bluuebunny/crossref_metadata_2025_split huggingface dataset:
Controlled Antenatal Thyroid Screening II: Effect of Treating Maternal Suboptimal Thyroid Function on Child Behavior
Authors: Hales Charlotte , Taylor Peter N , Channon Sue , McEwan Kirsten , Thapar Anita , Langley Kate , Muller Ilaria , Draman Mohd S , Dayan Colin , Gregory John W , Okosieme Onyebuchi , Lazarus John H , Rees D Aled , Ludgate Marian 
Published: October 2019

Abstract

Context & Objectives
The Controlled Antenatal Thyroid Screening (CATS) study was the first randomized controlled trial to investigate effects of treating suboptimal gestational thyroid function (SGTF) on child cognition. Since observational studies indicated that SGTF may also increase symptoms of autism and attention-deficit/hyperactivity disorder (ADHD), the CATS cohort was used to investigate whether treatment of mothers affected their children’s behavior.

Design & Participants
Mothers (N = 475) completed 3 questionnaires: the Strengths and Difficulties Questionnaire (SDQ), the Child ADHD Questionnaire, and the Social Communication Questionnaire (SCQ, used as a screen for autism spectrum disorder [ASD]), about their children (mean age 9.5 years). Group comparisons of total scores, numbers of children above clinical thresholds, and association between high maternal free thyroxine (FT4) (&gt; 97.5th percentile of the UK cohort, “overtreated”) and child neurodevelopment were reported.

Results
There were no differences in total scores between normal gestational thyroid function (GTF) (n = 246), treated (n = 125), and untreated (n = 104) SGTF groups. More children of treated mothers scored above clinical thresholds, particularly the overtreated. Scores were above thresholds in SDQ conduct (22% vs 7%), SCQ total scores (7% vs 1%), and ADHD hyperactivity (17% vs 5%) when comparing overtreated (n = 40) and untreated (N = 100), respectively. We identified significantly higher mean scores for SDQ conduct (adjusted mean difference [AMD] 0.74; 95% confidence interval [CI], 0.021-1.431; P = 0.040, effect size 0.018) and ADHD hyperactivity (AMD 1.60, 95% CI, 0.361-2.633; P = 0.003, effect size 0.028) comparing overtreated with normal-GTF children.

Conclusions
There was no overall association between SGTF and offspring ADHD, ASD, or behavior questionnaire scores. However, children of “overtreated” mothers displayed significantly more ADHD symptoms and behavioral difficulties than those of normal-GTF mothers. Thyroxine supplementation during pregnancy requires monitoring to avoid overtreatment.
Elevated Cholesteryl Ester Transfer Protein Activity Early in Pregnancy Predicts Prediabetes 5 Years Later
Authors: Ueland Thor , Roland Marie Cecilie Paasche , Michelsen Annika E , Godang Kristin , Aukrust Pål , Henriksen Tore , Bollerslev Jens , Lekva Tove 
Published: October 2019

AbstractContextCholesteryl ester transfer protein (CETP) regulates high-density lipoprotein (HDL) cholesterol levels and interaction between glucose, and HDL metabolism is central in the development of diabetes.ObjectiveWe hypothesized that CETP levels would be regulated in diabetic pregnancies. We tested the hypothesis by evaluating CETP activity measured multiple times during pregnancy and at 5 years’ follow-up in a prospective cohort (STORK) and investigated its association with gestational diabetes mellitus (GDM) during pregnancy or development of prediabetes 5 years after pregnancy. We also evaluated the strongest correlation of CETP activity among measures of adipocity and glucose metabolism, lipoproteins, adipokines, and monocyte/macrophage activation markers.DesignA population-based longitudinal cohort study was conducted from 2001 to 2013.SettingThe study setting was Oslo University Hospital.Patients or Other ParticipantsA total of 300 women during pregnancy and at 5 years postpartum participated in this study.Main Outcome MeasuresCETP activity was measured at 14 to 16, 22 to 24, 30 to 32, and 36 to 38 weeks’ gestation, and at 5 years’ follow-up.ResultsWe found higher CETP activity in pregnancy in women developing prediabetes but no association with GDM. CETP activity decreased throughout pregnancy and remained low at follow-up. High CETP activity was associated with sCD14 levels, in particular in women who developed prediabetes. These data show that enhanced CETP activity during pregnancy is associated with systemic indices of monocyte/macrophage activation, in particular in women who develop prediabetes later in life.ConclusionsCETP activity during pregnancy identifies women at risk for later diabetes development.
The Selective Progesterone Receptor Modulator Ulipristal Acetate Inhibits the Activity of the Glucocorticoid Receptor
Authors: Small Benjamin , Millard Charles E F , Kisanga Edwina P , Burman Andreanna , Anam Anika , Flannery Clare , Al-Hendy Ayman , Whirledge Shannon 
Published: October 2019

Abstract

Context
The selective progesterone modulator ulipristal acetate (ulipristal) offers a much-needed therapeutic option for the clinical management of uterine fibroids. Although ulipristal initially passed safety evaluations in Europe, postmarketing analysis identified cases of hepatic injury and failure, leading to restrictions on the long-term use of ulipristal. One of the factors potentially contributing to significant side effects with the selective progesterone modulators is cross-reactivity with other steroid receptors.

Objective
To determine whether ulipristal can alter the activity of the endogenous glucocorticoid receptor (GR) in relevant cell types.

Design
Immortalized human uterine fibroid cells (UtLM) and hepatocytes (HepG2) were treated with the synthetic glucocorticoid dexamethasone and/or ulipristal. Primary uterine fibroid tissue was isolated from patients undergoing elective gynecological surgery and treated ex vivo with dexamethasone and/or ulipristal. In vivo ulipristal exposure was performed in C57Bl/6 mice to measure the effect on basal gene expression in target tissues throughout the body.

Results
Dexamethasone induced the expression of established glucocorticoid-target genes period 1 (PER1), FK506 binding protein 51 (FKBP5), and glucocorticoid-induced leucine zipper (GILZ) in UtLM and HepG2 cells, whereas cotreatment with ulipristal blocked the transcriptional response to glucocorticoids in a dose-dependent manner. Ulipristal inhibited glucocorticoid-mediated phosphorylation, nuclear translocation, and DNA interactions of GR. Glucocorticoid stimulation of PER1, FKBP5, and GILZ was abolished by cotreatment with ulipristal in primary uterine fibroid tissue. The expression of glucocorticoid-responsive genes was decreased in the lung, liver, and uterus of mice exposed to 2 mg/kg ulipristal. Interestingly, transcript levels of Fkbp5 and Gilz were increased in the hippocampus and pituitary.

Conclusions
These studies demonstrate that ulipristal inhibits endogenous glucocorticoid signaling in human fibroid and liver cells, which is an important consideration for its use as a long-term therapeutic agent.
Exposure to Glucocorticoids in the First Part of Fetal Life is Associated with Insulin Secretory Defect in Adult Humans
Authors: Riveline Jean-Pierre , Baz Baz , Nguewa Jean-Louis , Vidal-Trecan Tiphaine , Ibrahim Fidaa , Boudou Philippe , Vicaut Eric , Brac de la Perrière Aude , Fetita Sabrina , Bréant Bernadette , Blondeau Bertrand , Tardy-Guidollet Véronique , Morel Yves , Gautier Jean-François 
Published: October 2019

Abstract

Objective
High glucocorticoid levels in rodents inhibit development of beta cells during fetal life and lead to insulin deficiency in adulthood. To test whether similar phenomena occur in humans, we compared beta-cell function in adults who were exposed to glucocorticoids during the first part of fetal life with that of nonexposed subjects.

Research Design and Methods
The study was conducted in 16 adult participants exposed to glucocorticoids during the first part of fetal life and in 16 nonexposed healthy participants with normal glucose tolerance who were matched for age, sex, and body mass index (BMI). Exposed participants had been born to mothers who were treated with dexamethasone 1 to 1.5 mg/day from the sixth gestational week (GW) to prevent genital virilization in children at risk of 21-hydroxylase deficiency. We selected offspring of mothers who stopped dexamethasone before the 18th GW following negative genotyping of the fetus. Insulin and glucagon secretion were measured during an oral glucose tolerance test (OGTT) and graded intravenous (IV) glucose and arginine tests. Insulin sensitivity was measured by hyperinsulinemic-euglycemic-clamp.

Results
Age, BMI, and anthropometric characteristics were similar in the 2 groups. Insulinogenic index during OGTT and insulin sensitivity during the clamp were similar in the 2 groups. In exposed subjects, insulin secretion during graded IV glucose infusion and after arginine administration decreased by 17% (P = 0.02) and 22% (P = 0.002), respectively, while glucagon secretion after arginine increased.

Conclusion
Overexposure to glucocorticoids during the first part of fetal life is associated with lower insulin secretion at adult age, which may lead to abnormal glucose tolerance later in life.
Associations of Exposure to Perfluoroalkyl Substances With Thyroid Hormone Concentrations and Birth Size
Authors: Xiao Christina , Grandjean Philippe , Valvi Damaskini , Nielsen Flemming , Jensen Tina Kold , Weihe Pal , Oulhote Youssef 
Published: October 2019

Abstract

Background
Adequate thyroid function during pregnancy is essential for optimal fetal growth. Gestational exposure to perfluoroalkyl substances (PFAS) can negatively affect birth size and disrupt maternal and neonatal thyroid function, although the interrelationship is unclear.

Objective
We aimed to quantify the associations between maternal serum–PFAS concentrations and birth weight, birth length, and cranial circumference. We also aimed to estimate associations between PFAS and thyroid hormone (TH) concentrations, thereby elucidating whether THs potentially mediate the associations between PFAS concentrations and birth size.

Methods
We studied a population-based prospective cohort of 172 mother-singleton pairs from the Faroe Islands. Twelve PFAS were measured in maternal serum obtained at 34 weeks of gestation. THs were measured in maternal and cord serum. Associations between PFAS concentrations and birth size and TH concentrations were estimated using multivariable linear regressions. Sex-stratified analyses along with a mediation analysis were performed to estimate potential mediating effects of THs in the association between PFAS and birth outcomes.

Results
Several PFASs were negatively associated with birth weight, length, and head circumference, and a general positive association between maternal serum–PFASs and cord serum–thyroid-stimulating hormone (TSH; also known as thyrotropin) was found. For instance, a doubling in perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA) was associated with a 53% (95% CI, 18%-99%) and 40% (95% CI, 8%-81%) increases in TSH concentrations, respectively. There was little evidence of sexually dimorphic associations. Overall, THs were not found to mediate associations between PFASs and birth size.

Conclusion
In this study, several PFASs were negatively associated with birth size and increased THs; however, this did not explain lower birth weight among children exposed to PFAS.
Glucose-Dependent Insulinotropic Polypeptide Receptor Therapies for the Treatment of Obesity, Do Agonists = Antagonists?
Authors: Killion Elizabeth A , Lu Shu-Chen , Fort Madeline , Yamada Yuichiro , Véniant Murielle M , Lloyd David J 
Published: October 2019

Abstract
Glucose-dependent insulinotropic polypeptide receptor (GIPR) is associated with obesity in human genome-wide association studies. Similarly, mouse genetic studies indicate that loss of function alleles and glucose-dependent insulinotropic polypeptide overexpression both protect from high-fat diet–induced weight gain. Together, these data provide compelling evidence to develop therapies targeting GIPR for the treatment of obesity. Further, both antagonists and agonists alone prevent weight gain, but result in remarkable weight loss when codosed or molecularly combined with glucagon-like peptide-1 analogs preclinically. Here, we review the current literature on GIPR, including biology, human and mouse genetics, and pharmacology of both agonists and antagonists, discussing the similarities and differences between the 2 approaches. Despite opposite approaches being investigated preclinically and clinically, there may be viability of both agonists and antagonists for the treatment of obesity, and we expect this area to continue to evolve with new clinical data and molecular and pharmacological analyses of GIPR function.
A Randomized Controlled Trial of Enhanced Recovery After Surgery Versus Standard of Care Recovery for Emergency Cesarean Deliveries at Mbarara Hospital, Uganda
Authors: Baluku Moris , Bajunirwe Francis , Ngonzi Joseph , Kiwanuka Joseph , Ttendo Stephen 
Published: October 2019

BACKGROUND:
Enhanced recovery after surgery (ERAS) expedites return to patient baseline and functional status by reducing surgical trauma, stress, and organ dysfunction. Despite the potential benefits of enhanced recovery protocols, limited research has been done in low-resource settings, where 95% of cesarean deliveries are emergent and could possibly benefit from the application of ERAS protocols.

METHODS:
In a prospective, randomized, single-blind, controlled trial, mothers delivering by emergency cesarean delivery were randomly assigned to either an ERAS or a standard of care (SOC) recovery arm. Patients in the ERAS arm were treated with a modified ERAS protocol that included modified counseling and education, prophylactic antibiotics, antiemetics, normothermia, restrictive fluid administration, and multimodal analgesia. They also received early initiation of mobilization, feeding, and urethral catheter removal. The primary end point was length of hospital stay. The secondary end points were complications and readmission rates. Mean length of stay in the intervention and control arms were compared using t tests. Statistical analyses were performed using STATA version 13 (College Station, TX).

RESULTS:
A total of 160 patients were enrolled in the study, with 80 randomized to each arm. There was a statistically significant shorter length of stay for the ERAS arm compared to SOC, with a difference of −18.5 hours (P < .001, 95% confidence interval [CI], −23.67, −13.34). The incidence of complications of severe pain and headache was lower in the ERAS arm compared to SOC (P = .001 for both complications). However, pruritus was more common in the ERAS arm compared to SOC (P = .023).

CONCLUSIONS:
Use of an ERAS protocol for women undergoing emergency cesarean delivery in a low-income setting is feasible and reduces length of hospital stay without generally increasing the complication rate.
Ambient and Indoor Air Pollution in Pregnancy and the risk of Low birth weight and Ensuing Effects in Infants (APPLE): A cohort study in Bangalore, South India
Authors: Shriyan Prafulla , Babu Giridhara R , Ravi Deepa , Ana Yamuna , van Schayck Onno CP , Thankachan Prashanth , Murthy GVS 
Published: October 2019

Background: Exposure to air pollution (IAP) from the combustion of solid fuels is a significant cause of morbidity and mortality in developing countries. Pregnant women exposed to higher pollutant levels are at higher risk of delivering a low-birth-weight (LBW) baby. There is a lack of standardized data regarding the levels and types of specific pollutants and how they impact LBW. We aim to prospectively assess the association between ambient and indoor air pollution levels in pregnancy and low birth weight and understand the subsequent risk of adiposity in these infants. Methods: We will conduct a prospective cohort study of 516 pregnant women recruited before 18 weeks of gestation in the urban slums of Bangalore, who have voluntarily consented to participate. We will estimate the level of air pollutants including coarse particulate matter 10 ug/m3 (PM10 ), fine particulate matter 2.5 ug/m3(PM2.5) and carbon monoxide (CO) parts per million (ppm) levels in both indoor and ambient environment. The follow-up of the delivered children will be done at delivery until the infant is two years old. The association between pollutants and LBW will be evaluated using logistic regression adjusting for potential confounders.Further, we will explore the mediation role of LBW in the hypothesized causal chain of air pollution and adiposity. Nested within a larger Maternal Antecedents of Adiposity and Studying the Transgenerational role of Hyperglycemia and Insulin (MAASTHI) cohort, we can estimate the absolute risk of having low birth weight caused by air pollution and other variables. Discussion: Understanding the association between exposures to ambient and indoor air pollution and low birth weight is essential in India. LBW babies have a higher risk of developing obesity and Non-Communicable Diseases (NCDs) during adulthood. The results from this study can inform the efforts for controlling the air pollution-related chronic diseases in India.
The Ministry of Health and Sanitation, Sierra Leone – Public Health England (MOHS-PHE) Ebola Biobank
Authors: Hannigan Bernie , Whitworth Jimmy , Carroll Miles , Roberts Allen , Bruce Christine , Samba Thomas , Sahr Foday , Coates Elizabeth 
Published: October 2019

During the Ebola outbreak in 2014-2015 in Sierra Leone, residual clinical specimens and accompanying data were collected from routine diagnostic testing in Public Health England (PHE) led laboratories. Most of the samples with all the accompanying data were transferred to PHE laboratories in the UK for curation by PHE. The remainder have been kept securely in Sierra Leone. The biobank holds approximately 9955 samples of which 1108 tested positive for Ebola virus. Researchers from the UK and overseas, from academia, government other research organisations and commercial companies can submit proposals to the biobank to access and use the samples. The Ministry of Health and Sanitation in Sierra Leone (MOHS) retains ownership of the data and materials and is working with PHE and other researchers to develop and conduct a series of research projects that will inform future healthcare and public health strategies relating to Ebola. The Ebola Biobank Governance Group (EBGG) was established to guarantee equality of access to the biobank for the most scientifically valuable research including by researchers from low and middle-income countries. Ensuring benefit to the people of Sierra Leone is an over-arching principle for decisions of the EBGG. Four ongoing research collaborations are based on the first wave of biobank proposals approved by EBGG. Whilst the biobank is a valuable resource its completeness and sample quality are consistent with the outbreak conditions under which they were collected.
Development of physical fitness – gender differences and characteristics
Authors: Piotrowska Katarzyna , Pabianek Łukasz 
Published: October 2019

Physical activity, recreational sports as well as competitive sports effect the human body. Changes that occur under training are mainly connected to the adaptation process of body to specific form of activity. But on the other hand, changes that may be observed may lead to body functioning dysregulations that may affect health of sportsmen. Most of the changes are being observed mainly in the functioning of the female body system, despite the fact that they are not gender specific. In women, the undesirable effect of intensive training and heavy training loads may be inhibition of sexual maturation, withdrawal of the menstrual cycle and its irregularity, as well as resolution of the reproductive system function. That’s why the understanding of gender specific changes are so important for the sportsmen and trainers to understand what may be observed during training and what it may lead to.The aim of this work was to show the basic differences between gender physical fitness development observed during body development and physical training.
Neonatal Tetanus Evaluation of Treatment and a Proposal for Classification of Severity
Authors: Husada Tjandra , Rampengan T. H. , Harjanto Ign. , Arif I. D. , Munir Muzief 
Published: October 2019

An evaluation was made on 22 neonates with Tetanus Neonatorum (age 5 - 21 days), who were admitted to the Military Hospital, Teling, Manado, in 1973. Seventeen of our patients were babies born in their homes and were delivered by the "dukun kampong"; 5 babies were born in the maternity clinic and were helped by midwives.
The therapy given were :

Anti-Tetanus serum 10,000 U, single dose, given immediately on admission.
Procain Penicilline 100,000 U/kg. b.w./day; i.m. divided into 2 equal doses for 10 days.
Diazepam (valium) 5 mg./kg. b.w./day; oral, divided into 8 equal doses, and 2.5 mg, parenterally 4 times a day.
Description of Renal Biopsy in Frequently Relapsing and Corticosteroid Non Responsive Nephrotic Syndrome in Childhood
Authors: Bahrun D. , Nazir M. , N. K. Yangtjik 
Published: October 2019

A study of 71 children with nephrotic syndrome admitted to the Department of Child Health, Medical School, Sriwijaya University Palembang General Hospital between November 1981 and November 1983 has been reported.
Of the 71 children, there were 50 (70.4%) boys and 21 (29.6%) girls, in which 31 were less than 6 years of age. During the first eight weeks complete rem1sswn was found in 66 patients. The other five were steroid resistant.
Among the 66 patients who responded to steroid, 61 had remission with the first 4 weeks. Further observation up to two years, 3 patients were still in remission, 36 had one relapse and 22 had frequent relapses.
The other 5 patients, who had remission on the second 4 weeks, one had one relapse, two had frequent relapses and the other two were not available for follow up.
Renal biopsy was performed in 31 patients. The representative results of the renal biopsy were found in only 20 patients :

Eleven patients showed minimal change nephrotic syndrome (MCNS). Ten of these patients had frequent relapses while one patient was steroid resistant. Two had renal insufficiency.
Three patients had focal glomerulosclerosis (FGS); two of them were frequently relapsing patients and the other one had steroid resistant.
Four patients had mesangial proliferative glomerulonephritis (Mes. PGN). All of them had frequent relapses.
One patient with diffuse proliferative glomerulonephritis (DPGN) was steroid resistant.
One patient with crescentic glomerulonephritis (CrGN) was also steroid resistant.