bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sequence-dependent cost for Z-form shapes the torsion-driven B–Z transition via close interplay of Z-DNA and DNA bubble
Authors: Kim Sook Ho , Jung Hae Jun , Lee Il-Buem , Lee Nam-Kyung , Hong Seok-Cheol 
Published: February 2021

Abstract
Despite recent genome-wide investigations of functional DNA elements, the mechanistic details about their actions remain elusive. One intriguing possibility is that DNA sequences with special patterns play biological roles, adopting non-B-DNA conformations. Here we investigated dynamics of thymine-guanine (TG) repeats, microsatellite sequences and recurrently found in promoters, as well as cytosine–guanine (CG) repeats, best-known Z-DNA forming sequence, in the aspect of Z-DNA formation. We measured the energy barriers of the B–Z transition with those repeats and discovered the sequence-dependent penalty for Z-DNA generates distinctive thermodynamic and kinetic features in the torque-induced transition. Due to the higher torsional stress required for Z-form in TG repeats, a bubble could be induced more easily, suppressing Z-DNA induction, but facilitate the B–Z interconversion kinetically at the transition midpoint. Thus, the Z-form by TG repeats has advantages as a torsion buffer and bubble selector while the Z-form by CG repeats likely behaves as torsion absorber. Our statistical physics model supports quantitatively the populations of Z-DNA and reveals the pivotal roles of bubbles in state dynamics. All taken together, a quantitative picture for the transition was deduced within the close interplay among bubbles, plectonemes and Z-DNA.
Maternal Characteristics and Causes Associated With Refractory Postpartum Hemorrhage After Vaginal Birth: A Secondary Analysis of the WHO CHAMPION Trial Data
Authors: Widmer M. , Piaggio G. , Hofmeyr G.J. , Carroli G. , Coomarasamy A. , Gallos I. , Goudar S. , Gulmezoglu A.M. , Lin S.L. , Lumbiganon P. , Mugerwa K. , Owa O. , Qureshi Z. , Althabea F. 
Published: February 2021

(BJOG. 2020;127:628–634)
A leading cause of maternal morbidity and mortality in low- and middle-income countries is postpartum hemorrhage (PPH). The most common cause of PPH is uterine atony. As PPH occurs in 6% of all live births worldwide, the World Health Organization (WHO) recommends a set of interventions for women who begin to bleed, which include uterine massage and uterotonic medications. For women who continue to bleed despite this first-line of treatment, additional measures are recommended prior to surgical intervention including secondary uterotonics, tranexamic acid, and intrauterine balloon tamponades.
Coronavirus Disease 2019 (COVID-19) Pandemic and Pregnancy
Authors: Dashraath P. , Wong J.L.J , Lim M.X.K , Lim L.M. , Li S. , Biswas A. , Choolani M. , Mattar C. , Su L.L. 
Published: February 2021

(Am J Obstet Gynecol. 2020;222:521–531)
Caring for vulnerable populations is a critical component of pandemic management. Pregnant women are susceptible to respiratory illness with an increased infectious morbidity and mortality. While clinical information is limited on the effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on the pregnant population, both the SARS-CoV and MERS-CoV outbreaks of the last 2 decades resulted in approximately one third of infected pregnant women dying from the illness. The purpose of this paper was to summarize the clinical features of coronavirus disease 2019 (COVID-19) in pregnant women, and present a pragmatic and integrated framework for handling complex intricacies involved in disease management.
Reducing Post-cesarean Delivery Surgical Site Infections: A Narrative Review
Authors: Douville S.E. , Callaway L.K. , Amoako A. , Roberts J.A. , Eleya V.A. 
Published: February 2021

(Int J Obstet Anesth. 2020;42:76–86)
Surgical site infection (SSI) occurs in both cesarean and vaginal deliveries, though there are many challenges to estimating rates of incidence. There are many proposed and implemented strategies to prevent postcesarean SSI. This review aimed to examine evidence on the prevention of postcesarean SSI with a concentration on pharmacological interventions and their effects on neonates.
Social Determinants of Pregnancy-related Mortality and Morbidity in the United States: A Systematic Review
Authors: Wang E. , Glazer K.B. , Howell E.A. , Janevic T.M. 
Published: February 2021

(Obstet Gynecol. 2020;135:896–915)
The United States has one of the highest maternal mortality rates among high-income countries. This rate, along with maternal morbidity in the United States, has been rising. While health factors such as increased obesity and chronic disease, older maternal age, and high cesarean rates may contribute to maternal mortality and morbidity, social determinants of health are also a contributor. Social determinants of health include environmental conditions and socioeconomic factors like income, education, occupation, race and ethnicity, and sex. Previous studies have examined social determinants of health in relation to neonatal or birth outcomes, but there has been little research on the relationship between social determinants of health and maternal outcomes in the United States. This systematic review aimed to examine social determinants of maternal mortality and morbidity in the United States while identifying areas for future research and action.
Pregnancy-related Mortality in the United States, 2003-2016: Age, Race, and Place of Death
Authors: Burgess A.P.H. , Dongarwar D. , Spigel Z. , Salihu H.M. , Moaddab A. , Clark S.L. , Fox K. 
Published: February 2021

(Am J Obstet Gynecol. 2020;222:489.e1–489.e8)
In the United States, the pregnancy-related mortality rate (PRMR), is several times higher than that of other high-income countries and this has been attributed to a number of medical, social, political, and cultural factors. Programs aimed at addressing this problem have been developed by the Society for Maternal-Fetal Medicine and the American College of Obstetricians and Gynecologists, but there is a lack of data on their impact. This study used data on the place of death, age of death, and deaths by race and ethnicity to explore the contributions of medical factors compared with social, cultural, and environmental factors in pregnancy-related deaths.
Validation of a Comorbidity Index for Use in Obstetric Patients: A Nationwide Cohort Study
Authors: Bliddal M. , Möller S. , Vinter C.A. , Rubin K.H. , Gagne J.J. , Pottegård A. 
Published: February 2021

(Acta Obstet Gynecol Scand. 2020;99:399–405)
Severe maternal morbidity associated with childbirth has increased in the last 30 years in the United States. A score to predict risk for maternal morbidity would be useful to help place high-risk women at better-equipped facilities and also address some confounding factors in research. The Obstetric Comorbidity Index (OCI) was developed by Bateman and Gangne to accomplish these goals, but has only been validated in very specific populations. This study used the Danish health registers, which contain complete data on all obstetric patients, to examine the ability of the OCI to predict morbidity and discriminate between low-risk and high-risk obstetric patients for maternal end-organ injury and death.
A Population-based Analysis of French Transfusion Practice for Women Experiencing Severe Postpartum Hemorrhage
Authors: Deleu F. , Deneux-Tharaux C. , Chiesa-Dubruille C. , Seco A. , Bonneta M.P. 
Published: February 2021

(Int J Obstet Anesth. 2020;42:11–19)
Severe postpartum hemorrhage (SPPH) is the leading cause of severe maternal mortality worldwide. Blood transfusion is a central part of managing SPPH, but there is a lack of prospective population-based studies on transfusion practices. The EPIMOMS study on severe acute maternal morbidity provides data on transfusion management for SPPH. This retrospective study used data from the EPIMOMS study and aimed to describe transfusion practices and evaluate those practices in terms of compliance with French PPH management guidelines.
Severe Maternal Morbidity Due to Obstetric Haemorrhage: Potential Preventability
Authors: Lepine S.J. , Geller S.E. , Pledger M. , Lawton B. , MacDonald E.J. 
Published: February 2021

(Aust N Z J Obstet Gynaecol. 2020;60:212–217)
Obstetric hemorrhage (postpartum hemorrhage) accounts for 16% of maternal deaths in developed regions and 27% in developing regions. In New Zealand, it is the most common reason for admission to the intensive care unit (ICU) or high-dependency unit (HDU). Yet, many cases of obstetric hemorrhage may be preventable. The aim of this study was to conduct a critical analysis of severe obstetric hemorrhage cases to highlight areas for potential improvements in care.
Target Populations to Reduce Cesarean Rates After Induced Labor: A National Population-based Cohort Study
Authors: Blanc-Petitjean P. , Schmitz T. , Salomé M. , Goffinet F. , Le Ray C. 
Published: February 2021

(Acta Obstet Gynecol Scand. 2020;99:406–412)
There is a wide variation in the rate of cesarean delivery following induction of labor (IOL), and the reasons for this difference are unclear. The disparity may be explained in part by differences in obstetric practices or by risk factors like obesity, nulliparity, or previous cesarean delivery. This study used a 10-group classification system to identify populations with higher rates of cesarean delivery after IOL.
Sexual and Gender Minorities Educational Content Within Obstetric Anesthesia Fellowship Programs: A Survey
Authors: MacCormick H. , George R.B. 
Published: February 2021

(Can J Anesth/J Can Anesth. 2020;67:532–540)
Sexual and gender minorities (SGM) is an umbrella term for groups of individuals who identify themselves as 2-spirit, transgender, homosexual, bisexual, nonbinary, intersex, or queer. SGM communities face unique difficulties in accessing high-quality health care. Members of SGM communities are at high risk of developing substance or alcohol abuse, homelessness, and depression. More specifically, transgender patients are at higher risk of venous thromboembolism due to hormone therapy. It is critical for anesthesiologists to possess the skills necessary to communicate with obstetric patients, especially in the SGM population. This study surveyed the SGM-related educational content in obstetric anesthesia fellowship programs in North America.
The Association Between the Introduction of a Quantitative Assessment of Postpartum Blood Loss and Institutional Changes in Clinical Practice: An Observational Study
Authors: Katz D. , Wang R. , O’Neil L. , Gerber C. , Lankford A. , Rogers T. , Gal J. , Sandler R. , Beilin Y. 
Published: February 2021

(Int J Obstet Anesth. 2020;42:4–10)
Delayed recognition of postpartum hemorrhage significantly contributes to maternal morbidity and mortality. One cause of delayed recognition of postpartum hemorrhage is inaccurate blood loss estimation. The use of quantitative assessment of blood loss (QBL) over visually estimated blood loss has been advocated by maternal safety organizations. QBL methods include gravimetric (weight-based), volumetric, and colorimetric approaches. The Triton system uses both colorimetric and gravimetric techniques and has demonstrated accuracy. This study aimed to examine the use of the Triton QBL system in a single institution.
Do Quantitative Blood Loss Measurements and Postpartum Hemorrhage Protocols Actually Make a Difference? Yes, No, and Maybe
Authors: Chau A. , Farber M.K. 
Published: February 2021

(Int J Obstet Anesth. 2020;42:1–3)
Postpartum hemorrhage (PPH) is a leading cause of severe maternal morbidity. In California, hospitals that adopted the United States National Partnership for Maternal Safety (NPMS) Consensus Bundle for Obstetric Hemorrhage reduced hemorrhage-related severe maternal morbidity by 20.8%. Quantitation of blood loss (QBL) and protocol utilization during PPH were 2 elements of the NPMS bundle and have been evaluated in recent studies, which may shed light on the contribution of these 2 practices to the observed improved outcomes.
Spinal Anesthesia for Patients With Coronavirus Disease 2019 and Possible Transmission Rates in Anesthetists: Retrospective, Single-centre, Observational Cohort Study
Authors: Zhong Q. , Liu Y.Y. , Lou Q. , Zou Y.F. , Jiang H.X. , Li H. , Zang J.J. , Li Z. , Yang X. , Ma M. , Tang L.J. , Chen Y.Y. , Zheng F. , Ke J.J. , Zhang Z.Z. 
Published: February 2021

(Br J Anaesth. 2020;124:670–675)
Since COVID-19 has been declared an international public health emergency, clinical characteristics of COVID-19 infection, including pregnant women undergoing cesarean section, have been reported. However, there have not been reports on the perioperative characteristics or anesthetic management of infected patients undergoing surgery. Clinicians may be at high risk of infection during surgeries. This single-center, retrospective, observational cohort study was intended to describe experiences of performing spinal anesthesia in infected patients, report on the perioperative characteristics of patients with COVID-19, and report outcomes in patients who received spinal anesthesia, as well as describing the possible transmission rates in anesthetists administering spinal anesthesia.
Enhanced Recovery After Surgery at Cesarean Delivery to Reduce Postoperative Length of Stay: A Randomized Controlled Trial
Authors: Teigen N.C. , Sahasrabudhe N. , Doulaveris G. , Xie X. , Negassa A. , Bernstein J. , Bernstein P.S. 
Published: February 2021

(Am J Obstet Gynecol. 2020;222:372.e1–372.e10)
Enhanced recovery after surgery (ERAS) involves multiple changes in perioperative care to improve patient outcomes, reduce postoperative patient stay, and standardize postoperative patient care to optimize patient satisfaction levels. Currently, no randomized studies exist addressing possible postoperative impacts of ERAS for cesarean deliveries. This study aimed to investigate whether the implementation of an ERAS pathway versus standard care could improve patient satisfaction and reduce the postoperative length of stay for patients undergoing cesarean deliveries.
Health Resource Utilization of Labor Induction Versus Expectant Management
Authors: Grobman W.A. , Sandoval G. , Reddy U.M. , Tita A.T.N. , Silver R.M. , Mallett G. , Hill K. , Rice M.M. , El-Sayed Y.Y. , Wapner R.J. , Rouse D.J. , Saade G.R. , Thorp J.M. , Chauhan S.P. , Iams J.D. , Chien E.K. , Casey B.M. , Gibbs R.S. , Srinivas S.K. , Swamy G.K. , Simhan H.N. , Macones G.A. 
Published: February 2021

(Am J Obstet Gynecol. 2020;222:369.e1–369.e11)
The A Randomized Trial of Induction Versus Expectant Management (ARRIVE) trial was conducted to analyze the effects of planned elective induction of labor on 6000 low-risk nulliparous women in comparison with expectant management. The ARRIVE trial found that planned elective labor induction at 39 weeks resulted in decreased cesarean delivery, fewer pregnancies with hypertensive disorders, and decreased neonatal respiratory morbidity. The aim of the current study was to compare health care resource utilization between planned elective induction of labor at 39 weeks and expectant management in nulliparous women during 3 time periods: antepartum, delivery admission, and discharge until 8 weeks postpartum.
Carbetocin at Elective Cesarean Section: A Sequential Allocation Trial to Determine the Minimum Effective Dose in Obese Women
Authors: Drew T. , Balki M. , Farine D. , Ye X.Y. , Downey K. , Carvalho J.C.A. 
Published: February 2021

(Anaesthesia. 2020;75:331–337)
Uterotonics are widely used in cesarean deliveries to prevent postpartum hemorrhage, which can cause maternal death or severe morbidity. Obesity, among other factors, has been implicated as a contributing factor to the rise in atonic postpartum hemorrhage in developed countries. The use of carbetocin, a synthetic oxytocin analogue, is associated with a reduced need for uterotonics in cesarean deliveries. While previous studies found 90% effective dose (ED90) of carbetocin for women with a body mass index (BMI) <40 kg/m2, none have addressed the ED90 for obese women. This study aimed to find the ED90 of carbetocin in women with a BMI ≥40 kg/m2 undergoing elective cesarean delivery.
Use of a Novel Electronic Maternal Surveillance System and the Maternal Early Warning Criteria to Detect Severe Postpartum Hemorrhage
Authors: Klumpner T.T. , Kountanis J.A. , Meyer S.R. , Justin Ortwine J. , Bauer M.E. , Carver A. , Piehl A.M. , Smith R. , Mentz G. , Tremper K.K. 
Published: February 2021

(Anesth Analg. 2020;131:857–865)
Responding early and appropriately to the clinical warning signs of postpartum hemorrhage (PPH) is one factor in preventing maternal death. While procedures to quantify blood loss can support the timely diagnosis of PPH, an early warning surveillance system triggered by maternal vital signs may provide an additional means of detecting this complication after delivery. The aim of this study was to assess the ability of an automated surveillance system and the Maternal Early Warning Criteria (MEWC) to predict severely morbid postpartum hemorrhage (sPPH) outside of the operating room.
Fetal Growth and Fetoplacental Circulation in Pregnancies Following Bariatric Surgery: A Prospective Study
Authors: Maric T. , Kanu C. , Muller D.C. , Tzoulaki I. , Johnson M.R. , Savvidou M.D. 
Published: February 2021

(BJOG. 2020;127:839–846)
Nearly one third of the population within the United States and one fourth of the population of the UK can be classified as obese, which includes one quarter of all reproductive-aged women. There are significant short-term and long-term adverse outcomes for both baby and mother associated with pregnancy while obese. Obese mothers exhibit a higher propensity for gestational diabetes mellitus, preeclampsia, cesarean delivery, or postpartum hemorrhage, as well as the development of cardiovascular disease and type 2 diabetes later in life. In addition to macrosomia, children of obese mothers are more likely to develop type 2 diabetes and cardiovascular disease in adulthood. Bariatric surgery, an effective weight-reduction treatment, is becoming more common for women of childbearing age. This study aimed to investigate the intrauterine fetal growth pattern and placental function, in postbariatric pregnancies as compared with patients of no history of maternal weight-loss surgery.
Early Acute Respiratory Support for Pregnant Patients With Coronavirus Disease 2019 (COVID-19) Infection
Authors: Pacheco Luis D. , Saad Antonio F. , Saade George 
Published: February 2021

(Obstet Gynecol. 2020;136:1–4)
While pregnant patients appear to have less severe symptoms of coronavirus disease 2019 (COVID-19) than the general population, there are cases of severe disease in pregnancy. This report gives recommendations for basic initial respiratory support interventions for pregnant patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
Supporting Lactation Within an Academic Anesthesia Department: Obstacles and Opportunities
Authors: Titler S.S. , Pearson A.C.S. 
Published: February 2021

(Anesth Analg. 2020;131:1304–1307)
There is a growing number of women in academic anesthesiology, many of whom are in their prime reproductive years. Following maternity leave, many would like to continue breastfeeding, but there are a number of barriers. This report identifies common barriers to lactation in the workplace, solutions for removing these barriers, and requirements for lactation spaces in the workplace.
Single-Center Outcome of Fetoscopic Tracheal Balloon Occlusion for Severe Congenital Diaphragmatic Hernia
Authors: Baschat A.A. , Rosner M. , Millard S.E. , Murphy J.D. , Blakemore M.J. , Keiser A.M. , Kearney J. , Bullard J. , Nogee L.M. , Bembea M. , Jelin E.B. , Miller J.L. 
Published: February 2021

(Obstet Gynecol. 2020;135:511–521)
Congenital diaphragmatic hernia, caused by the absence of the diaphragm or part of the diaphragm, leads to impaired fetal lung development as the abdominal contents move into the chest cavity. This is commonly managed with high-frequency oscillatory ventilation, pulmonary vasodilators, and extracorporeal membrane oxygenation, but the survival rate is <20% in cases with an observed lung/head ratio of <25% and intrathoracic liver herniation. In temporary fetoscopic tracheal balloon occlusion (FETO), the lungs are stretched and increase growth in airways and lung vasculature takes place. FETO has demonstrated increased survival rates, but is also associated with adverse outcomes such as preterm labor, rupture of membranes, and preterm birth. This study aimed to determine feasibility of FETO in cases of severe congenital diaphragmatic hernia.
Causal Genetic Variants in Stillbirth
Authors: Stanley K.E. , Giordano J. , Thorsten V. , Buchovecky C. , Thomas A. , Ganapathi M. , Liao J. , Dharmadhikari A.V. , Revah‐Politi A. , Ernst M. , Lippa N. , Holmes H. , Povysil G. , Hostyk J. , Parker C.B. , Goldenberg R. , Saade G.R. , Dudley D.J. , Pinar H. , Hogue C. , Reddy U.M. , Silver R.M. , Aggarwal V. , Allen A.S. , Wapner R.J. , Goldstein D.B. 
Published: February 2021

(N Engl J Med. 2020;383:1107–1116)
Between 25% and 60% of stillbirth cases are unexplained. Exome sequencing has been used to determine the cause of disease, especially in childhood disorders and fetal structural anomalies. There is an opportunity to further apply clinical exome sequencing to investigating the cause of stillbirth. Previous studies on this topic have been small, concentrated on predetermined causes, and used data from early miscarriages. This study aimed to evaluate the diagnostic utility of clinical exome sequencing in stillbirth using a diverse cohort.
Molecular Interaction Between Butorphanol and K-opioid Receptor
Authors: Ji J. , Lin W. , Vrudhula A. , Xi J. , Yeliseev A. , Grothusen J.R. , Bu W. , Liu R. 
Published: February 2021

(Anesth Analg. 2020;131:935–942)
An estimated 4% of adults in the United States misuse prescription opioids, caused in part by inappropriate prescribing. There is a lack of understanding of the pharmacological profiles of opioids and their medical indications. Butorphanol is a schedule intravenous opioid, less likely to be abused than morphine, but a more potent analgesic. Morphine is a full μ-opioid receptor agonist, while butorphanol is a partial μ-opioid receptor agonist and a K-opioid receptor (KOR) agonist. The butorphanol and KOR interactions between may be unique and of pharmacological and clinical importance. This study used computational and in vitro experiments to explore the interactions between butorphanol and KOR.
III. REGIONAL ANESTHESIA Norepinephrine for the Prevention of Spinal-induced Hypotension During Cesarean Delivery Under Combined Spinal-epidural Anesthesia
Authors: Wei C. , Qian J. , Zhang Y. , Chang X. , Hu H. , Xiao F. 
Published: February 2021

(Eur J Anaesthesiol. 2020;37:309–315)
Phenylephrine is considered the first-line therapy for the prevention of hypotension in obstetric anesthesia. However, phenylephrine may cause bradycardia and decreased maternal cardiac output. Norepinephrine has been proposed as an alternative to phenylephrine for treating or preventing hypotension during cesarean delivery. The primary goal of this study was to determine the effective dose (ED) of norepinephrine to prevent spinal-induced hypotension during cesarean delivery. The secondary aim was to examine adverse events and neonatal outcomes seen with various infusion rates of norepinephrine.