bluuebunny/crossref_metadata_2025 huggingface dataset:
Artificial intelligence & Trusts and Trustees: a new dawn of investment opportunities and risks?
Authors: Brown Lloyd A
Published: November 2024

This article examines the opportunities and risks that can be created for trusts by generative artificial intelligence. In particular, the work is concerned with how AI investment tools may affect trusts, given their growing use in investment management. It is argued that trusts can be exposed to the risks and opportunities that this technology may create through the trustees’ general investment power. However, currently, trustees can undertake appropriate risk management by exercising their section 4 and 5 duties relating to investment. The work ends by suggesting that targeted statutory reform and guidance is needed to deal with AI risks.
Muscle type‐specific effects of bilateral abobotulinumtoxinA injection on muscle growth and contractile function in spastic mice
Authors: Rivares Cintia , Vignaud Alban , Noort Wendy , Baan Guus , Koopmans Bastijn , Loos Maarten , Wüst Rob C. I. , Kalinichev Mikhail , Jaspers Richard T.
Published: November 2024

Intramuscular injection of botulinum neurotoxin type A (BoNT‐A) is commonly used to improve or maintain the joint range of motion in young children with spasticity. However, the effectiveness of BoNT‐A treatment is variable and movement limitations are recurrent. Here we show long‐term effects of a single, bilateral abobotulinumtoxinA (aboBoNT‐A) injection in the gastrocnemius medialis and soleus muscles of wild‐type and spastic (B6.Cg‐Glrbspa/J with a mutation in the glycine receptor) mice at a young age (6–7 days). Specifically, we evaluated the impact of aboBoNT‐A‐A on gait, physical performance, and spontaneous physical behavior, as well as on contractile force characteristics, morphology, and histological phenotype of soleus and gastrocnemius muscles by comparing their results to those of saline‐injected controls up to 9 weeks after the injection. The detailed time course of the study specifies the timing of the aboBoNT‐A injection at 1 week, the period of behavioral studies from 4–9 weeks, and the age of the mice (10 weeks) at the time of contractile force characteristics and histology assessments. In spastic mice, aboBoNT‐A injection had a minor and very specific effect on physical performance, by only modestly increasing stride length as a function of age. aboBoNT‐A injection caused a reduction in the force‐generating capacity and a slightly smaller physiological cross‐sectional area in gastrocnemius medialis, but not in soleus. Reduced physiological cross‐sectional area in aboBoNT‐A‐injected muscles was due to a lower number of muscle fibers, rather than reduced muscle fiber cross‐sectional area. The percentage of slow‐type muscle fibers and mitochondrial succinate dehydrogenase activity were increased, which was associated with an improved muscle endurance capacity. In conclusion, aboBoNT‐A injection reduced the number of muscle fibers, causing muscle hypertrophy in remaining fibers and a shift towards more oxidative fibers, resulting in an improved endurance capacity and gait. This study proposed potential cellular mechanisms for the therapeutic efficacy of aboBoNT‐A in spasticity.
Maternal Mortality in the United States: Are the High and Rising Rates Due to Changes in Obstetrical Factors, Maternal Medical Conditions, or Maternal Mortality Surveillance?
Authors: Joseph K.S. , Lisonkova S. , Boutin A. , Muraca G.M. , Razaz N. , John S. , Sabr Y. , Chan W.S. , Mehrabadi A. , Brandt J.S. , Schisterman E.F. , Ananth C.V.
Published: November 2024

(Am J Obstet Gynecol. 2024;230:440.e1–440.e13. doi: 10.1016/j.ajog.2023.12.038)

Maternal health concerns in the United States have intensified due to rising maternal mortality rates (MMR). However, there is skepticism about the accuracy of these estimates. Maternal mortality is often underreported, even in countries with reliable vital registration systems, as pregnancy status at the time of death can be overlooked. In 2003, adding a pregnancy checkbox to death certificates was recommended by the National Center for Health Statistics (NCHS). Although this led to an apparent increase in MMRs from 2003 to 2017, further analysis revealed that the increase was an artifact, with errors such as older women being incorrectly certified as pregnant at the time of death. Subsequently, NCHS introduced new guidelines restricting the use of the pregnancy checkbox to deaths among women aged 15 to 44 years to minimize errors.
Overcoming Obstacles: The Legacy of Fidel Pagés, Founder of the Epidural, 100 Years After His Passing
Authors: Chinn G.A. , Gray A.T. , Larson M.D.
Published: November 2024

(Anesth Analg. 2024;138(2):475–479. doi: 10.1213/ANE.0000000000006706)

Fidel Pagés, a pioneer in segmental anesthesia, revolutionized the field by accessing the epidural space over a century ago, laying the groundwork for modern neuraxial techniques. This year commemorates the centennial of his premature death. Despite his early passing and subsequent challenges, the high-quality anesthesia he introduced propelled epidural anesthesia into routine clinical practice.
Social Determinants of Health and Obstetric Outcomes: A Report and Recommendations of the Workshop of the Society for Maternal-Fetal Medicine
Authors:   Society for Maternal-Fetal Medicine, Grobman W.A. , Entringer S. , Headen I. , Janevic T. , Kahn R.S. , Simhan H. , Yee L.M. , Howell E.A.
Published: November 2024

(Am J Obstet Gynecol. 2024;230(2):B2–B16. doi:10.1016/j.ajog.2023.10.013)

Addressing adverse social determinants of health (SDOH) caused by structural racism is crucial to improving obstetrical outcomes and eliminating health disparities. Obstetrical outcomes include those identified before or during pregnancy, affecting individuals and their children throughout life. Although SDOH can be positive and negative, the focus here is on adverse effects. Structural racism encompasses systemic racial discrimination in societies through housing, education, employment, health care, and criminal justice, fundamentally causing health disparities.
Postdural Puncture Headache After Intentional or Unintentional Dural Punctures: Time to Think About Risk Reduction and Acknowledge the Burden of Sequelae
Authors: Landau R. , Weiniger C.F.
Published: November 2024

(Reg Anesth Pain Med. 2024;49:1–3. doi:10.1136/rapm-2023-104945)

Postdural puncture headache (PDPH) is a complication arising from either intentional or accidental dural puncture (DP) during neuraxial procedures. The annual global incidence of DP is unknown, but they impact a wide range of individuals undergoing diagnostic, therapeutic, or analgesic procedures. Many patients experience PDPH, and increasingly, more serious long-term consequences are being reported. Despite this, the global health burden of PDPH remains under described.
Hospital Discharge Codes and Overestimating Severe Maternal Morbidity During Delivery Hospitalization
Authors: Quist-Nelson J. , Meng M.-L. , Mallampati D. , Federspiel J.J. , Kucirka L.M. , Fuller M. , Menard M.K.
Published: November 2024

(Obstet Gynecol. 2024;143(4):582–584. doi: 10.1097/AOG.0000000000005537)

Administrative data play a crucial role in understanding severe maternal morbidity (SMM) events, yet their interpretation heavily relies on coding quality. Overestimation of SMM during birth hospitalizations might occur due to International Classification of Diseases, Tenth Revision (ICD-10) codes being carried forward from predelivery events. This study aimed to describe SMM distribution across the antepartum, birth, and postpartum periods and to assess the potential false discovery rate of SMM events, hypothesizing that some events are subject to carry-forward coding. Following IRB approval and data-use agreements, a shared, deidentified database was created using the PCORnet Common Data Model at the University of North Carolina and Duke University.
The Accuracy of ChatGPT-Generated Responses in Answering Commonly Asked Patient Questions About Labor Epidurals: A Survey-Based Study
Authors: Mootz A.A. , Carvalho B. , Sultan P. , Nguyen T.P. , Reale S.C.
Published: November 2024

(Anesth Analg. 2024;138(5):1142–1144. doi: 10.1213/ANE.0000000000006801)

Artificial intelligence (AI) is a relatively new mainstream technology that has recently been applied in many different contexts. ChatGPT (Chat Generative Pre-Trained Transformer), created by OpenAI, has previously demonstrated competence in some aspects of clinical reasoning in medical education, though there is little evidence about its ability to answer questions in specific clinical applications. There is no current literature that addresses the medical accuracy of ChatGPT in answering questions related to pregnancy and childbirth. This study was designed to fill that gap and evaluate the accuracy of ChatGPT responses to commonly asked questions about neuraxial analgesia during labor.
The Accuracy of ChatGPT-Generated Responses in Answering Commonly Asked Patient Questions About Labor Epidurals: Correspondence
Authors: Daungsupawong H , Wiwanitkit
Published: November 2024

(Anesth Analg. 2024;138(6):e37. doi: 10.1213/ANE.0000000000006978)

This article is a response to a comment on the article “The accuracy of ChatGPT-generated responses in answering commonly asked patient questions about labor epidurals: a survey-based study,” which evaluated the accuracy of artificial intelligence (AI) in responding to patient inquiries about epidural medication during labor. The main object of the study was to determine if accurate counsel can be given to patients using AI, using gathered patient questions and evaluating response accuracy.
A Comparison of the Effect of Phenylephrine and Norepinephrine on Uteroplacental Vascular Resistance During the Treatment of Postspinal Hypotension in Preeclamptic Patients: A Randomized Controlled Study
Authors: Fu F , Yang M , Xu L , Chen X
Published: November 2024

(Eur J Anaesthesiol. 2024;41(2):150–152. doi: 10.1097/EJA.0000000000001924)

Preeclampsia is often characterized by moderate to severe hypertension, and thus postspinal hypotension is less common; however, because of the physiology involved, the effects and hazards of postspinal hypotension in these patients are more severe. Recent research in this area has presented norepinephrine as an alternative to phenylephrine in patients with normal blood pressure and is as yet poorly understood as a treatment for patients with preeclampsia. This article is a letter to the editor describing the outcome of a randomized controlled trial whose aim was to provide evidence for norepinephrine in the context of preeclampsia.
A Spatial Memory Deficit in Male But Not Female Rats After Neonatal Diazepam Exposure: A New Model for Developmental Sedative Neurotoxicity
Authors: Chinn G.A. , Cummins M.H. , Sall J.W.
Published: November 2024

(Anesth Analg. 2024 Apr 1;138(4):856–865. doi: 10.1213/ANE.0000000000006583)

Current models show that drugs targeting GABA receptors can be very damaging to neurodevelopment, though results are conflicting in human studies as opposed to animal studies. A robust time period of research in animal models has suggested; however, that some differences in cognition caused by anesthetic drugs can be difficult to detect in a clinically significant way, though their presence is a distinct possibility. Previous studies by these authors have investigated the sex-dependent differences in neurodevelopment and thus in response to neurodevelopmental toxicity and have found that both sex and timing of drug administration have significant impacts on neurodevelopmental deficits in later life. Limitations of previous studies include the specificity of the drugs used and variable mechanisms at work in addition to acting as a GABA agonist. This study aims to address these limitations by assessing a similar model of neurodevelopmental toxicity using a benzodiazepine medication, diazepam, which specifically targets GABA receptors. The primary outcome was the effect of diazepam on postnatal day 7 rats on sex-dependent spatial memory deficit.
Perinatal Morbidity Among Women With a Previous Cesarean Delivery (PRISMA Trial): A Cluster-Randomized Trial
Authors: Chaillet N. , Mâsse B. , Grobman W.A. , Shorten A. , Gauthier R. , Rozenberg P. , Dugas M. , Pasquier J.C. , Audibert H.A. , Suzanne D. , Piedboeuf  , Fraser W.D. , Gagnon R. , Gagné G.P. , Francoeur D. , Giard  , Duperron L. , Bédard M.J. , Johri M. , Dubé E. , Blouin S. , Ducret T. , Giard M. , Bujold E.
Published: November 2024

(Lancet. 2024; 403:44–54. doi: 10.1016/ S0140-6736(23)01855-X)

Pregnant women with a previous cesarean delivery (CD) face a difficult decision between attempting a trial of labor after a cesarean (TOLAC), hoping for a successful vaginal delivery (VD), or opting for a planned repeat CD. Recent studies suggest women need support in decision-making as both delivery modes have unique risks. TOLAC is associated with a risk of uterine rupture and perinatal complications, while repeat CD is associated with an increased risk of maternal complications.
Oxytocin is Not Associated With Postpartum Hemorrhage in Labor Augmentation in a Retrospective Cohort Study in the United States
Authors: Zhu H. , Lu D. , Branch D.W. , Troendle J. , Tang Y. , Bernitz S. , Zamora J. , Betran A.P. , Zhou Y. , Zhang J.
Published: November 2024

Am J Obstet Gynecol. 2024;230:247.e1–247.e9. https://doi.org/10.1016/j.ajog.2023.07.054

Postpartum hemorrhage (PPH) is a significant cause of maternal mortality and morbidity, affecting about 3% to 5% of obstetric patients, with uterine atony being responsible for over 70% of cases. Recent decades have seen a rise in PPH incidence and an increase in oxytocin use for labor induction and augmentation. Prolonged oxytocin use may desensitize oxytocin receptors in the myometrium, potentially leading to uterine atony and PPH. Previous studies have shown inconsistent results regarding oxytocin’s impact on PPH, mainly due to methodological issues such as confounding by labor dystocia, the primary reason for oxytocin use, and a risk factor for PPH.
The Minimum Effective Dose (ED90) of Prophylactic Oxytocin Infusion During Cesarean Delivery in Patients With and Without Obesity: An Up-Down Sequential Allocation Dose-Response Study
Authors: Tyagi A. , Nigam C. , Malhotra R.K. , Bodh P. , Deep S. , Singla A.
Published: November 2024

Int J Obstet Anesth. 2024;57:103962. https://doi.org/10.1016/j.ijoa.2023.103962

A leading cause of maternal morbidity and mortality, with uterine atony being the primary factor, is postpartum hemorrhage (PPH). The administration of oxytocin, used as the first-line prophylactic to prevent uterine atony during cesarean delivery (CD), varies in dose, timing, and duration across clinical practices. Lower oxytocin doses are often used to minimize maternal side effects linked to high-dose boluses or empirically titrated infusions. With rising obesity rates and significant pregnancy weight gain, higher oxytocin doses are required for labor induction and augmentation in obese patients. Research indicates obesity may reduce oxytocin-induced myometrial contractility. Despite this, only one study has evaluated the optimal oxytocin dose in patients with a BMI ≥40 kg/m2 undergoing CD, highlighting a need for more research. The study aims to determine the minimum effective oxytocin infusion dose for adequate uterine tone in obese patients, comparing it with a control group of nonobese patients.
The Association Between Maternal Vitamin D Deficiency and Postpartum Hemorrhage and Uterine Atony
Authors: Stevenazzi A.S. , Pihl S. , Blomberg M. , Axelsson D.
Published: November 2024

(Acta Obstet Gynecol Scand. 2024;103:286–293. DOI: 10.1111/aogs.14719)

Postpartum hemorrhage (PPH) is the leading cause of maternal mortality and morbidity globally, causing about 140,000 deaths per year. PPH can be attributed to 4 primary causes: tone, trauma, tissue, and thrombin. The most common cause is an atonic uterus (70% of cases), followed by trauma (20%), tissue (10%), and thrombin (1%). Hemostasis after delivery primarily relies on uterine myometrium contraction, which compresses the large vessels in the placental bed. Vitamin D deficiency, prevalent globally and in Sweden (25% to 60%), varies with diet, season, and supplementation. It is measured by serum 25-hydroxylated vitamin D (25 OHD) levels, with insufficiency defined as <50 nmol/L and deficiency as <25 nmol/L.
Transabdominal and Transvaginal Ultrasound Findings Help to Guide the Clinical Management of Placenta Accreta Spectrum Cases
Authors: Aryananda R.A. , Duvekot J.J. , Van Beekhuizen H.J. , Clininta N.I. , Ariani G. , Dachlan E.G.
Published: November 2024

(Acta Obstet Gynecol Scand. 2024;103(1):93–102. doi: 10.1111/aogs.14715)

In recent years, the incidence of placenta accreta spectrum (PAS) has risen while there is no current treatment defined as the standard. The favored conservative surgery options include 1-step conservative surgery (OSCS) and triple-P surgery. Diagnosis of PAS is often accomplished through ultrasound due to ease of use, availability, and low cost. During ultrasound screening many different signs are used to examine the uteroplacental interface, abnormal lacunae, and hypervascularity. Previous studies have sought to link ultrasound signs with histopathology, but the relationship remains unclear. This study aimed to link ultrasound signs and OSCS success, in order to understand how the signs could be used as predictors.
Reference Ranges for Third-Trimester Maternal Cardiovascular Function Parameters Measured in Normotensive Pregnant Women Using a Noninvasive Cardiac Output Monitor: A Study Based on Data From the Prospective PEACH Cohort Study
Authors: Lihme F. , Basit S. , Persson L.G. , Larsen M.O. , Lauridsen K.H. , Lykke J.A. , Andersen A.S. , Halse K. , Thorsen-Meyer A. , Melbye M. , Wolfahrt J. , Boyd H.A.
Published: November 2024

(BJOG. 2024;131:463–471. doi: 10.1111/1471-0528.17667)

Changes to the cardiovascular system during pregnancy are expected; however, maladaptation is indicative of pregnancy-related cardiovascular disease and should be screened for. Invasive catheterization and echocardiography have traditionally been the tools used for detection of such conditions; however, more noninvasive alternatives have become available, such as the Ultrasound Cardiac Output Monitor 1A (US-COME-1A). This device uses continuous-wave Doppler ultrasound and has been used in pregnant patients with similar results to third trimester echocardiography. Clinicians would benefit further from reference ranges to make this a more useful tool; thus, this study seeks to provide such reference ranges for cardiac output (CO), stroke volume (SV), and systemic vascular resistance (SVR) in singleton pregnancies.
The Contribution of Hypertensive Disorders of Pregnancy to Late Preterm and Term Admissions to Neonatal Units in the UK 2012 to 2020 and Opportunities to Avoid Admission: A Population-Based Study Using the National Neonatal Research Database
Authors: Conti-Ramsden F. , Fleminger J. , Lanoue J. , Chappell L.C. , Battersby C. ,   the UK Neonatal Collective
Published: November 2024

(BJOG. 2024;131:88–98. doi:10.1111/1471-0528.17574)

It is essential to avoid unnecessary admission of infants to neonatal units (NNU). Respiratory distress, infection, and hypoglycemia are common indications for the NNU admission of a full-term neonate. Infants are more likely to be born preterm and be at risk of hypoglycemia if their mother is diagnosed with a hypertensive disorder during pregnancy (HDP). This study focused on quantifying the extent to which maternal HDP affects NNU admission rates among infants born at ≥34 weeks’ gestation with the overall goal of understanding where clinical practice could be improved to reduce NNU admission rates.
Evaluation of Sleep in Pregnant Inpatients Compared With Outpatients
Authors: Panelli D.M. , Miller H.E. , Simpson S.L. , Hurtado J. , Shu C.-H.M. , Boncompagni A.C. , Chueh J. , Barwick F. , Carvalho B. , Sultan P. , Aghaeepour N. , Druzin M.L.
Published: November 2024

(Obstet Gynecol. 2024;143(6):803–810. doi: 10.1097/AOG.0000000000005591)

Sleep disturbances are common during pregnancy, with up to 42% experiencing issues such as insomnia. A high-risk group includes those hospitalized for pregnancy complications, although research in this area is limited. Approximately 1% of all pregnancies involve antepartum hospitalization. This study compares sleep quality and duration between hospitalized pregnant inpatients and outpatients of similar gestational ages. Previous literature indicates a high prevalence of short sleep duration among antepartum inpatients and suggests that sleep interventions are feasible. Given the link between sleep disturbances and complications like gestational diabetes, hypertensive disorders, and preterm birth, this study evaluates whether antepartum hospitalization affects sleep differently than outpatient care.
Prophylactic Unfractionated Heparin in Antepartum Hospitalizations: A Randomized Controlled Trial
Authors: Mok T. , Nguyen A.V. , Kwan L. , Steinberg  , Vallera C. , Silverman N.S. , Rao R.
Published: November 2024

(Obstet Gynecol. 2024;144(1):118–125. doi: 10.1097/AOG.0000000000005599)

Obstetric venous thromboembolism (VTE) is a significant cause of maternal morbidity and mortality, particularly in cases of prolonged antepartum hospitalizations. Comprehensive thromboembolism prevention strategies have helped reduce maternal mortality from thromboembolism. Current recommendations emphasize expanded heparin prophylaxis during antepartum hospitalizations to mitigate VTE risks. However, there is a lack of data on how pregnancy-induced physiological changes affect unfractionated heparin (UFH) disposition, potentially necessitating higher dosing during pregnancy. Studies suggest pregnant patients may require increased heparin doses due to lower peak plasma concentrations and altered coagulation parameters.
Association of Pain Catastrophizing With Labor Pain and Analgesia Consumption in Obstetrical Patients
Authors: Peralta F.M. , Condon L.P. , Torrez D. , Neumann K.E. , Pollet A.L. , McCarthy R.J.
Published: November 2024

(Intl J Obstet Anesthesia. 2024;57:103954. DOI: 10.1016/j.ijoa.2023.103954)

Pain catastrophizing is an exaggerated negative response to pain, linked to increased pain severity and negative outcomes. In obstetrics, it is associated with greater labor pain, more analgesic use, and poor postpartum recovery. This study aimed to quantify the impact of pain catastrophizing on labor and postpartum pain, hypothesizing that high-catastrophizing (HC) women would report higher pain and analgesic use than low-catastrophizing (LC) women.
The Association Between Epidural Labor Analgesia and the Fetal Outcome and Mode of Delivery of the Second Twin: A Nationwide Register-Based Cohort Study in Finland
Authors: Vaajala M. , Kekki M. , Mattila V.M. , Kuitunen I.
Published: November 2024

(Int J Obstet Anesth. 2023;56:103924. https://doi.org/10.1016/j.ijoa.2023.103924)

Multiple pregnancies carry heightened risk of maternal and fetal health issues, including mortality, compared with singleton pregnancies. However, the perinatal mortality rate for twins in Finland has declined, with rates dropping to 0.7% for the first twin and 1.2% for the second twin in recent decades. While vaginal birth trials are generally safe for twin pregnancies, there remain challenges, especially during the delivery of the second twin, leading to higher complication rates than in singleton births. Epidural analgesia is often beneficial, facilitating obstetric procedures without additional anesthesia, as recommended by the 2019 UK NICE guidelines for reducing emergency cesarean deliveries for the second twin. Despite its advantages, epidural analgesia also poses risks, such as increased chances of operative vaginal delivery and potentially prolonged labor. This study aimed to explore the correlation between epidural analgesia, second-twin delivery mode, and the health outcomes of the second twin.
Influence of Different Volumes and Frequency of Programmed Intermittent Epidural Bolus in Labor on Maternal and Neonatal Outcomes: A Systematic Review and Network Meta-Analysis
Authors: Howle R. , Ragbourne S. , Zolger D. , Owolabi A. , Onwochei D. , Desai N.
Published: November 2024

(J Clin Anesth. 2024;93:111364. https://doi.org/10.1016/j.jclinane.2023.111364)

Potentially causing physiological and long-term emotional effects, labor is one of the most painful experiences for women. Epidural analgesia, involving the insertion of a catheter and administration of local anesthetics like levobupivacaine and opioids such as fentanyl, is the gold standard for pain relief. Local anesthetics and opioids can be administered through the epidural catheter either by continuous epidural infusion (CEI) or programmed intermittent epidural bolus (PIEB).
Effect of Preoperative Patient Anxiety on Postspinal Shivering During Elective Cesarean Delivery: A Prospective Observational Study
Authors: Jeevan S. , Ashok  , Jain K. , Jain
Published: November 2024

(Intl J Obstet Anesthesia. 2024;57:103936. DOI: 10.1016/j.ijoa.2023.103936)

It is reported that 36% to 71% of patients undergoing cesarean delivery (CD) under neuraxial anesthesia have intraoperative shivering. Postspinal shivering is traditionally seen as a thermoregulatory response to sympathectomy, but new evidence suggests anxiety might also influence this shivering by affecting the thermoregulatory center. This prospective study investigated the relationship between preoperative anxiety and postspinal shivering in elective CD patients at a single center, and also evaluated other potential risk factors.
Availability of Total Intravenous Anesthesia for Obstetric Surgery: A Survey of UK Practice
Authors: Scale R. , Johnson-Hughes H. , Metodiev Y.
Published: November 2024

(Eur J Anaesthesiol. 2024;41(2):146–152. doi: 10.1097/EJA.0000000000001855)

Though general anesthesia (GA) is used in only a small percentage of cesarean deliveries (CD), the majority of these instances use a rapid induction with an inhalation agent for maintenance. A newer technique that is rising in popularity is total intravenous anesthesia (TIVA), as it has less of an environmental impact. This article is a letter to the editor that details a survey-based study about the current practice of TIVA in obstetric surgery as well as its availability and barriers to inclusion in routine practice.
Use of the Obstetric Quality-of-Recovery Score (ObsQoR-11) to Measure the Impact of an Enhanced Recovery Programme for Elective Cesarean Section
Authors: Kielty J. , Borkowska A. , Lawlor E. , EL-Khuffash A.F. , Doherty A. , O’Flaherty D.
Published: November 2024

(Int J Obstet Anesth. 2024;57:103955. https://doi.org/10.1016/j.ijoa.2023.103955)

Cesarean deliveries (CD) are increasingly common worldwide, yet recovery after CD is often slower than after vaginal birth, impacting individuals, families, and workplaces. Enhanced recovery after cesarean (ERAC) programs aim to improve this recovery process. However, there is variability in how ERAC outcomes are reported, hindering comparisons and recommendations. Many current measures, like length of stay (LOS) and pain scores, need to be improved in capturing overall patient recovery. Patient-reported outcome measures (PROMs), such as the Obstetric Quality-of-Recovery (ObsQoR) score, offer a more comprehensive view from the patient’s perspective. Despite their importance, ERAC studies often overlook PROMs. The CRADLE study recently identified vital outcomes, including ObsQoR, for evaluating ERAC programs. We proposed using ObsQoR-11 to assess ERAC’s impact on patient recovery post-CS, expecting improved scores with ERAC implementation.
Stress and glucocorticoids impair inhibitory avoidance memory retrieval and extinction in male mice: the ameliorative effect of Ginkgo biloba extract
Authors: Alizadeh Neda , Dehbashi Fatemeh , Gholami Emad , Tarahomi Paria , Rashidy-Pour Ali , Vafaei Abbas Ali , Raise-Abdullahi Payman
Published: November 2024

Memory retrieval involves recalling previously consolidated information, while memory extinction refers to the gradual weakening of such memories after recall. Stress and glucocorticoids influence the retrieval and extinction of memory. This study employed a passive avoidance task to examine the impact of acute mild stress and equivalent doses of exogenous corticosterone on fear memory retrieval and extinction in male mice. Subsequently, we investigated the potential therapeutic effects of Ginkgo biloba extract, EGb 761, on memory impairments induced by stress and corticosterone. Corticosterone was administered systemically 30 min before memory reactivation to model glucocorticoid activity during retrieval. Mild acute stress, like the stress levels typically experienced before an exam, was induced through 20-min restraint immediately before reactivation in separate groups. EGb 761 was injected 30 min before corticosterone or stress exposure. Results demonstrated that both corticosterone and acute stress impaired context-specific fear memory retrieval and enhanced subsequent extinction. Pretreatment with EGb 761 inhibited these impairing effects of acute stress and corticosterone on avoidance memory retrieval and extinction. Our findings suggest that the glucocorticoid system and acute stress markedly influence avoidance memory retrieval and extinction. Ginkgo biloba may possess therapeutic and memory-enhancing effects, particularly in stressful situations.
Federal Priorities to Address Homelessness as a Community Health Problem
Authors: Tsai Jack
Published: November 2024

Homelessness is a major public health problem across communities in the United States. This commentary reviews required Learning Agendas of all 24 US federal agencies for items related to homelessness and housing instability covering the years 2022-2026. Across 7 federal agencies (Departments of Agriculture; Homeland Security; Labor; Health and Human Services; Housing and Urban Development; Treasury; Veterans Affairs) and 2 cross-government plans (American Rescue Plan Equity; Lesbian, Gay, Bisexual, Transgender, Queer, and Intersex Equity), there is a stated focus on homelessness and housing instability. These federal priorities seek to address homelessness and housing instability in families, Native American communities, unsheltered individuals, veterans, and sexual and gender minority individuals. Several agencies also have a stated focus on evaluating the impact of housing assistance and other supports provided during the COVID-19 pandemic. These findings reflect a national recognition and reframe of homelessness as an interdisciplinary, community health problem with opportunities for inter-agency collaboration and government support for primary and secondary prevention that have not been fully realized.
Elastic Fibers in Orbital Septum
Authors: Kakizaki Hirohiko , Vaidya Aric , Naito Munekazu , Takahashi Yasuhiro
Published: November 2024

Purpose:

To examine microscopically the nature of the elastic fibers of the orbital septum in elderly specimens in comparison with the young specimen.

Materials and methods:

Histological evaluation of 15 tissues of the orbital septa from upper eyelid (8 right, 7 left) from 11 Japanese cadavers (age range: 36–94 years old, average: 75.5) was performed. The 36-year-old specimen was the only sample with a young age, so it was used as the reference. The age range of the other specimens was, therefore, from 54 to 94, with an average of 79.4 years old. The specimens were fixed in 10% formalin and stained with Elastica van Gieson.

Results:

Elastic fibers in the orbital septa were stained with Elastica van Gieson. The elastic fibers from the elderly specimens illustrated fragmentation, but those from the 36-year-old specimen showed flexibility.

Conclusion:

The elastic fibers in older specimens underwent fragmentation, while those in the young one were flexible.
Overview of diabetes agents in cardiovascular disease: it takes an orchestra to play Tchaikovsky in symphony
Authors: Loh Wann Jia
Published: November 2024

Purpose of review

The aim of this review was to discuss the use and concerns of diabetes agents, clinical targets, and key aspects to be considered in the management of patients with type 2 diabetes mellitus (T2DM), and at high risk or established cardiovascular disease (CVD).

Recent findings

The recent European and American guidelines recommended SGLT2 inhibitors and GLP-1 receptor agonists as the preferred first-line diabetes agents in patients with T2DM and CVD. This is a paradigm shift from using metformin as first-line therapy. Amid their widespread use, however, there are also concerns about their side effects. With the rapidly growing diabetes regimens available, questions arise about how best to approach the management of patients with T2DM and CVD.

To reduce CVD morbidity and mortality in patients with T2DM and at high or very high risk for CVD, the two key diabetes agents SGLT2i and/or GLP1-based therapies should be offered. Although lacking cardiovascular benefit, other diabetes agents remain necessary for many patients with T2DM for their glucocentric effects; Metformin and pioglitazone are useful in severe insulin resistance, while insulin therapy is often necessary in advanced diabetes; GLP1-RA is cautioned in patients with active gastrointestinal and mental health conditions, while DPP4 inhibitor is likely a well tolerated option in a challenging psychosocial setting. Other important aspects that should be considered include obesity, chronic kidney disease, women's cardiovascular health, and psychosocial factors.
Transient residence of the repulsive client Shutdown in Yb bodies plays a critical role in Piwi-piRISC biogenesis and maintaining fertility
Authors: Hirakata Shigeki , Fujita Aoi , Siomi Mikiko C.
Published: November 2024

Nonmembranous organelles, such as Yb bodies inDrosophilaovarian somatic cells, form through liquid-liquid phase separation of scaffold proteins. Client proteins transiently accumulate in these organelles by binding to scaffolds. However, the regulation of this process is not well understood. Here, we investigate Shutdown, a client protein in Yb bodies, the site of Piwi-piRISC precursor (pre-Piwi-piRISC) formation. We found that Shutdown connects Armitage and Piwi in the cytosol to promote Piwi deposition to Yb bodies, before quickly returning to the cytosol. This return allows Armitage to transfer pre-Piwi-piRISC to the mitochondria for maturation. Shutdown’s self-repulsion via its acidic N-terminus enables its transient residence in Yb bodies. A point mutation in Armitage, similar to a human Armitage/MOV10L1 mutation associated with azoospermia, traps Shutdown in Yb bodies, blocking Piwi-piRISC generation. This study reveals the mechanism of Shutdown’s transient localization in Yb bodies and its essential role in Piwi-piRISC production and maintaining fertility.
Elucidating conformational alteration of human islet amyloid polypeptide by nonsynonymous substitution
Authors: Bashar Md Abul , Barua Largess , Paul Supti , Dash Nayan , Sadhu Toma , Mitra Sarmistha , Dash Raju
Published: November 2024

Islet amyloid polypeptide (IAPP) is a peptide hormone that serves multiple essential functions, including metabolism and regulating gastric emptying and satiation through amylin receptors. However, mutations in theIAPP, notably in the amyloidogenic segment (20-29 amino acid residues), cause its aggregation and amyloid formation, which leads to β-cell toxicity and death in type 2 diabetes mellitus (T2DM) and protein misfolding disorders (PMDs). The current work aims to elucidate the non-synonymous variants in theIAPP, which may adversely affect its function and rise to T2DM and PMDs. We harnessedin siliconon-synonymous single-nucleotide polymorphisms (nsSNPs) assessment and molecular dynamics (MD) simulation to discover the potential deleterious mutants that cause T2DM and PMDs. Firstly, we executed nsSNPs prediction inIAPPusing the NCBI dbSNP server, and then, all the predicted nsSNPs were assessed by a total of 26in silicotools to find out which possessed the most deleterious effect in IAPP. Finally, MD simulation was carried out utilizing the most deleterious nsSNPs to check which significantly alters the conformational dynamics of IAPP. We found a total of 62 nsSNPs, among which the top 4 deleterious nsSNPs (T37P, L45P, G66R, and T69I) were selected based on the deleteriousness predictions by in silico tools and their location in the matureIAPPsequence (34-70 amino acid residues). MD simulations further confirm that three variants (T37P, L45P, and G66R) significantly alter the conformational dynamics of IAPP, suggesting a potential starting point for future research to elucidate the roles of these variants in IAPP aggregation and amyloid formation and their associations with T2DM and PMDs.
Combined analysis of somatic mutations and gene expression reveals nuclear speckles-associated enhanced stemness in gingivobuccal carcinoma under DNA damage response
Authors: Kumar Sachendra , De Tamasa , Subramani Janavi , Rangarajan Annapoorni , Pal Debnath
Published: November 2024

Smokeless tobacco chewing habits in India lead to a high prevalence of Gingivobuccal oral squamous cell carcinoma (OSCC-GB). Cancer stem cells (CSCs) are a sub-population of cancer cells within a tumor with stem-like properties and are believed to contribute to tumor initiation, progression, increased resistance to drug therapy, and promote post-therapeutic cancer relapse. An RNA-seq data-based integrative analysis of somatic mutation and gene expression was performed to explore the role of CSCs in disease progression using the novel Indian-origin OSCC-GB cell line ‘IIOC019’ from a patient with tobacco-chewing habit. The identified DNA damage-related known mutational signature (ID1, SBS5) indicates the impact of smokeless tobacco-related carcinogens in the IIOC019 cell line. The differentially expressed somatic variants, functional impact predictions, and survival analysis reveal the role of DNA damage response (DDR)-related genes in OSCC-GB, with the SON gene as a significant player. The study suggests that the loss of function in a somatic variant of the SON gene is associated with enhanced stemness and increased risk of disease progression in OSCC-GB under DDR conditions. The newly identified CSC-associated somatic variants appear to promote cancer spread, local recurrence, and resistance to chemotherapy or radiotherapy, contributing to the high mortality rates among Indian OSCC-GB patients.
Design of highly potent anti-biofilm, antimicrobial peptides using explainable artificial intelligence
Authors: Pikalyova Karina , Akhmetshin Tagir , Orlov Alexey , Haney Evan F. , Akhoundsadegh Noushin , You Jiaying , Hancock Robert E. W. , Horvath Dragos , Marcou Gilles , Cherkasov Artem , Varnek Alexandre
Published: November 2024

Antimicrobial peptides have emerged as a potential alternative to traditional small molecule antibiotics. They possess broad-spectrum efficacy and increasingly confront the challenges of bacterial resistance, especially the adaptive resistance of biofilms. However, advanced rational peptide design methods are still required to ensure optimal property profiles of such peptides, while limiting the cost of their synthesis and screening. Here we present a computational pipeline for the rational de novo design of antimicrobial and anti-biofilm peptides based on an explainable artificial intelligence (XAI) framework. The developed framework combines a Wasserstein Autoencoder (WAE) and a non-linear dimensionality reduction method termed generative topographic mapping (GTM). The WAE was used to learn the latent representation of the peptide space, while the GTM guided the generation of novel AMPs through an illustrative depiction of the latent space in the form of 2D maps. The efficacy of the peptides generated with the developed pipeline was experimentally verified by synthesis and testing for activity against methicillin resistantStaphylococcus aureus(MRSA), achieving a 100% hit rate in targeting biofilms. Notably, the most potent anti-biofilm peptide developed in this study demonstrated almost one order of magnitude improvement in IC50value compared with the potent anti-biofilm peptide reference “1018”, used as a positive control. The developed pipeline is readily extendable for the optimization of additional peptide properties, including cytotoxicity, tendency to aggregate and proteolytic stability, underscoring its potential utility for rational design of the peptide-based therapeutics.
Demographic pathways linking sex-chromosome system to adult sex ratio variation across tetrapods
Authors: Pipoly Ivett , Bókony Veronika , Gaillard Jean-Michel , Lemaître Jean-François , Székely Tamás , Liker András
Published: November 2024

Sex chromosomes determine male and female phenotypes, and the resulting sex differences can have significant impacts on ecology and life history. One manifestation of this link is that ZZ/ZW sex-determination systems are associated with more male-skewed adult sex ratio (ASR, proportion of males in the adult population) than XY/XX systems across tetrapods (amphibians, reptiles, birds, and mammals). Here we investigate four demographic processes: male and female offspring production, sex differences in juvenile and adult mortalities and in timing of maturation that can contribute to ASR variation between XY/XX and ZZ/ZW systems, using phylogenetic analyses of a large dataset collected from tetrapod species in the wild. We show that sex differences in adult mortality reliably predict ASR, and it is also more male-biased in XY/XX species than in ZZ/ZW species. Sex differences in juvenile mortality or in maturation time also contribute to ASR skews, but do not differ consistently between XY/XX and ZZ/ZW systems. Phylogenetic path analyses confirm an influence of sex-determination system on ASR through sex-biased adult mortality. Thus, these results infer that sex chromosomes can impact, via demographic pathways, frequency-dependent selection emerging from the relative number of males and females. We call for follow-up studies to uncover the potentially complex web of associations between sex determination, population dynamics, and social behaviour.
Limited involvement of Ca2+/calmodulin-dependent kinase II α and β in mammalian sleep
Authors: Yang Weiwen , Shi Jingyi , Li Chenggang , Yang Jingqun , Yu Jianjun , Huang Juan , Rao Yi
Published: November 2024

While sleep is important, our understanding of its molecular mechanisms is limited. Over the last two decades, protein kinases have been implicated in sleep regulation, with a prominent role for Ca++/calmodulin-dependent kinase II (CaMKII) β. Of all the known mouse genetic mutants, the biggest changes in sleep was reported to be observed inCamk2bgene knockout mice: sleep was reduced by approximately 120 minutes (mins) over 24 hours (hrs). We have reexamined the sleep phenotype inCamk2aandCamk2bknockout mice, and while we have observed sleep reduction inCamk2aknockout mice, we did not find sleep reduction inCamk2bmutants.We did find bothCamk2aandCamk2bparticipated in homeostatic sleep rebound, though. Because CamKII α and β are widely known to be crucial kinases with interesting properties, it is worthwhile to keep our results in record for a general service to the field.
PROSER1 modulates DNA demethylation through dual mechanisms to prevent syndromic developmental malformations
Authors: Fleming Anna , Knatko Elena V. , Li Xiang , Zoch Ansgar , Heckhausen Zoe , Stransky Stephanie , Brenes Alejandro J. , Sidoli Simone , Hajkova Petra , O'Carroll Dónal , Rasmussen Kasper D.
Published: November 2024

The link between DNA methylation and neurodevelopmental disorders is well established. However, how DNA methylation is fine-tuned—ensuring precise gene expression and developmental fidelity—remains poorly understood. PROSER1, a known TET2 interactor, was recently linked to a severe neurodevelopmental disorder. Here, we demonstrate that PROSER1 interacts with all TET enzymes and stabilizes chromatin-bound TET–OGT–PROSER1–DBHS (TOPD) complexes, which regulate DNA demethylation and developmental gene expression. Surprisingly, we found that PROSER1 also sequesters TET enzymes, preventing widespread demethylation and transposable element derepression. Our findings identify PROSER1 as a key factor that both positively and negatively regulates DNA demethylation essential for mammalian neurodevelopment.
Power corrections to quasidistribution amplitudes of a heavy meson
Authors: Han Chao , Wang Wei , Zhang Jia-Lu , Zhang Jian-Hui
Published: November 2024

It has been recently demonstrated that light cone distribution amplitudes (LCDAs) for a heavy meson, defined in the heavy quark limit, can be extracted by simulating quasidistribution amplitudes on the lattice with a large meson momentum Pz. This extraction involves a two-step procedure. In the first step, the quasidistribution amplitudes are matched onto the QCD LCDAs in the large Pz limit. In the second step, the QCD LCDAs are matched onto the desired LCDAs defined in heavy quark effective theory. In this work, we present the mH2n/(Pz)2n and ΛQCD2/(xPz)2 and ΛQCD2/((1−x)Pz)2 corrections in the first step with mH being the heavy meson mass and x being the momentum fraction of the light quark. To account for mH2n/(Pz)2n corrections, we employ two methods: the moment relation that can provide mass corrections to all orders, and a leading-twist projector that gives the leading-order mass corrections. For the ΛQCD2/(Pz)2 corrections, we employ a renormalon model that addresses the renormalon ambiguity stemming from the divergence of the perturbative series. We adopt two parametrizations for QCD LCDAs to conduct a numerical analysis. The results suggest that these corrections are typically smaller than 20% in the region 0.2<x<0.8, and should be included in a precision analysis. These findings will serve as a valuable guide for future studies on heavy meson LCDAs, particularly in the context of lattice QCD, where accounting for such corrections is crucial for improving the accuracy and reliability of the results.

Published by the American Physical Society
2024
Detecting the flavor content of the vacuum using the Dirac operator spectrum
Authors: Liang Jian , Alexandru Andrei , Bi Yu-Jiang , Draper Terrence , Liu Keh-Fei , Yang Yi-Bo ,   χQCD Collaboration
Published: November 2024

We compute the overlap Dirac spectrum on three gauge ensembles generated using 2+1-flavor domain wall fermions. The three ensembles have different lattice spacings, and two of them have quark masses tuned to the physical point. The spectral density is determined up to λ∼100  MeV with subpercentage statistical uncertainty. We find that the density is close to a constant below λ∼20  MeV as predicted by chiral perturbative theory (χPT) and then increases linearly due to the strange quark mass. By fitting to the next-to-leading order χPT form and using the nonperturbative renormalization using the regularization independent momentum subtraction scheme, the SU(2) (keeping the strange quark mass at the physical point) and SU(3) chiral condensates at MS¯ 2 GeV are determined to be Σ=(265.4(0.5)(4.2)  MeV)3 and Σ0=(234.3(0.5)(25.8)  MeV)3, respectively. The pion decay constants are also determined to be F=84.1(1.9)(8.0) and F0=58.6(0.5)(10.0)  MeV. The systematic errors are carefully estimated including the effects of fitting ranges and the uncertainty of low-energy constant L6. We also show that one can resolve the sea flavor content of the sea quarks and constrain their masses with ∼10%–20% statistical uncertainties using the Dirac spectral density.

Published by the American Physical Society
2024