bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating the performance of open-source and proprietary processing of actigraphy sleep estimation in children with suspected sleep disorders: a comparison with polysomnography
Authors: Cepni Aliye B , Burkart Sarah , Zhu Xuanxuan , White James , Finnegan Olivia , Nelakuditi Srihari , Beets Michael , Brown III David , Pate Russell , Welk Gregory , de Zambotti Massimiliano , Ghosal Rahul , Wang Yuan , Armstrong Bridget , Adams Elizabeth , van Hees Vincent , Weaver R Glenn 
Published: November 2024

Abstract

Study Objectives
Evaluate the performance of actigraphy-based open-source and proprietary sleep algorithms compared to polysomnography in children with suspected sleep disorders.

Methods
In a sleep clinic, 110 children (5–12 years, 54% female, 50% black, 82% with sleep disorders) wore wrist-placed ActiGraph GT9X during overnight polysomnography. Actigraphy data were scored as sleep or wake using open-source GGIR and proprietary ActiLife software. Discrepancy and epoch-by-epoch analyses were conducted to assess agreement between algorithms and polysomnography, along with equivalence testing.

Results
The open-source vanHees2015 algorithm showed good accuracy (79.5% ± 12.0%), sensitivity (81.1% ± 13.5%), and specificity (66.0% ± 23.8%) for sleep detection but was outperformed by the proprietary ActiLife algorithms. The magnitude and trend of bias for total sleep time (TST), sleep efficiency (SE), sleep onset latency, and wake after sleep onset were similar between algorithms. TST and SE were statistically equivalent for the Cole-Kripke (Actilife) and vanHees2015 algorithms compared to the Sadeh (Actilife) algorithm. The Cole-Kripke (ActiLife) demonstrated higher sensitivity (90.5%) to detect sleep but lower specificity (61.2%) than Cole-Kripke (GGIR) (sensitivity: 62.7%, specificity: 79.9%). Sadeh and Cole-Kripke estimated sleep outcomes were not statistically equivalent between implementations in ActiLife and GGIR.

Conclusions
The open-source vanHees2015 algorithm performed well but slightly worse than the proprietary ActiLife algorithms in children. The open-source nature vanHees2015 makes it ideal for clinical pediatric use. Implementation of the Sadeh and Cole-Kripke algorithms in the proprietary ActiLife and open-source GGIR software yield different sleep estimates, so comparisons between studies using these different implementations should be avoided.
Connecting the Dots Between Inpatient Quality of Obstetric Recovery and Postpartum Depression: Are We Ready for a Cultural Shift?
Authors: Landau R. 
Published: November 2024

(J Clin Anesth. 2024;96:111372 I. https://doi.org/10.1016/j.jclinane.2023.111372 I)
Enhanced recovery protocols have recently been developed to improve recovery after childbirth, focusing on minimizing maternal morbidity and pain following cesarean delivery. However, there is limited literature on the effort it takes to return to a healthy and normal standard in the postpartum period. The measurement of recovery quality is a new area of focus in the research and practice of obstetric anesthesia. Aspects such as postpartum discomfort, nausea, lightheadedness, shaking, ease, movement, capacity to care for the baby, self-care, and sense of empowerment all influence the quality of recovery during hospitalization. Pervez and colleagues developed a new survey called Obstetric Quality of Recovery (ObsQoR-10), which is a patient-reported outcome measure (PROM) used to evaluate recovery after vaginal and cesarean deliveries in hospital settings. Although numerous studies have assessed global PROMs for postpartum healing and screening tools for postpartum depression (PPD), there is still a lack of ideal measures for assessing outpatient recovery quality.
Society for Maternal-Fetal Medicine Consult Series #68: Sickle Cell Disease in Pregnancy
Authors:   Society for Maternal-Fetal Medicine, Sinkey R.G. , Ogunsile F.J. , Kanter J. , Bean C. , Greenberg M. ,   Society for Maternal-Fetal Medicine Publications Committee
Published: November 2024

(Am J Obstet Gynecol. 2024;230(2):B17–B40. doi: 10.1016/j.ajog.2023.10.031)
The Society for Maternal-Fetal Medicine (SMFM) has published recommendations for managing sickle cell disease (SCD) in pregnancy as part of its Consult Series. The guidance also summarizes what is known about the disease.
Perinatal Depression and Risk of Mortality: Nationwide, Register-Based Study in Sweden
Authors: Hagatulah N. , Bränn E. , Oberg A.S. , Validmarsdóttir U.A. , Shen Q. , Lu D. 
Published: November 2024

(BMJ. 2024;384:e075462. doi: 10.1136/bmj-2023-075462)
Perinatal depression (PD), which occurs either during pregnancy or after delivery, is diagnosed with the Diagnostic and Statistical Manual of mental disorders (DSMMD). Although PD is associated with decreased maternal well-being and an increased risk of suicide, the impact on maternal mortality is not clearly understood. The risk of death following a diagnosis of PD is specifically explored in this matched cohort Swedish study. To understand whether there are familial risk factors, including genetics and shared childhood experiences, in PD, the study design includes sibling comparison. Data for the study was sourced from the Swedish health registers, including the medical birth register, the national patient register, the national drug register, the multigenerational register, and the causes of death register. Pregnancies from 2001 to 2017 were examined, with exclusions including: multiple pregnancies, pregnancies after PD, and missing age. After exclusions, 1,029,215 women were considered part of the study base, while 86,551 of these women had received their first diagnosis of PD and received treatment either with antidepressants or other care (before the first year postpartum). The women diagnosed with PD were followed based on whether they were diagnosed with antepartum or postpartum depression. Ten women from the study base without a PD diagnosis were included for each woman (index) diagnosed with PD. Specifically, these 865,510 women, which make up the reference group for the study, were chosen based on their similar age and similar delivery date with the index women. In total, the reference group and the index women make up the population cohort. In addition, the sibling cohort was selected, with all pregnant women who gave birth during the study years (2001 to 2017) and had at least 1 full sister included.
Time Trends in Preeclampsia and Gestational Diabetes in Denmark and Alberta, Canada, 2005 to 2018: A Population-Based Cohort Study
Authors: Lihme F. , Savu A. , Basit S. , Sia W. , Yeung R. , Barrett O. , Luoma L. , Ngwezi D.P. , Davidge S. , Norris C.M. , Ospina M.B. , Cooke C.L. , Greiner R. , Wohlfahrt J. , Melbye M. , Lykke J. , Kaul P. , Boyd H.A. 
Published: November 2024

(Acta Obstet Gynecol Scand. 2024;103:266–275. doi: 10.1111/aogs.14703)
Preeclampsia (PEC) and gestational diabetes mellitus (GDM) have similar risk factors including increased maternal age and obesity. Both conditions are associated with adverse pregnancy outcomes and long-term health issues for mothers and children, and health care resources could be strained if the prevalence of PEC and GMA are increasing.
Safety of GLP-1 Receptor Agonists and Other Second-Line Antidiabetics in Early Pregnancy
Authors: Cesta C.E. , Rotem R. , Bateman B.T. , Gabriel C. , Cohen J.M. , Furu K. , Gissler M. , Huybrechts K.F. , Kjerpeseth L.J. , Leinonen M.K. , Pazzagli L. , Zoega H. , Seely E.W. , Patorno E. , Hernandez-Diaz S. 
Published: November 2024

JAMA Intern Med. 2024;184(2):144–152. doi: 10.1001/jamainternmed.2023.6663
Metformin is the first-line treatment in T2D. However, more patients are taking second-line antidiabetic medications (ADMs) as well to achieve adequate glycemic control. In pregnancy, insulin has historically been used due to its safety profile and metformin administration is now also common. With the recent increased use of ADMs, unintended exposure in early pregnancy is occurring and the risk of major congenital malformations (MCMs) in the infant is unknown. This large multinational study looked at the use and safety of GLP-1 receptor agonists and other noninsulin ADMs early in pregnancy in comparison to insulin.
First Trimester Use of Buprenorphine or Methadone and the Risk of Congenital Malformations
Authors: Suarez E.A. , Bateman B.T. , Straub L. , Hernandez-Diaz S. , Jones H.E. , Gray K.J. , Connery H.S. , Davis J.M. , Lester B. , Terplan M. , Zhu Y. , Vine S.M. , Mogun H. , Huybrechts K.F. 
Published: November 2024

(JAMA Intern Med. 2024;184(3):242–251. doi: 10.1001/jamainternmed.2023.6986)
For pregnant patients with opioid use disorder (OUD), buprenorphine and methadone are prescribed to lower the risk of overdose and prevent withdrawal symptoms. Studies have shown a lower risk of preterm birth, low birth weight, and neonatal abstinence syndrome using buprenorphine compared with methadone. There have not been large studies to understand the risk of congenital malformations. This retrospective cohort study looked at data from a national Medicaid database on first-trimester pregnancies from 2000 to 2018. The goal was to assess the comparative risk of congenital malformations among infants exposed to buprenorphine compared with methadone.
The Effect of Digital Health Interventions on Postpartum Depression or Anxiety: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Lewkowitz A.K. , Whelan A.R. , Ayala N.K. , Hardi A. , Stoll C. , Battle C.L. , Tuuli M.G. , Ranney M.L. , Miller E.S. 
Published: November 2024

(Am J Obstet Gynecol. 2024;230(1):12–43. https://doi.org/10.1016/j.ajog.2023.06.028)
Around 15% of women experience postpartum depression (PPD) and 20% encounter postpartum anxiety (PPA) within the first year after childbirth. Research has shown that psychoeducation, psychotherapies, and mindfulness can effectively prevent and treat PPD and PPA. However, <20% of women with these conditions can access these interventions due to a shortage of trained mental health professionals during the perinatal period. Digital health interventions (DHIs) offer a potential solution by providing evidence-based psychoeducation and psychotherapy through the Internet, smartphone apps, or text messaging services. DHIs are highly accessible, as nearly all reproductive-age individuals in the US own smartphones, and a majority have broadband internet access. They also overcome barriers such as lack of childcare and unreliable transportation, which hinder adherence to in-person postpartum care. In addition, DHIs can be scaled effectively without compromising intervention fidelity.
Method of Anesthesia and Perioperative Risk Factors, Maternal Anesthesia Complications, and Neonatal Mortality Following Cesarean Delivery in Africa: A Substudy of a 7-Day Prospective Observational Cohort Study
Authors: Gerber C. , Bishop D.G. , Dyer R.A. , Maswime S. , Rodseth R.N. , van Dyk D. , Biccard B.M. ,   on behalf of the African Surgical Outcomes Study (ASOS) Investigators
Published: November 2024

(Anesth Analg. 2024;138(6):1275–1284.)
Maternal and neonatal mortality rates are significantly high in Africa. The African Surgical Outcomes Study (ASOS) revealed that maternal mortality (MM) following cesarean delivery is 50 times higher in Africa compared with high-income countries, primarily due to obstetric hemorrhage and anesthesia complications. General anesthesia (GA) was particularly risky, with 1 in 66 GAs resulting in maternal death and a higher MM rate compared with spinal anesthesia (SA) (1.5% vs. 0.3%). A substudy was conducted within ASOS to estimate the association between preoperative risk factors and anesthesia methods. Secondary aims included examining the relationship between anesthesia type and maternal intraoperative hypotension, severe anesthesia complications, and neonatal mortality. This secondary analysis of the ASOS obstetric cohort involved patients aged 18 and older across 183 hospitals in 22 African countries. Data collected included gravidity, parity, gestational age, and complications like preeclampsia and eclampsia. The study followed the STROBE guidelines and received ethical approvals from relevant committees.
Shock Index as a Predictor of Postpartum Hemorrhage After Vaginal Delivery: Secondary Analysis of a Multicenter Randomized Controlled Trial
Authors: Madar H , Deneux-Tharaux C , Sentilhes L ,   on behalf of the TRAAP Study Group
Published: November 2024

(BJOG. 2024;131:343–352. doi: 10.1111/1471-0528.17634)
A reliable predictive indicator of postpartum hemorrhage (PPH) could be a significant medical advance. Shock index (SI) is a measurement dividing heart rate (bpm) by systolic blood pressure (mmHg), with a healthy individual usually between 0.5 and 0.7 and the cutoff, where morbidity and mortality is expected, at 0.9. Elevated SI values have been associated with various cardiovascular conditions including hypovolemia and left heart dysfunction. Previous studies have shown values in the immediate postpartum period to range from 0.5 to 0.9, although these studies excluded women who experienced PPH. Additional research suggests the potential for SI to be used as an early sign of PPH, with a range of 0.9 and 1.0; however, the SI included for each patient was their highest in the postpartum period, which technically means the value is being used as a detection tool rather than a predictor. SI is currently recommended as a tool for PPH management.
Mid-Trimester Uterine Artery Doppler for Aspirin Discontinuation in Pregnancies at High Risk for Preterm Preeclampsia: Post Hoc Analysis of StopPRE Trial
Authors: Bonacina E. , Garcia-Manau P. , Lopez M. , Caamina S. , Vives A. , Lopez-Quesada E. , Ricart M. , Maroto A. , de Mingo L. , Pintado E. , Castillo-Ribelles L. , Martin L. , Rodriguez-Zurita A. , Garcia E. , Pallarols M. , Vidal-Sagnier L. , Teixidor M. , Orizales-Lago C. , Perez-Gomez A. , Ocana  , Puerto L. , Millan P. , Alsius M. , Diaz S. , Maiz N. , Carreras E. , Suy A. , Mendoza M. 
Published: November 2024

(BJOG. 2024;131(3):334–342. doi: 10.1111/1471-0528.17631)
Preeclampsia (PEC) is characterized by hypertension and proteinuria or organ dysfunction after 20 weeks of gestation. The cause of the condition has not been fully elucidated; however, PEC is associated with a defect in the development of the placenta in early-onset patients. In unaffected individuals, uterine artery flow impedance (UtA) decreases during early gestation through week 24. However, if pulsatility index (PI) in UtA remains high, it is a sign of maladaptation and is commonly found in patients with preterm PEC. An additional consequence of impaired placentation is uteroplacental ischemia, during which the levels of placental growth factor (PIGF) are decreased and soluble fms-like tyrosine kinase-1 (sFlt-1) increases. In screening first trimester patients for risk of PEC, UtAPI and PIGF may be used. Clinicians prescribe aspirin daily as a preventative measure in patients who screen at risk for PEC. Although the incidence of PEC greatly decreases with this treatment, it is also noteworthy that screening for risk of PEC during the first trimester results in a high false positive rate. Thus, most women pre-emptively receiving aspirin for PEC are false positives. The authors previously performed a study where aspirin was discontinued in patients between 24 and 28 weeks of gestation with a normal sFlt-1/PlGF ratio of ≤38, identifying false positives cases. Although this study showed promising results, the ratio may not be available for use in every clinic. Thus, in this study, the authors examine whether UtAPI can be a correlate for these angiogenic factors and act as an alternative screening measure at 24 to 28 weeks of gestation with the same purpose to discontinue aspirin and assess incidence of preterm PEC.
Maternal Morbidity According to Mode of Delivery Among Pregnant Patients With Pulmonary Hypertension
Authors: Meng M.-L. , Fuller M. , Federspiel J.J. , Engelhard M. , McNeil A. , Ernst L. , Habib A.S. , Shah S.H. , Quist-Nelson J. , Raghunathan K. , Ohnuma T. , Krishnamoorthy  
Published: November 2024

(Anesth Analg. 2024;138(5):1011–1019. doi: 10.1213/ANE.0000000000006523)
Pulmonary hypertension (PHTN) conveys significant risk for morbidity and mortality during pregnancy leading to many patients being counseled against pregnancy or for termination should pregnancy occur. Despite this risk, some women do proceed with pregnancy beyond 25 weeks; however, information on these cases remains elusive and limited to case series or reports with small samples. Current recommendations surrounding delivery for women with PHTN recommend cesarean delivery (CD), but new evidence is showing that trial of labor in these circumstances is safe and that vaginal delivery (VD) may reduce associated rates of morbidity and mortality. This study assessed the association between mode of delivery and maternal morbidity in individuals with PHTN and pregnancies past 25 weeks of gestation, with a hypothesis that an intended VD has lower morbidity rates than intended CD.
Association Between Intrapartum Nitrous Oxide for Labor Analgesia and Short-Term Neonatal Outcomes
Authors: Starosta A. , Lundsberg L. , Culhane J. , Partridge C. , Grechukhina O. , Son M. 
Published: November 2024

(Obstet Gynecol. 2024;143:677–682. doi: 10.1097/AOG.0000000000005554)
Methods of management for pain during labor can include systemic opioids, inhaled gas, and neuraxial analgesia; one popular and effective method is inhaled nitrous oxide, with its use increasing recently in the United States. Though its use is increasing, it is known to cross the placenta and it is unknown if its use is associated with adverse neonatal outcomes. There are biologically plausible concerns about the short-term effects on neonates if nitrous oxide is used intrapartum, but little evidence to support one conclusion or another. This study was designed to assess an association between intrapartum nitrous oxide and adverse short-term neonatal outcomes, with a null hypothesis that there would be no significant differences.
Prevalence and Persistence of Prescription Opioid Use Following Hospital Discharge After Childbirth: An Australian Population-Based Cohort Study
Authors: Varney B. , Zoega H. , Bjørn Gillies M. , Gisev N. , Weston Shand A. , Pearson S.-A. , Havard A. 
Published: November 2024

(Anesth Analg. 2024;138(5):970–979. doi: 10.1213/ANE.0000000000006582)
Childbirth accounts for nearly 300,000 hospitalizations a year in Australia and is associated with acute pain. Pain treatment has shown that nonopioid analgesics are effective for mild to moderate pain, and opioids are effective for severe pain; the prescription rate of opioids in Australia is considered high, ranked eighth internationally in 2016. Opioid use has many general risks, but in addition to these the risk of persistent use after being exposed to opioids postpartum are elevated. In the United States, this risk has been shown to be up to 2.5 times higher for those prescribed opioids within a week of a vaginal delivery, along with a 1.5-fold risk of developing opioid use disorder and a 2-fold risk of an opioid overdose. This study was designed to evaluate the prevalence of dispensing of opioid medications following childbirth in Australia, as well as the extent to which individuals experienced persistent opioid use.
Intraoperative Burst Suppression by Analysis of Raw Electroencephalogram Postoperative Delirium in Older Adults Undergoing Spine Surgery: A Retrospective Cohort Study
Authors: Pawar Niti , Zhou Sara , Duarte Karina , Wise Amy , García Paul S. , Kreuzer Matthias , Barreto Chang Odmara L. 
Published: November 2024

Background:
Postoperative delirium is a common complication in older adults, associated with poor outcomes, morbidity, mortality, and higher health care costs. Older age is a strong predictor of delirium. Intraoperative burst suppression on the electroencephalogram (EEG) has also been linked to postoperative delirium and poor neurocognitive outcomes.

Methods:
In this a secondary analysis of data from the Perioperative Anesthesia Neurocognitive Disorder Assessment-Geriatric (PANDA-G) observational study, the raw EEGs of 239 spine surgery patients were evaluated. Associations between delirium and age, device-generated burst suppression ratio, and visual detection of the raw EEG were compared.

Results:
Demographics and anesthesia durations were similar in patients with and without delirium. There was a higher incidence of burst suppression identified by analysis of the raw EEG in the delirium group than in the no delirium group (73.45% vs. 50.9%; P=0.001) which appeared to be driven largely by a higher incidence of burst suppression during maintenance of anesthesia (67.2% vs. 46.3%; P=0.004). Burst suppression was more strongly associated with delirium than with age; estimated linear regression coefficient for burst suppression 0.182 (SE: 0.057; P=0.002) and for age 0.009 (SE: 0.005; P=0.082). There was no significant interaction between burst suppression and age (−0.512; SE: 0.390; P=0.190). Compared with visual detection of burst suppression, the burst suppression ratio overestimated burst suppression at low values, and underestimated burst suppression at high values.

Conclusion:
Intraoperative burst suppression identified by visual analysis of the EEG was more strongly associated with delirium than age in older adults undergoing spine surgery. Further research is needed to determine the clinical importance of these findings.
Cell therapy for end-stage liver disease: Current state and clinical challenge
Authors: Zhang Lin , Deng Yuntian , Bai Xue , Wei Xiao , Ren Yushuang , Chen Shuang , Deng Hongxin 
Published: November 2024

Abstract
Liver disease involves a complex interplay of pathological processes, including inflammation, hepatocyte necrosis, and fibrosis. End-stage liver disease (ESLD), such as liver failure and decompensated cirrhosis, has a high mortality rate, and liver transplantation is the only effective treatment. However, to overcome problems such as the shortage of donor livers and complications related to immunosuppression, there is an urgent need for new treatment strategies that need to be developed for patients with ESLD. For instance, hepatocytes derived from donor livers or stem cells can be engrafted and multiplied in the liver, substituting the host hepatocytes and rebuilding the liver parenchyma. Stem cell therapy, especially mesenchymal stem cell therapy, has been widely proved to restore liver function and alleviate liver injury in patients with severe liver disease, which has contributed to the clinical application of cell therapy. In this review, we discussed the types of cells used to treat ESLD and their therapeutic mechanisms. We also summarized the progress of clinical trials around the world and provided a perspective on cell therapy.
Retroperitoneal laparoscopy for hydronephrosis due to multiple fibroepithelial polyps: A case series
Authors: Nguyen Huy-Hoang , Do Ngoc-Son , Do Minh-Tung 
Published: November 2024

Abstract
We retrospectively reviewed the medical records of four men and one woman who underwent retroperitoneal laparoscopic pyeloplasty for multiple fibroepithelial polyps in a tertiary hospital. The median age of the patients was 30 years (13–39 years). Ispsilateral flank pain was observed in all patients while two patients had hematuria. Preoperative computed tomography urography showed a contrast-enhanced solid mass in the arterial phase and hydronephrosis with images of a filling defect or frond-like in the excretory phase. Length of ureteral segment containing fibroepithelial polyp ranges from 4.3 to 5.6 cm (median, 4.7 cm) The median operation time was 80 minutes (range, 70–90 min) without any complications. Postoperative urine leakage was not observed. Flank pain was resolved in all patients. In addition, hydronephrosis was resolved in two cases and downgraded in three cases. Histopathology revealed fibroepithelial polyp in all cases.