bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preeclampsia-like Syndrome Induced by Severe COVID-19: A Prospective Observational Study
Authors: Mendoza M. , Garcia-Ruiz I. , Maiz N. , Rodo C. , Garcia-Manau P. , Serrano B. , Lopez-Martinez R.M. , Balcells J. , Fernandez-Hidalgo N. , Carreras E. , Suya A. 
Published: August 2021

(BJOG. 2020;127:1374–1380)
Coronavirus disease 2019 (COVID-19) typically presents as a respiratory infection. Of note, compared with the general pregnant population, increased rates of preeclampsia have been reported in mothers infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Endothelial damage caused by placental oxidative stress leads to the clinical features of preeclampsia including hypertension, proteinuria, elevated levels of liver enzymes, renal dysfunction, thrombocytopenia, and other symptoms. This study aimed to examine the prevalence of clinical, biochemical, and ultrasonographic findings of preeclampsia in women infected with SARS-CoV-2 and also to assess the accuracy in differentiating between actual preeclampsia and preeclampsia-like features associated with COVID-19.
Evaluation for SARS-CoV-2 in Breast Milk From 18 Infected Women
Authors: Chambers C. , Krogstad P. , Bertrand K. , Contreras D. , Tobin N.H. , Bode L. , Aldrovandi G. 
Published: August 2021

(JAMA. 2020;324:1347)
While the concern that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may be transmitted to infants via breastfeeding has been raised, organizations recommend women infected with SARS-CoV-2 may continue to breastfeed if they so choose. There had been no documented cases of transmission of the virus to the infant through breast milk and to date the virus has not been directly isolated from breast milk.
Critical Obstetric Patients During the Coronavirus Disease 2019 Pandemic: Operationalizing an Obstetric Intensive Care Unit
Authors: Martinez R. , Bernstein K. , Ring L. , Ona S. , Baptiste C. , Syeda S. , Aziz A. , Robinson K. , Valderrama N. , Sheen J.-J. , D’Alton M. , Goffman D. , Gyamfi-Bannerman C. , Moroz L. , Landau R. 
Published: August 2021

(Anesth Analg. 2021;132:46–51)
In the early months of the coronavirus pandemic, the incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in pregnant patients presenting to labor and delivery (L&D) units in New York City was 15.4%. As intensive care unit (ICU) beds became scarce and nonemergent surgeries were halted, one large academic institution in NYC decided to create an obstetric intensive care unit (OBICU), which was fully operational by the end of March 2020. This article describes how the hospital staffed and operated the OBICU to treat critically ill peripartum patients with a quality of care equal to that of a surgical or medical ICU.
The Effect of Carbetocin Dose on Transmural Dispersion of Myocardial Repolarization in Healthy Parturients Scheduled for Elective Cesarean Delivery Under Spinal Anesthesia: A Prospective, Randomized Clinical Trial
Authors: Clunies-Ross N. , Roston T.M. , Taylor J. , Whyte S. , Albert A. , Görges M. , Chau A. 
Published: August 2021

(Anesth Analg. 2021;132:485–492)
Transmural dispersion of myocardial repolarization (TDR) is the interval between the peak of the T wave and end of the TV wave (Tp-e). Increased TDR is a more reliable predictor of drug torsadogenicity than prolonged QT interval. Carbetocin, a synthetic analog of oxytocin, is used to prevent postpartum hemorrhage following cesarean delivery, though the effect dose varies. Carbetocin has been shown to increase mean correct QT, but there is a paucity of information on the effects of carbetocin of TDR. This study examined the effects of carbetocin dose on TDR in patients undergoing cesarean delivery under spinal anesthesia.
Intrapartum-related Perinatal Deaths in Births Planned in Midwifery-led Settings in Great Britain: Findings and Recommendations From the ESMiE Confidential Enquiry
Authors: Rowe R. , Draper E.S. , Kenyon S. , Bevan C. , Dickens J. , Forrester M. , Scanlan R. , Tuffnell D. , Kurinczuka J.J. 
Published: August 2021

(BJOG. 2020;127:1665–1675)
The UK has higher rates of stillbirth and neonatal mortality than similar countries. A 2015 UK-wide confidential inquiry, Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK (MBRRACE-UK), identified key issues contributing to perinatal death, including inadequate maternal monitoring, errors in fetal monitoring, and failure to recognize the transition from the latent phase of labor to the active phase. The majority of deaths included in MBRRACE-UK occurred in hospital obstetric units (OUs), but the proportion of births occurring in midwifery-led settings in England is increasing. While there is no evidence that midwifery-led settings experience higher rates of intrapartum-related perinatal deaths compared with OU, contributing factors to perinatal deaths in midwifery settings may differ. Enhancing the safety of Midwifery-led births Enquiry (ESMiE) reviewed the quality of care in pregnancy, labor, birth, and postpartum in births resulting in intrapartum-related deaths in midwifery-led settings and compared the findings with those of MBRRACE-UK.
Emergency Cerclage in Singleton Pregnancies With Painless Cervical Dilatation: A Meta-analysis
Authors: Chatzakis C. , Efthymiou A. , Sotiriadis A. , Makrydimas G. 
Published: August 2021

(Acta Obstet Gynecol Scand. 2020;99:1444–1457)
Cervical insufficiency in the second trimester has essentially 3 treatment options at the discretion of the clinician: expectant management, placement of a cervical pessary, and placement of cervical cerclage. These methods are typically used in addition to courses of antibiotics, additional prescriptions (ie, progesterone, corticosteroids), and bed rest. This meta-analysis aimed to compare emergency cerclage versus expectant management for maternal and perinatal outcomes, as well as to identify areas requiring additional or better-quality clinical evidence.
Changes in Seizure Frequency and Antiepileptic Therapy During Pregnancy
Authors: Pennell P.B. , French J.A. , May R.C. , Gerard E. , Kalayjian L. , Penovich P. , Gedzelman E. , Cavitt J. , Hwang S. , Pack A.M. , Sam M. , Miller J.W. , Wilson S.H. , Brown C. , Birnbaum A.K. , Meador K.J. 
Published: August 2021

(N Engl J Med. 2020;383:2547–2556)
The management of pregnant women with epilepsy involves weighing the need to control seizures with the risks of antiepileptic drugs negatively affecting the development of the fetus. Epilepsy is associated with higher rates of maternal mortality compared with nonepileptic mothers. Pregnancy has been reported to increase the rate of seizures in women with epilepsy. This study aimed to compare the frequency of seizures in pregnant and nonpregnant women and investigated changes in required doses of antiepileptic drugs in pregnant women compared with nonpregnant women.
The Effect of Spinal Hypotension and Anesthesia-to-delivery Time Interval on Neonatal Outcomes in Planned Cesarean Delivery
Authors: Knigin D. , Avidan A. , Weiniger C.F. 
Published: August 2021

(Am J Obstet Gynecol. 2020;223:747.e1–747.e13)
While spinal anesthesia is the preferred anesthetic in planned cesarean deliveries (CDs), one of its major drawbacks is the potential for maternal hypotension. The literature has demonstrated the relationship between the degree of hypotension and neonatal acidosis, but the effect of hypotension duration is unclear. In addition, the window between the administration of anesthesia to delivery may provide an opportunity to decrease the risk of adverse neonatal events. The aim of this study was to examine the effect of maternal hypotension and the anesthesia-to-delivery time interval on neonatal events in planned CDs.
Spinal Anesthesia-induced Hypotension: Is it More Than Just a Pesky Nuisance?
Authors: Wong C.A. 
Published: August 2021

(Am J Obstet Gynecol. 2002;223:621–623)
As early as the 1930s, maternal hypotension had been recognized as a significant problem when administering spinal anesthesia. Over the decades, the use of spinal anesthesia has peaked and waned as the practice of anesthesia has evolved. But since the 1990s, it has seen a resurgence as pencil-point needles reduced headache risk and the hemodynamic changes were better understood and management strategies were developed.
A 26-Year-Old Pregnant Woman With Ventricular Tachycardia and Shock
Authors: Scott N.S. , Thomas S.S. , DeFaria Yeh D. , Fox A.S. , Smith R.N. 
Published: August 2021

(N Engl J Med. 2021;384:272–282)
A 26-year-old patient, pregnant with monochorionic, diamniotic twins at 32 weeks gestation, was transferred to the hospital following cardiac arrest caused by ventricular tachycardia. This was the patient’s third pregnancy and the previous 2 were uncomplicated. One week before presenting to the hospital, the patient had a cough, sore throat and ear pain, and new edema in her legs. She was prompted to seek care at an emergency department when pain in her right leg progressed. While in the emergency department, painful contractions began, the cervix was 2 cm dilated, and preterm labor management began. There was no further cervical dilation after 24 hours but the patient remained hospitalized. After 5 days the edema had worsened, and an occlusive thrombus was found in the left peroneal vein. Intravenous heparin was administered. The next day, the patient experienced chest pain before becoming unresponsive. Monomorphic ventricular tachycardia was detected. Spontaneous circulation resumed after epinephrine and cardioversion were administered. The patient underwent tracheal intubation and then emergency cesarean section, which resulted in 2 health male infants and an intraoperative blood loss of 1600 mL.
Immunity status in patients with periprosthetic knee joint infection
Authors: Mamonova Irina A. , Babushkina Irina. V. , Bondarenko Aleksandr S. , Ulyanov Vladimir Yu. 
Published: August 2021

AbstractImplant-associated infection is one of the most severe complications after total replacement of larger joints. The diagnosis of periprosthetic infection are often impeded as 5-34% of bacteriological tests are false-negative. Now the investigations of the immune status of patients suspected of periprosthetic infection are considered perspective as these are aimed at finding the most significant indicators for underlying the diagnosis of this pathology. In this research, we assessed immunology indicators in peripheral blood of patients with periprosthetic infection in their knee joints. We determined immunology characteristics associated with the clinical aspects of the progressing pathology. Our findings can be used as the basis for further search of pathophysiological mechanisms of periprosthetic infection progress in the knee joint as well as defining new diagnostic approaches.Reviewers:Ivanov A.N., MD, DSc;Prof. Puchinyan D.M., MD, DSc
You aren’t what you eat, you become what you eat
Authors: Stephens Christopher R. , Easton Jonathan F. , Sicilia Heriberto Román 
Published: August 2021

AbstractObesity (and the consequent obesity epidemic) is a complex, adaptive process, taking place over a time span of many years. Energy intake is recognized as a potentially important driver of obesity, especially in the context of an identifiable energy imbalance which, it is surmised, must lead to weight gain. Similarly, energy expenditure must play an important role. However, both show an enormous degree of individual variation. Therefore, measuring them is an exceedingly difficult task, especially in the context of large populations and long time periods. It has been argued that population-level observed weight gain can be traced back to very small daily energy imbalances while, at the same time, positing that a much larger maintenance energy gap is responsible for maintaining the energy requirements of the increased weight population. In this paper we examine the relation between BMI and energy intake as functions of age. The convexity of the BMI curves as a function of age and gender demonstrate the enhanced obesity risk apparent in young adults and women, and imply that no settling points exist at the population level. Consistent with other studies, overall weight increases are consistent with a very small daily energy imbalance, about 7 cal. Consumption as a function of age shows a small, steady, linear decrease of about 8 cal per year, and can be associated with a maximal energy excess/deficit of about 250cal for the youngest and oldest age groups. By examining weight differences between age groups as a function of age, we argue that this excess/deficit is an important motor for the observed weight differences, and argue that the apparent energy imbalance of 250 cal, due to excess consumption, leads to an effective imbalance of only 7 cal due to the existence of various physiological and behavioral mechanisms that enhance weight homeostasis and effectively reduce the energy excess from 250 cal to 7 cal. We discuss several possibilities for such mechanisms.
Environmental Exposure to Volatile Organic Compounds is Associated with Endothelial Injury
Authors: Riggs Daniel W. , Malovichko Marina V. , Gao Hong , McGraw Katlyn E. , Taylor Breandon S. , Krivokhizhina Tatiana , Rai Shesh N. , Keith Rachel J. , Bhatnagar Aruni , Srivastava Sanjay 
Published: August 2021

ABSTRACTObjectiveVolatile organic compounds (VOCs) are airborne toxicants abundant in outdoor and indoor air. High levels of VOCs are also present at various Superfund and other hazardous waste sites; however, little is known about the cardiovascular effects of VOCs. We hypothesized that ambient exposure to VOCs exacerbate cardiovascular disease (CVD) risk by depleting circulating angiogenic cells (CACs).Approach and ResultsIn this cross-sectional study, we recruited 603 participants with low-to-high CVD risk and measured 15 subpopulations of CACs by flow cytometry and 16 urinary metabolites of 12 VOCs by LC/MS/MS. Associations between CAC and VOC metabolite levels were examined using generalized linear models in the total sample, and separately in non-smokers. In single pollutant models, metabolites of ethylbenzene/styrene and xylene, were negatively associated with CAC levels in both the total sample, and in non-smokers. The metabolite of acrylonitrile was negatively associated with CD45dim/CD146+/CD34+/AC133+cells and CD45+/CD146+/AC133+, and the toluene metabolite with AC133+cells. In analysis of non-smokers (n=375), multipollutant models showed a negative association with metabolites of ethylbenzene/styrene, benzene, and xylene with CD45dim/CD146+/CD34+cells, independent of other VOC metabolite levels. Cumulative VOC risk score showed a strong negative association with CD45dim/CD146+/CD34+cells, suggesting that total VOC exposure has a cumulative effect on pro-angiogenic cells. We found a non-linear relationship for benzene, which showed an increase in CAC levels at low, but depletion at higher levels of exposure. Sex and race, hypertension, and diabetes significantly modified VOC associated CAC depletion.ConclusionLow-level ambient exposure to VOCs is associated with CAC depletion, which could compromise endothelial repair and angiogenesis, and exacerbate CVD risk.
Spatial inequity in distribution of COVID-19 vaccination services in Aotearoa
Authors: Whitehead Jesse , Carr Polly Atatoa , Scott Nina , Lawrenson Ross 
Published: August 2021

AbstractAimThis research examines the spatial equity, and associated health equity implications, of the geographic distribution of Covid-19 vaccination services in Aotearoa New Zealand.MethodWe mapped the distribution of Aotearoa’s population and used the enhanced-two-step-floating-catchment-method (E2SFCA) to estimate spatial access to vaccination services, taking into account service supply, population demand, and distance between populations and services. We used the Gini coefficient and both global and local measures of spatial autocorrelation to assess the spatial equity of vaccination services across Aotearoa. Additional statistics included an analysis of spatial accessibility for priority populations, including Māori (Indigenous people of Aotearoa), Pacific, over 65-year-olds, and people living in areas of high socioeconomic deprivation. We also examined vaccination service access according to rurality, and by District Health Board region.ResultsSpatially accessibility to vaccination services varies across Aotearoa, and appears to be better in major cities than rural regions. A Gini coefficient of 0.426 confirms that spatial accessibility scores are not shared equally across the vaccine-eligible population. Furthermore, priority populations including Māori, older people, and residents of areas with socioeconomic constraint have, on average, statistically significantly lower spatial access to vaccination services. This is also true for people living in rural areas. Spatial access to vaccination services, also varies significantly by District Health Board (DHB) region as does equality of access, and the proportion of DHB priority population groups living in areas with poor access to vaccination services. A strong and significant positive correlation was identified between average spatial accessibility and the Māori vaccination rate ratio of DHBs.ConclusionCovid-19 vaccination services in Aotearoa are not equitably distributed. Priority populations, with the most pressing need to receive Covid-19 vaccinations, have the worst access to vaccination services.
Endophenotype Effect Sizes Provide Evidence Supporting Variant Pathogenicity in Monogenic Disease Susceptibility Genes
Authors: Morrill Valerie N. , Halford Jennifer L. , Choi Seung Hoan , Jurgens Sean J. , Melloni Giorgio , Marston Nicholas A. , Weng Lu-Chen , Nauffal Victor , Hall Amelia W. , Gunn Sophia , Austin-Tse Christina A. , Pirruccello James P. , Khurshid Shaan , Rehm Heidi L. , Benjamin Emelia J. , Boerwinkle Eric , Brody Jennifer A. , Correa Adolfo , Fornwalt Brandon K. , Gupta Namrata , Haggerty Christopher M. , Harris Stephanie , Heckbert Susan R. , Hong Charles C. , Kooperberg Charles , Lin Henry J. , Loos Ruth J. F. , Mitchell Braxton D. , Morrison Alanna C. , Post Wendy , Psaty Bruce M. , Redline Susan , Rice Kenneth M , Rich Stephen S. , Rotter Jerome I. , Schnatz Peter F. , Soliman Elsayed Z. , Sotoodehnia Nona , Wong Eugene K. ,   NHLBI Trans-Omics for Precision Medicine (TOPMed) Consortium, Sabatine Marc S. , Ruff Christian T. , Lunetta Kathryn L. , Ellinor Patrick T. , Lubitz Steven A. 
Published: August 2021

ABSTRACTAccurate and efficient classification of variant pathogenicity is critical for research and clinical care. Using data from three large studies, we demonstrate that population-based associations between rare variants and quantitative endophenotypes for three monogenic diseases (low-density-lipoprotein cholesterol for familial hypercholesterolemia, electrocardiographic QTc interval for long QT syndrome, and glycosylated hemoglobin for maturity-onset diabetes of the young) are proxies for variant pathogenicity. Effect sizes were associated with pathogenic ClinVar assertions (P<0.001 for each trait) and discriminated pathogenic from non-pathogenic variants (area under the curve 0.82-0.83 across endophenotypes). Large effect size thresholds provided evidence supporting pathogenicity for up to 35% of rare variants of uncertain significance or not in ClinVar in disease susceptibility genes, using an effect size threshold of ≥ 0.5 times the endophenotype standard deviation. We propose that variant associations with quantitative endophenotypes for monogenic diseases can provide evidence supporting pathogenicity.
“Prevalence, Patterns, Clinico-social and Behavioural factors associated with the Consumption of Sugar Sweetened Beverages among Undergraduate Medical Students of Central India”
Authors: Mandal Soumya Kanti , Revadi G , Parida Darshan , Majumdar Anindo 
Published: August 2021

AbstractBackgroundExcessive consumption of Sugar Sweetened Beverages (SSBs) in adolescents has become a global issue. As its link to obesity and non-communicable diseases is clear, it is imperative to understand SSB consumption behaviours in the future healthcare professionals.ObjectiveTo document the prevalence, patterns and clinic-social and behavioural factors predicting high intake of SSBs among medical students.MethodsThis cross-sectional study was conducted using a self-reported, web-based, questionnaire. All the students and interns who were part of a publicly funded premiere teaching hospital during October and November 2019 were included. The semi-structured questionnaire enquired regarding socio-demographic, clinical details, amount, behavioural patterns and money spent in connection with SSB consumption. Data were analysed using IBM SPSS version 24.ResultsThe mean (SD) age of participants was 19.3 (1.6) years, 71.7% being males. The current prevalence of SSB consumption was 90.5 %. Also, 49.9% and 29.1% participants preferred soft drinks and sweetened fruit juice respectively. Multivariable analysis showed that male gender (aOR 1.83, 95% CI 1.03-3.25), current alcohol consumption (aOR 4.09, 95% CI 1.25-13.42), and recent (last week) consumption of a SSB predicted high intake of SSBs (aOR 7.36, 95% CI 3.41-15.87) whereas, preference of energy/sports category of drinks predicted low intake of SSBs (aOR 0.10, 95% CI 0.02-0.47).ConclusionThe consumption of SSBs among medical students was high. Targeted health education and behaviour change interventions should be provided to males, alcohol users and frequent consumers.
The emergence of SARS-CoV-2 variants of concern is driven by acceleration of the evolutionary rate
Authors: Tay John H. , Porter Ashleigh F. , Wirth Wytamma , Duchene Sebastian 
Published: August 2021

AbstractThe ongoing SARS-CoV-2 pandemic has seen an unprecedented amount of rapidly generated genome data. These data have revealed the emergence of lineages with mutations associated to transmissibility and antigenicity, known as variants of concern (VOCs). A striking aspect of VOCs is that many of them involve an unusually large number of defining mutations. Current phylogenetic estimates of the evolutionary rate of SARS-CoV-2 suggest that its genome accrues around 2 mutations per month. However, VOCs can have around 15 defining mutations and it is hypothesised that they emerged over the course of a few months, implying that they must have evolved faster for a period of time. We analysed genome sequence data from the GISAID database to assess whether the emergence of VOCs can be attributed to changes in the evolutionary rate of the virus and whether this pattern can be detected at a phylogenetic level using genome data. We fit a range of molecular clock models and assessed their statistical fit. Our analyses indicate that the emergence of VOCs is driven by an episodic increase in the evolutionary rate of around 4-fold the background phylogenetic rate estimate that may have lasted several weeks or months. These results underscore the importance of monitoring the molecular evolution of the virus as a means of understanding the circumstances under which VOCs may emerge.