bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prepregnancy Maternal Body Mass Index and Venous Thromboembolism: A Population-based Cohort Study
Authors: Butwick A.J. , Bentley J. , Leonard S.A. , Carmichael S.L. , El-Sayed Y.Y. , Stephansson O. , Guo N. 
Published: February 2020

(BJOG. 2019;126:581–588)
Obesity is a risk factor for pregnancy-related venous thromboembolism (VTE), a leading cause of maternal death. Recommendations for VTE prevention specific to maternal body mass index (BMI) are limited and inconsistent across various organizations such as the Royal College of Obstetricians and Gynecologists and the American College of Obstetricians and Gynecologists. The aim of this study was to examine the association between maternal BMI and pregnancy-related VTE.
Cardiac Structure and Function in Morbidly Obese Parturients: An Echocardiographic Study
Authors: Buddeberg B.S. , Fernandes N.L. , Vorster A. , Cupido B.J. , Lombard C.J. , Swanevelder J.L. , Girard T. , Dyer R.A. 
Published: February 2020

(Anesth Analg. 2019;129(2):444–449)
Obesity’s negative effects on cardiovascular health are well documented in the general adult population. However, little is known about the impact that obesity has on cardiovascular changes during pregnancy. The aim of this study was to compare cardiovascular health in morbidly obese pregnant women [body mass index (BMI) ≥40 kg/m2] versus pregnant women of normal body mass (BMI≤30 kg/m2).
Resting Hemodynamics and Response to Exercise Using the 6-Minute Walk Test in Late Pregnancy: An International Prospective Multicentre Study
Authors: Dennis A.T. , Salman M. , Paxton E. , Flint M. , Leeton L. , Roodt F. , Yentis S. , Dyer R.A. 
Published: February 2020

(Anesth Analg. 2019;129(2):450–457)
The 6-Minute Walk Test (6MWT) is a validated tool that has been used to assess cardiorespiratory reserve in the nonpregnant population. Tools to identify pregnant women who have developed or are at risk of developing cardiac disease is lacking. Early recognition of cardiac disease and its risk in the pregnant population can reduce maternal morbidity and mortality as well as complications during and after birth. The aim of this study is to establish reference intervals for resting heart rate (HR) and the 6MWT in healthy women in late pregnancy, and to determine the expected and actual ratings of perceived exertion and breathlessness during exercise.
Nifedipine Alone or Combined With Sildenafil Citrate for Management of Threatened Preterm Labour: A Randomized Trial
Authors: Maher M.A. , Sayyed T.M. , El-khadry S.W. 
Published: February 2020

(BJOG. 2019;126:729–735)
Threatened preterm labor (PTL) (between 20 and 37 wks’ gestation) can be postponed using tocolytic therapy to transfer the patient to a center with a neonatal intensive care unit (NICU) and/or administer corticosteroids for the prevention or management of respiratory morbidity. Nifedipine is a calcium channel blocker that has been shown to be more effective and safer than ritodrine for tocolytic therapy of threatened PTL. This study aimed to compare a combination of nifedipine and sildenafil citrate (SC), a selective inhibitor of cyclic guanosine monophosphate-specific phosphodiesterase-5, compared with nifedipine alone, in terms of tocolytic effects in PTL cases.
Association Between Apgar Scores of 7 to 9 and Neonatal Mortality and Morbidity: A Population-based Cohort Study of Term Infants in Sweden
Authors: Razaz N. , Cnattingius S. , Joseph K.S. 
Published: February 2020

(BMJ. 2019;365:l1656)
While low Apgar scores (<7) have been associated with increased risk of poor neonatal outcomes including mortality and morbidity, there have not been any investigations into whether the risks of these outcomes vary between normal Apgar scores of 7, 8, and 9 compared with a score of 10. This information could be useful in predicting the risk of conditions such as neonatal infection, respiratory distress, and hypoxic-ischemic encephalopathy, which have been associated with worse neurodevelopmental status later in childhood compared with children without these conditions. This population-based Swedish study examined the risks of neonatal mortality and morbidity associated with Apgar scores of 7, 8, and 9 (vs. 10) at 1, 5, and 10 minutes.
The Effect of Labor Epidural Analgesia on Breastfeeding Outcomes: A Prospective Observational Cohort Study in a Mixed-parity Cohort
Authors: Orbach-Zinger S. , Landau R. , Davis A. , Oved O. , Caspi L. , Fireman S. , Fein S. , Ioscovich A. , Bracco D. , Hoshen M. , Eidelman L.A. 
Published: February 2020

(Anesth Analg. 2019;129(3):784–791)
Breastfeeding is recommended by many international organizations and institutes because of its health benefits for the breastfed neonate as well as for the mother, and many efforts have been made to promote breastfeeding in the postnatal setting. Researchers have examined the relationship between labor epidural analgesia (LEA) and successful breastfeeding, but factors such as intent to breastfeed, past breastfeeding experience, and mothers’ working status have not been taken into account in prior studies. These investigators conducted this current study to investigate the influence of LEA on breastfeeding status at 6 weeks postpartum in a mixed parity cohort who delivered vaginally at an institution that encourages breastfeeding.
Preclinical Evaluation of Ropivacaine in 2 Liposomal Modified Systems
Authors: Rennó C.C. , Papini J.Z.B. , Cereda C.M.S. , Martinez E. , Montalli V.A. , de Paula E. , Pedrazzoli Júnior J. , Calafatti S.A. , Tofoli G.R. 
Published: February 2020

(Anesth Analg. 2019;129(2):387–396)
Postoperative pain management is a challenge, with only 1 in 4 surgical patients in the United States reporting adequate pain relief. This can lead to unwanted consequences, such as excessive analgesic use. The authors of this study recently developed new liposomal delivery models for ropivacaine (RVC), and they sought to assess these formulations for postoperative pain control in animal models.
Connective tissue growth factor as an unfavorable prognostic marker promotes the proliferation, migration, and invasion of gliomas
Authors: Song Zi-Bin , Yang Hui-Ping , Xu An-Qi , Zhan Zheng-Ming , Song Ye , Li Zhi-Yong 
Published: February 2020

Abstract

Background
In consideration of the difficulty in diagnosing high heterogeneous glioma, valuable prognostic markers are urgent to be investigated. This study aimed to verify that connective tissue growth factor (CTGF) is associated with the clinical prognosis of glioma, also to analyze the effect of CTGF on the biological function.

Methods
In this study, glioma and non-tumor tissue samples were obtained in 2012 to 2014 from the Department of Neurosurgery of Nanfang Hospital of Southern Medical University, Guangzhou, China. Based on messenger RNA (mRNA) data from the Cancer Genome Atlas (TCGA) and CCGA dataset, combined with related clinical information, we detected the expression of CTGF mRNA in glioma and assessed its effect on the prognosis of glioma patients. High expression of CTGF mRNA and protein in glioma were verified by reverse transcription-polymerase chain reaction, immunohistochemistry, and Western blotting. The role of CTGF in the proliferation, migration, and invasion of gliomas were respectively identified by methylthiazoletetrazolium assay, Transwell and Boyden assay in vitro. The effect on glioma cell circle was assessed by flow cytometry. For higher expression of CTGF in glioblastoma (GBM), the biological function of CTGF in GBM was investigated by gene ontology (GO) analysis.

Results
In depth analysis of TCGA data revealed that CTGF mRNA was highly expressed in glioma (GBM, n = 163; lowly proliferative glioma [LGG], n = 518; non-tumor brain tissue, n = 207; LGG, t = 2.410, GBM, t = 2.364, P
< 0.05). CTGF mRNA and protein expression in glioma (86%) was significantly higher than that in non-tumor tissues (18%) verified by collected samples. Glioma patients with higher expression of CTGF showed an obviously poorer overall survival (35.4 and 27.0 months compared to 63.3 and 55.1 months in TCGA and Chinese Glioma Genome Atlas (CGGA) databases separately, CGGA: χ
2 = 7.596, P = 0.0059; TCGA: χ
2 = 10.46, P = 0.0012). Inhibiting CTGF expression could significantly suppress the proliferation, migration, and invasion of gliomas. CTGF higher expression had been observed in GBM, and GO analysis demonstrated that the function of CTGF in GBM was mainly associated with metabolism and energy pathways (P < 0.001).

Conclusions
CTGF is highly expressed in glioma, especially GBM, as an unfavorable and independent prognostic marker for glioma patients and facilitates the progress of glioma.
Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) for Visual Rehabilitation in Limbal Stem Cell Deficiency
Authors: Kim Kyeong Hwan , Deloss Karen S. , Hood Christopher T. 
Published: February 2020

Objectives:
To evaluate the clinical outcomes of patients with limbal stem cell deficiency (LSCD) who were fitted with the Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) scleral device.

Methods:
In this retrospective, interventional case series, we reviewed the charts of 31 eyes of 19 consecutive patients clinically diagnosed with LSCD who were evaluated for the PROSE device. Clinical data were reviewed before PROSE evaluation and at the last available follow-up. The main outcomes measures were best-corrected distance visual acuity (CDVA) and modified ocular involvement score (OIS), graded using a previously described system for corneal findings.

Results:
Corrected distance visual acuity improved from 0.86±0.50 logarithm of the minimal angle of resolution (Snellen equivalent, 20/145) at baseline to 0.46±0.44 (Snellen equivalent, 20/58) with PROSE at the last follow-up (mean, 25.1±18.0 months; P<0.0001). In 27 eyes (87.1%) CDVA improved, with 22 eyes (71.0%) gaining 2 or more lines of Snellen acuity. When categorized by disease severity, CDVA improved in less severe eyes (stage 1) and more severe eyes (stage 2 or 3; P=0.049 and P=0.00009, respectively). Total OIS was not significantly different between baseline and last follow-up (P=0.754); however the epithelial defect score was significantly less (P=0.034). Twenty-four of 31 eyes (77.4%) continued wearing the PROSE device, with a mean daily wearing time of 10.0±4.6 hrs.

Conclusions:
In patients with LSCD, vision improved and the OIS remained stable with PROSE, suggesting that the device could be considered for visual rehabilitation in this population.
Ocular Surface Changes in Hashimoto's Thyroiditis Without Thyroid Ophthalmopathy
Authors: Altin Ekin Meryem , Karadeniz Ugurlu Seyda , Egrilmez Emine Deniz , Oruk Guzide Gonca 
Published: February 2020

Objective:
We sought to evaluate ocular surface changes in patients with Hashimoto's thyroiditis without thyroid ophthalmopathy and elucidate the relationship between dry eye syndrome and meibomian gland dysfunction (MGD) in cases of Hashimoto's thyroiditis.

Methods:
This prospective study included 105 patients with Hashimoto's thyroiditis and 105 age- and sex-matched controls. The 12-item Ocular Surface Disease Index (OSDI) questionnaire was administered to all patients. Both eyes affected by Hashimoto's thyroiditis and normal eyes were evaluated and compared with regard to the following parameters: Hertel exophthalmometry, palpebral fissure height, tear-film breakup time (TBUT), Schirmer 1 test, area and density scores for corneal fluorescein staining, eyelid abnormality, meibomian gland expression, meibography scores, and areas of meibomian gland loss.

Results:
The eyes affected by Hashimoto's thyroiditis demonstrated significantly lower TBUTs (P<0.001), Schirmer 1 test scores (P<0.001), and meibomian gland expression (P<0.05) and significantly higher OSDI scores (P<0.001), corneal fluorescein staining results (P<0.05), eyelid abnormality scores (P<0.05), meibography scores (P<0.05), and areas of meibomian gland loss (P<0.05). Ocular Surface Disease Index scores were significantly positively correlated with eyelid abnormality scores (P=0.025), meibography scores (P<0.05), and areas of meibomian gland loss (P<0.05) and negatively correlated with meibomian gland expression (P<0.05). The duration of Hashimoto's thyroiditis was significantly positively correlated with MGD (P<0.05).

Conclusion:
Dry eye syndrome and ocular discomfort symptoms are significantly more common among patients with Hashimoto's thyroiditis, even in the absence of thyroid ophthalmopathy. Dry eye syndrome in patients with Hashimoto's thyroiditis is believed to result from MGD and is correlated with the duration of the thyroid disease.
Potential Biomarkers for Allergic Conjunctival Diseases
Authors: Roy Neeta , Levanon Shir , Asbell Penny A. 
Published: February 2020

Abstract:
Allergic conjunctival diseases (ACDs) are a group of ocular allergies that include allergic conjunctivitis, atopic keratoconjunctivitis, vernal keratoconjunctivitis, and giant papillary conjunctivitis. Although a large body of information exists on the pathophysiology of ACDs, this has not yet lead to the development of clear recommendations and guidelines for the diagnosis of ACDs or development of conclusive and objective diagnostic tools. Identification of objectively measurable biomarkers that represent the molecular and cellular mechanisms associated with ACDs will be an important step toward achieving these aims. This is a comprehensive review of biological markers that have the potential to become “biomarker(s)” for ACDs and aid in the classification, diagnosis, and development of new therapeutic strategies for these group of allergic conditions.
Development of a Questionnaire for Detecting Changes in Dry Eye Disease–Related Symptoms
Authors: Pinto-Fraga José , Calonge Margarita , Enríquez-de-Salamanca Amalia , Fernández Itziar , González-García María J. , Steven Philipp 
Published: February 2020

Objectives:
Determining the changes in symptomatology suffered by dry eye disease (DED) patients after an intervention is difficult because there is only one validated questionnaire specifically designed to measure these changes and it is somewhat complex. This work uses a simplified questionnaire to evaluate the changes in DED-related symptoms.

Methods:
A new questionnaire based on a global rating of change scale was designed. The Change in Dry Eye Symptoms Questionnaire (CDES-Q) consists of 2 questions: CDES-Q1 asks for the change in symptoms (“better,” “same,” or “worse”) relative to a determined previous time and CDES-Q2 quantifies this change (range: 0 to +100). To evaluate the CDES-Q, a prospective observational study was performed. At baseline (V1; day-0), DED-related symptoms were evaluated using the ocular surface disease index (OSDI). In the post-treatment visit (V2; day-90), OSDI, Symptoms Assessment Questionnaire in Dry Eye (SANDE) II, and CDES-Q were used. Also, clinical evaluations were performed in each visit.

Results:
Thirty-six patients were included. At V2, OSDI, SANDE II, and CDES-Q showed a significant reduction in symptoms (−7.17±12.73, P=0.0021; −11.29±20.95, P=0.0035; −25.28±42.28, P=0.0011, respectively). Patients who answered “better” in CDES-Q1 showed a significantly lower SANDE II than those who answered “same” or “worse,” while SANDE II did not discriminate between these groups.

Conclusions:
CDES-Q can be a useful tool for the evaluation of changes in DED-related symptoms. It is simple and better discriminates patients without changes from those who suffered a worsening than SANDE II.
Epidemiology and Etiology of Severe Childhood Encephalitis in The Netherlands
Authors: de Blauw Dirkje , Bruning Andrea H.L. , Busch C.B.E , Kolodziej Lisa M. , Jansen N.J.G. , van Woensel J.B.M. , Pajkrt Dasja ,   for the Dutch Pediatric Encephalitis Study Group
Published: February 2020

Background:
Limited data are available on childhood encephalitis. Our study aimed to increase insight on clinical presentation, etiology, and clinical outcome of children with severe encephalitis in the Netherlands.

Methods:
We identified patients through the Dutch Pediatric Intensive Care Evaluation database and included children diagnosed with encephalitis <18 years of age admitted to 1 of the 8 pediatric intensive care units (PICU) in the Netherlands between January 2003 and December 2013. We analyzed demographic characteristics, clinical symptoms, neurologic imaging, etiology, treatment and mortality.

Results:
We included 121 children with a median age of 4.6 years (IQR 1.3–9.8). The most frequently described clinical features were headache (82.1%), decreased consciousness (79.8%) and seizures (69.8%). In 44.6% of the children, no causative agent was identified. Viral- and immune-mediated encephalitis were diagnosed in 33.1% and 10.7% of the patients. A herpes simplex virus infection (13.2%) was mainly seen in children <5 years of age, median age, 1.73 years (IQR 0.77–5.01), while immune-mediated encephalitis mostly affected older children, median age of 10.4 years (IQR, 3.72–14.18). An age of ≥ 5 years at initial presentation was associated with a lower mortality (OR 0.2 [CI 0.08–0.78]). The detection of a bacterial (OR 9.4 [CI 2.18–40.46]) or viral (OR 3.7 [CI 1.16–11.73]) pathogen was associated with a higher mortality.

Conclusions:
In almost half of the Dutch children presenting with severe encephalitis, a causative pathogen could not be identified, underlining the need for enhancement of microbiologic diagnostics. The detection of a bacterial or viral pathogen was associated with a higher mortality.
Physical Activity in Healthcare Workers With Low Back Pain
Authors: Bernardelli Giuseppina , Vigna Luisella , Nava Carlo , De Gennaro Colonna Vito , Andersen Lars L. , Consonni Dario , Riboldi Luciano 
Published: February 2020

Objective:
To evaluate the effects of physical activity program in healthcare workers with low back pain (LBP).

Methods:
A group of healthcare workers participated voluntarily to a meeting about LBP and to be accepted, were randomly allocated to workplace program or to home-based exercises, illustrated in a booklet and in a video available on the company intranet website. Both programs consisted in 7 weeks of moderate intensity exercises adapted to LBP.

Results:
Most outcomes improved in both groups, however with larger improvement of the Oswestry Disability Index in the workplace group (P = 0.02).

Conclusions:
Regular physical exercise, at home or at the workplace among healthcare workers with LBP, represents a great opportunity to improve health and reduce disability.
Cardiovascular Disease Risk Factor Changes Over 5 Years Among Male and Female US Firefighters
Authors: Smith Denise L. , Graham Elliot , Stewart Donald , Mathias Kevin C. 
Published: February 2020

Objective:
To examine changes in measures of cardiovascular health in male and female firefighters over 5 years.

Methods:
Anthropometrics and biomarkers of cardiovascular health from two occupational medical exams separated by 5 years (2009 to 2016) were examined from a cohort of US career firefighters in Virginia (males, n = 603; females, n = 69). Changes over time were tested using paired t-tests and McNemar's tests.

Results:
At baseline, 29% of males and 10% of females were obese. Body weight and body mass index significantly increased (P < 0.05) in males (2.5 ± 0.2 kg) (0.8 ± 0.1 kg·m–2) and females (2.5 ± 0.8 kg) (1.0 ± 0.3 kg·m–2) over the 5-year period. The prevalence of obesity, hypercholesterolemia, hypertensive medication usage, and high blood glucose significantly increased in males over the 5-year period.

Conclusions:
While improvements in blood pressure were observed, large percentages of firefighters, particularly males, had cardiovascular disease risk factors that increased over time.
The Effectiveness of bFGF in the Treatment of Tympanic Membrane Perforations: A Systematic Review and Meta-Analysis
Authors: Huang Juntao , Teh Bing Mei , Eikelboom Robert Henry , Han Liyuan , Xu Guodong , Yao Xu , Hu Yi , Zheng Minghao , Shen Yi 
Published: February 2020

Objective:
To investigate the effectiveness of basic fibroblast growth factor (bFGF) versus placebo or no intervention in the treatment of tympanic membrane (TM) perforations from randomized controlled trials (RCTs), prospective and retrospective studies.

Data Sources:
PubMed, EMBASE, and Cochrane databases were screened from their inceptions to June 2019.

Study Selection:
Inclusion criteria: 1) English language; 2) observational (retrospective or prospective) or treatment (RCT) studies; 3) reported the outcomes on the application of bFGF in adult or pediatric population. Exclusion criteria: 1) studies without a control group; 2) animal studies, in vitro studies, review studies, and case reports.

Data Extraction:
Number of patients, cause of TM perforation, perforation size, treatment, mean age, follow-up time, sex, closure rate, healing time, mean air-bone gap improvement.

Data Synthesis:
A total of 14 studies were included, including seven RCTs and seven non-RCTs with a total of 1,072 participants. The odds ratio for closure rate of bFGF treatment was 7.33 (95% confidence interval [CI], 4.65 to 11.53; p < 0.01; I

2
= 44%) and the standardized mean difference (SMD) for healing time was –5.89 (95% CI: –7.85 to –3.93, p < 0.01, I
2 = 98%), suggesting bFGF application has a significant effect on closure of TM perforations. However, no significant change in hearing (SMD: 0.08, 95% CI: –0.11 to 0.27, p = 0.39, I
2 = 0%) was seen as a result of bFGF treatment.

Conclusions:
Our meta-analysis has revealed that the application of bFGF can significantly enhance the closure rate as well as shorten the healing time for TM perforations. In terms of hearing, there is as yet no evidence that bFGF has a significant effect. Given its ease, availability, and safety, bFGF can be used effectively for TM repair.
Severity of Villous Atrophy at Diagnosis in Childhood Does Not Predict Long‐term Outcomes in Celiac Disease
Authors: Kröger Sofia , Kurppa Kalle , Repo Marleena , Huhtala Heini , Kaukinen Katri , Lindfors Katri , Arvola Taina , Kivelä Laura 
Published: February 2020

ABSTRACTObjectives:Current pediatric guidelines allow noninvasive diagnosis of celiac disease in selected children. We investigated in a large cohort study whether the severity of villous atrophy at diagnosis is associated with clinical characteristics or long‐term health outcomes, thus having a prognostic significance.Methods:Comprehensive medical data on 906 children with celiac disease were analyzed. Long‐term health outcomes of 503 adult patients diagnosed in childhood were moreover assessed with a specific study questionnaire and validated Gastrointestinal Symptom Rating Scale (GSRS) and Psychological General Well‐Being (PGWB) questionnaires. Patients were classified into 3 groups according to the severity of villous atrophy at diagnosis, and all variables were compared.Results:Altogether 34% of the patients had partial, 40% subtotal, and 26% total villous atrophy. Children with milder lesions were diagnosed more recently (median year 2007 vs 2006 vs 2001, respectively, P < 0.001), more often by screening (30% vs 25% vs 17%, P < 0.001) and they suffered less often from anemia (16% vs 21% vs 32%, P < 0.001) and growth disturbances (22% vs 36% vs 54%, P < 0.001) and had lower transglutaminase‐2 antibody levels (median 64 U/L vs 120 U/L vs 120 U/L, P < 0.001). There was no difference in other disease features.Altogether 212 adults diagnosed in childhood completed the questionnaires. Severity of villous atrophy at childhood diagnosis did not predict presence of complications or comorbidities, persistent symptoms, and self‐perceived health, quality of life or adherence to a gluten‐free diet in adulthood.Conclusion:Presence of advanced villous atrophy at diagnosis is associated with more severe clinical characteristics but not with poorer long‐term health and treatment outcomes.