bluuebunny/crossref_metadata_2025_split huggingface dataset:
Normal Range for Maternal Lactic Acid during Pregnancy and Labor: A Systematic Review and Meta-Analysis of Observational Studies
Authors: Bauer Melissa E. , Balistreri Michael , MacEachern Mark , Cassidy Ruth , Schoenfeld Robert , Sankar Keerthana , Clauw Daniel J. , Langen Elizabeth 
Published: November 2018

Objective This article systematically reviews the literature to establish the normal range of lactic acid in healthy pregnant women.
Study Design Ovid MEDLINE, Embase.com, and Clinicaltrials.gov were searched to identify studies that reported maternal lactic acid in healthy pregnant women. Pooled aggregate means and two standard deviations for each time period were computed using the inverse variance weighting technique. Analyses were performed separately for 1st, 2nd, and 3rd trimesters, scheduled cesarean delivery, early labor, active labor, 2nd stage of labor, and delivery.
Results Overall, 22 studies met the inclusion criteria. There were 1,193 patients, and 2,008 observations identified. All time periods had maternal venous lactic acid aggregate means and two-standard-deviation ranges less than 4 mmol/L. Outside of labor, all ranges were less than 2 mmol/L. All labor periods had a range higher than 2 mmol/L. While the pooled ranges were less than 4 mmol/L, many individual studies reported ranges > 4 mmol/L during labor.
Conclusion This meta-analysis suggests that venous lactic acid levels can be used as a screening tool in pregnant women just as the test would be used in nonpregnant women, except that elevations may be seen during labor, especially later in labor when there is maximal skeletal muscle contraction.
Pregnancy Outcomes after Early Amniotomy among Class III Obese Gravidas Undergoing Induction of Labor
Authors: Pasko Daniel , Miller Kathryn , Jauk Victoria , Subramaniam Akila 
Published: November 2018

Objective We sought to evaluate differences in pregnancy outcomes following early amniotomy in women with class III obesity (body mass index ≥40 kg/m2) undergoing induction of labor.
Study Design This is a retrospective cohort study of women with class III obesity undergoing term induction of labor from January 2007 to February 2013. Early amniotomy was defined as artificial membrane rupture at less than 4 cm cervical dilation. The primary outcome was cesarean delivery. Secondary outcomes included length of labor, a maternal morbidity composite, and a neonatal morbidity composite. A subgroup analysis examined the effect of parity. Multivariable logistic regression was used to adjust for covariates.
Results Of 285 women meeting inclusion criteria, 107 (37.5%) underwent early amniotomy and 178 (62.5%) underwent late amniotomy. Early amniotomy was associated with cesarean delivery after multivariable adjustments (adjusted odds ratio [aOR], 2.05; 95% confidence interval [CI], 1.21–3.47). There were no significant differences in length of labor or maternal and neonatal morbidity between groups. When stratified by parity, early amniotomy was associated with increased cesarean delivery (aOR, 3.10; 95% CI, 1.47–6.58) only in nulliparous women.
Conclusion Early amniotomy among class III obese women, especially nulliparous women, undergoing labor induction may be associated with an increased risk of cesarean delivery.
Infantile Refsum Disease Associated with Hypobetalipoproteinemia
Authors: Matsuo Muneaki , Akutsu Tsugio , Kanazawa Naomi , Shimozawa Nobuyuki 
Published: November 2018

Infantile Refsum disease (IRD) is a rare peroxisome biogenesis disorder with wide range of clinical severity. Herein, we report a mild form of IRD who had been followed as a symptomatic hypobetalipoproteinemia resembling with abetalipoproteinemia. At 6 years of age, the patient was diagnosed as having hypobetalipoproteinemia with spinocerebellar degeneration, peripheral neuropathy, retinitis pigmentosa, mild mental retardation, and sensorineural hearing loss. Although low vitamin E levels normalized after oral supplementation, the patient's clinical symptoms worsened very slowly. At 30 years of age, elevated levels of very long chain fatty acids and phytanic acid and decreased plasmalogen levels were detected in the plasma. Genetic analysis revealed a homozygous mutation of Q67R in PEX10.Although hypocholesterolemia is relatively common in IRD, it has been overlooked so far. Since there are many similarities between IRD and abetalipoproteinemia or symptomatic hypobetalipoproteinemia, care should be taken to differentiate symptomatic hypobetalipoproteinemia from IRD.
Bilingualism and aging
Authors: Del Maschio Nicola , Fedeli Davide , Abutalebi Jubin 
Published: November 2018

AbstractWhether bilingualism acts positively against neurocognitive decline is intensely debated. Although some reasons for it might be ideological, variability in sampling procedures and experimental design represent potential sources of inconsistency among studies. In this paper, we contend that bilingualism renders the extra-years of life of an increasingly long-lived population cognitively healthy, but only under specific conditions such as continuous practice and immersion in bilingual environments. We thus disagree with some authors’ recommendation that bilingualism be removed from consideration as a neuroprotective factor. We suggest, at the same time, that bilingualism should not be treated as axiologically superior to other environmental measures that promise to contrast the progressive loss of functional independence with increasing age. We conclude by emphasizing the need to evaluate the protective effects of L2-learning on the aging brain in a multimodal intervention perspective, thereby dissociating the effects of bilingualism from those of other cognitively stimulating factors.
Does the shape of forelimb long bones co-vary with grasping behaviour in strepsirrhine primates?
Authors: Fabre Anne-Claire , Peckre Louise , Pouydebat Emmanuelle , Wall Christine E 
Published: November 2018

AbstractFine prehensile activities are often thought to have been associated with the evolution of the human hand. However, there has been no holistic approach establishing the link between the morphology of the forelimb and grasping ability in living primates. The present study investigated the possible relationships between grasping behaviour and the morphology of the forelimb in strepsirrhines in a phylogenetic context. To do so, grasping behaviour during feeding and the shape of the long bones of the forelimb were analysed for 22 species of strepsirrhines. The data obtained show that there is a phylogenetic signal in forelimb morphology in primates in relation to grasping behaviour, but also that there is a marked co-evolution between grasping behaviour and the shape of the humerus and radius. This latter finding suggests a functional association between grasping and forelimb shape, which in turn suggests that bone shape constrains or facilitates behaviour. This result may permit future inferences to be made regarding this behaviour in extinct species and deserves further examination in more detail.
Short-term Pasteurization of Breast Milk to Prevent Postnatal Cytomegalovirus Transmission in Very Preterm Infants
Authors: Bapistella Sascha , Hamprecht Klaus , Thomas Wolfgang , Speer Christian P , Dietz Klaus , Maschmann Jens , Poets Christian F , Goelz Rangmar 
Published: November 2018

Abstract

Background
Postnatally acquired cytomegalovirus (pCMV) infection through breast milk (BM) may cause severe illness and even death, yet BM is advantageous for preterm infants. Therefore, effective methods to prevent CMV transmission are needed.

Methods
To assess the effectiveness of short-term pasteurization (62°C for 5 seconds) in preventing CMV transmission via BM in preterm infants. Design: Prospective interventional bicentric cohort study with infant enrollment between 6/2010 and 1/2012. A cohort from the Tuebingen neonatal intensive care unit (NICU) from 1995–1998 served as historical controls. Differences in CMV transmission were compared with reference to the cumulative time at risk for CMV transmission. Setting: Two German level-3 NICUs. Eighty-seven preterm infants of 69 CMV immunoglobulin G-positive mothers with birth weight <1500 g or gestational age <32 weeks and 83 historical controls were included. Intervention: BM samples were short-term pasteurized from postnatal day 4 to discharge. Primary endpoint: CMV status at discharge, evaluated by polymerase chain reaction and short-term microculture from urine.

Results
Two of 87 (2.3%) study infants had a pCMV transmission. This compared to 17 of 83 (20.5%) controls. Total time under risk for infection was 9.6 years vs 10.0 years in controls, yielding an incidence of 0.21/year (95% confidence interval [CI], 0.03 to 0.75/year) vs 1.70/year (95% CI, 0.99 to 2.72/year), respectively. The risk ratio controls vs study infants was 8.3 (95% CI, 2.4 to 52.4) according to Cox proportional hazard model (P = .0003).

Conclusions
Short-term pasteurization significantly reduces the incidence of pCMV infection through BM in the NICU.

Clinical Trials Registration
NCT01178905.
Optimal error estimates of finite difference time domain methods for the Klein–Gordon–Dirac system
Authors: Yi Wenfan , Cai Yongyong 
Published: November 2018

AbstractWe propose and analyze finite difference methods for solving the Klein–Gordon–Dirac (KGD) system. Due to the nonlinear coupling between the complex Dirac ‘wave function’ and the real Klein–Gordon field, it is a great challenge to design and analyze numerical methods for KGD. To overcome the difficulty induced by the nonlinearity, four implicit/semi-implicit/explicit finite difference time domain (FDTD) methods are presented, which are time symmetric or time reversible. By rigorous error estimates, the FDTD methods converge with second-order accuracy in both spatial and temporal discretizations, and numerical results in one dimension are reported to support our conclusion. The error analysis relies on the energy method, the special nonlinear structure in KGD and the mathematical induction. Thanks to tensor grids and discrete Sobolev inequalities, our approach and convergence results are valid in higher dimensions under minor modifications.
Competing Principals and Non-Vote Decisions in the European Parliament
Authors: Font Nuria 
Published: November 2018

Abstract
This article analyses the effects of competing principals on legislators’ decisions not to vote in the European Parliament. We argue that Members of the European Parliament (MEPs) are likely to decide not to vote to avoid defecting from either the national party or the European political group when both political principals disagree. Moreover, the article demonstrates that competing demands between principals interact with the expected closeness of a vote. MEPs are more likely to opt for not voting when they have few chances to influence the vote outcome and are torn between the two main principals. Based on a novel data set on individual votes in the 2009–2014 term, this article demonstrates that competing demands moderate the effect of the expected vote closeness on non-vote decisions and highlights the need to incorporate this type of legislative non-response in future research.
PATIENTS DOSE ESTIMATION IN CT EXAMINATIONS USING SIZE SPECIFIC DOSE ESTIMATES
Authors: Choudhary Neha , Rana Bhupendra Singh , Shukla Arvind , Oinam Arun Singh , Singh Narinder Paul , Kumar Sanjeev 
Published: November 2018

Abstract
The present work reports data of radiation exposure to the patients during head, chest, pelvis and abdomen CT examinations performed on a third-generation 16-slice CT machine. Radiation exposure was estimated using size specific dose estimates (SSDE) method, which takes into account patient’s physical dimensions in phantom measured computed tomography dose index (CTDI) value. The reported median CT dose volume index CTDIvol values in head, chest, pelvis and abdomen examinations were 26.76, 16.27, 29.81 and 14.74 mGy, respectively. The median doses evaluated using SSDE methodology for the above mentioned procedure were 54.1, 23.1, 42.8 and 20.1 mGy, respectively. Our results showed variation in dose values estimated using CTDI and SSDE methods in all examinations. The evaluated SSDE values were also compared to the values derived from data reported by the American Association of Physicist in Medicine (AAPM). SSDE values in present measurements are 4–8% lower than AAPM values. The present results show that CTDI parameters recorded on CT console should not be used to specify patient dose during CT procedures.
Pregnancy and Childbirth After Sexual Trauma
Authors: Sobel Lauren , O'Rourke-Suchoff Danielle , Holland Erica , Remis Kimberly , Resnick Kirsten , Perkins Rebecca , Bell Shannon 
Published: November 2018

OBJECTIVE:
To explore the pregnancy and childbirth experiences and preferences of women with a history of sexual trauma in order to identify trauma-informed care practices that health care providers may use to improve obstetric care.

METHODS:
We conducted a qualitative study consisting of semistructured interviews with women who either self-identified as having a history of sexual trauma or did not. Participants were recruited from a tertiary care ambulatory clinic and had at least one birth experience within the past 3 years. Interviews were audio-recorded and transcribed verbatim. Grounded theory was used to derive themes using the participants' own words.

RESULTS:
From 2015 to 2017, we interviewed 20 women with a history of sexual trauma and 10 without. Women with a history of sexual trauma desired clear communication about their history between prenatal care providers and the labor and delivery team. In the intrapartum period, they desired control over who was present in the labor room at the time of cervical examinations and for health care providers to avoid language that served as a stressing reminder of prior sexual trauma. They wanted control over the exposure of their bodies during labor and to be asked about their preference for a male health care provider. In the postpartum period, some women with a history of sexual trauma found breastfeeding healing and empowering.

CONCLUSION:
Women with a history of sexual trauma have clear needs, preferences, and recommendations for obstetric care providers regarding disclosure, cervical examinations, health care provider language, body exposure, and male health care providers. They offer insight into unique breastfeeding challenges and benefits.
Menopause-Related Cognitive Impairment
Authors: Devi Gayatri 
Published: November 2018

BACKGROUND:
Identifying the cognitive changes associated with the menopausal transition prevents misattribution of symptoms to more ominous causes such as neurodegenerative disease.

CASE:
Two women with cognitive loss and objective evidence of menopause-related cognitive impairment are presented, misattributed to Alzheimer disease in one case and frontotemporal dementia in the other. Neurocognitive testing, neuroimaging, and laboratory findings are reviewed. Both women were diagnosed with menopause-related cognitive impairment and were stable in follow-up over 4 or more years.

CONCLUSIONS:
Recognizing the cognitive changes associated with menopause and distinguishing from cognitive impairment resulting from other etiologies—including neurodegenerative diseases such as Alzheimer disease—has important clinical implications both for treatment and for prognosis.
Home Self-Collection by Mail to Test for Human Papillomavirus and Sexually Transmitted Infections
Authors: Des Marais Andrea C. , Zhao Yuqian , Hobbs Marcia M. , Sivaraman Vijay , Barclay Lynn , Brewer Noel T. , Smith Jennifer S. 
Published: November 2018

OBJECTIVE:
To evaluate the validity and acceptability of at-home self-collection to test for high-risk human papillomavirus (HPV) and sexually transmitted infections among women overdue for cervical cancer screening by national guidelines.

METHODS:
Low-income, infrequently screened women were recruited from the general population in North Carolina to participate in an observational study. Participants provided two self-collected cervicovaginal samples (one at home and one in the clinic) and a clinician-collected cervical sample. Samples were tested for high-risk HPV, Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, and Mycoplasma genitalium. Cervical samples were also tested by liquid-based cytology.

RESULTS:
Overall, 193 women had conclusive high-risk HPV results for all three samples and cytology results. Prevalence of high-risk HPV within self-home samples (12.4%) was not different from that within clinician samples (11.4%; P=.79) and from that within self clinic samples (15.5%; P=.21). Positivity for high-risk HPV in all sample types increased with increasing grades of cervical abnormality (P<.001). Self-home samples detected high-risk HPV in all identified cases of high-grade squamous intraepithelial lesions and of cervical intraepithelial neoplasia 2 or worse. Detection was comparable across sample types for T vaginalis (range 10.2–10.8%), M genitalium (3.3–5.5%), C trachomatis (1.1–2.1%), and N gonorrhoeae (0–0.5%). Kappa values between sample types ranged from 0.56 to 0.66 for high-risk HPV, 0.86–0.91 for T vaginalis, and 0.65–0.83 for M genitalium. Most participants reported no difficulty understanding self-collection instructions (93.6%) and were willing to use self-collection in the future (96.3%).

CONCLUSION:
Mail-based, at-home self-collection for high-risk HPV and sexually transmitted infection detection was valid and well accepted among infrequently screened women in our study. These findings support the future use of high-risk HPV self-collection to increase cervical cancer screening rates among higher risk women in the United States.
Retroperitoneal Ectopic Pregnancy
Authors: Pak Janie O. , Durfee John Keyes , Pedro Lucio , Osborne Alicea , Larkins-Pettigrew Margaret 
Published: November 2018

BACKGROUND:
Retroperitoneal ectopic pregnancies are rare and have a tendency to implant along major vessels of the abdomen and pelvis. Clinical manifestations can vary from no symptoms to hypovolemic shock and death.

CASE:
A 30-year-old woman presented in hypovolemic shock with left flank and abdominal pain after attempting to medically terminate her first-trimester pregnancy. Intraoperative findings revealed normal pelvic organs with a massive retroperitoneal hematoma containing chorionic villi confirmed on histopathology.

CONCLUSIONS:
In a woman with a pregnancy of unknown location presenting with worsening flank pain, a retroperitoneal ectopic pregnancy must be considered. Prompt diagnosis and management in a low-resource setting presents additional challenges.
Massive Hemorrhage From Suspected Iatrogenic Uterine Rupture
Authors: Nguyen Kim T. , Lozada M. James , Gorrindo Phillip , Peralta Feyce M. 
Published: November 2018

BACKGROUND:
Intrauterine balloon tamponade is recommended for refractory postpartum hemorrhage resulting from atony, but few studies have assessed complications associated with placement.

CASE:
A 39-year-old woman, gravida 4 para 1, with posterior placenta previa and suspected placenta accreta had a postpartum hemorrhage after a scheduled cesarean delivery. An intrauterine balloon tamponade device was easily placed transcervically; however, the patient required additional analgesia for constant severe stabbing pain worsened on examination. Three hours after placement, the balloon was expelled from the cervix, resulting in 1,500 mL of fresh blood and clot. Emergent exploratory laparotomy identified a uterine rupture inferior and lateral to the hysterotomy site.

CONCLUSION:
Intrauterine balloon tamponade may contribute to iatrogenic uterine rupture and should be considered in patients with refractory hemorrhage, hemodynamic instability, or severe pain despite analgesia.
Nonsteroidal Antiinflammatory Drug Administration and Postpartum Blood Pressure in Women With Hypertensive Disorders of Pregnancy
Authors: Anastasio Hannah B. , Campbell Lauren E. , Buermeyer Alison , Saccone Gabriele , Moreno Sindy , Cruz Yuri , Berghella Vincenzo , Schoen Corina , Roman Amanda 
Published: November 2018

OBJECTIVE:
To evaluate whether postpartum nonsteroidal antiinflammatory drug (NSAID) administration is associated with increased blood pressure in women with hypertensive disorders of pregnancy and to estimate the association between NSAID administration and use of opioid medication.

METHODS:
We conducted a retrospective cohort study of women with hypertensive disorders of pregnancy. Patients were analyzed in two groups according to whether they received NSAIDs postpartum. Study participants were women delivered at a tertiary care center from 2008 to 2015. The primary outcome was change in mean arterial pressure during the postpartum period. Secondary outcomes were postpartum pain scores, cumulative postpartum opioid requirement, initiation or dose escalation of antihypertensive agents, and adverse postpartum outcomes including acute renal failure, change in hematocrit, and maternal readmission for hypertensive disorder.

RESULTS:
Two hundred seventy-six women with hypertensive disorders of pregnancy were included (129 NSAID-unexposed and 147 NSAID-exposed). Postpartum NSAID administration was not associated with a statistically significant change in mean arterial pressure compared with no NSAID administration (−0.7 vs −1.8; mean difference 1.10, 95% CI −1.44 to 3.64). Similarly, no difference was observed between the cohorts in terms of need for initiation or escalation in dose of antihypertensive agents or maternal readmission for hypertensive disorder. The study was underpowered to determine whether NSAID administration was associated with any difference in less frequent secondary outcomes (eg, incidence of acute renal insufficiency, need for postpartum transfusion) or cumulative opioid use.

CONCLUSION:
Nonsteroidal antiinflammatory drug administration to postpartum patients with hypertensive disorders of pregnancy is not associated with a change in blood pressure or requirement for antihypertensive medication.