bluuebunny/crossref_metadata_2025_split huggingface dataset:
Maternal caffeine consumption and pregnancy outcomes: a narrative review with implications for advice to mothers and mothers-to-be
Authors: James Jack E. 
Published: August 2020

ObjectivesCaffeine is a habit-forming substance consumed daily by the majority of pregnant women. Accordingly, it is important that women receive sound evidence-based advice about potential caffeine-related harm. This narrative review examines evidence of association between maternal caffeine consumption and negative pregnancy outcomes, and assesses whether current health advice concerning maternal caffeine consumption is soundly based.MethodsDatabase searches using terms linking caffeine and caffeinated beverages to pregnancy outcomes identified 1261 English language peer-reviewed articles. Screening yielded a total of 48 original observational studies and meta-analyses of maternal caffeine consumption published in the past two decades. The articles reported results for one or more of six major categories of negative pregnancy outcomes: miscarriage, stillbirth, low birth weight and/or small for gestational age, preterm birth, childhood acute leukaemia, and childhood overweight and obesity.ResultsOf 42 separate sets of findings reported in 37 observational studies, 32 indicated significantly increased caffeine-related risk and 10 suggested no or inconclusive associations. Caffeine-related increased risk was reported with moderate to high levels of consistency for all pregnancy outcomes except preterm birth. Of 11 studies reporting 17 meta-analyses, there was unanimity among 14 analyses in finding maternal caffeine consumption to be associated with increased risk for the four outcome categories of miscarriage, stillbirth, low birth weight and/or small for gestational age, and childhood acute leukaemia. The three remaining meta-analyses were also unanimous in reporting absence of a reliable association between maternal caffeine consumption and preterm birth. No meta-analyses were identified for childhood overweight and obesity, although four of five original observational studies reported significant associations linking maternal caffeine consumption to that outcome category.ConclusionsThe substantial majority finding from observational studies and meta-analyses is that maternal caffeine consumption is reliably associated with major negative pregnancy outcomes. Reported findings were robust to threats from potential confounding and misclassification. Among both observational studies and meta-analyses, there were frequent reports of significant dose–response associations suggestive of causation, and frequent reports of no threshold of consumption below which associations were absent. Consequently, current evidence does not support health advice that assumes "moderate" caffeine consumption during pregnancy is safe. On the contrary, the cumulative scientific evidence supports pregnant women and women contemplating pregnancy being advised to avoid caffeine.
May lamotrigine be an alternative to topiramate in the prevention of migraine with aura? Results of a retrospective study
Authors: Smeralda Carmelo Luca , Gigli Gian Luigi , Janes Francesco , Valente Mariarosaria 
Published: August 2020

BackgroundEvidence suggests that lamotrigine could be effective in reducing aura frequency and duration. However, studies comparing lamotrigine to other, first-line prophylactic agents solely involving patients suffering from migraine with aura are still lacking. The aim of this study was to compare the efficacy of lamotrigine and topiramate for the preventive treatment of migraine with aura.MethodsFifty-three patients suffering from migraine with aura treated with lamotrigine or topiramate for at least 6 months were included. Pre- and post-treatment clinical data regarding monthly aura frequency and duration, monthly migraine frequency, days of headache and rescue medication used per month were collected.ResultsResponder rates were similar between the two treatment groups at 6-month follow-up. Interestingly, responder rates for aura frequency and duration were higher in the lamotrigine group compared with the topiramate group (88% vs 79% and 73% vs 54%). Moreover, 50% of the lamotrigine-treated patients reported a complete disappearance of migraine aura compared with 37% of topiramate-treated patients. Side effects were more frequent in topiramate group compared with lamotrigine group (p=0.004).ConclusionsLamotrigine should be considered in clinical practice for the preventive treatment of migraine with aura especially for patients reporting prolonged aura and who do not respond, have contraindications or discontinue topiramate treatment due to side effects.
Burden of adult neurological diseases in Odeda Area, Southwest Nigeria
Authors: Otubogun Folajimi Morenikeji , Akinyemi Rufus , Ogunniyi Sola 
Published: August 2020

BackgroundFew population-based studies have been conducted to determine the burden of neurological diseases in sub-Saharan Africa. A better understanding of the magnitude and impact of these disorders is pivotal to effective planning and provision of neurological services.MethodsA cross-sectional survey of 2392 adults in Odeda Local Government Area, Ogun State, Southwest Nigeria was conducted between May and June 2015. Trained non-medical interviewers administered a screening instrument designed to measure the prevalence of neurological diseases and disability, while positive responders were subsequently examined by neurologists. Diagnoses were made clinically according to well-established criteria.ResultsThe mean age of respondents was 37.2±16.1 years. A total of 842 cases of neurological diseases/disability were diagnosed in 815 individuals (26 individuals with more than one disorder). The all-cause neurological morbidity rate was 352 per 1000, while the crude prevalence rates of common neurological disorders were 304.3 per 1000 for primary headaches, 16.3 per 1000 for tropical ataxic neuropathy, 7.11 per 1000 for stroke, 5.85 per 1000 for essential tremor and 4.18 per 1000 for Parkinson’s disease. Neurological years lost due to disability was 2806.18 per 100 000.ConclusionThis study provides evidence of a high neurological disease burden within the communities surveyed, which may be representative of Southwest Nigeria. In comparison with findings from previous studies within the same region, this report suggests a persistence of toxiconutritional disorders and postinfectious neurological sequelae on one hand and increased prevalence of non-communicable neurological disorders such as stroke and Parkinson’s disease.
Online contraceptive discussion forums: a qualitative study to explore information provision
Authors: Courtenay Tom , Baraitser Paula 
Published: August 2020

BackgroundWomen in the UK spend up to 30 years avoiding pregnancy, and effective use of contraception requires detailed information and support. Online forums offer opportunities to discuss contraception with few restrictions. Analysis of these discussions may generate learning on the information needs and preferences of their users. We analysed contraceptive discussions on forums to explore content, motivation for engaging, behaviours observed and outcomes reported.MethodsWe selected 50 threads across five English-speaking public forums, which contained more than 1000 contraceptive-specific threads. We generated a stratified sample of these threads (n=250) and then completed a qualitative thematic analysis.ResultsForum users seek urgent help, emotional support and the detailed accounts of others. The work of posting on forums is significant and includes framing the question to generate the desired response type, managing responses and assessing their value. Conversations were consistently framed in relation to healthcare and were important for preparing for, understanding and responding to consultations. Most of the technical information was accurate or corrected within the conversation. For most users this enquiry was part of a broader decision-making process and there was no evidence that users planned to make decisions based on forum discussions alone.ConclusionsOur analysis has implications for healthcare organisations that offer or signpost to online information on contraception. It suggests that improvements in the online ‘wrap around’ information are needed to help decide when to consult, prepare for the consultation, understand the information given and manage post-consultation questions.
A novel homozygous variant in TRAPPC2L results in a neurodevelopmental disorder and disrupts TRAPP complex function
Authors: Al-deri Noraldin , Okur Volkan , Ahimaz Priyanka , Milev Miroslav , Valivullah Zaheer , Hagen Jacob , Sheng Yufeng , Chung Wendy , Sacher Michael , Ganapathi Mythily 
Published: August 2020

BackgroundNext-generation sequencing has facilitated the diagnosis of neurodevelopmental disorders with variable and non-specific clinical findings. Recently, a homozygous missense p.(Asp37Tyr) variant in TRAPPC2L, a core subunit of TRAPP complexes which function as tethering factors during membrane trafficking, was reported in two unrelated individuals with neurodevelopmental delay, post-infectious encephalopathy-associated developmental arrest, tetraplegia and accompanying rhabdomyolysis.MethodsWe performed whole genome sequencing on members of an Ashkenazi Jewish pedigree to identify the underlying genetic aetiology of global developmental delay/intellectual disability in three affected siblings. To assess the effect of the identified TRAPPC2L variant, we performed biochemical and cell biological functional studies on the TRAPPC2L protein.ResultsA rare homozygous predicted deleterious missense variant, p.(Ala2Gly), in TRAPPC2L was identified in the affected siblings and it segregated with the neurodevelopmental phenotype within the family. Using a yeast two-hybrid assay and in vitro binding, we demonstrate that the p.(Ala2Gly) variant, but not the p.(Asp37Tyr) variant, disrupted the interaction between TRAPPC2L and another core TRAPP protein, TRAPPC6a. Size exclusion chromatography suggested that this variant affects the assembly of TRAPP complexes. Employing two different membrane trafficking assays using fibroblasts from one of the affected siblings, we found a delay in traffic into and out of the Golgi. Similar to the p.(Asp37Tyr) variant, the p.(Ala2Gly) variant resulted in an increase in the levels of active RAB11.ConclusionOur data fill in a gap in the knowledge of TRAPP architecture with TRAPPC2L interacting with TRAPPC6a, positioning it as a putative adaptor for other TRAPP subunits. Collectively, our findings support the pathogenicity of the TRAPPC2L p.(Ala2Gly) variant.
Control, trust and the sharing of health information: the limits of trust
Authors: Holm Soren , Kristiansen Thomas Birk , Ploug Thomas 
Published: August 2020

Clinical information about patients is increasingly being stored in electronic form and has therefore become more easily shareable. Data are collected as part of clinical care but have multiple other potential uses in relation to health system planning, audit and research. The use of clinical information for these secondary uses is controversial, and the ability to safeguard personal and sensitive data under current practices is contested.In this study, we investigate the attitudes of a representative sample of the Danish population towards transfer of clinical data from their general practice for secondary use. We specifically study: (1) patients’ trust in different types of healthcare professionals, (2) their interest in being asked about secondary use of data and (3) their willingness to dispense from a requirement of informed consent based on their trust in healthcare professionals.We find that adult Danes are positive towards research that use patient data, and they generally trust general practitioners, hospitals and researchers to treat their data confidentially.Nevertheless, they feel that they have a right to control the use of their data, only 7.3% disagreeing, and that the data belong to them, only 14.0% disagreeing. Answers to further questions about the relation between trust, information and consent show that although trust modifies the wish for information and consent, there is still a strong view that the patient should control the use of data. We find no differences between those who have frequent contact with the healthcare system and those who do not.
International experience of mechanical thrombectomy during the COVID-19 pandemic: insights from STAR and ENRG
Authors: Al Kasab Sami , Almallouhi Eyad , Alawieh Ali , Levitt Michael R , Jabbour Pascal , Sweid Ahmad , Starke Robert M , Saini Vasu , Wolfe Stacey Q , Fargen Kyle M , Arthur Adam S , Goyal Nitin , Pandhi Abhi , Fragata Isabel , Maier Ilko , Matouk Charles , Grossberg Jonathan A , Howard Brian M , Kan Peter , Hafeez Muhammad , Schirmer Clemens M , Crowley R Webster , Joshi Krishna C , Tjoumakaris Stavropoula I , Chowdry Shakeel , Ares William , Ogilvy Christopher , Gomez-Paz Santiago , Rai Ansaar T. , Mokin Maxim , Guerrero Waldo , Park Min S , Mascitelli Justin R , Yoo Albert , Williamson Richard , Grande Andrew Walker , Crosa Roberto Javier , Webb Sharon , Psychogios Marios N , Ducruet Andrew F , Holmstedt Christine A , Ringer Andrew J , Spiotta Alejandro M 
Published: August 2020

BackgroundIn response to the COVID-19 pandemic, many centers altered stroke triage protocols for the protection of their providers. However, the effect of workflow changes on stroke patients receiving mechanical thrombectomy (MT) has not been systematically studied.MethodsA prospective international study was launched at the initiation of the COVID-19 pandemic. All included centers participated in the Stroke Thrombectomy and Aneurysm Registry (STAR) and Endovascular Neurosurgery Research Group (ENRG). Data was collected during the peak months of the COVID-19 surge at each site. Collected data included patient and disease characteristics. A generalized linear model with logit link function was used to estimate the effect of general anesthesia (GA) on in-hospital mortality and discharge outcome controlling for confounders.Results458 patients and 28 centers were included from North America, South America, and Europe. Five centers were in high-COVID burden counties (HCC) in which 9/104 (8.7%) of patients were positive for COVID-19 compared with 4/354 (1.1%) in low-COVID burden counties (LCC) (P<0.001). 241 patients underwent pre-procedure GA. Compared with patients treated awake, GA patients had longer door to reperfusion time (138 vs 100 min, P=<0.001). On multivariate analysis, GA was associated with higher probability of in-hospital mortality (RR 1.871, P=0.029) and lower probability of functional independence at discharge (RR 0.53, P=0.015).ConclusionWe observed a low rate of COVID-19 infection among stroke patients undergoing MT in LCC. Overall, more than half of the patients underwent intubation prior to MT, leading to prolonged door to reperfusion time, higher in-hospital mortality, and lower likelihood of functional independence at discharge.
Efficacy and safety of iron therapy in patients with chronic heart failure and iron deficiency: a systematic review and meta-analysis based on 15 randomised controlled trials
Authors: Zhang Junyi , Hu Shengda , Jiang Yufeng , Zhou Yafeng 
Published: August 2020

AbstractTrials studying iron administration in patients with chronic heart failure (CHF) and iron deficiency (ID) have sprung up these years but the results remain inconsistent. The aim of this meta-analysis was to comprehensively evaluate the efficacy and safety of iron therapy in patients with CHF and ID. A literature search was conducted across PubMed, Embase, Cochrane Library, OVID and Web of Science up to 31 July 2019 to search for randomised controlled trials (RCT) comparing iron therapy with placebo in CHF with ID, regardless of presence of anaemia. Published studies reporting data of any of the following outcomes were included: all-cause death, cardiovascular hospitalisation, adverse events, New York Heart Association (NYHA) functional class, left ventricular ejection fraction (LVEF), N-terminal pro b-type natriuretic peptide, peak oxygen consumption, 6 min walking test (6MWT) distance and quality of life (QoL) parameters. 15 RCTs with a total of 1627 patients (911 in iron therapy and 716 in control) were included. Iron therapy was demonstrated to reduce the risk of cardiovascular hospitalisation (OR 0.35, 95% CI 0.12 to 0.99, p=0.049), but was ineffective in reducing all-cause death (OR 0.59, 95% CI 0.33 to 1.06, p=0.078) or cardiovascular death (OR 0.80, 95% CI 0.39 to 1.63, p=0.540). Iron therapy resulted in a reduction in NYHA class (mean difference (MD) −0.73, 95% CI −0.99 to −0.47, p&lt;0.001), an increase in LVEF (MD +4.35, 95% CI 0.69 to 8.00, p=0.020), 6MWT distance (MD +35.44, 95% CI 11.55 to 59.33, p=0.004) and an improvement in QoL: EQ-5D score (MD +4.07, 95% CI 0.84 to 7.31, p=0.014); Minnesota Living With Heart Failure Questionnaire score (MD −19.47, 95% CI −23.36 to −15.59, p&lt;0.001) and Patients Global Assessment (PGA) scale (MD 0.71, 95% CI 0.32 to 1.10, p&lt;0.001). There was no significant difference in adverse events or serious adverse events between iron treatment group and control group. Iron therapy reduces cardiovascular hospitalisation in patients with CHF with ID, and additionally improves cardiac function, exercise capacity and QoL in patients with CHF with ID and anaemia, without an increase of adverse events.
Short-term outcome of local pancreatic complications in a public hospital from North India
Authors: Kumar Ashok , Gupta Monica , Kochhar Suman , Singh Ram , Lehl Sarabmeet S 
Published: August 2020

ABSTRACTIntroductionDearth in the literature pertaining to natural history of acute pancreatitis (AP) necessitates further studies to evaluate the outcome of local pancreatic complications using the revised Atlanta classification.ObjectiveTo evaluate the outcomes of local pancreatic complications after first episode of AP, risk factors for their development and predictors of need for intervention.MethodologyA prospective study was carried out on 50 consecutive cases of AP who developed local pancreatic complications from January 2015 to July 2016. After imaging, they were categorised into acute pancreatic fluid collection (APFC) and acute necrotic collection (ANC). The risk factors for their development and the need for intervention were assessed.ResultsOf 50 patients, 20 developed APFC and 30 ANC. Of ANC cases, 27 progressed into walled-off necrosis (WON), of which 4 were managed conservatively and 18 collections were drained percutaneously, 3 underwent endotherapy (transmural drainage and endoscopic necrosectomy) and 2 died following percutaneous drainage (PCD) and surgery. Ten WON collections persisted at the end of 3rd month. Collections resolved in 6 of 20 APFC patients, 14 formed pseudocysts, of which 10 showed resolution with or without intervention and only 4 of them persisted at the end of study. Size of collection ≥6 cm was independent predictor of intervention irrespective of type of collections while in cases of ANC, extensive necrosis (&gt;30%) and multiple collections were more likely to require intervention.ConclusionIncidence of ANC is more common than APFC when local pancreatic fluid collections develop most of which develop WON and require intervention.
Discrepancies in the Brazilian tobacco production chain: raw inputs, international trade and legal cigarette production
Authors: Ribeiro Livio Santos de Leite , Pinto Vilma da Conceição 
Published: August 2020

BackgroundThe significant market share of illicit cigarettes in Brazil is well established in the literature, nonetheless lacking clarity in terms of its actual size. Paraguay has a paramount role in this discussion, acting both as a supplier of illegal tobacco products to Brazil and as buyer of inputs from Brazil. A proper analysis of the illicit cigarette market in Brazil necessarily involves a deeper discussion of the Paraguayan production chain and its interaction with the Brazilian market.MethodsInternational data were used to establish the bilateral legal trade pattern of tobacco-related products between Paraguay and Brazil, including inputs and final outputs. Inspired by the technical requirements methodology, available unmanufactured tobacco within Brazil was obtained by adding-up domestic production with net imports. Its historical behaviour was compared with legal cigarette production patterns within Brazil. Supposing rational agents, these two links of the Brazilian cigarette production chain should behave similarly: for lower final usage, less domestically available supply. Any discrepancies would suggest something abnormal in the production chain.ResultsBrazil is a relevant legal supplier of intermediate goods for the Paraguayan tobacco complex and has an irrelevant position as legal buyer of Paraguayan tobacco-related goods (either inputs or final goods). Paraguayan net imports of production inputs seem to be abnormally high for their legal needs. In Brazil, a clear discrepancy between domestically available unmanufactured tobacco (input) and tax-based cigarette production (output) emerged throughout the years and, even more striking, has been growing over the years.ConclusionsExcessive cigarette production inputs in Paraguay suggest a potential oversupply of cigarettes in that country—likely diverted to illicit trade. Likewise, discrepancies in the Brazilian tobacco production chain are also evidence of illicit tobacco trading in Brazil—not necessarily of final products. A deeper analysis of the Brazil/Paraguay tobacco supply chain would be welcomed given the likely operation of these two countries as a single ‘production/consumption hub’ of both legal and illegal products (either inputs or final tobacco products). Public policies should foster controls not only on cigarettes but also on raw inputs for their production.
Triple-pomeron amplitude in the effective action approach
Authors: Braun M. A. 
Published: August 2020

AbstractIn the effective action approach the imaginary part of the triple pomeron amplitude is calculated. The found dependence on the longitudinal momentum transfer $$e_{-}$$e- is found to separate as a simple factor $$1/|e_{-}|$$1/|e-|. This result is used to calculate the high-mass diffraction on a hadron and double scattering cross-section off a composite target.
A study on the phase transformation of BCuAl9Fe4 alloy
Authors: Vu Anh Tuan , Nguyen Duong Nam , Mai Ba Linh , Mai Khanh Pham 
Published: August 2020

This paper’s aim is to describe the results of the phase transformation of BCuAl9Fe4 alloy after casting, quenching and aging. After casting, the microstructure of this alloy consists of [Formula: see text] phase with grain size about 100 [Formula: see text]m, mixture [Formula: see text] and the inter-metallic phase Fe3Al. However, the proportion of the [Formula: see text] phase in the casting alloy is coarse. The alloy was heated at [Formula: see text]C for 2 h then quickly cooling in water. After quenching, the microstructure of alloy shows that the grain size reduced to about 40 [Formula: see text]m. After quenching, the alloy was aged at [Formula: see text]C for 2 h, the martensite phase of this alloy decomposed into order phase ([Formula: see text] with fine grain size, dispersed in the matrix. The intermetallic phase was fine and evenly dispersed in the matrix. By TEM analysis, after heat treatment, the structure of martensite and the inter-metallic phase in this alloy which had small grain size were formed.