bluuebunny/crossref_metadata_2025 huggingface dataset:
TAOK1 suppression improves doxorubicin-induced cardiomyopathy by preventing cardiomyocyte death and dysfunction
Authors: Suga Takaomi , Kitani Tomoya , Kogure Masaya , Oishi Masatsugu , Ito Fumiaki , Hoshino Atsushi , Ogata Takehiro , Ikeda Koji , Matoba Satoaki
Published: February 2025

Aims

Doxorubicin (DOX) is one of the most effective chemotherapeutic agents for various types of cancers. However, DOX often causes cardiotoxicity, which is referred to as DOX-induced cardiomyopathy (DIC). Despite extensive research, only a limited number of effective treatments are currently available. In this study, we aimed to identify a potential therapeutic target for DIC by preventing DOX-induced cell injury in cardiomyocytes.

Methods and results

We performed a kinome-wide CRISPR gene knockout screen in human cardiomyocytes derived from pluripotent stem cells (hPSC-CMs) and identified a member of the STE20 kinase family, thousand and one amino acid protein kinase 1 (TAOK1) as a potential regulator of DOX-induced cardiomyocyte death. Using CRISPR-mediated gene knockout and siRNA-mediated gene knockdown, we demonstrated that TAOK1 suppression improved DOX-induced cardiomyocyte death and dysfunction, including sarcomere disarray, contractile dysfunction, DNA damage, and mitochondrial dysfunction in hPSC-CMs. Transcriptome analysis using RNA-Seq also showed that DOX-induced mitochondrial dysfunction was attenuated by TAOK1 suppression. In contrast to the protective role of TAOK1 against DOX toxicity in cardiomyocytes, TAOK1 suppression did not induce DOX resistance in human cancer cell lines. DOX-induced activation of p38 MAPK was markedly attenuated in TAOK1-knockout hPSC-CMs. Furthermore, DOX-induced cardiomyocyte death and disruption of mitochondrial membrane potential were augmented by TAOK1 overexpression, which was partially attenuated by an inhibitor or knockdown of p38 MAPK or an apoptosis inhibitor. Finally, we demonstrated that TAOK1 suppression using AAV-mediated gene silencing attenuated DOX-induced myocardial damage, including myocardial fibrosis, apoptosis, and cardiomyocyte atrophy, resulting in improved cardiac function in a mouse model of DIC.

Conclusion

Our results indicate that TAOK1 suppression is a promising therapeutic approach for treating DIC in patients with cancer and highlight the advantages of hPSC-CMs as a platform to study drug-induced cardiotoxicity.
Genome size evolution and phenotypic correlates in the poison frog family Dendrobatidae
Authors: Douglas Tyler E , Márquez Roberto , Holmes V Renee , Johnston J Spencer , Tarvin Rebecca D
Published: February 2025

Adaptive and neutral processes have produced a spectrum of genome sizes across organisms. Amphibians in particular possess a wide range in C-values, from <1 to over 125 pg. However, the genome size of most amphibians is unknown, and no single family has been comprehensively assessed. We provide new estimates for 32 poison frog species representing the major lineages within Dendrobatidae using Feulgen staining of museum specimens and flow cytometry of fresh tissue. We show that genome size in Dendrobatidae has likely evolved gradually, with potential evolutionary rate shifts in the genera Phyllobates and Hyloxalus, which respectively possess species with the largest (13.0 pg) and second smallest (2.6 pg) genomes in the family. Phylogenetically controlled regression analyses indicate that genome size is positively correlated with snout-vent-length, oocyte number, and clutch size, but negatively correlated with active metabolic rate and metabolic scope. While body size and metabolic rate are also correlates of toxicity, we found no relationship between genome size and evolution of chemical defense within Dendrobatidae. Genome size evolution in Dendrobatidae provides insight into the processes shaping genome size evolution over short timescales and establishes a novel system in which to study the mechanistic links between genome size and organismal physiology.
A Fully Validated LC-QTOF-MS Screening Workflow for the Analysis of Drugs in Oral Fluid
Authors: Coulter Cynthia , Gonzales Jonah , Coulter Campbell A , Wagner Jarrad , Moore Christine
Published: February 2025

A simple liquid-liquid extraction procedure (LLE) followed by liquid chromatography quadrupole time of flight tandem mass spectrometry (LC-QTOF-MS) analysis for drugs in oral fluid collected with the Quantisal™ device has been developed. The decision point cut-off concentrations were at or below those recommended by the National Safety Council’s Alcohol, Drugs, and Impairment Division (NSC-ADID) for toxicological investigation of driving under the influence of drugs cases (DUID). Currently ANSI/ASB standard 120 does not cover the analysis of oral fluid collected in impaired driving investigations, instead guidance from the NSC-ADID was used. The supporting mass spectral based screening library was adapted from commercially available databases and included Tier 1 and Tier 2 recommended compounds. Further, the additional inclusion of novel psychoactive substances and synthetic cannabinoids was based on the Center for Forensic Science Research and Education’s (CFSRE) quarterly publications of 2023. Metabolites from those publications were not included in this method since, with some exceptions, parent drugs are the dominant compounds in oral fluid. Briefly, Quantisal™ (1mL) was mixed with organic solvents, centrifuged, and decanted; followed by a second liquid-liquid process which extracted all the drugs in a single aliquot. A gradient liquid chromatography program using 0.1% formic acid in water and 0.1% formic acid in methanol was used and the runtime was 10 minutes. LC-QTOF-MS settings were optimized to promote greater sensitivity for a wide range of drug classes. The method was fully validated using ANSI/ASB 036 Standard Practices for Method Validation in Forensic Toxicology as guidance. Interference studies, limit of detection, precision at and around the decision points, ionization suppression/enhancement, and processed sample stability up to 96 hours were completed for each drug in the library database. While ion suppression or enhancement of the analytes varied greatly, the decision point was not significantly affected and internal standards that mimicked similar responses were chosen for each analyte. The method was applied to proficiency program samples, routine samples received into the laboratory, and blind samples screened against the search engine. The optimization of specific tune characteristics and instrument settings allowed the user to meet or exceed recommended screening limits for drugs in Quantisal™ collected oral fluid samples without the need for immunoassay testing.
Latitudinal gradient patterns and driving factors of the fruit types of woody plants based on multiple forest dynamic monitoring plots
Authors: Liu Wenjun , Shao Yizhen , Guo Shengqian , Liu Fengqin , Tian Xiangyu , Chen Yun , Yuan Zhiliang
Published: February 2025

Fruit type influences seed dispersal mode and its effectiveness, reflecting plant adaptability to their environments. However, the large-scale patterns of fruit type distribution in forest communities and differences in the drivers of various fruit types remain unclear. We present a large-scale biogeographic model of woody plant fruit types along a latitudinal gradient through the data analysis of 30 forest dynamic plots. Results showed the following. (1) Fleshy and dry fruits exhibited distinct distribution patterns in large-scale space. The distribution of fleshy fruits was greater in tropical and subtropical zones, while dry fruits were more common in temperate zones. (2) Climatic factors primarily drove the geographical distribution of the fruit types of woody plants. Climatic and spatial factors exerted greater effects on the species richness of dry fruits compared with that of fleshy fruits. Our results demonstrated the difference in the latitudinal gradient patterns of fleshy and dry fruits and identified the major abiotic environmental factors that drove their distribution in large-scale spaces, demonstrating the biogeography of the fruit types of woody plants.
Long-rising Type II supernovae resembling supernova 1987A - II. A new analytical model to describe these events
Authors: Pumo M L , Cosentino S P
Published: February 2025

With the aim of improving our knowledge on supernova (SN) 1987A-like objects and, more in general, on H-rich SNe, we have developed a new analytic model to describe their post-explosive evolution. The distinctive features of this model are the possibility to evaluate the emitted luminosity and the SN expansion velocity, taking into account the recombination of the ejected material, the heating effects due to the 56Ni decay in the computation of the recombination front position, and the presence of an outer thin shell not-homologously expanding. In this paper, we present the model and a comparison with observations of SN 1987A, showing that its bolometric light curve and expansion velocity are accurately reproduced by the model. We also investigate the modeling degeneration problem in H-rich SNe and the possibility to ‘standardize’ the subgroup of SN 1987A-like objects. Moreover we present new Ni-dependent relationships, based on our model, which link some features of the bolometric light curve of 1987A-like SNe (namely, the peak luminosity and its width) with the main physical properties of their progenitor at the explosion (i.e. the ejected mass, the explosion energy, the progenitor radius at the explosion, and the amount of 56Ni present in the ejecta), showing that such relations are in excellent agreement with observations of real SNe. From our model, we also deduce new scaling relations which may be used for estimating the main SN progenitor’s physical properties at the explosion, once only the photometric behaviour of the SN 1987A-like object is known.
Comparison of Efficacy and Safety of Parenteral vs Oral Route of Vitamin B12 Supplementation for the Treatment of Vitamin B12 Deficiency Anemia in Children: A Systematic Review
Authors: Sachdeva Meenakshi , Purohit Abhishek , Malik Meenakshi , Jain Lovely , Pradhan Pranita , Mathew Joseph L
Published: February 2025

Context

Vitamin B12 deficiency in children is treated with either parenteral or oral supplementation. Although the efficacy of supplementation is reportedly comparable for the 2 routes in adults, there is limited data for children.

Objective

The objective of this review was to compare the efficacy and safety of parenteral vs oral B12 supplementation in children with vitamin B12 deficiency anemia.

Data Sources

A comprehensive literature search was conducted in PubMed, EMBASE, the Cochrane Library, Scopus, Web of Science, four Clinical Trials Registries, and 2 gray literature databases, for randomized controlled trials (RCTs) comparing the parenteral vs oral routes of administering B12 in children with vitamin B12 deficiency anemia.

Data Extraction

Among 6467 citations screened, there was only 1 eligible RCT, in which children with vitamin B12 deficiency anemia received 1 dose of 1000 µg parenterally before being randomized to either parenteral or oral therapy.

Data Analysis

After 3 months, the parenteral route resulted in higher B12 levels compared with the oral route (median [IQR]: 653 [459, 835] vs 506 [399, 726] pg/mL). The changes from baseline in vitamin B12 levels (median [IQR]: 600 [389, 775] vs 399 [313, 606] pg/mL, P = .016) and hemoglobin (2.7 [0.4, 4.6] vs 0.5 [−0.1, 1.2] g/dL, P = .001) were also significantly greater with the parenteral route. There was no data on safety. In terms of quality, the RCT was judged to be at “high risk of bias.”

Conclusion

Limited evidence from a single, methodologically weak RCT suggested that the parenteral route is more efficacious than the oral route. However, considering the limitations in quality and quantity of the available evidence, this should be interpreted with caution.

Systematic Review Registration

PROSPERO registration No. CRD42024526597.
Efficacy of cyclin-dependent kinase inhibitors with concurrent proton pump inhibitors in patients with breast cancer: a systematic review and meta-analysis
Authors: Guo Zijie , Zhu Ziyu , Luo Mingpeng , Cao Yijia , Lin Xixi , Wu Qingliang , Wang Shenkangle , Wang Linbo , Zhou Jichun
Published: February 2025

Background

The impact of concurrent proton pump inhibitors (PPIs) use on the prognosis of patients with breast cancer undergoing cyclin-dependent kinase inhibitors (CDKIs) treatment is currently uncertain. Considerable divergence exists regarding the clinical studies. In this study, we aim to perform a comprehensive analysis to evaluate the influence of concomitant PPI use on the effectiveness and adverse effects of CDKIs in patients with breast cancer.

Methods

This study encompassed all pertinent clinical studies published up to the present, following the PRISMA guidelines. The study used hazard ratio (HR) or odds ratio (OR) as a summary statistic and used fixed or random effects models for pooled estimation.

Results

This study incorporated 10 research articles involving 2993 participants. Among patients with breast cancer undergoing treatment with CDKIs, the simultaneous administration of PPIs was associated with a notable reduction in overall survival (HR = 2.00; 95% CI, 1.35-2.96). Nevertheless, no substantial correlation was observed between the simultaneous utilization of PPIs and the progression-free survival (PFS) of patients (HR = 1.30; 95% CI, 0.98-1.74). PFS did not change significantly when considering different drugs, treatment lines, or regions alone. Furthermore, the simultaneous administration of PPIs was found to result in a notable decrease in the incidence of grades 3/4 risk factors (OR = 0.63, 95% CI, 0.46-0.85).

Conclusion

The concurrent administration of PPIs did not result in significant alterations in the risk of disease advancement among patients with breast cancer undergoing CDKIs treatment. The utilization of PPIs led to a decrease in the adverse effects linked to the administration of CDKIs.
Blocking mobile internet on smartphones improves sustained attention, mental health, and subjective well-being
Authors: Castelo Noah , Kushlev Kostadin , Ward Adrian F , Esterman Michael , Reiner Peter B
Published: February 2025

Smartphones enable people to access the online world from anywhere at any time. Despite the benefits of this technology, there is growing concern that smartphone use could adversely impact cognitive functioning and mental health. Correlational and anecdotal evidence suggests that these concerns may be well-founded, but causal evidence remains scarce. We conducted a month-long randomized controlled trial to investigate how removing constant access to the internet through smartphones might impact psychological functioning. We used a mobile phone application to block all mobile internet access from participants’ smartphones for 2 weeks and objectively track compliance. This intervention specifically targeted the feature that makes smartphones “smart” (mobile internet) while allowing participants to maintain mobile connection (through texts and calls) and nonmobile access to the internet (e.g. through desktop computers). The intervention improved mental health, subjective well-being, and objectively measured ability to sustain attention; 91% of participants improved on at least one of these outcomes. Mediation analyses suggest that these improvements can be partially explained by the intervention's impact on how people spent their time; when people did not have access to mobile internet, they spent more time socializing in person, exercising, and being in nature. These results provide causal evidence that blocking mobile internet can improve important psychological outcomes, and suggest that maintaining the status quo of constant connection to the internet may be detrimental to time use, cognitive functioning, and well-being.
Health Care Professionals’ Views of Barriers and Facilitators for Implementing a Fall Risk Screening Tool in Clinical and Public Health Settings
Authors: Frisendahl Nathalie , Karlsson Patrik , Sandlund Christina , Ek Stina , Franzén Erika , Boström Anne-Marie , Welmer Anna-Karin
Published: February 2025

OBJECTIVE

The experiences of health care professionals using new screening tools in clinical and public health settings are crucial to the implementation process. However, further research is needed on their experiences with fall risk screening. This study utilized the integrated-Promoting Action on Research Implementation in Health Services (i-PARIHS) framework to explore health care professionals’ experiences with the First-time Injurious Falls (FIF) screening tool, aiming to identify barriers and facilitators for implementing the FIF tool in primary health care and public health settings.

METHODS

A qualitative study with 4 focus group interviews and 7 individual interviews was carried out, using a semi-structured interview guide. The interviews were recorded, transcribed verbatim, and analyzed with reflexive thematic analysis. The study.

included 20 participants (13 females and 7 males), with a mean age of 39 years (range 24 to 54). The participants were working in the primary health care setting (8 physical therapists, 3 occupational therapists, 3 managers, 2 registered nurses, and 1 dietician) and in a public health project (1 physical therapist and 2 health educators).

RESULTS

The analysis resulted in 3 themes: “A valuable tool in clinical practice,” “How to get everyone onboard when implementing fall risk screening,” and “Applicable in many areas of health services but not in all” with 4 related subthemes “Quick and easy to use for all health care professionals,” “Simplifies assessment and creates a platform for discussion,” “Need for clear instructions and action list,” and “Should be incorporated into daily routines.”

CONCLUSION

The FIF tool was well-received by participants in practice as it was user-friendly and potentially effective in preventing falls. However, there is room for improvement, particularly in clarifying instructions to mitigate possible misinterpretations. The participants emphasized that implementation of a new screening tool requires favorable organizational conditions such as managerial support, that the tool is easily accessible, and the results are easy to document.

IMPACT

The FIF tool seems to be a valuable screening tool for predicting first-time injurious falls in older adults, suitable for use by various health care professionals.
Arbitration with Uninformed Consumers
Authors: Egan Mark , Matvos Gregor , Seru Amit
Published: February 2025

This paper studies the impact of the arbitrator selection process on consumer outcomes. Using data from consumer arbitration cases in the securities industry over the past two decades, where we observe detailed information on case characteristics, the randomly generated list of potential arbitrators presented to both parties, the selected arbitrator, and case outcomes, we establish several motivating facts. These facts suggest that firms hold an informational advantage over consumers in selecting arbitrators, resulting in industry-friendly arbitration outcomes. We then develop and calibrate a quantitative model of arbitrator selection in which firms hold an informational advantage in selecting arbitrators. Arbitrators, who are compensated only if chosen, compete with each other to be selected. The model allows us to decompose the firms’ advantage into two components: the advantage of choosing pro-industry arbitrators from a given pool and the equilibrium pro-industry tilt in the arbitration pool that arises because of arbitrator competition. Selecting arbitrators without the input of firms and consumers would increase consumer awards by $60,000 on average relative to the current system. Forty percent of this effect arises because the pool of arbitrators skews pro-industry due to competition. Even an informed consumer cannot avoid this pro-industry equilibrium effect. Counterfactuals suggest that redesigning the arbitrator selection mechanism for the benefit of consumers hinges on whether consumers are informed. Policies intended to benefit consumers, such as increasing arbitrator compensation or giving parties more choice, would benefit informed consumers but hurt the uninformed.
Cardiac Arrest in Obstetric Patients Receiving Anesthetic Care: Results From the 7th National Audit Project of the Royal College of Anaesthetists
Authors: Lucas DN , Kursumovic E , Cook TM , Kane AD , Armstrong RA , Plaat F , Soar J
Published: February 2025

(Anaesthesia. 2024, 79, 514–523. doi:10.1111/anae.16204)

Cardiac arrest (CA) among pregnant women is not common, occurring between 2.78 per 100,000 patients and 1 in 12,000 hospitalizations. Effective management of such situations necessitates modifications to customary resuscitation procedures, like manual left uterine displacement and prompt cesarean delivery (CD), to improve likelihood of maternal survival. In the UK, anesthetic complications such as local anesthetic toxicity and high neuraxial blocks, are the primary reasons for obstetric CA occurring before delivery. On the other hand, in the United States, typical reasons are bleeding, cardiac complications, amniotic fluid embolism, and septicemia.
Preventing Maternal Cardiac Arrest: How Do We Reach the Next Level of Safety in Obstetric Anaesthesia?
Authors: Monks DT , Singh PM , Palanisamy A
Published: February 2025

(Anaesthesia. 2024, 79, 461–464. doi:10.1111/anae.16230)

It is uncommon for maternal cardiac arrests (CA) to occur, leading to limited opportunities to learn from these unfortunate occurrences. The 7th National Audit Project (NAP7) organizers should be commended for adjusting their approach to incorporate instances of CA in obstetric patients receiving anesthesia, regardless of their location. The study conducted by Lucas and colleagues offers valuable findings on anesthetic care during childbirth to avoid rare yet severe occurrences. The results suggest that the primary reason for most maternal CAs in NAP7 was related to anesthetic management factors. This aligns with additional studies, like the CAPS research, that found comparable results regarding maternal CA from obstetric anesthesia.
Unlocking Maternal Health: Labour Epidurals and Severe Morbidity
Authors: Devroe S , Rex S , Lucas N
Published: February 2025

(BMJ. 2024;385:q1053. http://dx.doi.org/10.1136/bmj.q1053)

The World Health Organization (WHO) suggests using epidural analgesia (EA) for healthy pregnant women who desire pain relief during childbirth, taking into account personal preferences. Yet, a prevalent worry while obtaining consent is the potential adverse impacts of EA on the mother, the baby, or the delivery. Limited evidence is still available to handle these concerns. Kearns and colleagues researched to investigate the impact of EA on severe maternal morbidity (SMM). The results showed a notable correlation, as EA was connected to a 35% decrease in SMM, especially in women with a medical reason for using EA and those with preterm deliveries. These results have significant consequences for anesthetic care during childbirth and women’s health, underscoring the importance of additional research.
Saint Didacus, Fetal Death, and the Problem of Dual Loyalty
Authors: Posever N
Published: February 2025

(N Engl J Med. 391;20. doi:10.1056/NEJMp2402783.)

One Christmas morning, an emergency call in labor and delivery marked the beginning of a deeply emotional and ethically complex situation for a physician. A woman, involved in a car accident and found to be intoxicated, had suffered a fetal demise at 20 weeks gestation. After counseling, she opted for an induction to deliver the stillborn fetus. As the labor progressed, the physician learned that the woman had other children at home and had been sober for several years. After the delivery, the physician helped with the care of the fetus and then made a required phone call to report the fetal death to the medical examiner, as per legal obligations in Massachusetts for any fetal death after 20 weeks. The cause of death was trauma from the car crash, exacerbated by alcohol use. This act of reporting, however, led to significant ethical dilemmas for the physician, who feared potential legal consequences for the mother.
Incidence of Shoulder Dystocia and Risk Factors for Recurrence in the Subsequent Pregnancy—A Historical Register-Based Cohort Study
Authors: Jeppegaard M , Larsen MH , Thams AB , Schmidt AB , Rasmussen SC , Krebs L
Published: February 2025

(Acta Obstet Gynecol Scand. 2024;103(10):1975–1984. doi:10.1111/aogs.14784)

Shoulder dystocia (SD) is an unusual obstetric issue in which the front shoulder gets stuck behind the pubic bone following the delivery of the fetal head. It is associated with significant risks for both the newborn and the mother, such as brachial plexus injury, fractures, lack of oxygen, and excessive bleeding after childbirth. It occurs in 0.2% to 3% of cases and is usually described as an inability to deliver the shoulders using gentle traction, necessitating further actions. Maternal obesity, diabetes, macrosomia, labor induction, prolonged labor, and operative vaginal delivery are all risk factors for primary SD. The risk of recurrence varies from 1% to 25%, with previous SD and higher birth weight plays a significant role.
Risk Factors for the Increasing Incidence of Pregnancy-Associated Cancer in Sweden: A Population-Based Study
Authors: Lundberg FE , Stensheim H , Ullenhag GJ , Sahlgren HM , Lindemann K , Fredriksson  , Johansson ALV
Published: February 2025

(Acta Obstet Gynecol Scand. 2024;103(4):669–683. doi:10.1111/aogs.14677)

Pregnancy-related cancer, referred to as PAC, is cancer that is detected either during pregnancy or within 1 year after giving birth, with a frequency of around 1 in 1000 births. Diagnosing and treating cancer while pregnant is difficult because of the dangers it can pose to both the mother and the unborn baby, with limited options based on when the cancer is detected in the pregnancy. Cancers discovered after giving birth are affected by changes in the body from pregnancy. Still, they are easier to treat, and delays in diagnosis during pregnancy might lead to postpartum cases. Therefore, a thorough understanding of PAC necessitates detailed information on pregnant and new mothers.
Randomized Trial of Very Early Medication Abortion
Authors: Brandell K , Jar-Allah T , Reynolds-Wright J , Kallner HK , Hognert H , Gyllenberg F , Kaislasuo J , Tamang A , Tuladhar H , Boerma C , Schimanski K , Gibson G , Løkeland M , Teleman P , Bixo M , Kjaer MM , Kallfa E , Bring J , Heikinheimo O , Cameron S , Gemzell-Danielsson K ,   VEMA (Very Early Medication Abortion) Study Group
Published: February 2025

(N Engl J Med. 2024;391:1685–1695. doi:10.1056/NEJMoa2401646)

The research examines how safe and effective medication abortion (MA) (using mifepristone and misoprostol) is at very early stages of pregnancy before confirming an intrauterine pregnancy with ultrasound. Although MA is a commonly accepted and successful option for abortion, there is not much information available about its use during gestational periods where pregnancies are not visible on ultrasound.
Adherence to Different Forms of Plant-Based Diets and Pregnancy Outcomes in the Danish National Birth Cohort: A Prospective Observational Study
Authors: Hedegaard S , Nohr EA , Olsen SF , Halldorsson TI , Renault KM
Published: February 2025

(Acta Obstet Gynecol Scand. 2024;103(6):1046–1053. doi:10.1111/aogs.14778)

There has been a notable increase in the popularity of plant-based diets, especially veganism, in Western cultures due to environmental concerns, ethics, and animal welfare. In Denmark, the prevalence of veganism rose from <1% in 2010 to 3% in 2022, with young adults (18 to 34 y) noting 7.4%. Seventy percent of vegetarians are women, indicating elevated numbers among pregnant women. Although plant-based diets are associated with lower mortality rates, research also points out the potential dangers of lacking essential nutrients in such restrictive eating patterns. Studies on these diets and their effects on birth outcomes show varied findings. Initial reviews did not report any regular negative impacts. However, recent research has shown a decrease in birth weight and an increase in small-for-gestational-age babies in vegan mothers, possibly because of differences in diet and insufficient nutrient information.
Acetaminophen Use During Pregnancy and Children’s Risk of Autism, ADHD, and Intellectual Disability
Authors: Ahlqvist VH , Sjöqvist H , Dalman C , Karlsson H , Stephansson O , Johansson S , Magnusson C , Gardner RM , Lee BK
Published: February 2025

(JAMA. 2024;331(14):1205–1214. doi:10.1001/jama.2024.3172)

The potential link between acetaminophen (paracetamol) use during pregnancy and increased risks of neurodevelopmental disorders in children, such as autism, attention-deficit/hyperactivity disorder (ADHD), and intellectual disability, has been a major subject of concern. Confounding bias may play a role in existing findings. If such a link were found, it could significantly impact how fever and pain are managed during pregnancy.
Feasibility of Focused Cardiac Ultrasound Performed by Trainees During Cesarean Delivery
Authors: Ortner CM , Sheikh M , Athar MW , Padilla C , Guo N , Carvalho B
Published: February 2025

(Anesth Analg. 2024;139(2):332–338. doi:10.1213/ANE.0000000000006747)

The number one cause of death in mothers is due to cardiovascular disorders. Focused cardiac ultrasound (FCU) has been found to have benefits in maternal care. This studied aimed to see whether or not trainees would be able to successfully capture quality photos using FCU in order to help the medical team in decision-making during cesarean delivery (CD).
Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) as Adjunct Treatment in Life Threatening Postpartum Hemorrhage: 14 Years’ Experience From a Single Norwegian Center
Authors: Stensæth KH , Carlsen MIS , Løvvik TS , Uleberg O , Brede JR , Søvik E
Published: February 2025

(Acta Obstet Gynecol Scand. 2024;103:965–969. doi:10.1111/aogs.14767)

Postpartum hemorrhage (PPH) continues to be a critical global health challenge, contributing to nearly 27% of maternal deaths worldwide and rising in prevalence within high-income countries. Traditional treatments, such as uterotonic medications, blood transfusions, and surgical interventions, are sometimes insufficient in controlling hemorrhage or preventing hysterectomy. Early recognition and timely treatment could potentially avert two-thirds of maternal deaths caused by hemorrhage. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is currently used as an adjunct therapy for noncompressible traumatic hemorrhage and has shown promising results in managing PPH. Initially introduced at St. Olav’s Hospital in 2008, REBOA was envisioned as a minimally invasive treatment to control life-threatening PPH while preserving the uterus.
Uterine Inversion
Authors: Pararajasingam SS , Tsen LC , Onwochei DN
Published: February 2025

(BJA Educ. 2024;24(4):109e112. doi:10.1016/j.bjae.2024.01.004. Epub February 2024.)

Uterine inversion (UI) is a serious condition where the uterus protrudes into the endometrial cavity and in more extreme cases, through the vaginal orifice. It can occur either during the puerperal (peripartum) periods of vaginal delivery (VD) or cesarean delivery, or nonpuerperal periods. The severity of UI is categorized into 4 grades, defined by which structures the uterus reaches during an inversion. This article focuses on the subset of puerperal UIs occurring after the third stage of VD. UI can lead to severe complications such as postpartum hemorrhage (PPH) due to impaired uterine contraction and subsequent hemodynamic instability. Prompt recognition and management are crucial to prevent severe morbidity and mortality.
Preventing Posttraumatic Stress Disorder Following Childbirth: A Systematic Review and Meta-Analysis
Authors: Dekel S , Papadakis JE , Quagliarini B , Pham CT , Pacheco-Barrios K , Hughes F , Jagodnik KM , Nandru R
Published: February 2025

(Am J Obstet Gynecol. 2024; 230:6p610–641.e14. doi:10.1016/j.ajog.2023.12.013)

Posttraumatic stress disorder (PTSD) is a psychiatric condition triggered by exposure to death, threatened death, or serious injury, whether experienced personally or witnessed. PTSD from childbirth involves situations where a woman feels her life or her infant’s life are at risk. A more inclusive definition of birth trauma includes any childbirth-related event or interaction that leads to intense distress and negatively affect a woman’s well-being. This review aimed to address the gap in effective treatments for PTSD related to childbirth, a significant issue given that approximately one-third of delivering women in the United States likely experience highly stressful and potentially traumatic childbirth. Currently, there are no established routine treatments to prevent or alleviate PTSD resulting from childbirth. The research involved a systematic review and meta-analysis of clinical trials [both randomized controlled trials (RCTs) and nonrandomized trials] assessing various therapies intended to prevent or treat PTSD associated with childbirth.
Labour Agentry and Subsequent Adverse Mental Health Outcomes: A Follow-Up Study of the ARRIVE Trial
Authors: Canfield DR , Allshouse AA , Smith J , Metz TD , Grobman WA , Silver RM
Published: February 2025

(BJOG. 2024;131(7):970–976. doi:10.1111/1471-0528.17703)

Over 20% of women experience maternal mental health disorders like postpartum depression, anxiety, and PTSD before and after childbirth. These factors may coexist and play a causative role in pregnancy health concerns and maternal death in both the short and long term. In a report from 2022, it was discovered that mental health disorders were the primary reason for deaths related to pregnancy, making up 22.7% of instances. Furthermore, traumatic birthing experiences and a sense of lack of control during delivery are identified as risk factors for PTSD. The impact of control during labor on future mental health outcomes is not well understood. The Labor Agentry Scale (LAS), a validated scoring tool, can gauge labor agentry which is defined as the perceived control level during childbirth. A decrease in LAS scores signifies a lower level of perceived control. While labor advocacy has been associated with increased patient satisfaction, its impact on postpartum mental well-being is not yet understood.
Labor Induction at 41+0 Gestational Weeks or Expectant Management for the Nulliparous Woman: The Finnish Randomized Controlled Multicenter Trial
Authors: Place K , Rahkonen L , Tekay A , Väyrynen K , Orden M-R , Vääräsmäki M , Uotila J , Tihtonen K , Rinne K , Mäkikallio K , Heinonen S , Kruit H
Published: February 2025

(Acta Obstet Gynecol Scand. 2024;103:505–511. doi:10.1111/aogs14755)

Post-term deliveries increase risks to both mothers and neonates, increasing further with greater gestational age. Recent studies show that labor induction (IOL) at 41 weeks’ gestation or earlier would decrease complication rates without increasing cesarean deliveries (CD) or other costs associated with delivery. In Finland, current guidelines recommend IOL between 41 weeks and 5 days and 42 weeks and 1 day of gestation for healthy pregnancies. Reasons for this include the negative effects of induced labor and allowing the maximum amount of time for spontaneous labor to occur. This study was designed to assess the most beneficial timing of IOL in nulliparous late-term and post-term gestations with a closed cervix, comparing IOL at 41 weeks and 0 days with expectant management and induction at the recommended gestational age. It was hypothesized that earlier IOL would reduce adverse labor outcomes and decrease CD rates.
Predictive Performance of Shock Index for Postpartum Hemorrhage During Cesarean Delivery
Authors: Mizutani H , Ushida T , Ozeki K , Tano S , Iitani Y , Imai K , Nishiwaki K , Kajiyama H , Kotani T
Published: February 2025

(Int J Obstet Anesth. 58;2024:103957. https://doi.org/10.1016/j.ijoa.2023.103957)

Postpartum hemorrhage (PPH) is a significant obstetric emergency that accounts for ∼20% of maternal deaths globally. In cesarean deliveries (CD), PPH is often described as blood loss >1000 mL, with reported rates ranging from 4.8% to 30%. High-risk pregnancies, like those with advanced maternal age, assisted reproductive technology, multiple pregnancies, or placenta accreta spectrum disorders, are major contributors to the rising rates of PPH. Although there are risk assessment tools available for PPH, they are not universally proven, and around 60% of cases of PPH happen in women who lack risk factors.
Preeclampsia at Term: Evidence of Disease Heterogeneity Based on the Profile of Circulating Cytokines and Angiogenic Factors
Authors: Chaiworapongsa T , Romero R , Gomez-Lopez N , Suksai M , Gallo DM , Jung E , Berry SM , Awonuga A , Tarca AL , Bryant DR
Published: February 2025

(Am J Obstet Gynecol. 2024;230:450.e1–450.e18. doi:10.1016/j.ajog.2023.10.002)

Preeclampsia (PEC) is one of the leading causes of perinatal and maternal morbidity and mortality in the world. PEC, characterized by high blood pressure and organ damage in pregnancy, occurs in 3% to 7% of pregnancies, and has been linked to intravascular inflammation and an antiangiogenic state. Recent findings suggest that low performance of angiogenic biomarkers in women with PEC at term might be due to only about half of these women having an abnormal angiogenic profile, unlike 90% to 98% of those with early PEC. Early PEC is marked by severe intravascular inflammation, while the role of inflammation in late PEC is still being explored.
Improving Motor Function in Fetal Surgery for Open Spina Bifida
Authors: David AL
Published: February 2025

(BJOG. 2024;131:768. doi: 10.1111/1471-0528.17730)

The mini commentary describes progress in fetal surgery for open spina bifida (or myelomeningocele, known as MMC), with a primary emphasis on enhancing motor function results. Prenatal surgery for MMC has been widely embraced as the preferred treatment option following the 2011 Management of Myelomeningocele Study (MOMS) clinical trial, leading to enhanced brain and motor function outcomes compared to postnatal surgery. Nevertheless, numerous children encounter obstacles, including mobility limitations and the requirement for daily urinary catheterization, which impacts their quality of life. Spinal cord tethering often occurs after surgery due to fibrosis and inflammation near the repair site of the MMC, which has prompted researchers to investigate ways to enhance surgical outcomes through neuroprotective and immunomodulatory strategies.
Late-Preterm Corticosteroids Exposure and Neurodevelopmental Outcomes
Authors: Vidaeff AC , Asztalos E
Published: February 2025

(JAMA. 2024; 331(19):1626–1627. doi:10.1001/jama.2024.2228. Epub 2024 April.)

Recent research has prompted a reevaluation of the recommended gestational age limit for administering antenatal corticosteroids. Traditionally, corticosteroids were recommended up to 34 weeks of gestation to improve outcomes for preterm infants. However, studies over the past decade have investigated extending this limit to 37 weeks, potentially benefiting infants born late preterm (34- to 37 wk).
Effective and Simple Interventions to Improve Outcomes for Preterm Infants Worldwide: The FIGO PremPrep-5 Initiative
Authors: Hall M , Valencia CM , Soma-Pillay P , Luyt K , Jacobsson B , Shennan A ,   FIGO Preterm Birth Committee
Published: February 2025

(Int J Gynecol Obstet. 2024;165:929–935. doi:10.1002/ijgo.15269. Epub 2024 January.)

The 2023 WHO Born Too Soon report details the significant impact of preterm birth on global health, emphasizing its role as the leading cause of neonatal and infant mortality worldwide. Preterm birth is defined as delivery before 37 weeks of gestation, and it affected ∼10% of infants globally in 2020, translating to 13.4 million children born preterm. The consequences of preterm birth extend beyond immediate health risks, such as intraventricular hemorrhage and necrotizing enterocolitis, to long-term complications including cerebral palsy, developmental delays, and chronic lung disease.
Reframing Cerebral Palsy as a Lifelong Physical Disability
Authors: Peterson MD
Published: February 2025

(N Engl J Med. 2024;391(18):1668–1670. doi:10.1056/NEJMp2403366)

Mark D. Peterson, PhD, promotes a change in perspective regarding cerebral palsy (CP), shifting from viewing it as a childhood condition to recognizing it as a permanent physical disability. This shift mirrors the increasing number of grown-ups with CP, which results from improved pediatric health care and boosted lifespan. Despite this change, medical and research facilities still mainly cater to children, resulting in a need for more support and clinical guidance for adults with CP.
A Retrospective Cohort Study of the Anesthetic Management of Postpartum Tubal Ligation
Authors: Ansari J , Sheikh M , Riley E , Guo N , Traynor A , Carvalho B
Published: February 2025

(Int J Obstet Anesth. 58;2024:103974. https://doi.org/10.1016/j.ijoa.2023.103974)

Tubal ligation after childbirth is a popular birth control option in the United States. ACOG views postpartum tubal ligation (PPTL) as a time-sensitive procedure that must be done promptly to avoid unintended pregnancies. Recent limitations on abortion may lead to an additional rise in the utilization of PPTL. As a large number of women opt for neuraxial labor analgesia, it is common practice to reactivate a current epidural for PPTL, with failure rates ranging from 8% to 26%. Research, such as the one conducted at Lucille Packard Children’s Hospital, discovered decreased failure rates when surgery is done soon after the epidural is placed. As a result, the organization suggested transitioning to de novo spinal anesthesia (SA) after 24 hours postpartum, citing a 2002 study that demonstrated the effectiveness of de novo SA.
Are We Closer to Determining a Gold Standard for Sensory Block Testing During Labor Epidural Analgesia?
Authors: Munro A , Uppal V
Published: February 2025

(Can J Anesth. 2024;71(6):720–726. doi:10.1007/s12630-023-02686-x)

The use of an epidural during birth is a decision many women make to adequately reduce their pain. Clinicians use sensory block testing to ensure the anesthesia is appropriately delivered to the body in a manner that will adequately alleviate pain and not inhibit critical processes. Munro and Uppal comment on the recent publication by Casellato and colleagues, to review their protocol and findings while also reviewing the field generally.
An Innovative Approach to Determine Programmed Intermittent Epidural Bolus Pump Settings for Labor Analgesia: A Randomized Controlled Trial
Authors: Munro A , George RB , Andreou P
Published: February 2025

(Anesth Analg. 2024;139(3):545–554. doi:10.1213/ANE.0000000000006813)

Programmed intermittent epidural bolus (PIEB) analgesia has many benefits in the labor and delivery setting. This article had the goal of using response surface methodology (RSM) to determine optimal PIEB settings while also evaluating maternal satisfaction, clinician-administered manual bolus requirements, and the delivered amount of patient-controlled epidural analgesia (PCEA) doses.
Brief Assessment of Patient Phenotype to Explain Variability in Postsurgical Pain and Opioid Consumption After Cesarean Delivery: Performance of a Novel Brief Questionnaire Compared To Long Questionnaires
Authors: He J , Wilson JM , Fields KG , Zachos KMF , Franqueiro AR , Reale SC , Farber MK , Bateman BT , Edwards RR , Rathmell JP , Soens M , Schreiber KL
Published: February 2025

(Anesthesiology. 2024;140:701–714. doi:10.1097/ALN.0000000000004900)

Moderate or severe postsurgical pain is reported by a high number of patients following cesarean delivery (CD). Globally, it is the most common surgery performed, and higher pain levels after surgery are associated with persistent postsurgical pain and chronic opioid use. In addition, pain that is present before surgery is associated with worse postoperative pain and thus greater consumption of medications to manage pain. Current tools used to assess psychosocial factors associated with use of pain medication and postoperative pain levels include mainly dichotomous measures or extremely long comprehensive assessments. This study was designed to compare 3 sets of questionnaires that differ in length and detail to explain postoperative pain and opioid consumption variability after CD; first, a 3-item questionnaire (3-IQ); second, a 58-item long questionnaire with the 3-IQ; and third, a novel 19-item brief questionnaire in addition to the 3-IQ.
Cross-sectional Analysis of Zoom Fatigue on Clinical Decision-making in Nursing Students
Authors: Gutiérrez-Puertas Vanesa , Gutiérrez-Puertas Lorena , Aguilera-García Gabriel , Aguilera-Manrique Gabriel , Galera-Barbero Trinidad Maria , Márquez-Hernández Verónica V.
Published: February 2025

Zoom fatigue may affect nursing students, as there has been an increase in the use of videoconferencing for academic as well as clinical applications. Fatigue can negatively interfere with clinical decision-making and lead to clinical errors. This study aimed to explore the association between Zoom fatigue and perceived clinical decision-making ability of nursing students. This cross-sectional study assessed self-reported sociodemographic characteristics, Zoom fatigue, and clinical decision-making. Nursing students reported a medium level of Zoom fatigue (2.50 ± 0.78) and moderate effects on clinical decision-making (150.924 ± 12.561). Statistically significant differences were found between Zoom fatigue, the number of videoconferences held in the last month (r
s = 0.065, P = .030), prolonged use of electronic devices (χ
2
3 = 12.817, P = .005), and sex of the participants (U = 4043.500, P = .046). In addition, a negative relationship was observed between Zoom fatigue and clinical decision-making (r
s = −0.519, P < .001). Nursing students have shown a moderate level of Zoom fatigue. The number of videoconferences attended as well as the prolonged use of electronic devices could increase students’ level of Zoom fatigue. Students’ perception of their clinical decision-making is moderate. As the Zoom fatigue levels of nursing students increased, their perception of clinical decision-making ability decreased. In the academic and clinical settings, there is a need to develop strategies to prevent Zoom fatigue in nursing students and improve the quality of care provided to patients.
Sexually Transmitted Infection Considerations Following Sexual Assault
Authors: Dutra Karley , Lewis Ariana , Counts Rachel
Published: February 2025

Sexual assault is common, disproportionately impacting women, persons of color, and young adults. Evaluation should include a history and exam, collection of forensic evidence, and evaluation for mental health disorders. Management of sexually transmitted infections (STI) is important, as 15% will acquire an STI. Prophylaxis is recommended for gonorrhea, chlamydia, and, for individuals with vaginas, trichomonas. HIV and hepatitis B post-exposure prophylaxis are indicated in high-risk scenarios. HPV vaccination is recommended. Follow-up and lab monitoring is indicated for up to 6 months. We aim to summarize up-to-date evidence on the screening, evaluation, and management of STIs following sexual assault.