96 also impeded Shr binding to hemoglobin and GAS growth on hemoglobin iron.

Conclusions

Interference with iron acquisition is central for TRL186 efficacy against GAS. This study supports the concept of antibody-based immunotherapy targeting the heme uptake proteins to combat streptococcal infections.
Outcomes of Early and Intensive Use of a Palm and Digit Extension Orthosis in Young Children After Burn Injury
Authors: Thomas Rhianydd , Wicks Stephanie , Dale Marita , Pacey Verity
Published: August 2020

Burns to the palmar aspect of the hand are prevalent in young children. The development of scar tissue across the flexor surface of the hand combined with the years of growth ahead may result in considerable complications. This study was undertaken to describe outcomes of early and intensive use of a palm and digit extension orthosis with the elbow immobilized at 90° flexion following a palmar hand burn. A retrospective review of 107 children (mean age 18 months [SD 10]) treated at a statewide Pediatric Burns Unit from 2012 to 2016 was performed. Three children (3%) developed contracture during the 24-month study follow-up period. The other 104 children (97%) had full ROM at 24 months or at either the point of discharge or loss to follow-up. Early signs of contracture, defined as loss of full movement or significant banding, developed in 26 children (24%) in the first 9 months after burn. With intensive physiotherapy, 23 children regained full movement by 12 months after burn. Children who did not achieve complete wound healing at 1 month after burn and children with hypertrophic scarring at 2 months after burn were significantly more represented among cases of early signs of contracture (P = .013). When undertaken with regular clinical review, early and intensive use of a palm and digit extension orthosis can maintain full extension of the palm and digits in children after palmar burn.
Subversive Faith and Competition in Patronage: A Note on ΠΙΣΤΙΣ in Mark
Authors: Smit Peter-Ben
Published: August 2020

In her influential monograph Roman Faith and Christian Faith: Pistis and Fides in the Early Roman Empire and Early Churches, Theresa Morgan has convincingly shown how closely the early Christian discourse on ‘faith’ was bound up with similar notions in the broader Greco-Roman world, particularly in relation to the system of patronage, with both humans and deities fulfilling the role of (trustworthy and trusted) patrons. Thus, she has shifted attention from πίστις/fides as a primarily ‘theological’ notion to an interpretation along more ‘social’ lines and situated it in realm of human and divine/human relations. She also analyses this in relation to the Gospel of Mark, showing how Mark also fits this general picture. This note builds on Morgan’s work and will further develop one aspect of Mark’s use of the language (and concept) of patronage and πίστις. This is its subversive character, which is present to a lesser extent in Morgan's work; by calling for πίστις directed to him on the part of the people that he encounters, Jesus also draws these people away from other allegiances and ‘πίστις commitments’, that is, intersubjective relationships based on trust and leading to personal allegiance.
The tidal disruption event AT 2018hyz – I. Double-peaked emission lines and a flat Balmer decrement
Authors: Short P , Nicholl M , Lawrence A , Gomez S , Arcavi I , Wevers T , Leloudas G , Schulze S , Anderson J P , Berger E , Blanchard P K , Burke J , Segura N Castro , Charalampopoulos P , Chornock R , Galbany L , Gromadzki M , Herzog L J , Hiramatsu D , Horne Keith , Hosseinzadeh G , Howell D Andrew , Ihanec N , Inserra C , Kankare E , Maguire K , McCully C , Müller Bravo T E , Onori F , Sollerman J , Young D R
Published: August 2020

We present results from spectroscopic observations of AT 2018hyz, a transient discovered by the All-Sky Automated Survey for Supernova survey at an absolute magnitude of MV ∼ −20.2 mag, in the nucleus of a quiescent galaxy with strong Balmer absorption lines. AT 2018hyz shows a blue spectral continuum and broad emission lines, consistent with previous TDE candidates. High cadence follow-up spectra show broad Balmer lines and He i in early spectra, with He ii making an appearance after ∼70–100 d. The Balmer lines evolve from a smooth broad profile, through a boxy, asymmetric double-peaked phase consistent with accretion disc emission, and back to smooth at late times. The Balmer lines are unlike typical active galactic nucleus in that they show a flat Balmer decrement (Hα/Hβ ∼ 1.5), suggesting the lines are collisionally excited rather than being produced via photoionization. The flat Balmer decrement together with the complex profiles suggests that the emission lines originate in a disc chromosphere, analogous to those seen in cataclysmic variables. The low optical depth of material due to a possible partial disruption may be what allows us to observe these double-peaked, collisionally excited lines. The late appearance of He ii may be due to an expanding photosphere or outflow, or late-time shocks in debris collisions.
A successful search for intervening 21 cm H i absorption in galaxies at 0.4 < z <1.0 with the Australian square kilometre array pathfinder (ASKAP)
Authors: Sadler Elaine M , Moss Vanessa A , Allison James R , Mahony Elizabeth K , Whiting Matthew T , Johnston Helen M , Ellison Sara L , Lagos Claudia del P , Koribalski Bärbel S
Published: August 2020

We have used the Australian Square Kilometre Array Pathfinder (ASKAP) radio telescope to search for intervening 21 cm neutral hydrogen (H i) absorption along the line of sight to 53 bright radio continuum sources. Our observations are sensitive to H i column densities typical of Damped Lyman Alpha absorbers (DLAs) in cool gas with an H i spin temperature below about 300–500 K. The six-dish Boolardy Engineering Test Array (BETA) and twelve-antenna Early Science array (ASKAP-12) covered a frequency range corresponding to redshift 0.4 < z < 1.0 and 0.37 < z < 0.77, respectively, for the H i line. Fifty of the 53 radio sources observed have reliable optical redshifts, giving a total redshift path Δz = 21.37. This was a spectroscopically untargeted survey, with no prior assumptions about the location of the lines in redshift space. Four intervening H i lines were detected, two of them new. In each case, the estimated H i column density lies above the DLA limit for H i spin temperatures above 50–80 K, and we estimate a DLA number density at redshift z ∼ 0.6 of $n(z)=0.19^{+0.15 }_{ -0.09}$. This value lies somewhat above the general trend of n(z) with redshift seen in optical DLA studies. Although the current sample is small, it represents an important proof of concept for the much larger 21 cm First Large Absorption Survey in H i (FLASH) project to be carried out with the full 36-antenna ASKAP telescope, probing a total redshift path $\Delta z\sim \, 50,000$.
How dark are filaments in the cosmic web?
Authors: Yang Tianyi , Hudson Michael J , Afshordi Niayesh
Published: August 2020

The cold dark matter model predicts that dark matter haloes are connected by filaments. Direct measurements of the masses and structure of these filaments are difficult, but recently several studies have detected these dark-matter-dominated filaments using weak lensing. Here we study the efficiency of galaxy formation within the filaments by measuring their total mass-to-light ratios and stellar mass fractions. Specifically, we stack pairs of luminous red galaxies (LRGs) with a typical separation on the sky of 8 h−1 Mpc. We stack background galaxy shapes around pairs to obtain mass maps through weak lensing, and we stack galaxies from the Sloan Digital Sky Survey to obtain maps of light and stellar mass. To isolate the signal from the filament, we construct two matched catalogues of physical and non-physical (projected) LRG pairs, with the same distributions of redshift and separation. We then subtract the two stacked maps. Using LRG pair samples from the Baryon Oscillation Spectroscopic Survey at two different redshifts, we find that the evolution of the mass in filament is consistent with the predictions from perturbation theory. The filaments are not entirely dark: Their mass-to-light ratios (M/L = 351 ± 137 in solar units in the rband) and stellar mass fractions (Mstellar/M = 0.0073 ± 0.0030) are consistent with the cosmic values (and with their redshift evolutions).
Radio frequency interference mitigation based on the asymmetrically reweighted penalized least squares and SumThreshold method
Authors: Zeng Qingguo , Chen Xue , Li Xiangru , Han J L , Wang Chen , Zhou D J , Wang Tao
Published: August 2020

As radio telescopes become more sensitive, radio frequency interference (RFI) is becoming more important for interesting signals of radio astronomy. There is a demand for developing an automatic, accurate and efficient RFI mitigation method. Therefore, we have investigated an RFI detection algorithm. First, we introduce an asymmetrically reweighted penalized least squares (ArPLS) method to estimate the baseline more accurately. After removing the estimated baseline, several novel strategies were proposed based on the SumThreshold algorithm for detecting different types of RFI. The threshold parameter in SumThreshold can be determined automatically and adaptively. The adaptiveness is essential for reducing human intervention and for the online RFI processing pipeline. Applications to data from the Five-hundred-meter Aperture Spherical Telescope (FAST) show that the proposed scheme based on ArPLS and SumThreshold is superior to some typically available methods for RFI detection with respect to efficiency and performance.
Gas accretion regulates the scatter of the mass–metallicity relation
Authors: De Lucia Gabriella , Xie Lizhi , Fontanot Fabio , Hirschmann Michaela
Published: August 2020

In this paper, we take advantage of the GAlaxy Evolution and Assembly (GAEA) semi-analytic model to analyse the origin of secondary dependencies in the local galaxy mass–gas metallicity relation. Our model reproduces quite well the trends observed in the local Universe as a function of galaxy star formation rate and different gas-mass phases. We show that the cold gas content (whose largest fraction is represented by the atomic gas phase) can be considered as the third parameter governing the scatter of the predicted mass–metallicity relation, in agreement with the most recent observational measurements. The trends can be explained with fluctuations of the gas accretion rates: a decrease of the gas supply leads to an increase of the gas metallicity due to star formation, while an increase of the available cold gas leads to a metallicity depletion. We demonstrate that the former process is responsible for offsets above the mass–metallicity relation, while the latter is responsible for deviations below the mass–metallicity relation. In low- and intermediate-mass galaxies, these negative offsets are primarily determined by late gas cooling dominated by material that has been previously ejected due to stellar feedback.
Redshift estimates for fast radio bursts and implications on intergalactic magnetic fields
Authors: Hackstein S , Brüggen M , Vazza F , Rodrigues L F S
Published: August 2020

Fast radio bursts are transient radio pulses from presumably compact stellar sources of extragalactic origin. With new telescopes detecting multiple events per day, statistical methods are required in order to interpret observations and make inferences regarding astrophysical and cosmological questions. We present a method that uses probability estimates of fast radio burst observables to obtain likelihood estimates for the underlying models. Considering models for all regions along the line of sight, including intervening galaxies, we perform Monte Carlo simulations to estimate the distribution of the dispersion measure (DM), rotation measure (RM), and temporal broadening. Using Bayesian statistics, we compare these predictions to observations of fast radio bursts. By applying Bayes theorem, we obtain lower limits on the redshift of fast radio bursts with extragalactic DM ≳ 400 pc cm−3. We find that intervening galaxies cannot account for all highly scattered fast radio bursts in FRBcat, thus requiring a denser and more turbulent environment than an SGR 1935+2154-like magnetar. We show that a sample of ≳103 unlocalized fast radio bursts with associated extragalactic RM ≥ 1 rad m−2 can improve current upper limits on the strength of intergalactic magnetic fields.
The Lynden-Bell bar formation mechanism in simple and realistic galactic models
Authors: Polyachenko E V , Shukhman I G
Published: August 2020

Using the canonical Hamilton–Jacobi approach we study the Lynden-Bell concept of bar formation based on the idea of orbital trapping parallel to the long or short axes of the oval potential distortion. The concept considered a single parameter – a sign of the derivative of the precession rate over angular momentum, determining the orientation of the trapped orbits. We derived a perturbation Hamiltonian that includes two more parameters characterizing the background disc and the perturbation, which are just as important as the earlier known one. This allows us to link the concept with the matrix approach in linear perturbation theory, the theory of weak bars, and explain some features of the non-linear secular evolution observed in N-body simulations.
Convective differential rotation in stars and planets – II. Observational and numerical tests
Authors: Jermyn Adam S , Chitre Shashikumar M , Lesaffre Pierre , Tout Christopher A
Published: August 2020

Differential rotation is central to a great many mysteries in stars and planets. In part I, we predicted the order of magnitude and scaling of the differential rotation in both hydrodynamic and magnetohydrodynamic convection zones. Our results apply to both slowly and rapidly rotating systems, and provide a general picture of differential rotation in stars and fluid planets. We further calculated the scalings of the meridional circulation, entropy gradient, and baroclinicity. In this companion paper, we compare these predictions with a variety of observations and numerical simulations. With a few exceptions, we find that these are consistent in both the slowly rotating and rapidly rotating limits. Our results help to localize core–envelope shear in red giant stars, suggest a rotation-dependent frequency shift in the internal gravity waves of massive stars, and potentially explain observed deviations from von Zeipel’s gravity darkening in late-type stars.
TBDB: a database of structurally annotated T-box riboswitch:tRNA pairs
Authors: Marchand Jorge A , Pierson Smela Merrick D , Jordan Thomas H H , Narasimhan Kamesh , Church George M
Published: August 2020

T-box riboswitches constitute a large family of tRNA-binding leader sequences that play a central role in gene regulation in many gram-positive bacteria. Accurate inference of the tRNA binding to T-box riboswitches is critical to predict their cis-regulatory activity. However, there is no central repository of information on the tRNA binding specificities of T-box riboswitches, and de novo prediction of binding specificities requires advanced knowledge of computational tools to annotate riboswitch secondary structure features. Here, we present the T-box Riboswitch Annotation Database (TBDB, https://tbdb.io), an open-access database with a collection of 23,535 T-box riboswitch sequences, spanning the major phyla of 3,632 bacterial species. Among structural predictions, the TBDB also identifies specifier sequences, cognate tRNA binding partners, and downstream regulatory targets. To our knowledge, the TBDB presents the largest collection of feature, sequence, and structural annotations carried out on this important family of regulatory RNA.
The long-term prognosis of pneumomediastinum associated with dermatomyositis: a two-centre retrospective cohort study
Authors: Li Can , Liang Mei’e , Jiang Hui , Zhao Jiuliang , Wu Chanyuan , Wang Qian , Zhang Liyun , Zhao Yan
Published: August 2020

Objectives

Pneumomediastinum (PnM) is a rare but life-threatening complication of DM. The present study aims to characterize the long-term prognosis and prognostic factors of DM-associated PnM.

Methods

Inpatients with DM-associated PnM were retrospectively enrolled from two tertiary referral centres for rheumatic disease. The enrolled patients were divided into survivors or non-survivors. Information about the demographics, clinical manifestations, CT scan features, laboratory findings and outcomes were collected from their medical records. A least absolute shrinkage and selection operator regularized Cox regression model was used to select the most relevant factors. Prognosis was analysed using a Kaplan–Meier curve. A Cox proportional hazards model was used to identify independent predictive factors for long-term survival.

Results

A total of 62 patients (26 women) with DM-associated PnM were enrolled. The mean age was 44.3 years (s.d. 11.7). The median follow-up duration was 17 days (quartiles 7, 266.5). Thirty-five patients died during follow-up. The survival rates were 75.4% at 1 week, 46.2% at 3 months and 41.9% at 1 year. The Cox proportional hazards model identified the development of fever [hazard ratio (HR) 3.23 (95% CI 1.25, 8.35), P = 0.02] and a decrease in the number of lymphocytes [HR 2.19 (95% CI 1.10, 4.39), P = 0.03] as independent risk factors for death.

Conclusion

The results suggest poor overall survival among patients with DM-associated PnM. Survival during the first 3 months is crucial for long-term survival. Meanwhile, the development of fever and a decrease in the number of lymphocytes were associated with long-term mortality. Early recognition and prompt treatment of this high-risk group of DM patients is therefore important.
Comparison of fracture risk between proton pump inhibitors and histamine-2 receptor antagonists in ANCA-associated vasculitis patients: a nested case–control study
Authors: Miyano Shinako , Michihata Nobuaki , Sada Ken-Ei , Uda Kazuaki , Matsui Hiroki , Fushimi Kiyohide , Nangaku Masaomi , Yasunaga Hideo
Published: August 2020

Objective

Whether acid suppressants [proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2RAs)] are associated with bone fractures in patients with ANCA-associated vasculitis (AAV) treated with glucocorticoids remains unclear. This study compared PPIs with H2RAs in terms of the risk of bone fractures in patients with AAV who received in-hospital induction therapy with glucocorticoids.

Methods

We retrospectively identified 149 patients with fractures among 22 821 patients newly diagnosed with AAV in 1730 hospitals using a nationwide inpatient database from July 2010 to March 2018. We conducted 1:4 case–control matching. Age, sex, duration of AAV treatment and fiscal year were matched between the cases and controls. A conditional logistic regression analysis was conducted to assess the association between acid suppressants and fractures.

Results

Of all enrolled patients with fractures, the median age was 77 years, and 99 (66%) were female. The median duration from AAV treatment to fracture was 52 days. The proportion of patients using PPIs was 91.3% (136 of 149) and 80.2% (478 of 596) in the case and control groups, respectively. Compared with H2RA use, PPI use was significantly associated with fractures after adjustment for age, sex, BMI, smoking habit, Charlson comorbidity index, renal failure, bisphosphonate and same fiscal year according to a multivariate analysis (adjusted odds ratio, 3.76; 95% CI: 1.37, 10.3).

Conclusion

PPI users had a higher risk of fractures than H2RA users among mostly advanced-age patients with AAV with remission induction therapy.
Dopamine and Glutamate in Antipsychotic-Responsive Compared With Antipsychotic-Nonresponsive Psychosis: A Multicenter Positron Emission Tomography and Magnetic Resonance Spectroscopy Study (STRATA)
Authors: Egerton Alice , Murphy Anna , Donocik Jacek , Anton Adriana , Barker Gareth J , Collier Tracy , Deakin Bill , Drake Richard , Eliasson Emma , Emsley Richard , Gregory Catherine J , Griffiths Kira , Kapur Shitij , Kassoumeri Laura , Knight Laura , Lambe Emily J B , Lawrie Stephen M , Lees Jane , Lewis Shôn , Lythgoe David J , Matthews Julian , McGuire Philip , McNamee Lily , Semple Scott , Shaw Alexander D , Singh Krish D , Stockton-Powdrell Charlotte , Talbot Peter S , Veronese Mattia , Wagner Ernest , Walters James T R , Williams Stephen R , MacCabe James H , Howes Oliver D
Published: August 2020

The variability in the response to antipsychotic medication in schizophrenia may reflect between-patient differences in neurobiology. Recent cross-sectional neuroimaging studies suggest that a poorer therapeutic response is associated with relatively normal striatal dopamine synthesis capacity but elevated anterior cingulate cortex (ACC) glutamate levels. We sought to test whether these measures can differentiate patients with psychosis who are antipsychotic responsive from those who are antipsychotic nonresponsive in a multicenter cross-sectional study. 1H-magnetic resonance spectroscopy (1H-MRS) was used to measure glutamate levels (Glucorr) in the ACC and in the right striatum in 92 patients across 4 sites (48 responders [R] and 44 nonresponders [NR]). In 54 patients at 2 sites (25 R and 29 NR), we additionally acquired 3,4-dihydroxy-6-[18F]fluoro-l-phenylalanine (18F-DOPA) positron emission tomography (PET) to index striatal dopamine function (Kicer, min−1). The mean ACC Glucorr was higher in the NR than the R group after adjustment for age and sex (F1,80 = 4.27; P = .04). This was associated with an area under the curve for the group discrimination of 0.59. There were no group differences in striatal dopamine function or striatal Glucorr. The results provide partial further support for a role of ACC glutamate, but not striatal dopamine synthesis, in determining the nature of the response to antipsychotic medication. The low discriminative accuracy might be improved in groups with greater clinical separation or increased in future studies that focus on the antipsychotic response at an earlier stage of the disorder and integrate other candidate predictive biomarkers. Greater harmonization of multicenter PET and 1H-MRS may also improve sensitivity.
Toxoplasma gondii Infection and Clinical Characteristics of Patients With Schizophrenia: A Systematic Review and Meta-analysis
Authors: Sutterland Arjen L , Mounir David A , Ribbens Juul J , Kuiper Bouke , van Gool Tom , de Haan Lieuwe
Published: August 2020

Schizophrenia is associated with an increased prevalence of IgG antibodies against Toxoplasma gondii (T. gondii seropositivity), whereby the infection seems to precede the disorder. However, it remains unclear whether a T. gondii infection affects clinical characteristics of schizophrenia. Therefore, a systematic review and meta-analysis was conducted following PRISMA guidelines examining the association between T. gondii seropositivity and severity of total, positive, or negative symptoms or age of onset in schizophrenia. PubMed, Embase, and PsycInfo were systematically searched up to June 23, 2019 (PROSPERO #CRD42018087766). Random-effects models were used for analysis. Furthermore, the influence of potential moderators was analyzed. Indications for publication bias were examined. From a total of 934 reports, 13 studies were included. No overall effect on severity of total, positive, or negative symptoms was found. However, in patients with a shorter duration of illness T. gondii seropositivity was associated with more severe positive symptoms (standardized mean difference [SMD] = 0.32; P < .001). Similar but smaller effects were seen for total symptoms, while it was absent for negative symptoms. Additionally, a significantly higher age of onset was found in those with T. gondii seropositivity (1.8 y, P = .015), although this last finding was probably influenced by publication bias and study quality. Taken together, these findings indicate that T. gondii infection has a modest effect on the severity of positive and total symptoms in schizophrenia among those in the early stages of the disorder. This supports the hypothesis that T. gondii infection is causally related to schizophrenia, although more research remains necessary.
Effect of Delayed Versus Immediate Umbilical Cord Clamping on Maternal Blood Loss in Term Cesarean Delivery: A Randomized Clinical Trial
Authors: Purisch S.E. , Ananth C.V. , Arditi B. , Mauney L. , Ajemian B. , Heiderich A. , Leone T. , Gyamfi-Bannerman C.
Published: August 2020

(JAMA. 2019;322:1869–1876)

In 2017, the American College of Obstetricians and Gynecologists recommended that providers delay umbilical cord clamping for at least 30 to 60 seconds after the birth of a preterm or term neonate, assuming that the neonate does not require resuscitation. While the literature strongly supports this recommendation as a neonatal benefit, studies on maternal outcomes are lacking. Furthermore, information regarding the impact of delayed umbilical cord clamping on the mother and neonate during cesarean delivery is also lacking. This study aimed to compare the impact of maternal blood loss when the umbilical cord was clamped immediately as compared with delayed during cesarean delivery.
International Consensus Statement on the Use of Uterotonic Agents During Cesarean Section
Authors: Heesen M. , Carvalho B. , Carvalho J.C.A. , Duvekot J.J. , Dyer R.A. , Lucas D.N. , McDonnell N. , Orbach-Zinger S. , Kinsella S.M.
Published: August 2020

(Anaesthesia. 2019;74:1305–1319)

Uterotonics are routinely used after delivery to manage uterine tone. While various guidelines exist for general management during cesarean deliveries, management of uterine tone following vaginal delivery, and treatment of postpartum hemorrhage, no previous international guideline has addressed uterotonic management during and following cesarean section. The use of uterotonics is largely based on tradition and varies in the choice of drug, timing of administration, dose, route, and speed, and maintenance of administration. Both first-line (oxytocin, carbetocin) and second-line uterotonics carry risk for adverse effects such as hypotension, tachycardia, and ST-segment depression. This consensus statement provides 10 recommendations for the use of uterotonic agents during cesarean section.
Dural Puncture Epidural Versus Conventional Epidural Block for Labor Analgesia: A Systematic Review of Randomized Controlled Trials
Authors: Heesen M. , Rijs K. , Rossaint R. , Klimek M.
Published: August 2020

(Int J Obstet Anesth. 2019;40:24–31)

The technique of dural puncture epidural (DPE) involves creating a dural hole with a small-gauge spinal needle inserted through a Tuohy needle after the epidural space is identified without injection of medication into the intrathecal space. This modification has been described as allowing epidurally administered medication to access the subarachnoid space to enable a faster onset of analgesia compared with epidural placement alone. Some authors posit that DPE also reduces side effects associated with the combined spinal-epidural technique. Studies comparing neuraxial block quality between DPE and continuous epidural analgesia have yielded mixed results. This systematic review aimed to analyze all available randomized controlled trials comparing DPE and epidural analgesia.
The Impact of Occupational Shift Work and Working Hours During Pregnancy on Health Outcomes: A Systematic Review and Meta-analysis
Authors: Cai C. , Vandermeer B. , Khurana R. , Nerenberg K. , Featherstone R. , Sebastianski M. , Davenport M.H.
Published: August 2020

(Am J Obstet Gynecol. 2019;221:563–576)

Women make up a significant proportion of the workforce, and most work during their pregnancies. While studies have found an association between adverse pregnancy outcomes and various working hours, such as shift work or working longer than the standard 40-hour work week, the results have been conflicting. The aim of this study was to assess the impact of shift work and long working hours during pregnancy on maternal and fetal outcomes, and to determine if there is a relationship between the length of working hours and these outcomes.
Vascular Balloon Occlusion and Planned Cesarean Hysterectomy for Morbidly Adherent Placenta: A Systematic Review
Authors: Makary M. , Chowdary P. , Westgate J.A.
Published: August 2020

(Aust N Z J Obstet Gynaecol. 2019;59:608–615)

Morbidly adherent placenta (MAP) is a rare but serious complication that can result in severe hemorrhage. Over time, there has been an increase in the occurrence of MAP due to Increasing maternal age as well as a higher cesarean section rate. Improved imaging techniques have resulted in the identification of MAP antenatally in many patients. This then allows obstetricians to proactively develop delivery plans that are focused both on minimizing and being prepared for managing blood loss during delivery. One technique is the preoperative placement of intra-arterial catheters into vessels such as the internal iliac and common iliac arteries for vascular balloon occlusion to prevent or control hemorrhage. While this approach is theorized to be effective, limited research has been conducted to clearly demonstrate it improves outcomes during planned or emergency cesarean hysterectomy (CH). The current investigators performed a systematic review to evaluate both the efficacy and rate of complications of vascular balloon occlusion in patients undergoing planned CH for MAP.
An Enhanced Recovery After Surgery Pathway for Cesarean Delivery Decreases Hospital Stay and Cost
Authors: Fay E.E. , Hitti J.E. , Delgado C.M. , Savitsky L.M. , Mills E.B. , Slater J.L. , Bollag L.A.
Published: August 2020

(Am J Obstet Gynecol. 2019;221:349.e1–349.e9)

Obstetric care providers are encouraged to use enhanced recovery after surgery (ERAS) guidelines following cesarean delivery (CD), one of the most commonly performed surgeries in the United States. While ERAS protocols have been shown to optimize patient recovery and shorten hospital stays for patients in a variety of surgical subspecialties, little research has been done evaluating the use of an ERAS protocol for planned and unplanned CDs. The aim of this study was to examine hospital length of stay and postoperative costs of CD patients before and after implementation of an ERAS protocol.
Massive Blood Transfusion in Relation to Delivery: Incidence, Trends, and Risk Factors: A Population-based Cohort Study
Authors: Thurn L. , Wikman A. , Westgren M. , Lindqvist P.G.
Published: August 2020

(BJOG. 2019;126:1577–1586)

Obstetric hemorrhage is a major contributor to maternal mortality resulting in ∼100,000 annual deaths worldwide. Massive transfusion may be an indicator of a “near miss event” and is defined as the transfusion of 10 U or more of red blood cells (RBCs) within 24 hours. Recent reports have shown an increase in the rate of massive blood transfusions for postpartum hemorrhage. Yet, the incidence and risk factors of pregnant women requiring massive transfusions is unknown. The aim of this study was to estimate the incidence, trends, and risk factors for massive blood transfusion before and at delivery. In addition, the plasma and RBC transfusion ratio was evaluated as well as the association between massive transfusion and peripartum hysterectomy.
A Survey of Antenatal and Peripartum Provision of Information on Analgesia and Anesthesia
Authors: Brinkler R. , Edwards Z. , Abid S. , Oliver C.M. , Lo Q. , Stewart A.
Published: August 2020

(Anaesthesia. 2019;74:1101–1111)

Women in labor often need to make important medical decisions quickly, and experiencing a lack of control or undergoing unplanned procedures can contribute to a negative birth experience. While laboring women are capable of discussing treatment options and making these decisions, information regarding anesthetic care should ideally be given to patients well before these decisions must be made. Previous studies in the United Kingdom have found that ∼45% of expectant mothers participate in antenatal classes while 75% use the Internet to find information on obstetric analgesia and anesthesia. Only 31% were aware of the National Health Service’s information for parents Web site. This large multicenter study examined the provision of anesthesia information to pregnant women in London hospitals.
Comparison of Nitroglycerin and Terbutaline for External Cephalic Version in Women Who Received Neuraxial Anesthesia: A Retrospective Analysis
Authors: Katz D. , Riley K. , Kim E. , Beilin Y.
Published: August 2020

(Anesth Analg. 2019. doi: 10.1213/ANE.0000000000004155)

At term, about 3% to 4% of worldwide pregnancies have a fetus in the breech presentation, a common risk factor for delivery complications. The current recommendation to reduce perinatal morbidity and mortality with breech presentation is to perform a cesarean delivery. An alternative is external cephalic version, in which the fetus is manually rotated into vertex position to allow for an attempted vaginal delivery. The success rate of this procedure increases via utilization of neuraxial anesthesia, which allows for the relaxation of abdominal muscles, and via tocolytic agents which provide uterine relaxation. Two examples of such tocolytic agents are nitroglycerin and terbutaline. The authors of this study hypothesized that no difference in the successful cephalic version rate would exist between nitroglycerin and terbutaline.
Four Years’ Experience of a ROTEM-Guided Algorithm for Treatment of Coagulopathy in Obstetric Hemorrhage
Authors: McNamara H. , Kenyon C. , Smith R. , Mallaiah S. , Barclay P.
Published: August 2020

(Anaesthesia. 2019;74:984–991)

Although many advances have been made in the care of obstetric patients, maternal hemorrhage is still a major contributor to morbidity and mortality. Fibrinogen levels, like most coagulation factors, are increased during normal pregnancy, which contributes to an increased risk of venous thromboembolism. In the setting of obstetric hemorrhage, though, a low fibrinogen level is associated with a greater risk of developing severe postpartum hemorrhage. Until 2012, the standard treatment for obstetric hemorrhage at the investigators’ institution was the administration of a standardized shock pack containing fresh frozen plasma, packed red blood cells, and platelets. After July 2012, the transfusion practice was changed and blood therapy was informed by rotational thromboelastometry (ROTEM) coagulation test results. For patients with ongoing hemorrhage, administration of fibrinogen concentrate was a component of the treatment. This observational study examined 4 years of cumulative data on the ROTEM-directed algorithm treatment for patients with obstetric hemorrhage, including assessment of blood product and fibrinogen concentrate usage.
Comparison of Outcome Between Intrauterine Balloon Tamponade and Uterine Artery Embolization in the Management of Persistent Postpartum Hemorrhage: A Propensity Score–matched Cohort Study
Authors: Ramler P.I. , Henriquez D.D.C.A. , van den Akker T. , Caram-Deelder C. , Groenwold R.H.H. , Bloemenkamp K.W.M. , van Roosmalen J. , van Lith J.M.M. , van der Bom J.G.
Published: August 2020

(Acta Obstet Gynecol Scand. 2019;98:1473–1482)

Peripartum hysterectomy can be life-saving in the setting of postpartum hemorrhage (PPH). However, it produces infertility and is therefore considered a treatment of last resort. Many other procedures are first attempted to control PPH in an effort to avoid peripartum hysterectomy, such as intrauterine balloon tamponade, uterine compression sutures, and uterine artery ligation or embolization. Uterine artery embolization and intrauterine balloon tamponade have not previously been compared in terms of their effectiveness in preventing maternal death or near miss in women experiencing PPH. Uterine artery embolization is costly and may lead to thromboembolic events and other complications. Intrauterine balloon tamponade has more recently emerged as a more inexpensive strategy for managing PPH. This study aimed to compare the effectiveness of these 2 techniques for the management of persistent PPH.
The Effectiveness and Safety of Introducing Condom-catheter Uterine Balloon Tamponade for Postpartum Hemorrhage at Secondary Level Hospitals in Uganda, Egypt, and Senegal: A Stepped Wedge, Cluster-randomized Trial
Authors: Anger H.A. , Dabash R. , Durocher J. , Hassanein N. , Ononge S. , Frye L.J. , Diop A. , Beye S.B. , Burkhardt G. , Darwish E. , Ramadan M.C. , Kayaga J. , Charles D. , Gaye A. , Eckardt M. , Winikoff B.
Published: August 2020

(BJOG. 2019;126:1612–1621)

The World Health Organization has recommended uterine balloon tamponade (UBT) as one intervention for postpartum hemorrhage (PPH), a leading cause of maternal mortality worldwide. This is important for low- and middle-income countries (LMICs), where uterotonics, blood products, and skilled surgical teams may not be readily available. A few studies have reviewed the use of condom-catheter UBT in LMICs, but they have demonstrated conflicting findings or lacked robust evidence on its effectiveness. The aim of this study was to examine if condom-catheter UBT reduced maternal morbidity and mortality associated with PPH in LMICs.
Vitamin D Supplementation During Pregnancy and the Prevention of Childhood Asthma
Authors: Von Mutius E. , Martinez F.D.
Published: August 2020

(N Engl J Med. 2020;382:574–575)

Asthma symptoms often first appear when children are preschool-age, and therefore many efforts to prevent asthma are aimed at the prenatal or early postnatal periods. During the preschool years, asthma symptoms and transient wheeze are nearly identical, so the outcomes of any intervention should be measured once children reach 5 or 6 years old.
Rapid Titration of Intravenous Treprostinil to Treat Severe Pulmonary Arterial Hypertension Postpartum: A Retrospective Observational Case Series Study
Authors: Wang T. , Lu J. , Li Q. , Chen Y. , Ye Q. , Gao J. , Yang D. , Zhao L. , Huang J. , Zhang J.
Published: August 2020

(Anesth Analg. 2019;129:1607–1612)

Pulmonary arterial hypertension (PAH) in pregnancy, though rare, is associated with significant maternal mortality. Pregnancy in women with PAH is often not advised. Termination of pregnancy is often encouraged if these women conceive, but some women become pregnant regardless. Also there are women diagnosed with PAH during pregnancy who choose against medical advice to proceed with the pregnancy. Intravenous infusion of the prostacyclin epoprostenol remains the mainstay of treatment for PAH, but epoprostenol has a short half-life and requires continuous intravenous infusion with a central venous catheter.
Induction of Labor Versus Expectant Management After Successful External Cephalic Version
Authors: Barbash-Hazan S. , Nattiv N. , Salzer-Sheelo L. , Bergel R. , Hadar E. , Osovsky M. , Shmueli A.
Published: August 2020

(Birth. 2019;46:623–627)

External cephalic version (ECV) is a well-established procedure that improves maternal and neonatal outcomes. However, the literature has produced varied results as to the risk and rate of cesarean delivery after successful ECV. Differing results also have been reported when comparing spontaneous labor after ECV versus induction of labor after ECV. The aim of this study was to compare obstetrical and neonatal outcomes after successful ECV among those who underwent immediate labor induction versus those who were managed expectantly.
Marijuana Use in Young Mothers and Adverse Pregnancy Outcomes: A Retrospective Cohort Study
Authors: Rodriguez C.E. , Sheeder J. , Allshouse A.A. , Scott S. , Wymore E. , Hopfer C. , Hermesch A. , Metza T.D.
Published: August 2020

(BJOG. 2019;126:1491–1497)

The use of marijuana has grown among pregnant women in the United States, increasing 62% between 2002 and 2014. Yet, the literature is mixed regarding the impact of marijuana use on perinatal outcomes in this population. Some studies have shown an association between marijuana and adverse pregnancy events, while others have found no associations. Also, studies have largely relied on the patient self-reporting her marijuana use—a limitation that may skew results because some study participants may be misclassified as nonusers. This study aimed to evaluate the association between maternal marijuana use and a composite adverse pregnancy outcome.
Implications of Vaginal Instrumental Delivery for Children’s School Achievement: A Population-based Linked Administrative Data Study
Authors: Hsieh D.C. , Smithers L.G. , Black M. , Lynch J.W. , Dekker G. , Wilkinson C. , Stark M.J. , Mol B.W.
Published: August 2020

(Aust N Z J Obstet Gynaecol. 2019;59:677–683)

Instrumental vaginal delivery is a relatively common obstetric procedure in both Australia and the UK, accounting for ∼10% to 13% of deliveries. It is typically performed in cases of prolonged second stage of labor, fetal compromise, or limited ability of the mother to push. While instrumental deliveries are performed when obstetricians believe the benefits outweigh the risks, there are numerous potential side effects for both mother and fetus. These include maternal soft tissue tears and anal and urinary sphincter dysfunction as well as fetal trauma injuries, such as intracranial and subgaleal bleeding, lacerations, and cranial nerve injuries. Researchers have been concerned about the potential long-term neurodevelopmental effects of instrumental vaginal delivery, but previous studies have not adequately compared the development of children who were born via spontaneous vaginal delivery versus those born via instrumental vaginal delivery. This study was conducted to determine whether vacuum extraction, forceps, or normal vaginal deliveries had an effect on academic performance at 8 years of age.