bluuebunny/crossref_metadata_2025_split huggingface dataset:
Accelerated Fetal Growth in Early Pregnancy and Risk of Preterm Birth: A Prospective Cohort Study
Authors: Elenis Evangelia , Wikström Anna-Karin , Simic Marija 
Published: July 2020

Abstract
Background: Preterm birth (occurring before 37 completed weeks of gestation) affects 15 million infants annually, 7.5% of which die due to related complications. The detection and early diagnosis are therefore paramount in order to prevent the development of prematurity and its consequences. So far, focus has been laid on the association between reduced intrauterine fetal growth during late gestation and prematurity. The aim of the current study was to investigate the association between accelerated fetal growth in early pregnancy and the risk of preterm birth. Methods: This prospective cohort study included 69 617 singleton pregnancies without congenital malformations and with available biometric measurements during the first and second trimester. Estimation of fetal growth was based on measurements of biparietal diameter (BPD) at first and second trimester scan. We investigated the association between accelerated fetal growth and preterm birth prior to 37 weeks of gestation. The outcome was further stratified into very preterm birth (before 32 weeks of gestation) or moderate preterm birth (between 32 and 37 weeks of gestation) and medically induced or spontaneous preterm birth and was further explored. Results: The odds of prematurity were increased among fetuses with accelerated BPD growth (> 90th centile) estimated between first and second ultrasound scan, even after adjustment for possible confounders (aOR 1.36; 95% CI 1.20-1.54). The findings remained significant what regards moderate preterm births but not earlier births. Regarding medically induced preterm birth, the odds were found to be elevated in the group of fetuses with accelerated growth in early pregnancy (aOR 1.34; 95% CI 1.11-1.63). On the contrary, fetuses with delayed fetal growth exhibited lower risk for both overall and spontaneous preterm birth.Conclusions: Fetuses with accelerated BPD growth in early pregnancy, detected by ultrasound examination during the second trimester, exhibited increased risk of being born preterm. The findings of the current study suggest that fetal growth in early pregnancy should be taken into account when assessing the likelihood for preterm birth.
Comparison of Curettage and Hysteroscopy Plus Curettage After Uterine Arterial Embolization in the Treatment of Cesarean Scar Pregnancy
Authors: Cao Lili , Qian Zhida , Huang Lili 
Published: July 2020

Abstract
Background: Caesarean scar pregnancy (CSP) stands for the advanced stage severe complication secondary to cesarean section, and its incidence shows an increasing trend recently. However, no consensus has been reached about the optimal CSP treatment. Methods: The childbearing CSP patients with a cesarean section history were evaluated by ultrasonography, with a gestational age of less than 10 weeks. 34 patients receiving dilation and curettage (D&C) and uterine artery embolization (UAE) were enrolled into the D&C group, while 46 undergoing hysteroscopy (H/S) and D&C after UAE were enrolled into the H/S+D&C group. Results: Differences in success rate and decrease in the β-hCG level in serum on the second day of surgery were not significant between D&C and H/S+D&C groups (P>0.05). Also, differences in side effect rate, intraoperative blood loss amount, postoperative bleeding time, and total length of stay were not significant between both groups (P>0.05). Compared with D&C group, H/S+D&C group had decreased postoperative length of stay (P<0.05), increased hospitalization cost (P<0.05), and significantly elevated time of CSP mass disappearance (P<0.05). In addition, 8 (18.19%) patients in H/S+D&C group developed anesthesia-related side effects.Conclusions:This study reveals no obvious difference between UAE+D&C and H/S+D&C in terms of the clinical efficacy and safety, except for the time of CSP mass disappearance. The hospitalization cost is more expensive for H/S+D&C, but the postoperative length of stay is shorter for H/S+D&C. Besides, H/S+D&C is associated with the risk of anesthesia-associated side effects. All these will affect the selection of patients for the two methods.
Longitudinal Change in Arterial Stiffness After Delivery in Women With Preeclampsia and Normotension: a Prospective Cohort Study
Authors: KIM Sehun , LIM Hyun Ja , KIM Jeung-Ran , OH Kung Joon , HONG Joon-Seok , Suh Jung-Won 
Published: July 2020

Abstract
BACKGROUND: Preeclampsia is associated with increased arterial stiffness during pregnancy. However, data on the longitudinal change in arterial stiffness after delivery in women with preeclampsia are lacking. We aimed to examine the longitudinal change in arterial stiffness after delivery in women with preeclamptic and normotensive pregnancies, using the cardio-ankle vascular index for assessment of arterial stiffness. METHODS: Pregnant women with preeclampsia (n=37) and normotension (n=36) who gave birth at Seoul National University Bundang Hospital between March 2013, and May 2016, were enrolled and followed up at day 1, 6 months, and 12 months after delivery. The longitudinal change in the cardio-ankle vascular index and other variables including blood pressure, lipid profiles, serum creatinine, liver enzymes were compared between the two groups using mixed-effect model, and interactions among the main predictors were examined. RESULTS: The longitudinal change in the cardio-ankle vascular index did not significantly differ between the two groups (β=0.11, 95% CI: -0.31 – 0.54, p=0.60). Predictors of the longitudinal change in the cardio-ankle vascular index included age, time since delivery, body mass index, and diabetes mellitus. Women with preeclampsia showed significantly elevated blood pressure, lipid profiles, serum creatinine, and liver enzymes compared to women with normotension over the course of one year of follow up. CONCLUSION: Preeclampsia is associated with unfavorable blood pressure and metabolic indices after delivery. However, there was no difference in the longitudinal change in arterial stiffness between women with preeclampsia and normotension over the course of one year after delivery.
Large Retrospective Cohort Study of the Association Between Maternal 25-Hydroxyvitamin D Status and Birth Weight of Neonate
Authors: Yu Li , Ke Hai-Jin , Che Di , Guo Yong , Wu Jie-Ling 
Published: July 2020

Abstract
Background: The effect of maternal vitamin D status on the birth weight of offspring is controversial as the results are inconsistent between different populations. This large retrospective cohort study aimed to assess the relationship between maternal vitamin D levels and birth weight of neonate. Methods: Serum samples were collected from 10,586 Chinese women in the 2 nd trimester of pregnancy, and the 25-hydroxyvitamin D [25(OH)D] level of the participants was assessed. Using the INTERGROWTH-21st standards, the offsprings were classified into three groups based on their gestational age and birth weight, which were as follows: small for gestational age (SGA), appropriate for gestational age (AGA), and large for gestational age (LGA). Results: The average maternal vitamin D concentration was 61.1 nmol/L. The 25(OH)D concentrations were <75.0, <50.0, and <25.0 nmol/L in 76.6%, 31.1%, and 1.6% of the participants, respectively. Approximately 6.4%, 86.4%, and 7.2% of women delivered SGA, AGA, and LGA infants, respectively. No significant differences were observed in vitamin D levels between the three groups (P = 0.562). With the increase in 25(OH)D levels, the risk of SGA and LGA tended to increase and decrease, respectively. However, the results were not precise. AGA was not affected by 25(OH)D levels. The results of the curve fitting and threshold effect analyses did not support the correlation between vitamin D levels and SGA or LGA. Based on the univariate prediction model and the model that adjusted for the risk factors, the area under the curve was extremely small. Thus, 25(OH)D level is not an effective predictor of SGA and LGA. Conclusions: Low maternal vitamin D levels were not associated with SGA or LGA.
A Consensus Time for Performing Quality Control of 225Ac-Labeled Radiopharmaceuticals
Authors: Kelly James M. , Amor-Coarasa Alejandro , Sweeney Elizabeth , Babich John 
Published: July 2020

Abstract
Background: As 225Ac-labeled radiopharmaceuticals continue to show promise as targeted alpha therapeutics, there is a growing need to standardize quality control (QC) testing procedures. The determination of radiochemical purity (RCP) is an essential QC test. A significant obstacle to RCP testing is the disruption of the secular equilibrium between actinium-225 and its daughter radionuclides during labeling and analysis. In order to accelerate translation of actinium-225 targeted alpha therapy, we aimed to determine the earliest time point at which the RCP of an 225Ac-labeled radiopharmaceutical can be accurately calculated.Results: Six ligands were conjugated to macrocyclic metal chelators and labeled with actinium-225 under conditions designed to generate diverse incorporation yields. RCP was determined by radio thin layer chromatography (radioTLC) followed by exposure of the TLC plate on a phosphor screen either 0.5, 2, 3.5, 5, 6.5, or 26 h after the plate was developed. The dataset was used to create models for predicting the true RCP using pre-equilibrium measurements at early time points. The 585 TLC measurements span RCP values of 1.8% to 99.5%. The statistical model created from these data predicted an independent data set with high accuracy. Predictions made at 0.5 h are more uncertain than predictions made at later time points. This is primarily due to the decay of bismuth-213. At 2 h the mean average error is < 3%. A measurement of RCP > 90% at this time point predicts a true RCP > 97%.Conclusions: RCP of 225Ac-labeled radiopharmaceuticals can be quantified with acceptable accuracy at least 2 h after radioTLC. This time point best balances the need to accurately quantify RCP with the need to safely release the batch as quickly as possible.
Autoantibody-negative insulin-dependent Diabetes after COVID-19
Authors: Hollstein Tim , Schulz Juliane , Glück Andreas , Schulte Dominik M , Schreiber Stefan , Bornstein Stefan R , Laudes Matthias 
Published: July 2020

Abstract
Here we report the manifestation of insulin dependent diabetes after a COVID-19 infection in the absence of typical autoantibodies for type 1 diabetes. A 19-year-old Caucasian male subject presented to our emergency department with diabetic ketoacidosis (DKA). C-peptide levels accounted to 0.62µg/L in the presence of blood glucose concentrations of 30.6 mmol/L (552 mg/dL). The patient´s case history revealed a COVID-19 disease 6-8 weeks prior to admission. This is of interest, since COVID-19 internalization into host cells is mediated via Angiotensin-converting enzyme 2 (ACE2) [1], a transmembrane glycoprotein which amongst others is crucial for β-cell homeostasis and function [2,3,4]. Detailed laboratory testing was performed, revealing no serum-antibodies against islet-cells (ICA), glutamic acid decarboxylase (GAD65-AA), tyrosine phosphatase (IA-2-AA), insulin (IAA) and zinc-transport-8 (ZnT8-AA), but against COVID-19. Hence, this is a presentation of an insulin-dependent diabetes mellitus in the absence of markers of autoimmunity, which might suggest direct cytolytic effects of COVID-19 on pancreatic β-cells presumably mediated via ACE2.
Ease and equity of access to free DR-TB services in Nigeria- a qualitative analysis of policies, structures and processes
Authors: Oga-Omenka Charity , Bada Florence , Agbaje Aderonke , Dakum Patrick , Menzies Dick , Zarowsky Christina 
Published: July 2020

Abstract
Introduction:
Persistent low rates of case notification and treatment coverage reflect that accessing diagnosis and treatment for drug-resistant tuberculosis (DR-TB) in Nigeria remains a challenge, even though it is provided free of charge to patients. Equity in health access requires availability of comparable, appropriate services to all, based on needs, and irrespective of socio-demographic characteristics. Our study analyzed elements that facilitate or hinder equitable access for different groups of patients within the current health system to support DR-TB management in Nigeria.
Methods:
We conducted documentary review of guidelines and workers manuals, as well as 29 qualitative interviews, including 5 focus group discussions, with a total of 86 participants, in Nigeria. Between August and November 2017, we interviewed patients who were on treatment, their treatment supporter, and providers in Ogun and Plateau States, as well as program managers in Benue and Abuja. We adapted and used Levesque’s patient-centered access to care framework to analyze DR-TB policy documents and interview data.
Results:
Thematic analysis revealed inequitable access to DR-TB care for some patient socio-demographic groups. While patients were mostly treated equally at the facility level, some patients experienced more difficulty accessing care based on their gender, age, occupation, educational level and religion. Health system factors including positive provider attitudes and financial support provided to the patients facilitated equity and ease of access. However, limited coverage and the absence of patients’ access rights protection and considerations in the treatment guidelines and workers manuals likely hampered access.
Conclusion:
In the context of Nigeria’s low case-finding and treatment coverage, applying an equity of access framework was necessary to highlight gaps in care. Differing social contexts of patients adversely affected their access to DR-TB care. We identified several strengths in DR-TB care delivery, including the current financial support that should be sustained. Our findings highlight the need for government’s commitment and continued interventions.
Development and Validation of Nomograms for Predicting Overall Survival and Cancer-Specific Survival in Patients with Ovarian Clear Cell Carcinoma
Authors: Chen Qian , Wang Shu , Lang Jing-he 
Published: July 2020

Abstract
Background
Ovarian clear cell carcinoma (OCCC) is a rare histologic type of ovarian cancer. There is a lack of useful prognostic predictive tool for OCCC in clinical work. This study aimed to construct and validate nomograms for predicting the overall survival (OS) and cancer-specific survival (CSS) in patients with OCCC.
Methods
Data of patients with primary diagnosed OCCC in the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2016 was extracted. Prognostic factors were evaluated with LASSO COX regression and multivariate Cox regression analysis, which were applied to construct nomograms. The performance of the nomogram models was assessed by concordance index (C-index), calibration plots, decision curve analysis (DCA) and risk subgroup classification. The Kaplan-Meier curves were plotted to compare survival outcomes between subgroups.
Results
A total of 1541 patients from SEER registries were randomly divided into a training cohort (n = 1079) and a validation cohort (n = 462). Age, laterality, stage, lymph node (LN) dissected, organ metastasis and chemotherapy were independently and significantly associated with OS, while laterality, stage, LN dissected, organ metastasis and chemotherapy were independent risk factors for CSS. Nomograms were developed for prediction of 3- and 5‐year OS and CSS. The C-indexes for OS and CSS were 0.802[95% confidence interval (CI) 0.773–0.831] and 0.802 (0.769–0.835), respectively, in the training cohort, while 0.746 (0.691–0.801) and 0.770 (0.721–0.819), respectively, in the validation cohort. Calibration plots illustrated favorable consistency between the nomogram predicted and actual survival. C-index and DCA curves also indicated better performance of nomogram than the AJCC staging system. Significant differences were observed in survival curves of different risk subgroups.
Conclusions
We constructed predictive nomograms and a risk classification system to evaluate the OS and CSS of OCCC patients. They were validated to be of satisfactory predictive value, and could aid in future clinical practice.
Monocyte Platelet Aggregates in Children with Kawasaki Disease- a Preliminary Study from a Tertiary Care Centre in North-West India
Authors: Vignesh Pandiarajan , Rawat Amit , Shandilya Jitendra Kumar , Sachdeva Man Updesh Singh , Ahluwalia Jasmina , Singh Surjit 
Published: July 2020

Abstract
Background:Platelet activation is an integral part of pathogenesis of Kawasaki disease (KD). However, there is paucity of literature on flow-cytometry based assessment of platelet activation in KD. We aimed to analyse monocyte-platelet aggregates (MPAs), one of the sensitive markers for platelet activation, by flow cytometry in children with Kawasaki disease (KD).Findings:In this single-centre prospective study, we have enrolled 14 children with KD and results were compared with age-matched febrile (n = 15) and healthy (n = 13) controls. After gating monocytes in side-scatter plot, MPAs were identified based on CD14 and CD41 expression. Two (2) ml of blood samples for children with KD were collected at 3 phases of illness- acute stage before start of intravenous immunoglobulin or aspirin, 24 hours after completion of IVIg infusion, and 3 months after acute episode of KD.Children with KD had a significantly higher MPA% values [Median (IQR)- 41.3% (26.6, 52.7)] when compared with febrile [Median (IQR)- 5.98% (2.98-9.72)] and normal [Median (IQR)- 4.48% (2.57-5.59)] controls, p<0.01. On follow-up, the MPA% showed a gradual decline in children with KD, but even at 3 months, the value [Median (IQR)- 7.55% (4.15-14.6)] was higher compared to healthy controls [Median (IQR)- 4.48% (2.57-5.59)].Conclusions:Our results suggest that MPA% was significantly elevated in acute stages in children with KD and activated platelets may continue to persist even after systemic inflammation has subsided. Future studies are warranted whether objective evidence of platelet activation may guide the use of immunomodulatory and anti-platelet therapy in KD.
Low-grade chronic inflammation is attenuated by exercise in obese adults through down-regulation of ASC gene: a pilot study
Authors: Barrón-Cabrera Elisa , González-Becerra Karina , Rosales-Chávez Gustavo , Mora-Jiménez Alondra , Hernández-Cañaveral Iván , Martinez-Lopez Erika 
Published: July 2020

Abstract
Background
Several factors are related to lifestyle behaviors, like physical inactivity and unbalanced diets, which increase the risk of developing obesity and thus represent an important health problem worldwide. Obesity is characterized by low-grade chronic inflammation and an excess of adipose tissue. The ASC protein is part of the NLRP3 inflammasome, a cytosolic multiprotein complex that is associated with inflammation and metabolic alterations.
Purpose
To evaluate the effect of a moderate-intensity structured exercise intervention on ASC gene expression and inflammatory markers in obese adults.
Methods
Thirty-seven obese individuals aged 25 to 50 years were randomized to the diet-exercise group or diet-group. The participants underwent a 4-month follow-up. Electrical bioimpedance was used for body composition analysis. Biochemical data were analyzed by dry chemistry and insulin levels by ELISA. Gene expression from peripheral blood was performed using real-time PCR. Dietary data was collected through questionnaires and analyzed using the Nutritionist Pro™ software. Quantification of cytokines was conducted using Bio-Plex Pro™ Human cytokine. The Astrand-Ryhming test was used to estimate the maximum oxygen volume and design the moderate-intensity structured exercise program.
Results
After the intervention, both study groups significantly improved body composition (decrease weight, fat mass, waist circumference and abdominal obesity, p < 0.05). Besides, the diet-exercise group significantly decreased ASC mRNA expression, MCP-1, and MIP-1β inflammatory cytokines compared to the diet-group (p < 0.05). While in the diet- group, MCP-1 and IL-8 exhibited significantly decreased levels (p < 0.05). In the diet-exercise group, a positive correlation between the atherogenic index and waist circumference was found (r = 0.822, p = 0.011), and a negative correlation was observed between the delta of ASC mRNA expression and IL-10 levels at the end of the intervention (r=-0.627, p = 0.019).
Conclusion
Low-grade chronic inflammation was attenuated through individualized exercise prescription and our findings highlight the role of the ASC gene in the inflammation of obese adults.
Selectional removal of the harmful gypsum weathering layer on the calcareous stone heritages
Authors: Liu Yan , Zhang Kun , Yang Fuwei 
Published: July 2020

Abstract
A novel method for the selectional removal of the harmful gypsum weathering layer on the calcareous stone heritages was studied. By this method, the gypsum weathering layer was cleared away and the carbonate substrate of the calcareous stone was left intact at the same time. The removal effect was evaluated by scanning electron microscopy with energy dispersive X-ray spectroscopy (SEM/EDX), X-ray diffraction (XRD), capillary suction and color difference measurement. This selectional removal method will be highly helpful for the conservation of the surface weathering calcareous stone relics.
18F-VUIIS1009B Features a Superior Imaging Performance to 18F-DPA-714 in TSPO Density Characterization for Neuroinflammatory PET Imaging
Authors: Huang Chen , Ding Fan , Hu Zhoumi , Wang Mengxin , Peng Wenxian , Li Wei , Wang Cheng , Tang Dewei 
Published: July 2020

Abstract
Purpose

Translocator protein (TSPO), an out-mitochondrial membrane protein, is regarded as a key biomarker for neuroinflammation in a variety of neurodegenerative diseases. In this study, we aim to evaluate two highly specific TSPO radiotracers 18F-VUIIS1009A and 18F-VUIIS1009B in a mild cerebral ischemic rat model, and to compare their in vivo performance to the well-established TSPO probe 18F-DPA-714 for neuroinflammation imaging. With multiple graphic analytical methods tested and macro parameters determined, we propose to find a suitable and best quantification method to profile neuroinflammation and measure TSPO density with the three TSPO radiotracers.
Methods

Cerebral ischemia rat model was created and imaged using 18F-VUIIS1009A, 18F-VUIIS1009B and 18F-DPA-714. Displacement studies using cold analogs were performed to evaluate the binding specificities of 18F-VUIIS1009A and 18F-VUIIS1009B individually. Imaging analysis using arterial plasma input functions (AIFs) was employed to generate Logan plots and parametric images of total distribution volume (VT) for each radiotracer. Reference Logan model using healthy brain as a reference region was introduced to generate parametric images for binding potential (BPND).
Results

When compared to 18F-DPA-714, 18F-VUIIS1009B demonstrated higher in vitro binding specificity, binding potential (BPND) and distribution volume ratio (DVR). Parameter images of BPND and VT also indicate 18F-VUIIS1009B has a superior imaging profile when compared with other two radiotracers in TSPO imaging. Correlation analysis between BPND for 18F-VUIIS1009B and 18F-DPA-714 also indicates 18F-VUIIS1009B is more sensitive than 18F-DPA-714 in TSPO density measurement.
Conclusions

This study demonstrates the superiority of 18F-VUIIS1009B to 18F-VUIIS1009A and 18F-DPA-714 in the neuroinflammation imaging. It also demonstrates that 18F-VUIIS1009B PET imaging coupled with parameter mapping (VT and BPND) and graphic analysis holds great promise for neuroinflammation characterization and TSPO density measurement.