bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of TPOAb-negative maternal subclinical hypothyroidism in early pregnancy on adverse pregnancy outcomes
Authors: Zhu Ping , Chu Ruifeng , Pan Shilei , Lai Xiaolan , Ran Jianmin , Li Xiuhong 
Published: October 2021

Purpose: To investigate the effect of subclinical hypothyroidism on pregnancy outcomes of women early in their pregnancy with different thyroid-stimulating hormone levels and thyroid peroxidase antibody–negative status and to explore reasonable thyroid-stimulating hormone levels for subclinical hypothyroidism in early pregnancy. Methods: A total of 2378 women early in their pregnancy were studied retrospectively. The baseline characteristics were collected from medical records. Pregnancy outcomes were compared between the euthyroidism and subclinical hypothyroidism groups that were diagnosed by 2011 or 2017 American Thyroid Association guidelines. In addition, the effect of different maternal thyroid-stimulating hormone levels on adverse pregnancy outcomes was analyzed using binary logistic regression. Results: According to the 2011 American Thyroid Association diagnostic criteria of subclinical hypothyroidism, the prevalence of pregnancy outcomes was not significantly higher in the subclinical hypothyroidism group than in the euthyroidism group. However, pregnant women with subclinical hypothyroidism identified by the 2017 American Thyroid Association criteria had a higher risk of premature delivery (odds ratio = 3.93; 95% confidence interval = 1.22–12.64), gestational diabetes mellitus (odds ratio = 2.69; 95% confidence interval = 1.36–5.32), and gestational anemia (odds ratio = 3.28; 95% confidence interval = 1.60–6.75). Moreover, no differences in the prevalence of adverse pregnancy outcomes were observed between the mildly elevated thyroid-stimulating hormone group (2.5 < thyroid-stimulating hormone ⩽4.0 mIU/l) and the normal thyroid-stimulating hormone group (0.27 < thyroid-stimulating hormone ⩽2.5 mIU/l). The significantly elevated thyroid-stimulating hormone group (4.0 < thyroid-stimulating hormone < 10.0 mIU/l) had a higher prevalence of premature delivery, gestational diabetes mellitus, and gestational anemia than the normal thyroid-stimulating hormone group, even after controlling for potential confounding factors. Conclusion: A mildly elevated thyroid-stimulating hormone level or maternal subclinical hypothyroidism diagnosed by 2011 American Thyroid Association guidelines during early pregnancy in thyroid peroxidase antibody–negative women was not associated with adverse pregnancy outcomes. However, maternal subclinical hypothyroidism identified by the 2017 American Thyroid Association guidelines increased the risks of several adverse pregnancy outcomes in women untreated with levothyroxine. The 2017 American Thyroid Association guidelines could be more reasonable for the diagnosis of subclinical hypothyroidism in southern China.
Hepatitis C outreach project and cross-sectional epidemiology in high-risk populations in Trondheim, Norway
Authors: Hannula Raisa , Söderholm Jonas , Svendsen Therese , Skaland Maja , Nordbø Svein A. , Steinum Harald , Damås Jan K. 
Published: October 2021

Background: Hepatitis C is highly prevalent among people who use drugs (PWUD), and the hepatitis C virus (HCV) epidemic is less characterised in Norway. The aims of the study were to assess the prevalence and treatment willingness in high-risk populations by reaching out to frequently visited sites for high-risk populations. Methods: Individuals from high-risk populations were included from September 2015 to March 2017. Two dedicated study nurses frequently visited the local opioid substitution clinic, outpatient clinics, PWUD day centres, local prison, and refugee centre in Trondheim, Norway. Demographic data, risk behaviour, and clinical symptoms were obtained by study questionnaire. Subjects with anti-HCV+ rapid test were subsequently tested for HCV RNA and genotyped. Viraemic patients were offered referral for HCV treatment evaluation. Results: A total of 381 participants were included in the study: 52 immigrants, 62 prisoners, and 267 PWUD. The anti-HCV prevalence rates were 0% ( n = 0) in immigrants, 40% ( n = 25) in prisoners, and 61% ( n = 164) in PWUD, with 24% ( n = 15) of prisoners and 42% ( n = 108) of PWUD being viraemic. Of those qualifying for treatment ( n = 31), 30 wished to be evaluated. Conclusion: This study showed high HCV prevalence in prisoners and PWUD and that infected high-risk patients were interested in treatment evaluation.
A bird in the hand is better than two in the bush: Investigating the relationship between financial slack and profitability in business groups
Authors: Lefebvre Vivien 
Published: October 2021

Using arguments from the behavioral theory of the firm, agency theory, and the literature on internal capital markets, this article investigates the relationship between financial slack and firms’ profitability in standalone versus business group–affiliated firms. Using a large sample of French privately held firms, we show that there is a quadratic, inverse U-shape relationship between financial slack and profitability for privately held firms. We observe that the relation is steeper for business group affiliated firms than for standalone firms, which is consistent with the idea that firms in business groups are in competition for the business groups resources. Moreover, we explore whether business groups characteristics and position and weight of a given affiliated firm in the business group organization influence the impact of financial slack on profitability. Our results show that for firms that are closest to the business group head firm and that have a higher weight in the business groups, the quadratic, inverse U-shaped relationship is steeper. These findings suggest that the bargaining power that firms have in business groups plays an important role in explaining the relation between financial slack and profitability. JEL CLASSIFICATION: G32, L22 and L25.
Ambidexterity in micro and small firms: Can competitive intelligence compensate for size constraints?
Authors: Boronat-Navarro Montserrat , Escribá-Esteve Alejandro , Navarro-Campos Jesús 
Published: October 2021

Ambidexterity has been linked to firm structures that are typical of organizations with a larger size. However, further research is needed to analyze whether the effect of firm size on ambidexterity is contingent on other aspects. We argue that micro and small firms that have developed some competitive intelligence routines (CIRs) may foster ambidextrous behavior and compensate for the limitations arising from a smaller size and lack of resources. We test our proposal on a sample of 200 firms in the furniture sector. Our results show that CIRs compensate for size constraints in that size is no longer a relevant variable to increase ambidextrous behavior in firms that achieve higher levels in these routines. Our results provide new and important insights into how ambidexterity may be fostered in small firms that lack resource slack or the ability to use separate units to develop knowledge exploration and exploitation activities. JEL CLASSIFICATION: M10, M21, O3
CPX-351 induces remission in newly diagnosed pediatric secondary myeloid malignancies
Authors: Hu Yixin , Caldwell Kenneth J. , Onciu Mihaela , Federico Sara M. , Salek Marta , Lewis Sara , Lei Shaohua , Zhang Jinghui , Nichols Kim E. , Takemoto Clifford M. , Triplett Brandon M. , Farrar Jason E. , Rubnitz Jeffrey E. , Ribeiro Raul C. , Wlodarski Marcin W. 
Published: October 2021

AbstractSecondary myelodysplastic syndromes and acute myeloid leukemia (sMDS/AML) are rare in children and adolescents and have a dismal prognosis. The mainstay therapy is hematopoietic cell transplantation (HCT), but there has been no innovation in cytoreductive regimens. CP X-351, a fixed 5:1 molar ratio of liposomal cytarabine to daunorubicin, has shown favorable safety and efficacy in elderly individuals with secondary AML and children with relapsed de novo AML. We report the outcomes of 7 young patients (6 with newly diagnosed sMDS/AML and 1 with primary MDS/AML) uniformly treated with CP X-351. Five patients had previously received chemotherapy for osteosarcoma, Ewing sarcoma, neuroblastoma, or T-cell acute lymphoblastic leukemia; 1 had predisposing genomic instability disorder (Cornelia de Lange syndrome) and 1 had MDS-related AML and multiorgan failure. The median age at diagnosis of myeloid malignancy was 17 years (range, 13-23 years). Patients received 1 to 3 cycles of CP X-351 (cytarabine 100 mg/m2 plus daunorubicin 44 mg/m2) on days 1, 3, and 5, resulting in complete morphologic remission without overt toxicity or treatment-related mortality. This approach allowed for adding an FLT3 inhibitor as individualized therapy in 1 patient. Six patients were alive and leukemia-free at 0.5 to 3.3 years after HCT. One patient died as a result of disease progression before HCT. To summarize, CP X-351 is an effective and well-tolerated regimen for cytoreduction in pediatric sMDS/AML that warrants prospective studies.
Benefits and risks of bronchoalveolar lavage in severe asthma in children
Authors: Ben Tkhayat Raja , Taytard Jessica , Corvol Harriet , Berdah Laura , Prévost Blandine , Just Jocelyne , Nathan Nadia 
Published: October 2021

BackgroundAlthough bronchoscopy can be part of the exploration of severe asthma in children, the benefit of bronchoalveolar lavage (BAL) is unknown. The present study aimed to decipher whether systematic BAL during a flexible bronchoscopy procedure could better specify the characteristics of severe asthma and improve asthma management.Material and methodsThe study took place in two departments of a university hospital in Paris. Children who underwent flexible bronchoscopy for the exploration of severe asthma between April 2017 and September 2019 were retrospectively included.ResultsIn total, 203 children were included, among whom 107 had a BAL. BAL cell count was normal in most cases, with an increasing number of eosinophils with age, independently from the atopic status of the patients. Compared with bronchial aspiration only, BAL increased the rate of identified bacterial infection by 1.5. Nonatopic patients had more bacterial infections (p<0.001). BAL induced a therapeutic modification only for azithromycin and omalizumab prescriptions. The practice of a BAL decreased bronchoscopy tolerance (p=0.037), especially in the presence of tracheobronchial malacia (p<0.01) and when performed in a symptomatic patient (p=0.019).Discussion and conclusionAlthough BAL may provide interesting information in characterising severe asthma, in most cases its impact on the patient's management remains limited. Moreover, BAL can be poorly tolerated and should be avoided in the case of tracheobronchial malacia or current asthma symptoms.
Family planning, pregnancy and birth in women with lung conditions: a worldwide survey
Authors: Williams Clare , Johnson Barbara , Middleton Peter G. , Backer Vibeke , Gibson Peter G. , Hollis Gill , Coleman Courtney 
Published: October 2021

Lung diseases can complicate pregnancy, but little is known about the experiences of pregnancy among women living with such diseases. This survey aimed to understand the experiences of women with a lung condition before and during pregnancy, in childbirth and post-partum.
The survey was translated into nine languages and hosted online between March and May 2018. This paper reports on 327 women who had asthma, cystic fibrosis (CF), lymphangioleiomyomatosis (LAM) and sarcoidosis as a sole or primary lung condition.
Women with CF and LAM were most likely to report that their condition influenced their decision to have children. Those with CF and LAM who did become pregnant reported greater satisfaction with their healthcare during pregnancy and gave more consideration to factors such as location and type of birth; they were also more concerned about the impact of the pregnancy on their health than women with other diseases. Women with sarcoidosis reported receiving conflicting advice as to both the impact of their condition on pregnancy and how becoming pregnant might impact their health. Women with asthma reported not always being able to access the information they needed from healthcare professionals.
The results suggest that healthcare providers should be having dialogues with affected women early on, from before conception, throughout the pregnancy and after giving birth, and training should be provided to healthcare staff to equip them with the information they need to do this.
Factors for severe outcomes following SARS-CoV-2 infection in people with cystic fibrosis in Europe
Authors: Jung Andreas , Orenti Annalisa , Dunlevy Fiona , Aleksejeva Elina , Bakkeheim Egil , Bobrovnichy Vladimir , Carr Siobhán B. , Colombo Carla , Corvol Harriet , Cosgriff Rebecca , Daneau Géraldine , Dogru Deniz , Drevinek Pavel , Vukic Andrea Dugac , Fajac Isabelle , Fox Alice , Fustik Stojka , Gulmans Vincent , Harutyunyan Satenik , Hatziagorou Elpis , Kasmi Irena , Kayserová Hana , Kondratyeva Elena , Krivec Uroš , Makukh Halyna , Malakauskas Kestutis , McKone Edward F. , Mei-Zahav Meir , de Monestrol Isabelle , Olesen Hanne Vebert , Padoan Rita , Parulava Tsitsino , Pastor-Vivero Maria Dolores , Pereira Luísa , Petrova Guergana , Pfleger Andreas , Pop Liviu , van Rens Jacqui G. , Rodic´ Milan , Schlesser Marc , Storms Valérie , Turcu Oxana , Woz´niacki Lukasz , Yiallouros Panayiotis , Zolin Anna , Downey Damian G. , Naehrlich Lutz 
Published: October 2021

BackgroundSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in people with cystic fibrosis (pwCF) can lead to severe outcomes.MethodsIn this observational study, the European Cystic Fibrosis Society Patient Registry collected data on pwCF and SARS-CoV-2 infection to estimate incidence, describe clinical presentation and investigate factors associated with severe outcomes using multivariable analysis.ResultsUp to December 31, 2020, 26 countries reported information on 828 pwCF and SARS-CoV-2 infection. Incidence was 17.2 per 1000 pwCF (95% CI: 16.0–18.4). Median age was 24 years, 48.4% were male and 9.4% had lung transplants. SARS-CoV-2 incidence was higher in lung-transplanted (28.6; 95% CI: 22.7–35.5)versusnon-lung-transplanted pwCF (16.6; 95% CI: 15.4–17.8) (p≤0.001).SARS-CoV-2 infection caused symptomatic illness in 75.7%. Factors associated with symptomatic SARS-CoV-2 infection were age >40 years, at least one F508del mutation and pancreatic insufficiency.Overall, 23.7% of pwCF were admitted to hospital, 2.5% of those to intensive care, and regretfully 11 (1.4%) died. Hospitalisation, oxygen therapy, intensive care, respiratory support and death were 2- to 6-fold more frequent in lung-transplantedversusnon-lung-transplanted pwCF.Factors associated with hospitalisation and oxygen therapy were lung transplantation, cystic fibrosis-related diabetes (CFRD), moderate or severe lung disease and azithromycin use (often considered a surrogate marker forPseudomonas aeruginosainfection and poorer lung function).ConclusionSARS-CoV-2 infection yielded high morbidity and hospitalisation in pwCF. PwCF with forced expiratory volume in 1 s <70% predicted, CFRD and those with lung transplants are at particular risk of more severe outcomes.
Agreement of the modified Medical Research Council and New York Heart Association scales for assessing the impact of self-rated breathlessness in cardiopulmonary disease
Authors: Ahmadi Zainab , Igelström Helena , Sandberg Jacob , Sundh Josefin , Sköld Magnus , Janson Christer , Blomberg Anders , Bornefalk Hans , Bornefalk-Hermansson Anna , Ekström Magnus 
Published: October 2021

BackgroundThe functional impact of breathlessness is assessed using the modified Medical Research Council (mMRC) scale for chronic respiratory disease and with the New York Heart Association Functional Classification (NYHA) scale for heart failure. We evaluated agreement between the scales and their concurrent validity with other clinically relevant patient-reported outcomes in cardiorespiratory disease.MethodsOutpatients with stable chronic respiratory disease or heart failure were recruited. Agreement between the mMRC and NYHA scales was analysed using Cramér's V and Kendall's tau B tests. Concurrent validity was evaluated using correlations with clinically relevant measures of breathlessness, anxiety, depression, and health-related quality of life. Analyses were conducted for all participants and separately in chronic obstructive pulmonary disease (COPD) and heart failure.ResultsIn a total of 182 participants with cardiorespiratory disease, the agreement between the mMRC and NYHA scales was moderate (Cramér's V: 0.46; Kendall's tau B: 0.57) with similar results for COPD (Cramér's V: 0.46; Kendall's tau B: 0.66) and heart failure (Cramér's V: 0.46; Kendall's tau B: 0.67). In the total population, the scales correlated in similar ways to other patient-reported outcomes.ConclusionIn outpatients with cardiorespiratory disease, the mMRC and NYHA scales show moderate to strong correlations and similar associations with other patient-reported outcomes. This supports that the scales are comparable when assessing the impact of breathlessness on function and patient-reported outcomes.
Working memory training efficacy in COPD: the randomised, double-blind, placebo-controlled Cogtrain trial
Authors: van Beers Martijn , Mount Sarah W. , Houben Katrijn , Gosker Harry R. , Schuurman Lisanne , Franssen Frits M.E. , Janssen Daisy J.A. , Schols Annemie M.W.J. 
Published: October 2021

BackgroundCognitive impairment is highly prevalent in COPD and is associated with a sedentary lifestyle, unhealthy diet and increased cognitive stress susceptibility. Enhancement of cognitive performance by working memory training (WMT) may reverse these effects. Therefore, this study aimed to investigate the efficacy of WMT in COPD on cognitive performance, healthy lifestyle behaviours and cognitive stress susceptibility.MethodsThe double-blind randomised, placebo-controlled Cogtrain trial consisted of a 12-week training phase comprising 30 active or sham WMT sessions, followed by a second 12-week maintenance phase with 12 sessions. Measurements took place at baseline and after the first and second phases. The primary outcome was cognitive performance. Secondary outcomes were the recall of prespecified healthy lifestyle goals, physical capacity and activity, dietary quality and cognitive stress susceptibility. Motivation towards exercising and healthy eating and psychological wellbeing were exploratory outcomes.ResultsSixty-four patients with moderate COPD (45% male, aged 66.2±7.2 years, median forced expiratory volume in 1 s 60.6% predicted) were randomised. WMT significantly increased patients’ performance on the trained tasks in the first phase, which remained stable in the second phase. Of the 17 cognitive outcome measures, only one measure of memory improved after the first phase and one measure of reaction time after the second phase. This intervention did not influence physical capacity and activity, recall of prespecified healthy lifestyle goals, psychological wellbeing or cognitive stress susceptibility.ConclusionWMT improved performance on the trained tasks but not overall cognitive performance, healthy lifestyle behaviours or cognitive stress susceptibility in patients with COPD.
Regional homogeneity alterations in multi-frequency bands in tension-type headache: a resting-state fMRI study
Authors: Zhang Shuxian , Li Huayun , Xu Qinyan , Wang Chao , Li Xue , Sun Jiawei , Wang Yaqi , Sun Tong , Wang Qianqian , Zhang Chengcheng , Wang Jili , Jia Xize , Sun Xihe 
Published: October 2021

Abstract
Objectives
In this study, we aimed to investigate the spontaneous neural activity in the conventional frequency band (0.01−0.08 Hz) and two sub-frequency bands (slow-4: 0.027–0.073 Hz, and slow-5: 0.01–0.027 Hz) in tension-type headache (TTH) patients with regional homogeneity (ReHo) analyses.

Methods
Thirty-eight TTH patients and thirty-eight healthy controls (HCs) underwent resting-state functional magnetic resonance imaging (RS-fMRI) scanning to investigate abnormal spontaneous neural activity using ReHo analysis in conventional frequency band (0.01−0.08 Hz) and two sub-frequency bands (slow-4: 0.027–0.073 Hz and slow-5: 0.01–0.027 Hz).

Results
In comparison with the HC group, patients with TTH exhibited ReHo increases in the right medial superior frontal gyrus in the conventional frequency band (0.01−0.08 Hz). The between group differences in the slow-5 band (0.01–0.027 Hz) highly resembled the differences in the conventional frequency band (0.01−0.08 Hz); even the voxels with increased ReHo were spatially more extensive, including the right medial superior frontal gyrus and the middle frontal gyrus. In contrast, no region showed significant between-group differences in the slow-4 band (0.027–0.073 Hz). The correlation analyses showed no correlation between the ReHo values in TTH patients and VAS scores, course of disease and number of seizures per month in conventional band (0.01−0.08 Hz), slow-4 band (0.027–0.073 Hz), as well as in slow-5 band (0.01–0.027 Hz).

Conclusions
The results showed that the superior frontal gyrus and middle frontal gyrus were involved in the integration and processing of pain signals. In addition, the abnormal spontaneous neural activity in TTH patients was frequency-specific. Namely, slow-5 band (0.01–0.027 Hz) might contain additional useful information in comparison to slow-4 band (0.027−0.073 Hz). This preliminary exploration might provide an objective imaging basis for the understanding of the pathophysiological mechanism of TTH.
Clinical utility of aVR lead T-wave in electrocardiogram of patients with ST-elevation myocardial infarction
Authors: Kazemi Babak , Sadat-Ebrahimi Seyyed-Reza , Ranjbar Abdolmohammad , Akbarzadeh Fariborz , Sadaie M. Reza , Safaei Naser , Esmaeil zadeh-Saboor Mehdi , Sohrabi Bahram , Ghaffari Samad 
Published: October 2021

Abstract
Background
aVR lead is often neglected in routine clinical practice largely because of its undefined clinical utility specifications. Nevertheless, positive T-wave in aVR lead has been reported to be associated with poor clinical outcomes in some cardiovascular diseases. This study aimed to prospectively investigate the prognostic value and clinical utility of T-wave amplitude in aVR lead in patients with acute ST-elevation myocardial infarction (STEMI).

Methods
A total of 340 STEMI patients admitted to a tertiary heart center were consecutively included. Patients were categorized into four strata, based on T wave amplitude in aVR lead in their admission ECG (i.e. < − 2, − 1 to − 2, − 1 to 0, and ≥ 0 mV). Patients’ clinical outcomes were also recorded and statistically analyzed.

Results
In-hospital mortality, re-hospitalization, and six-month-mortality significantly varied among four T wave strata and were higher in patients with a T wave amplitude of ≥ 0 mV (p 0.001–0.002). The groups of patients with higher T wave amplitude in aVR, had progressively increased relative risk (RR) of in-hospital mortality (RRs ≤ 0.01, 0.07, 1.00, 2.30 in four T wave strata, respectively). T wave amplitude in the cutoff point of − 1 mV exhibited a sensitivity and specificity of 95.83 (95% CI 78.88–99.89) and 49.68 (95% CI 44.04–55.33).

Conclusion
Our study demonstrated a significant association of positive T wave in aVR lead and adverse clinical outcomes in STEMI patients. Nevertheless, the clinical utility of T-wave amplitude at aVR lead is limited by its low discriminative potential toward prognosis of STEMI.