bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cannabis Use and Fetal Growth in Pregnant Women With Diabetes [18L]
Authors: Hamilton Owen J. C. , Fowose Mobolaji , Colditz Graham , Tuuli Methodius G. , Carter Ebony B. 
Published: April 2018

INTRODUCTION:
Cannabis use during pregnancy is associated with lower birth weight, but little is known about the impact of prenatal cannabis use in women with co-morbidities. Our objective was to examine the association between cannabis use and birthweight in women with pre-existing and gestational diabetes.

METHODS:
We performed a retrospective cohort study at the Center for Diabetes and Pregnancy at Barnes Jewish Hospital from 2012 to 2016. Women who self-reported cannabis use or had positive maternal or infant drug screens for cannabinoids were compared with those who did not. The primary outcome was large for gestational age (LGA) defined as birthweight >90 percentile. Secondary outcomes were mean birthweight and small for gestational age (SGA, birthweight <10 percentile). Outcomes were compared between women who used cannabis and those who did not. Logistic regression was used to control for potential confounders.

RESULTS:
Of 298 women who received care during the study period, 12.8% (38) used prenatal cannabis. Women who used cannabis were more likely to have a history of depression and use tobacco. Birthweight was significantly lower in women who used cannabis (2,732 versus 3,170 g; P<.003). Women who used cannabis prenatally were 78% less likely to have babies who were LGA (5.3% versus 19.2%, aOR 0.22, 95% CI 0.05–0.98) after controlling for tobacco use. There was no significant difference in SGA.

CONCLUSION:
Women with diabetes who use cannabis during pregnancy have lower rates of LGA. Larger prospective studies are needed to determine the impact of prenatal cannabis use on maternal, neonatal, and childhood behavioral outcomes in women with diabetes.
Preoperative Vaginal Preparation for Prevention of Post-Cesarean Endometritis [22L]
Authors: Edinoff Amber , Drake Chelsea , Pile Rachel , Sutton Maureen , Bhattarai Bikash , Coonrod Dean 
Published: April 2018

INTRODUCTION:
Endometritis complicates 6%–27% cesarean deliveries (CD). A recent meta-analysis showed a reduction in endometritis with vaginal cleansing prior to CD (4.5% versus 8.8%). Our study examines the proportions of endometritis from two time periods–prior to and after the implementation of vaginal preparation prior to CD at one hospital. We aim to see the effect shown in research in clinical practice.

METHODS:
A retrospective chart review of 356 women undergoing cesarean delivery prior to and after the policy change. After implementation of the vaginal preparation protocol, a policy of administration of 400 μg of buccal misoprostol for postpartum hemorrhage prophylaxis was instituted so this was recorded. Odds ratios (OR) and 95% confidence interval (CI) of endometritis diagnosed by ICD code or 2+ symptoms were calculated.

RESULTS:
The rate of endometritis was 3.8% in the pre-policy period and 15.2% post-policy, OR 4.5 (95% CI 1.7–11.8). Notably the frequency of fever was 4.5% pre-policy compared with 22.2% post-policy. When the rates of endometritis with those given misoprostol were excluded the rates were 3.8% pre-policy and 6.7% post-policy, OR 1.8 (95% CI 0.5–6.6).

CONCLUSION:
When comparing rates of endometritis after instituting a vaginal preparation protocol we found a paradoxical increase in the rate of endometritis. However, this could be driven by the increased rate of fevers associated with misoprostol prophylaxis. When this was accounted for, there was a non-significant increase. Confounding factors may lead to important differences from randomized studies and are important to assess when evaluating practice change.
Characterization of Placental Pathology in Treated Chronic Hypertensive Women [23L]
Authors: Ambia Anne M. , DuBois Molly , Morgan Jamie L. , Roberts Scott W. , Wells C. Edward , Nelson David B. 
Published: April 2018

INTRODUCTION:
Women with chronic hypertension (CHTN) during pregnancy are at increased risk for fetal-growth restriction. The fetal-placental (F/P) weight ratio has been used as a marker for abnormal growth of both the fetus and placenta. The aim of this study was to examine placental pathology among women with treated CHTN.

METHODS:
This was a retrospective cohort study of women with treated CHTN delivered from October 2008 to January 2016 with histopathological placental examination. The F/P ratio was analyzed and compared with published ratios for normal pregnancies. Placental pathology was grouped into categories including infection, vasculopathy, no abnormality, hypoplasia, and hyperplasia. Findings were examined according to gestational ages (23 to <34, 34 to <37, and 37 weeks). Each placenta may have had numerous findings in different categories.

RESULTS:
Histopathological examination was performed in 182 women. When the F/P weight ratios were plotted against previously published normal values, women with treated CHTN had significantly lower ratios beginning at 32 weeks (P<.05). This finding persisted in both small for gestational age and appropriate for gestational age infants. Pathological findings were described in 178 women. The prevalence of inflammatory lesions, vasculopathy, and hypoplasia were prominent across gestational ages at delivery. Those with deliveries <34 w were found to have increased rates of vasculopathy with 70% having evidence of vascular lesions (P=.008).

CONCLUSION:
Women with treated CHTN have evidence for abnormal fetal and placental growth when compared with growth curves for normal pregnant women. Moreover, the presence of placental vasculopathy was more prominent in preterm deliveries prior to 34 weeks.
Breast Cancer in Pregnancy: A Retrospective Cohort Study [24L]
Authors: Al-Sehli Hanan , D'Souza Rohan , Maxwell Cynthia 
Published: April 2018

INTRODUCTION:
Our objective is to report pregnancy outcomes and placental histopathologic findings in women with breast cancer.

METHODS:
We conducted a retrospective study including pregnant women with a prior history of breast cancer and those with gestational breast cancer (GBC) managed at Mount Sinai Hospital, Toronto, Canada between 2004 and 2015.

RESULTS:
We identified 69 patients—47 with a prior history of breast cancer and 22 with GBC. In 21/22 cases of GBC, treatment was initiated antepartum (surgeries in 16, mean gestational age [GA] 22.5 weeks and chemotherapy in 13 [mean GA 26 weeks]). Radiotherapy was deferred until the postpartum period. There was a significant difference between groups in terms of labor induction (32.6 versus 50%, P=.045) to facilitate treatment, resulting in higher preterm birth rates (8.7% versus 63.6%, P<.0001), but no difference in GA (37.8±4.4 versus 36.3±2.0 weeks, P=.95), birthweight (3,095.2±871.2 versus 2,727±663.4, P=.43) or spontaneous vaginal deliveries (41.3% versus 59.1%). Placental histopathology was abnormal in 42.9% versus 44.4% cases.

CONCLUSION:
With multidisciplinary management, women with breast cancer can anticipate good pregnancy outcomes. Surgery, chemotherapy and late preterm labour induction are not associated with adverse outcomes or higher cesarean delivery rates.
Maternal and Neonatal Outcomes in Pregnancies With Invasive Cancer [33L]
Authors: Alpay Savasan Zeynep , Zeb Amna 
Published: April 2018

INTRODUCTION:
To assess the maternal and neonatal outcomes in patients who had active cancer during pregnancy.

METHODS:
We reviewed the perinatal records of patients who had active cancer during or within the same year of pregnancy and delivered at Beaumont Health System between 2008 and 2017. We identified obstetrical maternal and neonatal adverse outcomes.

RESULTS:
There were total of 25 patients who had active cancer during pregnancy. These cancers include breast (n=12), lymphoma (n=5), uterine (n=2), malignant melanoma (n=1), acute myeloid leukemia (n=1), pancreas (n=1), colon (n=1), thyroid (n=1) and tongue (n=1). Among these patients 36% (9/25) had no maternal or neonatal complications, 28% (7/25) had both maternal and neonatal complications (spontaneous preterm delivery, gestational diabetes, thrombocytopenia, chorioamnionitis, low Apgar and meconium aspiration), 20% (5/25) had only maternal (epidural abscess, venous thrombosis, pulmonary embolism, hypertensive disorder of pregnancy, placental abruption and accreta), and 12% (3/25) had only neonatal (prematurity, small for gestational age, cleft palate and torticollis) complications. Patient with leukemia had termination of pregnancy. There were no neonatal or childhood cancers diagnosed among this group. The cancer type had no effect on identified perinatal complications.

CONCLUSION:
Patients with active cancer during pregnancy have an increased risk for perinatal complications. Due to the low prevalence of active cancer during pregnancy, a multicenter data analysis should be considered to confirm our data.
Pregnancy Outcomes in Anti Neutrophil Cytoplasmic Antibody-Associated Vasculitis: A Systematic Review [37L]
Authors: Elnazir Patrick , Andrejevic Katarina , Pagnoux Christian , D'Souza Rohan 
Published: April 2018

INTRODUCTION:
Information on pregnancy outcomes in Anti Neutrophil Cytoplasmic Antibody (ANCA)-associated vasculitis is limited to small case series. We systematically reviewed the literature to determine pregnancy outcomes in women with ANCA-associated vasculitis, to help with counselling and management of these women.

METHODS:
We searched Medline, Embase, Web of Science and PubMed from inception until July 2017, using keywords and subject headings related to pregnancy and ANCA-associated vasculitis. Abstract screening, data extraction and risk of bias assessment using the National Institute of Health tool for case reports and case series were performed in duplicate. Vasculitis- and pregnancy-related outcomes were obtained, and pooled incidence (95% confidence intervals) calculated.

RESULTS:
After screening 628 titles and 183 full texts, we included nine studies reporting 124 pregnancies in 89 women. Most studies (77.8%) had low risk of bias. There were 119 (91%) live births with a mean gestational age of 38.24 (37.35, 39.14) weeks and birth weight of 3.16 (2.95, 3.38) kg. Vasculitis flares were mostly in the ear, nose and throat 12.7% (4.9, 20.6%) and lungs 8.9% (2.9, 14.8%). Most patients were on glucocorticoids (43.5%) and/or Azathioprine (24.2%), increased doses of which successfully treated flares. Adverse outcomes included prematurity 10.3% (3.5, 17.1%), preeclampsia 5.5% (1.4, 9.5%), fetal growth restriction 4.9% (0.9, 8.9%) and congenital anomalies 3.7% (0.3, 7%).

CONCLUSION:
Women with ANCA-associated vasculitis can be assured that despite large numbers of flares during pregnancy, severe flares are rare and easily managed by high-dose glucocorticoids and immunosuppressants. Pregnancy outcomes are comparable to low-risk populations, apart from an increased risk of preterm birth.
Targeted inhibition of the BRAF pathway in a patient with stage IV melanoma
Authors: Buckley Breea , Pierce Bradley 
Published: April 2018

ABSTRACT
This article describes the use of vemurafenib, a BRAF inhibitor, to achieve disease regression in a woman with extensive metastatic melanoma and the BRAF V600 gene mutation. Given the improved survival rates seen in these patients, clinicians need to be aware of long-term patient management and adverse reactions to the drug.
Evaluation of Antepartum and Postpartum Remote Monitoring of Gestational Weight Gain in Low-Risk Pregnancy [1A]
Authors: DeNicola Nathaniel , Ganju Nihar , Marko Kathryn 
Published: April 2018

INTRODUCTION:
Gestational weight gain is an important marker of perinatal health. This study evaluates remote monitoring to track appropriate weight gain in low-risk pregnancies.

METHODS:
1058 low-risk pregnant women in 27 offices were enrolled in BabyscriptsTM (BRx), an integrated technology platform with a mobile application and connected blood pressure cuff and weight scale. Antepartum weight recordings were tabulated from 12–36 weeks gestation. Postpartum weight recordings were tabulated from 42–48 weeks gestation. Data was analyzed for mean weight gain during pregnancy and average interval between recordings.

RESULTS:
Antepartum weight monitoring of 1058 women showed a mean gestational weight gain: 22.42 lbs for underweight women (n=218), 20.27 lbs for normal weight women (n=468), 16.36 lbs for overweight women (n=203), and 11.22 lbs for obese women (n=169). A total of 45450 weight readings were recorded, with an average interval between recordings of 3.5 days. Postpartum monitoring of 395 women showed a mean weight loss of 7.79 lbs. On average 50% of gestational weight gain was lost by 6 weeks postpartum. During the postpartum period a total of 6071 weight readings were recorded, with an average interval between recordings of 3.5 days.

CONCLUSION:
Remote monitoring of gestational weight gain in low-risk pregnancy resulted in frequent recordings during the antepartum and postpartum period. In the future there is an opportunity for early intervention aided by connected platforms where deviations in recommend weight gain are identified. Adherence to weight monitoring highlights the ability to integrate this tool with high-risk care.
Multivariate machine learning distinguishes cross-network dynamic functional connectivity patterns in state and trait neuropathic pain
Authors: Cheng Joshua C. , Rogachov Anton , Hemington Kasey S. , Kucyi Aaron , Bosma Rachael L. , Lindquist Martin A. , Inman Robert D. , Davis Karen D. 
Published: April 2018

Abstract
Communication within the brain is dynamic. Chronic pain can also be dynamic, with varying intensities experienced over time. Little is known of how brain dynamics are disrupted in chronic pain, or relates to patients' pain assessed at various timescales (eg, short-term state vs long-term trait). Patients experience pain “traits” indicative of their general condition, but also pain “states” that vary day to day. Here, we used network-based multivariate machine learning to determine how patterns in dynamic and static brain communication are related to different characteristics and timescales of chronic pain. Our models were based on resting-state dynamic functional connectivity (dFC) and static functional connectivity in patients with chronic neuropathic pain (NP) or non-NP. The most prominent networks in the models were the default mode, salience, and executive control networks. We also found that cross-network measures of dFC rather than static functional connectivity were better associated with patients' pain, but only in those with NP features. These associations were also more highly and widely associated with measures of trait rather than state pain. Furthermore, greater dynamic connectivity with executive control networks was associated with milder NP, but greater dynamic connectivity with limbic networks was associated with greater NP. Compared with healthy individuals, the dFC features most highly related to trait NP were also more abnormal in patients with greater pain. Our findings indicate that dFC reflects patients' overall pain condition (ie, trait pain), not just their current state, and is impacted by complexities in pain features beyond intensity.
Unexplained reciprocal regulation of diabetes and lipoproteins
Authors: Higuchi Sei , Izquierdo M. Concepción , Haeusler Rebecca A. 
Published: April 2018

Purpose of review
Type 2 diabetes is associated with a characteristic dyslipidemia that may exacerbate cardiovascular risk. The causes of, and the effects of new antihyperglycemia medications on, this dyslipidemia, are under investigation. In an unexpected reciprocal manner, lowering LDL-cholesterol with statins slightly increases the risk of diabetes. Here we review the latest findings.

Recent findings
The inverse relationship between LDL-cholesterol and diabetes has now been confirmed by multiple lines of evidence. This includes clinical trials, genetic instruments using aggregate single nucleotide polymorphisms, as well as at least eight individual genes – HMGCR, NPC1L1, HNF4A, GCKR, APOE, PCKS9, TM6SF2, and PNPLA3 – support this inverse association. Genetic and pharmacologic evidence suggest that HDL-cholesterol may also be inversely associated with diabetes risk. Regarding the effects of diabetes on lipoproteins, new evidence suggests that insulin resistance but not diabetes per se may explain impaired secretion and clearance of VLDL-triglycerides. Weight loss, bariatric surgery, and incretin-based therapies all lower triglycerides, whereas SGLT2 inhibitors may slightly increase HDL-cholesterol and LDL-cholesterol.

Summary
Diabetes and lipoproteins are highly interregulated. Further research is expected to uncover new mechanisms governing the metabolism of glucose, fat, and cholesterol. This topic has important implications for treating type 2 diabetes and cardiovascular disease.
Muscle Strength of Lower Limbs as a Predictor of Postural Stability and Fear of Falling in Physically Active and Inactive Older Men and Women
Authors: Sadowska Dorota , Osiński Wiesław , Gumny Margareta 
Published: April 2018

Objectives:
The aim of this study was to analyze the strength of lower limb muscles, adjusted for potential modulating effects of physical activity, as a predictor of postural stability and the fear of falling (FoF) in older women and men.

Materials and Methods.
The study included 113 physically active and inactive persons older than 60 years (73.35 ± 7.05 years). The strength of 4 groups of lower limb muscles was determined, along with postural stability, that is, Timed Up and Go (TUG) test, Functional Reach (FR) test, and subjective FoF.

Results and Conclusions.
Shorter time to complete TUG test coexisted with the greater strength of all examined muscles (from r = −0.28 to r = −0.48), except the gastrocnemius. The results of FR test in physically active individuals correlated significantly with gastrocnemius muscle strength (r = 0.34). Subjective FoF showed statistically significant correlations with the strength of all examined muscles (from R = −0.38 to R = −0.44), as well as with the results of TUG (R = 0.45) and FR tests (R = −0.43). Physically inactive older men show a considerable decrease in quadriceps muscle and hamstring strength. The strength of these muscles is similar to that observed in physically inactive women. The strength of quadriceps muscle, hamstrings, and hip abductors is a good predictor of the results of TUG test, whereas the strength of the gastrocnemius predicts the outcome of FR test. Lesser strength of lower limb muscles and worse results of TUG and FR tests are associated with greater subjective FoF.
Association of intrauterine alcohol exposure and offspring depression: A negative control analysis of maternal and partner consumption
Authors: Easey Kayleigh E , Timpson Nicholas J , Munafò Marcus R 
Published: April 2018

AbstractBackgroundPrevious research has suggested that intrauterine alcohol exposure is associated with a variety of adverse outcomes in offspring. However, few studies have investigated its association with offspring internalising disorders in late adolescence.MethodsUsing data from the Avon Longitudinal Study of Parents and Children (ALSPAC), we investigated the associations of maternal drinking in pregnancy with offspring depression at age 18. We also examined partner drinking as a negative control for intrauterine exposure for comparison.ResultsOffspring of mothers that consumed any alcohol at 18 weeks gestation were at increased risk of having a diagnosis of depression (OR 1.15, 95% CI 1.00 to 1.32), but there was no clear evidence of association between partners alcohol consumption during pregnancy and increased risk of offspring depression (OR 0.90, 95% CI 0.78 to 1.04).ConclusionsMaternal drinking in pregnancy was associated with increased risk of offspring depression at age 18. Residual confounding may explain this association, but the negative control comparison of paternal drinking provides some evidence that it may be causal, and this warrants further investigation.
Inferring the ancestry of parents and grandparents from genetic data
Authors: Pei Jingwen , Zhang Yiming , Nielsen Rasmus , Wu Yufeng 
Published: April 2018

AbstractInference of admixture proportions is a classical statistical problem in population genetics. Standard methods implicitly assume that both parents of an individual have the same admixture fraction. However, this is rarely the case in real data. In this paper we show that the distribution of admixture tract lengths in a genome contains information about the admixture proportions of the ancestors of an individual. We develop a Hidden Markov Model (HMM) framework for estimating the admixture proportions of the immediate ancestors of an individual, i.e. a type of decomposition of an individual’s admixture proportions into further subsets of ancestral proportions in the ancestors. Based on a genealogical model for admixture tracts, we develop an efficient algorithm for computing the sampling probability of the genome from a single individual, as a function of the admixture proportions of the ancestors of this individual. This allows us to perform probabilistic inference of admixture proportions of ancestors only using the genome of an extant individual. We perform extensive simulations to quantify the error in the estimation of ancestral admixture proportions under various conditions. To illustrate the utility of the method, we apply it to real genetic data.Author summaryAncestry inference is an important problem in genetics and is used commercially by a number of companies affecting millions of consumers of genetic ancestry tests. In this paper, we show that it is possible, not only to estimate the ancestry fractions of an individual, but also, with some uncertainty, to estimate the ancestry fractions of an individual’s ancestors. For example, if an individual traces his/her ancestry 50% to Asia and 50% to Europe, it is possible to distinguish between the individual having two parents that each are 50:50 composites of Asian and European ancestry, or one parent from Asia and one from Europe. It is likewise also possible to make inferences about grandparents. We present a computationally efficient method for making such inferences called PedMix. PedMix is based on a probabilistic model for the descendant and the recent ancestors. PedMix infers admixture proportions of recent ancestors (parents, grandparents or even great grandparents) using whole-genome genetic variation data from a focal individual. Results on both simulated and real data show that PedMix performs reasonably well in most scenarios.
Evolution of Environmentally-Enforced, Repeat Protein Topology in the Outer Membrane
Authors: Franklin Meghan Whitney , Nepomnyachiy Sergey , Feehan Ryan , Ben-Tal Nir , Kolodny Rachel , Slusky Joanna S.G. 
Published: April 2018

AbstractOuter membrane beta barrels (OMBBs) are the proteins on the surface of Gram negative bacteria. These proteins have diverse functions but only a single topology, the beta barrel. It has been suggested that this common fold is a repeat protein with the repeating unit of a beta hairpin. By grouping structurally solved OMBBs by sequence, a detailed evolutionary story unfolds. A strand-number based pathway manifests with progression from a primordial 8-stranded barrel to 16-stranded and then to 18-stranded barrels. The transitions from 16- to 18-stranded barrels show mechanisms of strand number variation without domain duplication, such as a loop to hairpin transition. This indicates that repeat protein topology can be perpetuated without genetic duplication likely because the topology is being enforced by the membrane environment. Moreover, we find the evolutionary trace is particularly prominent in the C-terminal half of OMBBs which may be relevant to understanding OMBB folding pathways.