bluuebunny/crossref_metadata_2025 huggingface dataset:
Infectious Proctitis due to Human Mpox
Authors: Gedela Keerti , Da Silva Fontoura Dayana , Salam Alex , Gorman Gerry , Golden John , O’Hara Geraldine , Elowaidy Ahmed , Tittle Victoria , Girometti Nicolo , Whitlock Gary , Patel Sheel , Suchak Tara , Nugent Diarmuid , Asboe David , Boffito Marta , McOwan Alan
Published: September 2022

We describe 2 cases of infectious proctitis secondary to human monkeypox in patients presenting with rectal pain.

These cases highlight the importance of multidisciplinary management of monkeypox and in expanding case definitions and enabling clinical recognition in patients presenting without skin rash.
LiqBioer: a manually curated database of cancer biomarkers in body fluid
Authors: Geng Yiding , Jin Lu , Tang Guangjue , Zhao Zhangxiang , Gu Yunyan , Yang Dan
Published: September 2022

Cancer biomarkers are measurable indicators that play vital roles in clinical applications. Biomarkers in body fluids have gained considerable attention since the development of liquid biopsy, and their data volume is rapidly increasing. Nevertheless, current research lacks the compilation of published cancer body fluid biomarkers into a centralized and sustainable repository for researchers and clinicians, despite a handful of small-scale and specific data resources. To fulfill this purpose, we developed liquid biomarker (LiqBioer) containing 6231 manually curated records from 3447 studies, covering 3056 biomarkers and 74 types of cancer in 22 tissues. LiqBioer allows users to browse and download comprehensive information on body liquid biomarkers, including cancer types, source studies and clinical usage. As a comprehensive resource for body fluid biomarkers of cancer, LiqBioer is a powerful tool for researchers and clinicians to query and retrieve biomarkers in liquid biopsy.

Database URL

http://www.medsysbio.org:8080/LiqBioer
Chronic kidney disease in patients with congenital heart disease: a nationwide, register-based cohort study
Authors: Gillesén Mikaela , Fedchenko Maria , Giang Kok Wai , Dimopoulos Konstantinos , Eriksson Peter , Dellborg Mikael , Mandalenakis Zacharias
Published: September 2022

Aims

To investigate the risk of chronic kidney disease (CKD) in young patients with congenital heart disease (CHD) (age 0–47 years) compared with age- and sex-matched controls without CHD.

Methods and results

Using data from the Swedish National Patient Register and the Cause of Death Register, 71,936 patients with CHD (50.2% male) born between 1970 and 2017 were identified. Each patient with CHD was matched by sex and age to 10 controls without CHD (n = 714,457). Follow-up data were collected for patients with CHD and controls until 2017. During a median follow-up of 13.5 (5.8; 25.5) years, 379 (0.5%) patients with CHD and 679 (0.1%) controls developed CKD. The risk of CKD was 6.4 times higher in patients with CHD than controls [95% confidence interval (CI): 5.65–7.27] and was highest in patients with severe non-conotruncal defects [hazard ratio (HR): 11.31; 95% CI: 7.37–17.36]. Compared with matched controls, the absolute and relative risks of CKD were greater for CHD patients born between 1997 and 2017 (HR: 9.98; 95% CI: 8.05–13.37) (incidence 39.5 per 100 000 person-years). The risk of CKD remained significantly higher after adjusting for hypertension, acute kidney injury, and diabetes mellitus (HR: 4.37; 95% CI: 3.83–5.00).

Conclusion

Although the absolute risk of CKD in young patients with CHD is relatively low, patients with CHD are six times more likely to develop CKD than non-CHD controls up to the age of 47 years. Further data are needed to inform guidelines on the prevention and follow-up of CKD in CHD patients.
Patient reported experience and adherence to remote patient management in chronic heart failure patients: a posthoc analysis of the TIM-HF2 trial
Authors: Prescher Sandra , Winkler Sebastian , Riehle Leonhard , Hiddemann Meike , Moeller Volker , Collins Claudia , Deckwart Oliver , Spethmann Sebastian
Published: September 2022

Aims

Remote patient management (RPM) enables early detection and prevention of deterioration in heart failure (HF) patients by measuring vital parameters. The analysis objective is to assess patient reported experience with RPM, adherence to daily measurements, and outline affecting factors both.

Methods and results

Telemedical interventional management in-HF2 was conducted in 2013–18 with 1 538 HF patients with a 12-month follow-up. Under guidance of HF nurses, patients had to measure daily weight, blood pressure, electrocardiogram, and self-rated health status. At the end of the study, patients received a programme survey to analyse patient perceptions and satisfaction with telemedicine care and study organization. Adherence was distinguished between measurement of at least one [incomplete adherence (IA)] and all vital parameters [complete adherence (CA)] and defined as ratio of the number of days of measurements taken divided by the number of days of possible measurements. All data and group differences were analysed descriptively (mean ± SD) and by analysis of variance and t-test. Survey response rate was 79.7%. Patients were satisfied with the programme and device usability. CA was 89.1 ± 14.1%, consistently high over the study course and independent of severity of disease (left ventricular ejection fraction, N terminals pro brain natriuretic peptide, New York Heart Association). Lower IA was found with patients <70 years and prior to unplanned cardiovascular (CV) hospitalizations (difference by −5.2 ± 20.5%) and after unplanned CV hospitalizations compared with the entire study period (lower by −12.8 ± 24.7%). Patients from rural areas were found to have higher CA than patients from urban regions.

Conclusions

With user-friendly devices, pre-interventional patient training, regular patient contact and close cooperation between primary physicians and telemedical centre, a long-lasting high adherence and satisfaction could be achieved. A change in adherence might detect health deterioration and indicate the need to intensify RPM.

Registration

ClinicalTrials.gov (NCT01878630) and Deutsches Register Klinischer Studien (DRKS00010239).
genomicSimulation: fast R functions for stochastic simulation of breeding programs
Authors: Villiers Kira , Dinglasan Eric , Hayes Ben J , Voss-Fels Kai P
Published: September 2022

Simulation tools are key to designing and optimizing breeding programs that are multiyear, high-effort endeavors. Tools that operate on real genotypes and integrate easily with other analysis software can guide users toward crossing decisions that best balance genetic gains and genetic diversity required to maintain gains in the future. Here, we present genomicSimulation, a fast and flexible tool for the stochastic simulation of crossing and selection based on real genotypes. It is fully written in C for high execution speeds, has minimal dependencies, and is available as an R package for the integration with R’s broad range of analysis and visualization tools. Comparisons of a simulated recreation of a breeding program to a real data set demonstrate the simulated offspring from the tool correctly show key population features, such as genomic relationships and approximate linkage disequilibrium patterns. Both versions of genomicSimulation are freely available on GitHub: The R package version at https://github.com/vllrs/genomicSimulation/ and the C library version at https://github.com/vllrs/genomicSimulationC/.
Surviving Through Solitude: A Prospective National Study of the Impact of the Early COVID-19 Pandemic and a Visiting Ban on Loneliness Among Nursing Home Residents in Sweden
Authors: Gustafsson Per E , Schröders Julia , Nilsson Ingeborg , San Sebastián Miguel
Published: September 2022

Objectives

Targeted social distancing measures were widely implemented for nursing home residents when the extremely high coronavirus disease 2019 mortality in this setting became apparent. However, there is still scarce rigorous research examining how the pandemic and accompanying social distancing measures affected loneliness in this group. This prospective nationwide Swedish study of nursing home residents aimed to examine the impact on loneliness of the early phase of the pandemic and of a national visiting ban at nursing homes.

Methods

A panel was selected from a total population survey of all nursing home residents in Sweden March–May 2019 and 2020 (N = 11,782; age range 70–110 years; mean age 88.2 years; 71% women). Prospective pretest–posttest and controlled interrupted time series (ITS) designs were employed, with time trends estimated by date of returned questionnaire. Generalized linear models were used for estimation of effects, adjusting for demographic-, survey-, and health-related covariates.

Results

Loneliness prevalence increased from 17% to 19% from 2019 to 2020 (risk ratio, RR (95% confidence interval, CI) = 1.104 (1.060; 1.150)), but which was explained by self-reported health (RR (95% CI) = 1.023 (0.982; 1.066)). No additional impact of the visiting ban on loneliness trends was found in the ITS analyses (RR (95% CI) = 0.984 (0.961; 1.008)).

Discussion

The moderate but health-dependent increased risk of loneliness, and the lack of impact of the nationwide visiting ban at nursing homes, suggests that this ostensibly vulnerable group of nursing home residents also shows signs of resilience, at least during the early phase of the pandemic.
Ultrasound location of ground-glass opacity during thoracoscopic surgery
Authors: Messina Gaetana , Bove Mary , Natale Giovanni , Noro Antonio , Martone Mario , Opromolla Giorgia , Di Filippo Vincenzo , Leonardi Beatrice , Fasano Morena , Polito Rita , Fiorelli Alfonso , Santini Mario , Vicidomini Giovanni
Published: September 2022

OBJECTIVES

Application of video-assisted thoracoscopy brought lung surgery into the minimally invasive era; the lack of tactile feedback using VATS, remains a disadvantage because surgeons are unable to locate lesions with a finger or device. This study aimed to investigate the effectiveness, the applicability and the utility of intraoperative ultrasound (IU), for the localization of small ground-glass opacity (GGO) lesions in the parenchyma, as a guide in finding their margins in a deflated lung.

MATERIALS AND METHODS

We included 15 consecutive patients undergoing diagnostic resection of GGOs via VATS in the Thoracic Surgery Unit of the University of ‘Luigi Vanvitelli’ of Naples from November 2019 to December 2021. They were under general anaesthesia, when the lung had been collapsed, the probe was placed in the region where the target lesion was thought to reside on the basis of low-dose computed tomography scanning. GGO could be identified their sizes, echo levels and posterior echo was recorded by IU when the lung was completely deflated.

RESULTS

We conducted a retrospective single-centre study. All GGOs were identified by IU. The mean size and depth were 14.1 ± 0.5 and 4.8 ± 0.3 mm, respectively. Six (40%) lesions had hyperechoic patterns, 9 (60%) had mixed echogenicity where the hyperechoic patterns were irregularly mixed with hypoechoic patterns. The final diagnoses included 2 (15%) atypical adenomatous hyperplasia; 2 (15%) adenocarcinomas in situ; 3 (23%) minimally invasive adenocarcinomas and 6 (46%) invasive adenocarcinomas.

CONCLUSIONS

The results of our study showed that IU could safely and effectively detect GGOs.
Maximizing Micrograft Take in Extensive Back Burns
Authors: Ching Ann-Hui , Hong Qi-En , Chew Khong-Yik , Tan Bien-Keem
Published: September 2022

Extensive burns involving the back pose unique challenges. Offloading in the prone position is not possible with concomitant deep facial and neck burns. We describe our experience in maximizing graft take in a patient who had extensive back burns with concomitant anterior body burns. The two main goals in graft fixation for extensive back wounds are mechanical stabilization of micrografts to reduce shearing and prevention of water logging from exudates or bleeding to optimize contact with wound bed. Guided by the stages of wound healing, graft take, and burn care, we describe three stages of postoperative negative pressure wound therapy (NPWT) in a patient with 54% TBSA burns treated with micrografting. After complete excision of the deep dermal burns of the entire back, the wounds were covered with micrograft-allograft composites. In phase I, days 1 to 3, conventional topical negative pressure dressing with a thin sponge was applied and a leak-proof seal was achieved with gel sealant and high tack adhesive drapes. In phase II, days 4 to 5, foam dressings with topical negative pressure were applied, but with a less stringent seal, supported by wall suction. In phase III, the selective removal of allografts was initiated to facilitate expansion of micrografts. Negative pressure was continued for another 2 weeks at the most dependent site to prevent wound maceration from exudates. Micrograft take was optimized with the patient in the supine/semirecumbent position. The back wounds healed completely between 60 and 70 days without repeat micrografting. Since prone positioning was not possible in this patient, clearance of exudates and maintenance of micrograft contact with the wound bed using this technique proved successful.
Foramen of Winslow hernia: a case report of a rare life-threatening situation
Authors: Kharkhach Ayoub , Police Andrea , Mabilia Andrea , Charre Lionel
Published: September 2022

Internal hernias through the foramen of Winslow are considered as rare events. A 66-year-old female patient presented to our emergency department with epigastric and right upper quadrant pain associated with abdominal distention, nausea and vomiting and signs of shock. A computed tomography scan showed bowel strangulation with distended loops identified within the lesser sac. The diagnosis was confirmed by a midline laparotomy procedure. The ileum, the caecum and the ascending colon were found to herniate into the foramen of Winslow. A right hemicolectomy with a resection of the necrotic segment was performed. The patient recovered well postoperatively and was discharged on 10th day after surgery. The diagnosis and management of this rare disease remains challenging. Cross-sectional imaging with reconstruction is considered as the diagnostic modality of choice. Moreover, right hemicolectomy is a preferred procedure in order to decrease the rate of recurrence.
Modeling Group-Specific Interviewer Effects on Survey Participation Using Separate Coding for Random Slopes in Multilevel Models
Authors: Herzing Jessica M E , Blom Annelies G , Meuleman Bart
Published: September 2022

Despite its importance in terms of survey participation, the literature is sparse on how face-to-face interviewers differentially affect specific groups of sample units. This paper demonstrates how an alternative parametrization of the random components in multilevel models, so-called separate coding, delivers valuable insights into differential interviewer effects for specific groups of sample members. In the example of a face-to-face recruitment interview for a probability-based online panel, we detect small interviewer effects regarding survey participation for non-Internet households, whereas we find sizable interviewer effects for Internet households. We derive practical guidance for survey practitioners to address differential interviewer effects based on the proposed variance decomposition.
Nilaparvata lugens salivary protein NlG14 triggers defense response in plants
Authors: Gao Haoli , Zou Jianzheng , Lin Xumin , Zhang Huihui , Yu Na , Liu Zewen
Published: September 2022

The brown planthopper (BPH), Nilaparvata lugens (Stål) (Hemiptera: Delphacidae), is a serious insect pest on rice. It uses its stylet to collect sap by penetrating the phloem and at the same time it delivers saliva into the host plant, which can trigger a reaction. The molecular mechanisms by which BPH salivary proteins result in plant responses are poorly understood. In this study, we screened transcriptomic data from different BPH tissues and found a protein specific to the salivary gland, NlG14, that could induce cell death in plants. We determined that NlG14 is uniquely found in the insect family Delphacidae. Detailed examination of N. lugens showed that NlG14 was mainly localized in the A-follicle of the principal gland of the salivary gland, and that it was secreted into rice plants during feeding. Knockdown of NlG14 resulted in significant nymph mortality when BPH was fed on either rice plants or on an artificial diet. Further analysis showed that NlG14 triggered accumulation of reactive oxygen species, cell death, callose deposition, and activation of jasmonic acid signaling pathways in plants. Transient expression of NlG14 in Nicotiana benthamiana decreased insect feeding and suppressed plant pathogen infection. Thus, NlG14, an essential salivary protein of N. lugens, acted as a potential herbivore-associated molecular pattern to enhance plant resistance to both insects and plant pathogens by inducing multiple plant defense responses. Our findings provide new insights into the molecular mechanisms of insect–plant interactions and offer a potential target for pest management.
Democratic Ethical Consumption and Social Justice
Authors: Albertsen Andreas
Published: September 2022

Hassoun argues that the poor in the world have a right to health and that the Global Health Impact Index provides consumers in well-off countries with the opportunity to ensure that more people have access to essential medicines. Because of this, these consumers would be ethically obliged to purchase Global Health Impact Index-labeled products in the face of existing global inequalities. In presenting her argument, Hassoun rejects the so-called democratic account of ethical consumption in favor of the positive change account. Two versions of the democratic change account are relevant. One underscores the importance of democratic procedures and institutions, while the other stresses our fundamental moral equality. While at least one prominent institutionalist account has problems, revised versions would be less vulnerable to Hassoun’s counterexamples. Furthermore, institutionalist accounts come with the epistemological gains from democratic procedures and deliberations, which may be especially important under uncertainty. Finally, and perhaps more challenging for the Global Health Impact index project, this measure may place the burden unfairly on those who need to buy medicines. This is a pivotal insight from the non-institutionalist version of the democratic account of ethical consumption.
Enhancing Global Health Impact—Beyond the Basic Minimum, Metrics and Ethical Consumption
Authors: Hassoun Nicole
Published: September 2022

How should we measure medicines’ global health impact to set targets, monitor performance and improve health around the world? Can such a metric provide a philosophically well-grounded basis for an ethical consumption campaign that will create incentives for pharmaceutical companies and other agents to expand (equitable) access to essential medicines? And if such metrics exist, how should we think about our individual obligations to support ethical consumption campaigns on this basis? This paper reflects on these questions in light of Tim Campbell’s, Yukiko Asada’s, and Andreas Albertsen’s worries about the answers I provide in Global Health Impact: Extending Access on Essential Medicines. I explain how reflecting on treatments consequences for individuals’ ability to live minimally well supports the creation of the Global Health Impact (GHI) index (https://global-health-impact.org/). I also consider how the index might be modified to better support efforts to promote everyone’s human rights. Finally, I argue that individuals should often promote positive change through GHI and other ethical consumption campaigns.
Commercial mHealth Apps and Unjust Value Trade-offs: A Public Health Perspective
Authors: Rossmaier Leon W S
Published: September 2022

Mobile health (mHealth) apps for self-monitoring increasingly gain relevance for public health. As a mobile technology, they promote individual participation in health monitoring with the aim of disease prevention and the mitigation of health risks. In this paper, I argue that users of mHealth apps must engage in value trade-offs concerning their fundamental dimensions of well-being when using mobile health apps for the self-monitoring of health parameters. I particularly focus on trade-offs regarding the user’s self-determination as well as their capacity to form personal attachments. Depending on the user’s level of advantage or disadvantage, value trade-offs can pose a threat to the users’ sufficient fulfillment of the dimensions of well-being. As such, value trade-offs can entrench existing structural injustices and prevent disadvantaged users to benefit from this technology. I argue that value trade-offs are, to some, a type of injustice that can drive disadvantaged users away from a sufficiency threshold of well-being, risk users to fall below the threshold, or have an accumulative effect on different dimensions of the user’s well-being.
Firearm Violence in the United States: An Issue of the Highest Moral Order
Authors: Iwundu Chisom N , Homan Mary E , Moore Ami R , Randall Pierce , Daundasekara Sajeevika S , Hernandez Daphne C
Published: September 2022

Firearm violence in the United States produces over 36,000 deaths and 74,000 sustained firearm-related injuries yearly. The paper describes the burden of firearm violence with emphasis on the disproportionate burden on children, racial/ethnic minorities, women and the healthcare system. Second, this paper identifies factors that could mitigate the burden of firearm violence by applying a blend of key ethical theories to support population level interventions and recommendations that may restrict individual rights. Such recommendations can further support targeted research to inform and implement interventions, policies and laws related to firearm access and use, in order to significantly reduce the burden of firearm violence on individuals, health care systems, vulnerable populations and society-at-large. By incorporating a blended public health ethics to address firearm violence, we propose a balance between societal obligations and individual rights and privileges.
14-3-3 proteins contribute to autophagy by modulating SINAT-mediated degradation of ATG13
Authors: Qi Hua , Lei Xue , Wang Yao , Yu Shan , Liu Ting , Zhou Shun-Kang , Chen Jin-Yu , Chen Qin-Fang , Qiu Rong-Liang , Jiang Liwen , Xiao Shi
Published: September 2022

In multicellular eukaryotes, autophagy is a conserved process that delivers cellular components to the vacuole or lysosome for recycling during development and stress responses. Induction of autophagy activates AUTOPHAGY-RELATED PROTEIN 1 (ATG1) and ATG13 to form a protein kinase complex that initiates autophagosome formation. However, the detailed molecular mechanism underlying the regulation of this protein complex in plants remains unclear. Here, we determined that in Arabidopsis thaliana, the regulatory proteins 14-3-3λ and 14-3-3κ redundantly modulate autophagy dynamics by facilitating SEVEN IN ABSENTIA OF ARABIDOPSIS THALIANA (SINAT)-mediated proteolysis of ATG13a and ATG13b. 14-3-3λ and 14-3-3κ directly interacted with SINATs and ATG13a/b in vitro and in vivo. Compared to wild-type (WT), the 14-3-3λ 14-3-3κ double mutant showed increased tolerance to nutrient starvation, delayed leaf senescence, and enhanced starvation-induced autophagic vesicles. Moreover, 14-3-3s were required for SINAT1-mediated ubiquitination and degradation of ATG13a. Consistent with their roles in ATG degradation, the 14-3-3λ 14-3-3κ double mutant accumulated higher levels of ATG1a/b/c and ATG13a/b than the WT upon nutrient deprivation. Furthermore, the specific association of 14-3-3s with phosphorylated ATG13a was crucial for ATG13a stability and formation of the ATG1–ATG13 complex. Thus, our findings demonstrate that 14-3-3λ and 14-3-3κ function as molecular adaptors to regulate autophagy by modulating the homeostasis of phosphorylated ATG13.
Estimating Intergenerational and Assortative Processes in Extended Family Data
Authors: Collado M Dolores , Ortuño-Ortín Ignacio , Stuhler Jan
Published: September 2022

We quantify intergenerational and assortative processes by comparing different degrees of kinship within the same generation. This “horizontal” approach yields more, and more distant kinship moments than traditional methods, which allows us to account for the transmission of latent advantages in a detailed intergenerational model. Using Swedish registers, we find strong persistence in the latent determinants of status, and a striking degree of sorting—to explain the similarity of distant kins, assortative matching must be much stronger than previously thought. Latent genetic influences explain little of the variance in educational attainment, and sorting occurs primarily in non-genetic factors.
Basic helix-loop-helix transcription factor PxbHLH02 enhances drought tolerance in Populus (Populus simonii × P. nigra)
Authors: Gao Shangzhu , Li Caihua , Chen Xiaohui , Li Sida , Liang Nansong , Wang Hengtao , Zhan Yaguang , Zeng Fansuo
Published: September 2022

The basic helix-loop-helix (bHLH) transcription factors (TFs) are involved in plant morphogenesis and various abiotic and biotic stress responses. However, further exploration is required of drought-responsive bHLH family members and their detailed regulatory mechanisms in Populus. Two bHLH TF genes, PxbHLH01/02, were identified in Populus simonii × P. nigra and cloned. The aim of this study was to examine the role of bHLH TFs in drought tolerance in P. simonii × P. nigra. The results showed that the amino acid sequences of the two genes were homologous to Arabidopsis thaliana UPBEAT1 (AtUPB1) and overexpression of PxbHLH01/02 restored normal root length in the AtUPB1 insertional mutant (upb1-1). The PxbHLH01/02 gene promoter activity analysis suggested that they were involved in stress responses and hormone signaling. Furthermore, Arabidopsis transgenic lines overexpressing PxbHLH01/02 exhibited higher stress tolerance compared with the wild-type. Populus simonii × P. nigra overexpressing PxbHLH02 increased drought tolerance and exhibited higher superoxide dismutase and peroxidase activities, lower H2O2 and malondialdehyde content, and lower relative conductivity. The results of transcriptome sequencing (RNA-seq) and quantitative real-time PCR suggested that the response of PxbHLH02 to drought stress was related to abscisic acid (ABA) signal transduction. Overall, the findings of this study suggest that PxbHLH02 from P. simonii × P. nigra functions as a positive regulator of drought stress responses by regulating stomatal aperture and promoting ABA signal transduction.
Refractory Uterine Atony: Still a Problem After All These Years
Authors: Balki M. , Wong C.A.
Published: September 2022

(Int J Obstet Anesth. 2021;48:103207)

A substantial portion of uterine atony (up to 80%) of postpartum hemorrhage (PPH) cases can be attributed to uterine atony. Postpartum uterine atony also carries an increased risk of obstetric morbidity.
Umbilical Cord Prolapse: Revisiting its Definition and Management
Authors: Wong L.O. , Kwan A.H.W. , Lau S.L. , Sin W.T.A. , Leung T.Y.
Published: September 2022

(Am J Obstet Gynecol. 2021;225:357–366)

Umbilical cord prolapse is an uncommon condition but is associated with high perinatal mortality, with higher rates in low-income countries. It has an incidence from 1 to 6 per 1000 pregnancies. There are still many questions around umbilical cord prolapse. This review aimed to address variations in the definition and classification, the degree of urgency in delivery when umbilical cord prolapse is present, and the efficacy of maneuvers used to relieve cord compression before delivery.
Trends in Mortality Among Pregnant and Recently Pregnant Women in the US, 2015–2019
Authors: Howard J.T. , Sparks C.S. , Santos-Lozada A.R. , Olowolaju S.A. , Janak J.C. , Howard K.J.
Published: September 2022

(JAMA. 2021;326:1631–1633)

The United States has the highest maternal mortality rate of developed countries. By 2015, all states except Alabama and West Virginia had adopted the pregnancy checkbox on death certificates. This study reported on pregnancy-related causes of death among pregnant and recently pregnant women between 2015 and 2019 and compared the data with causes of death in all women of childbearing age.
Incidence and Risk Factors for Severe Preeclampsia, Hemolysis, Elevated Liver Enzymes, and Low Platelet Count Syndrome, and Eclampsia at Preterm and Term Gestation: A Population-based Study
Authors: Lisonkova S. , Bone J.N. , Muraca G.M. , Razaz N. , Wang L.Q. , Sabr Y. , Boutin A. , Mayer C. , Joseph K.S.
Published: September 2022

(Am J Obstet Gynecol. 2021;225:538.e1–538.e19)

Preeclampsia is a complication of pregnancy that is among the most common in high-income countries and portents other sequelae including severe preeclampsia, eclampsia, and HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count syndrome). Prevalence of these serious diagnoses range from 0.2 to 7.6 per 1000 deliveries in high-income countries. The risk factors and gestational age-specific incidence of preeclampsia with severe features, eclampsia and HELLP syndrome is not well characterized, and previous investigations of these outcomes have been hospital-based with small numbers of patients. This study provides a large population-based inquiry into the development of these further related conditions following preeclampsia at term and preterm gestation, along with associations of maternal and clinical factors.
Congenital Zika Syndrome: A Nationwide Cohort Study in Brazil, 2015-2018
Authors: Paixao E.S. , Cardim L.L. , Costa M.C.N. , Brickley E.B. , de Carvalho-Sauer R.C.O. , Carmo E.H. , Andrade R.F.S. , Rodrigues M.S. , Veiga R.V. , Costa L.C. , Moore C.A. , França G.V.A. , Smeeth L. , Rodrigues L.C. , Barreto M.L. , Teixeira M.G.
Published: September 2022

(N Engl J Med. 2022;386:757–767)

Zika virus circulated extensively in Brazil in the recent epidemic and is implicated as a teratogen in pregnancies by transplacental fetal exposure. A wide spectrum of effects presents as congenital Zika syndrome (CZS), ranging from no detected abnormalities to severe impacts on the central nervous system and death in infancy or childhood in 10% of cases. Observed anomalies include microcephaly, dysphagia, or epilepsy apparent at birth or infancy with first trimester Zika exposure recognized as the strongest predictive factor of severity.
Clinical Value of Early Viscoelastometric Point-of-Care Testing During Postpartum Hemorrhage for the Prediction of Severity of Bleeding; A Multicenter Prospective Cohort Study in the Netherlands
Authors: Ramler P.I. , Gillissen A. , Henriquez D.D.C.A. , Caram-Deelder C. , Markovski A.A. , de Maat M.P.M. , Duvekot J.J. , Eikenboom J.C.J. , Bloemenkamp K.W.M. , van Lith J.M.M. , van den Akker T. , van der Bom J.G.
Published: September 2022

(Acta Obstet Gynecol Scand. 2021;100:1656–1664)

Postpartum hemorrhage (PPH) is a leading cause of maternal morbidity and mortality worldwide. Early intervention before the development of coagulopathy can reduce hemostatic impairments, preventing the need for interventions including hysterectomy and massive blood transfusion. Tests currently used during PPH to evaluate clotting status include the FIBTEM and fibrinogen measurement. Results from these tests unfortunately can take up to an hour, during which time significant blood may be lost. Results of clot firmness from FIBTEM at 5 minutes (A5 measurement) can indicate the potential for PPH in only 15 minutes. In this multicenter study in the Netherlands researchers compared blood loss within 24 hours of birth to the results of these tests to determine accuracy in predicting severe PPH with blood loss ≥2000 mL.
Differences in Obstetrical Care and Outcomes Associated With the Proportion of the Obstetrician’s Shift Completed
Authors: Yee L.M. , McGee P. , Bailit J.L. , Wapner R.J. , Varner M.W. , Thorp J.M. , Caritis S.N. , Prasad M. , Tita A.T.N. , Saade S.R. , Sorokin Y. , Rouse D.J. , Blackwell S.C. , Tolosa J.E. ,   On behalf of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network
Published: September 2022

(Am J Obstet Gynecol. 2021;225:430.e1–11)

Obstetric provider decision-making may influence the quality of care. Previous studies have examined differences in provider decisions and obstetric outcomes based on time of day, though this may not accurately capture provider fatigue. This study examined provider decisions and obstetric outcomes in the context of the proportion of time completed by the provider in their work shift at the time of delivery.
The Evaluation of a Noninvasive Respiratory Volume Monitor in Mechanically Ventilated Neonates and Infants
Authors: Atkinson D.B. , Sens B.A. , Bernier R.S. , Gomez-Morad A.D. , Imsirovic J. , Nasr V.G.
Published: September 2022

(Anesth Analg. 2022;134:141–148)

Monitoring respiratory function is an essential part of caring for children in ambulatory and hospital settings. Yet, assessing ventilation in children by physical examination is difficult due to fast respiratory rates (RRs) and small tidal volumes (TV). In addition, pulse oximeters, capnometers, and other noninvasive respiratory monitors may not reliably assess minute ventilation (MV). While pulse oximeters detect oxygen desaturation, they do not directly monitor ventilation. Capnometers have also been found unreliable in intubated children. Recently a respiratory volume monitor (RVM) (ExSpiron, Watertown, MA) has been developed to measure TV, RRs, and MV noninvasively. It has been found to be accurate in adults and children above 1 year of age. The aim of this study is to evaluate the accuracy of the RVM on RRs, TV, and MV in neonates and infants below 1 year.
Receipt of mRNA Covid-19 Vaccines and Risk of Spontaneous Abortion
Authors: Zauche L.H. , Wallace B. , Smoots A.N. , Olson C.K. ,   Oduyebo et al and the CDC v-safe Covid-19 Pregnancy Registry Team
Published: September 2022

(N Engl J Med. 2021;385:1533–1535)

Pregnant women are at increased risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and associated maternal and neonatal adverse outcomes. While spontaneous abortion (pregnancy loss at <20 wk of gestation) associated with severe coronavirus disease 2019 (COVID-19) vaccination data is limited, this study aimed to identify risk estimates of the COVID-19 vaccination and spontaneous abortion.
Experience of 300 Cases of Prenatal Fetoscopic Open Spina Bifida Repair: Report of the International Fetoscopic Neural Tube Defect Repair Consortium
Authors: Sanz Cortes M. , Chmait R.H. , Lapa D.A. , Belfort M.A. , Carreras E. , Miller J.L. , Brawura Biskupski Samaha R. , Sepulveda Gonzalez G. , Gielchinsky Y. , Yamamoto M. , Persico N. , Santorum M. , Otaño L. , Nicolaou E. , Yinon Y. , Faig-Leite F. , Brandt R. , Whitehead W. , Maiz N. , Baschat A. , Kosinski P. , Nieto-Sanjuanero A. , Chu J. , Kershenovich A. , Nicolaides K.H.
Published: September 2022

(Am J Obstet Gynecol. 2021;225:678.e1–678.e11. [Epub June 3, 2021])

Prenatal repair of open spina bifida (OSB) showed increased chance of independent ambulation and increased outcomes of ventriculoperitoneal shunting compared with postnatal repair in a multicenter randomized controlled trial in the Management of Myelomeningocele Study (MOMS). The technique, involving a hysterotomy, has risks regarding the uterine incision used. Due to the risks, fetal surgeons worldwide have been attempting to repair OSB using minimally invasive techniques to mitigate adverse outcomes and improve neonatal neurologic benefits. One such technique is fetoscopic OSB repair.
Nirsevimab for Prevention of RSV in Healthy Late-preterm and Term Infants
Authors: Hammitt L.L. , Dagan R. , Yuan Y. , Baca Cots M. , Bosheva M. , Madhi S.A. , Muller W.J. , Zar H.J. , Brooks D. , Grenham A. , Wählby Hamrén U. , Mankad V.S. , Ren P. , Takas T. , Abram M.E. , Leach A. , Griffin M.P. , Villafana T. ,   MELODY Study Group
Published: September 2022

(N Engl J Med. 2022;386:837–846. doi: 10.1056/NEJMoa2110275)

Infants experience medically attended illness and hospitalization at elevated rates from respiratory syncytial virus (RSV) infection. As a monoclonal antibody with an extended half-life, Nirsevimab (N) is an emerging treatment that binds to the RSV fusion protein and has enhanced inhibitory potency for RSV in cell-culture and animal models over Palivizumab. Preterm (29 to <35 wk gestational age birth) infants receiving a single dose of N before RSV season showed 70.1% efficacy at protection against RSV with a favorable safety profile. The safety and efficacy of N in late-preterm and term infants entering their first RSV season is investigated in this phase 3 trial.
Prediction of Severe Adverse Neonatal Outcomes at the Second Stage of Labor Using Machine Learning: A Retrospective Cohort Study
Authors: Guedalia J. , Sompolinsky Y. , Novoselsky Persky M. , Cohen S.M. , Kabiri D. , Yagel S. , Unger R. , Lipschuetz M.
Published: September 2022

(BJOG. 2021;128:1824–1832)

During the second stage of labor, close maternal and neonatal monitoring is important for avoiding adverse outcomes. Machine learning has been used to analyze complex data patterns and has successfully predicted the need for emergent cesarean delivery (CD) and successful vaginal birth after CD. This study aimed to develop a model to predict adverse neonatal outcomes based on data available to clinicians before the onset of the second stage of labor using machine learning tools.
The Effect of Mode of Delivery and Duration of Labor on Subsequent Pregnancy Outcomes: A Retrospective Cohort Study
Authors: Van Winsen K.D. , Savvidou M.D. , Steer P.J.
Published: September 2022

(BJOG. 2021;128:2132–2139. [Epub August 30, 2021])

Gestational length of a pregnancy is varied with maternal age, medical conditions, race, and socioeconomic factors contributing. Highly correlated gestational length in subsequent pregnancies suggests that constitutional factors may also influence pregnancy outcomes. This study aimed to determine the method of delivery and labor duration of a first singleton labor on the subsequent pregnancy outcomes, including gestational length, method of delivery, and neonatal outcome.
Multicenter Study Evaluating Nitrous Oxide Use for Labor Analgesia at High- and Low-altitude Institutions
Authors: Wood C. , Arbet J. , Amura C. , Nodine P. , Collins M. , Orlando B. , Mayer D. , Stein D. , Anderson J.
Published: September 2022

(Anesth Analg. 2022;124:294–302)

The United States has used nitrous oxide as a labor analgesia since the 1940s because it has no impact on uterine myometrial contractility, it has little impact on maternal hemodynamics and respiration, and it is a noninvasive procedure. However, most medical professionals still prefer neuraxial analgesia. Previous studies report that 40% nitrous oxide successfully decreased pain and increased maternal satisfaction during labor compared with a placebo at sea level, but there are no studies evaluating the effect of nitrous oxide on maternal pain relief or satisfaction in high altitudes. Because of the partial pressure gas law, as elevation increases, the study hypothesized gas analgesia administration had less of an effect than at sea level, both in pain relief and side effects. This study evaluated altitude's effect on nitrous oxide administration by comparing high altitude and low altitude births.
Neuraxial Labor Analgesia Failure Rates in Women With a Body Mass Index ≥50 kg/m2: A Single-center Retrospective Study
Authors: Arnolds D. , Scavone B.
Published: September 2022

(Int J Obstet Anesth. 2021;48:103176)

Rates of emergency cesarean delivery (CD) are higher in obstetric patients with a body mass index (BMI) of 50 kg/m2 or more, known as super obesity. Reliable neuraxial techniques are needed in the event of emergency CD. While combined spinal-epidural technique results in a lower proportion of catheters replaced than epidurals without dural puncture (EPI) in the general population, it is not clear if this is also true for super-obese patients. This study aimed to determine the failure rate of first neuraxial catheter placement for labor analgesia in super-obese parturients.
Intrathecal 2-Chloroprocaine 3% Versus Hyperbaric Bupivacaine 0.75% for Cervical Cerclage: A Double-blind Randomized Controlled Trial
Authors: Lee A. , Shatil B. , Landau R. , Menon P. , Smiley R.
Published: September 2022

(Anesth Analg. 2022;134:624–632)

Cervical cerclage, an operation designed to reduce preterm delivery and improve perinatal outcomes, often utilizes spinal anesthesia. While the benefits of spinal anesthesia are well documented, an intrathecal local anesthetic agent, such as 2-chloroprocaine (2-CP), could shorten postanesthesia care unit stay as it has a fast onset and short duration. Currently, bupivacaine is commonly used during spinal anesthesia because of historical concern regarding 2-CP’s safety. This study randomly compared the outcome of 2-CP 3% 50 mg and hyperbaric bupivacaine 0.75% 9 mg on dermatomal level, sensory block resolution, ability to ambulate and void, and motor blockade.
Accuracy of Cricothyroid Membrane Identification Using Ultrasound and Palpation Techniques in Obese Obstetric Patients: An Observational Study
Authors: Lavelle A. , Drew T. , Fennessy P. , McCaul C. , Shannon J.
Published: September 2022

(Int J Obstet Anesth. 2021;48:103205)

Emergency front of neck access (e-FONA) is a potentially life-saving intervention but requires the accurate identification of the cricothyroid membrane (CTM). CTM identification failure is most common in obese females, who also have an increased risk of emergency and elective cesarean delivery. This study aimed to compare accuracy of CTM identification using ultrasound (US) compared with palpation in obese obstetric patients.
The Role of Echocardiography in Amniotic Fluid Embolism: A Case Series and Review of the Literature
Authors: Simard C. , Yang S. , Koolian M. , Shear R. , Rudski L. , Lipes J.
Published: September 2022

(Can J Anesth/J Can Anesth. 2021;68:1541–1548)

Amniotic fluid embolism (AFE) is not completely understood and can be difficult to diagnose, as it shares characteristics with other obstetric complications. AFE occurs during labor or soon after delivery and is characterized by acute hypotension, hypoxia, and coagulopathy. The Clark diagnostic criteria for diagnosis of AFE is as follows: sudden cardiorespiratory arrest or both hypotension and respiratory compromise; disseminated intravascular coagulation; clinical onset during labor or within 30 minutes of delivery of the placenta; and absence of fever. Situations that may lead to the exchange of maternal and fetal fluid, such as cesarean delivery or cervical trauma, have been reported as risk factors. Point-of-care echocardiography has recently been used to diagnose and manage maternal shock. This report details three cases of AFE that utilized point-of-care echocardiography.
Indocyanine Green Fluorescence-Guided Surgery for Gastrointestinal Tumors: A Systematic Review
Authors: Sposito Carlo , Maspero Marianna , Belotti Paolo , Simonotti Nicolò , Altomare Michele , Ciana Paolo , Mazzaferro Vincenzo
Published: September 2022

Objective:

To conduct a systematic review of the currently available literature on the use of ICG to guide surgical dissection in gastrointestinal (GI) cancer surgery.

Background:

Real-time indocyanine green (ICG) fluorescence-guided surgery has the potential to enhance surgical outcomes by increasing patient-tailored oncological precision.

Methods:

MEDLINE, PubMed, EMBASE, and Google Scholar were searched for publications on the use of ICG as a contrast agent in GI cancer surgery until December 2020. Perfusion studies were excluded. Quality of the studies was assessed with the Methodological Index for nonrandomized Studies or Jadad scale for randomized controlled trials. A narrative synthesis of the results was provided, with descriptive statistics when appropriate.

Results:

Seventy-eight studies were included. ICG was used for primary tumor and metastases localization, for sentinel lymph node detection, and for lymph flow mapping. The detection rate for primary colorectal and gastric tumors was 100% after preoperative ICG endoscopic injection. For liver lesions, the detection rate after intravenous ICG infusion was 80% and up to 100% for lesions less than 8 mm from the liver surface. The detection rate for sentinel lymph nodes was 89.8% for esophageal, 98.6% for gastric, 87.4% for colorectal, and 83.3% for anal tumors, respectively. In comparative studies, ICG significantly increases the quality of D2 lymphadenectomy in oncological gastrectomy.

Conclusion:

The use of ICG as a guiding tool for dissection in GI surgery is promising. Further evidence from high-quality studies on larger sample sizes is needed to assess whether ICG-guided surgery may become standard of care.
TREATMENT OF PERSISTENT MACULAR HOLES WITH HEAVY SILICONE OIL
Authors: Lohmann Tibor , Schwarzer Hendrik , Koutsonas Antonis , Djalali-Talab Yassin , Fuest Matthias , Widder Randolf A. , Walter Peter , Roessler Gernot
Published: September 2022

Background/Purpose:

To determine anatomical success and best-corrected visual acuity after secondary surgery with heavy silicone oil tamponade in patients with persistent full-thickness macular holes.

Methods:

In this retrospective study, 63 eyes with persistent full-thickness macular holes after primary pars plana vitrectomy and internal limiting membrane peeling underwent secondary surgery with heavy silicone oil tamponade. Macular spectral domain optical coherence tomography and best-corrected visual acuity measurements were performed during the follow-up.

Results:

Fifty of 63 eyes (79.4%) achieved anatomical success. In eyes achieving anatomical success, best-corrected visual acuity before primary vitreoretinal surgery was significantly better (0.77 [∼20/125 Snellen] ± 0.24 [1.3–0.3] logarithm of the minimum angle of resolution) compared with eyes not achieving anatomical success (0.88 [∼20/160 Snellen] ± 0.17 [1.1–0.6] logarithm of the minimum angle of resolution, P = 0.044). Minimum linear diameter of full-thickness macular holes was significantly smaller in eyes achieving anatomical success, both before primary (403.4 ± 128.7 [199.0–707.0] µm vs. 568.1 ± 209.1 [307.0–953.0] µm, P = 0.009) and secondary surgery (464.1 ± 215.0 [178.0–1,521.0] µm vs. 663.3 ± 228.5 [451.0–1,301.0] µm, P = 0.010). Patients remaining phakic during all three surgeries did not benefit from best-corrected visual acuity improvement, although anatomical success was achieved.

Conclusion:

Heavy silicone oil tamponade in secondary surgery for persistent full-thickness macular holes is a safe and efficient surgical method. Best-corrected visual acuity and minimum linear diameter before surgery may be indicators for anatomical success.
Unilateral Diffuse Uveal Melanocytic Proliferation (DUMP): Case Report and Brief Review
Authors: Cord Medina Flávio Mac , Reis Raphael Araujo , da Cunha Gomes Pereira Manoella , Gameiro Filho Aluisio Rosa
Published: September 2022

Purpose:

To report a case of unilateral diffuse uveal proliferation (DUMP), in a patient with history of breast cancer, with bone and hepatic metastasis.

Methods:

Case report with funduscopic examination, fundus autofluorescence and spectral domain optical coherence tomography

Results:

A 57-year-old female patient attended at our clinic for a routine glaucoma follow up. Fundoscopy was normal on the right eye, and showed multiple red patches, in the posterior pole and inferior arcade. Multimodal examination was performed, compatible to diffuse uveal melanocytic proliferation on her left eye, and excluding other conditions, such as choroidal metastasis.

Conclusion:

Diffuse uveal melanocytic proliferation is a rare paraneoplastic condition, which usually is presented bilaterally. Unilateral cases of DUMP have been previously described only 5 times on the literature, and are usually associated with breast cancer.