bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relativistic radiative transfer in relativistic spherical flows
Authors: Fukue Jun 
Published: November 2016

Abstract
Relativistic radiative transfer in relativistic spherical flows is numerically examined under the fully special relativistic treatment. We first derive relativistic formal solutions for the relativistic radiative transfer equation in relativistic spherical flows. We then iteratively solve the relativistic radiative transfer equation, using an impact parameter method/tangent ray method, and obtain specific intensities in the inertial and comoving frames, as well as moment quantities, and the Eddington factor. We consider several cases; a scattering wind with a luminous central core, an isothermal wind without a core, a scattering accretion on to a luminous core, and an adiabatic accretion on to a dark core. In the typical wind case with a luminous core, the emergent intensity is enhanced at the center due to the Doppler boost, while it reduces at the outskirts due to the transverse Doppler effect. In contrast to the plane-parallel case, the behavior of the Eddington factor is rather complicated in each case, since the Eddington factor depends on the optical depth, the flow velocity, and other parameters.
Maternal Deaths From Suicide and Overdose in Colorado, 2004–2012
Authors: Metz Torri D. , Rovner Polina , Hoffman M. Camille , Allshouse Amanda A. , Beckwith Krista M. , Binswanger Ingrid A. 
Published: November 2016

OBJECTIVE:
To ascertain demographic and clinical characteristics of maternal deaths from self-harm (accidental overdose or suicide) to identify opportunities for prevention.

METHODS:
We report a case series of pregnancy-associated deaths resulting from self-harm in the state of Colorado between 2004 and 2012. Self-harm deaths were identified from several sources, including death certificates. Birth and death certificates along with coroner, prenatal care, and delivery hospitalization records were abstracted. Descriptive analyses were performed. For context, we describe demographic characteristics of women with a maternal death from self-harm and all women with live births in Colorado.

RESULTS:
Among the 211 total maternal deaths in Colorado over the study interval, 30% (n=63) resulted from self-harm. The pregnancy-associated death ratio from overdose was 5.0 (95% confidence interval [CI] 3.4–7.2) per 100,000 live births and from suicide 4.6 (95% CI 3.0–6.6) per 100,000 live births. Detailed records were obtained for 94% (n=59) of women with deaths from self-harm. Deaths were equally distributed throughout the first postpartum year (mean 6.21±3.3 months postpartum) with only six maternal deaths during pregnancy. Seventeen percent (n=10) had a known substance use disorder. Prior psychiatric diagnoses were documented in 54% (n=32) and prior suicide attempts in 10% (n=6). Although half (n=27) of the women with deaths from self-harm were noted to be taking psychopharmacotherapy at conception, 48% of them discontinued the medications during pregnancy. Fifty women had toxicology testing available; pharmaceutical opioids were the most common drug identified (n=21).

CONCLUSION:
Self-harm was the most common cause of pregnancy-associated mortality, with most deaths occurring in the postpartum period. A four-pronged educational and program building effort to include women, health care providers, health care systems, and both governments and organizations at the community and national levels may allow for a reduction in maternal deaths.
Risk of Peripartum Hysterectomy and Center Hysterectomy and Delivery Volume
Authors: Govindappagari Shravya , Wright Jason D. , Ananth Cande V. , Huang Yongmei , D'Alton Mary E. , Friedman Alexander M. 
Published: November 2016

OBJECTIVE:
To characterize where women at risk for and undergoing peripartum hysterectomy delivered in terms of obstetric volume and procedural experience.

METHODS:
We used data from the Perspective database to retrospectively evaluate trends in peripartum hysterectomy and deliveries at high risk of peripartum hysterectomy based on placenta previa and prior cesarean delivery delivered from 2006 through 2014. Hospitals were categorized two separate ways for the analysis: 1) into five roughly equal quintiles based on annualized delivery volume and 2) by the mean number of hysterectomies performed annually over the study period.

RESULTS:
Four thousand eight hundred eleven hysterectomies occurred among 5,388,486 deliveries in 500 hospitals over the study period. The peripartum hysterectomy rate increased from 81.4 per 100,000 deliveries in 2006 to 98.4 in 2014. The prevalence rate of placenta previa in the setting of previous cesarean delivery also increased over the study period. Between 2006–2008 and 2012–2014, peripartum hysterectomy decreased in the lowest delivery volume quintile and increased in the highest delivery volume quintile (–14.9/100,000 deliveries, 95% confidence interval [CI] −25.6 to −4.2 and +35.4/100,000 deliveries, 95% CI 20.3–50.5, respectively). Similarly, hospitals performing high rates of hysterectomies saw the largest increase over the study period.

CONCLUSION:
With peripartum hysterectomy rates increasing in the population, hospitals with high delivery volumes and high rates of hysterectomies saw the largest increases in peripartum hysterectomy rates. These trends support that improved referral practices and uptake of evidence-based recommendations may be occurring.
State Insurance Mandates and Multiple Birth Rates After In Vitro Fertilization
Authors: Provost Meredith P. , Thomas Samantha M. , Yeh Jason S. , Hurd William W. , Eaton Jennifer L. 
Published: November 2016

OBJECTIVE:
To examine the association between state-mandated insurance coverage for in vitro fertilization (IVF) and the incidence of multiple birth while controlling for differences in baseline patient characteristics.

METHODS:
We conducted a retrospective cohort study using the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System from 2007 to 2011 to examine the association between state-mandated insurance coverage for IVF and the incidence of multiple birth while controlling for differences in baseline patient characteristics. Analyses were stratified according to patient age and day of embryo transfer (3 or 5).

RESULTS:
Of the 173,968 cycles included in the analysis, 45,011 (25.9%) were performed in mandated states and 128,957 (74.1%) in nonmandated states. The multiple birth rate was significantly lower in mandated states (29.0% compared with 32.8%, adjusted odds ratio [OR] 0.87, 99.95% confidence interval [CI] 0.80–0.94). After stratification, this association remained statistically significant only in women younger than 35 years old who underwent transfer on day 5 (33.1% compared with 38.6%, adjusted OR 0.81, 99.95% CI 0.71–0.92). Among women younger than 35 years with day 5 transfer, the elective single embryo transfer rate was significantly higher in mandated states (21.8% compared with 13.1%, adjusted OR 2.36, 99.95% CI 2.09–2.67).

CONCLUSION:
State-mandated insurance coverage for IVF is associated with decreased odds of multiple birth. This relationship is driven by increased use of elective single embryo transfer among young women undergoing day 5 transfer.
Naproxen Sodium for Pain Control With Intrauterine Device Insertion
Authors: Ngo Lynn L. , Braaten Kari P. , Eichen Eva , Fortin Jennifer , Maurer Rie , Goldberg Alisa B. 
Published: November 2016

OBJECTIVE:
To evaluate whether 550 mg oral naproxen sodium given 1 hour before intrauterine device (IUD) insertion is effective for pain relief as compared with placebo.

METHODS:
This was a randomized, double-blind, placebo-controlled trial. The primary outcome was pain with IUD insertion measured on a 100-mm visual analog scale (VAS). Our sample size was calculated to detect a 15-mm difference in VAS scores with 80% power (α=0.05). Secondary outcomes included pain with tenaculum placement, uterine sounding, and 5 and 15 minutes postinsertion.

RESULTS:
A total of 118 women were enrolled and analyzed (58 in the naproxen sodium arm, 60 in the placebo arm, 97% nulliparous) between May 11, 2015, and March 25, 2016. There were no differences in baseline demographics or reproductive characteristics between arms. There were no differences in median VAS pain scores for the primary outcome of pain with IUD insertion between the naproxen sodium arm compared with the placebo arm (69 compared with 66 mm, P=.89). There were no differences in the secondary outcomes of median VAS pain scores with tenaculum placement (37 compared with 32 mm, P=.97) or uterine sounding (60 compared with 58 mm, P=.66). However, median pain scores postprocedure were lower in the naproxen arm as compared with the placebo arm: 17 compared with 26 mm (P=.01) at 5 minutes and 13 compared with 24 mm (P=.01) at 15 minutes postinsertion.

CONCLUSION:
Oral naproxen sodium does not reduce pain with IUD insertion but does reduce pain after insertion and should be considered as a premedication.

CLINICAL TRIAL REGISTRATION:
ClinicalTrials.gov, http://clinicaltrials.gov, NCT02388191.
Managing Recurring Obstetric Cholestasis With Metformin
Authors: Elfituri Abdullatif , Ali Amanda , Shehata Hassan 
Published: November 2016

BACKGROUND:
Obstetric cholestasis is a pregnancy-related disorder associated with an adverse pregnancy outcome. It is characterized by generalized pruritus, elevated bile acids, and abnormal liver enzymes. Recent publications show that obstetric cholestasis is associated with, and likely to potentiate, the risk of developing gestational diabetes mellitus.

CASE:
This case describes an unusual pattern of the disease, in which obstetric cholestasis occurred in five consecutive pregnancies with a different course of the disease in the fifth pregnancy.

CONCLUSION:
A patient with recurrent cholestasis of pregnancy had worsening disease in her first four pregnancies. In her fifth pregnancy, treatment for gestational diabetes mellitus with metformin was associated with a lowering effect on bile acids and liver enzymes, indicating a possible role for metformin in the management of obstetric cholestasis.
Regeneration Process After Cervical Conization for Cervical Intraepithelial Neoplasia
Authors: Song Taejong , Seong Seok Ju , Kim Byoung-Gie 
Published: November 2016

OBJECTIVE:
To investigate whether there is a regeneration process after cervical conization and, if it exists, how much of the cervix will regenerate and when regeneration will be completed.

METHODS:
This was a prospective observational study of women undergoing conization for cervical intraepithelial neoplasia. Transvaginal ultrasonographic examinations of the cervical volume and length were performed just before conization and were repeated at 1, 3, 6, 9, and 12 months after conization. The volume and length of the cone excised were assessed with a volumetric tube and a vernier caliper, respectively.

RESULTS:
Of 99 women recruited for this study, 75 completed the 12-month follow-up. Cone volume and depth excised were 27.4±9.2% and 38.9±13.8% of the baseline, respectively. The steady increase of cervical volume after conization was statistically significantly until 6 months, but no further increase was observed from 6 to 12 months. At the 12-month follow-up, the cervical volume was 14.0±4.2 cm3, which corresponded to 93.1±19.1% of the baseline with a statistically significant difference between the baseline and 12-month follow-up (P=.006). These cervical regeneration patterns were also observed in cervical length.

CONCLUSION:
The time of regeneration completion was 6 months after conization, and the cervical dimensions after completion of the regeneration process were more than 90% of the initial measurements.
Mechanical and Pharmacologic Methods of Labor Induction
Authors: Levine Lisa D. , Downes Katheryne L. , Elovitz Michal A. , Parry Samuel , Sammel Mary D. , Srinivas Sindhu K. 
Published: November 2016

OBJECTIVE:
To evaluate the effectiveness of four commonly used induction methods.

METHODS:
This randomized trial compared four induction methods: misoprostol alone, Foley alone, misoprostol–cervical Foley concurrently, and Foley–oxytocin concurrently. Women undergoing labor induction with full-term (37 weeks of gestation or greater), singleton, vertex-presenting gestations, with no contraindication to vaginal delivery, intact membranes, Bishop score 6 or less, and cervical dilation 2 cm or less were included. Women were enrolled only once during the study period. Our primary outcome was time to delivery. Neither patients nor health care providers were blinded to assigned treatment group because examinations are required for placement of all methods; however, research personnel were blinded during data abstraction. A sample size of 123 per group (n=492) was planned to compare the four groups pairwise (P≤.008) with a 4-hour reduction in delivery time considered clinically meaningful.

RESULTS:
From May 2013 through June 2015, 997 women were screened and 491 were randomized and analyzed. Demographic and clinical characteristics were similar among the four treatment groups. When comparing all induction method groups, combination methods achieved a faster median time to delivery than single-agent methods (misoprostol–Foley: 13.1 hours, Foley–oxytocin: 14.5 hours, misoprostol: 17.6 hours, Foley: 17.7 hours, P<.001). When censored for cesarean delivery and adjusting for parity, women who received misoprostol–Foley were almost twice as likely to deliver before women who received misoprostol alone (hazard ratio 1.92, 95% confidence interval [CI] 1.42–2.59) or Foley alone (hazard ratio 1.87, 95% CI 1.87 1.39–2.52), whereas Foley–oxytocin was not statistically different from single-agent methods.

CONCLUSION:
After censoring for cesarean delivery and adjusting for parity, misoprostol–cervical Foley resulted in twice the chance of delivering before either single-agent method.

CLINICAL TRIAL REGISTRATION:
ClinicalTrials.gov, https://clinicaltrials.gov, NCT01916681.
Effect of Academic Grade Level on Return to Athletic Competition After Anterior Cruciate Ligament Reconstruction
Authors: Bauer Matthew , Feeley Brian T. , Gallo Robert A. 
Published: November 2016

Background:
After anterior cruciate ligament (ACL) reconstruction, 63% to 87% of high school athletes return to competition. Although physical and psychological factors are known contributors for failure to return to play, little attention has been paid to effect of academic grade level. Our purpose was to determine the influence of effect of academic grade level on return to competitive play. The primary hypothesis is that high school seniors who undergo ACL reconstruction or knee arthroscopy will be less likely to return to competitive play at 1 year than those in grades 9 to 11.

Methods:
We retrospectively reviewed high school athletes who injured their knee during competitive athletic activity and underwent arthroscopic knee surgery, including ACL reconstruction. We included those 14 to 18 years old at time of surgery and analyzed records for grade level, sporting activity, surgery details, and date of return to play. The definition of return to competitive play was return to same preinjury sport within 1 year of surgery and the sport had to be organized.

Results:
Our study group included 225 patients that underwent an ACL reconstruction and 74 had knee arthroscopy. Athletes undergoing ACL reconstructions were less likely to return to preinjury sport within 1 year than those undergoing knee arthroscopy (P=0.0163). Seniors were significantly less likely to return to play at 1 year than athletes in grades 9 to 11 after both ACL reconstruction (P<0.0001) and knee arthroscopy (P=0.0335). Although return to competitive play rates remained fairly constant within grades 9 to 11, a precipitous decline by 28.9% and 29.4% in return to play rates occurred in the ACL reconstruction and knee arthroscopy groups, respectively, between the junior and senior years of high school.

Discussion
Although return to competition rates were lower for high school athletes undergoing ACL reconstruction than those undergoing knee arthroscopy, both had declines in return when the surgery occurs during their senior season. These data are useful when interpreting return to play rates. Future studies would benefit from further defining this relationship, or at least, noting the number of “senior” athletes studied.

Level of Evidence:
Therapeutic study—Level III.
Clinicopathological and Prognostic Evaluations of Mixed Adenoneuroendocrine Carcinoma of the Colon and Rectum: A Case-Matched Study
Authors: Watanabe Jun , Suwa Yusuke , Ota Mitsuyoshi , Ishibe Atsushi , Masui Hidenobu , Nagahori Kaoru , Tsuura Yukio , Endo Itaru 
Published: November 2016

BACKGROUND:
Mixed adenoneuroendocrine carcinoma of the colon and rectum is a very rare type of tumor.

OBJECTIVE:
The aim of the present study was to evaluate the clinicopathological characteristics and prognosis of mixed adenoneuroendocrine carcinomas of the colon and rectum.

DESIGN:
This was a retrospective case-matched analysis (from March 2007 to December 2013).

SETTINGS:
This study was conducted at Yokosuka Kyosai Hospital.

PATIENTS:
One thousand three hundred six consecutive patients with a preoperative diagnosis of colorectal cancer and who underwent tumor resection were enrolled in the present study. Each patient diagnosed with mixed adenoneuroendocrine carcinoma was 1:2 matched with 2 counterparts who had been diagnosed with adenocarcinoma.

INTERVENTION:
Immunohistochemical staining for neuroendocrine markers (chromogranin A, synaptophysin, and CD56) was performed. Cases in which the neuroendocrine component accounted for >30% of the tumor were diagnosed as mixed adenoneuroendocrine carcinomas.

RESULTS:
Among 1306 patients, 42 patients (3.2%) were diagnosed with mixed adenoneuroendocrine carcinoma and were compared with 84 patients with adenocarcinoma who had been randomly case matched. The average Ki-67–labeling index value was 78.0% (range, 30.0%–99.0%). Chromogranin A, synaptophysin, and CD56 positivity were observed in 42.9% (18/42), 81.0% (34/42), and 33.3% (14/42) of the tumors. Both the disease-free survival and overall survival were significantly worse for mixed adenoneuroendocrine carcinoma than for adenocarcinoma. Ten patients underwent treatment with oxaliplatin-based chemotherapy. The response rate was 40.0%; the median progression-free survival and overall survival were 6.3 months and 18.1 months.

LIMITATIONS:
This was a retrospective single-institution study that included a limited number of cases. The treatment regimens used included different types of oxaliplatin-based chemotherapy.

CONCLUSION:
Mixed adenoneuroendocrine carcinoma of the colon and rectum has a poor prognosis after curative resection and should be distinguished from adenocarcinoma.
Long-term Outcomes of Sphincter-Saving Procedures for Diffuse Crohn’s Disease of the Large Bowel
Authors: Li Yi , Stocchi Luca , Mu Xing , Cherla Deepa , Remzi Feza H. 
Published: November 2016

BACKGROUND:Total abdominal colectomy with ileorectal anastomosis for Crohn’s colitis is acceptable in the presence of a suitable rectum. Intentional IPAA has been proposed for diffuse Crohn’s proctocolitis without enteric or anoperineal disease.OBJECTIVE:The aim of this study was to evaluate the long-term outcomes of sphincter-saving procedures for large-bowel Crohn’s disease.DESIGN:Patients with preoperative Crohn’s disease diagnosis undergoing intentional IPAA and ileorectal anastomosis were included.SETTINGS:The study was conducted at a tertiary care research center.PATIENTS:Ileorectal anastomosis was performed in 75 patients with Crohn’s disease, whereas 32 patients underwent intentional IPAA.MAIN OUTCOME MEASURES:Long-term functional results and permanent stoma requirement of sphincter-saving operations were assessed. Quality of life and postoperative medication use were also compared with a control group of patients undergoing total proctocolectomy and end ileostomy.RESULTS:Patients undergoing ileorectal anastomosis were older and had longer disease duration, higher prevalence of perianal and penetrating disease, and history of small-bowel resection than those receiving IPAA. Indications for surgery, preoperative use of immunomodulators, and postoperative use of biologics were also significantly different. Although functional defecatory outcomes were comparable, reported quality of life 3 years after surgery was significantly better in patients who underwent IPAA than in patients with ileorectal anastomosis. Patients with IPAA were associated with significantly lower cumulative rates of surgical recurrence (HR = 0.28 (95% CI, 0.09–0.84); p = 0.017), indefinite stoma diversion (HR = 0.35 (95% CI, 0.13–0.99); p = 0.039), and proctectomy with end ileostomy (HR = 0.27 (95% CI, 0.07–0.96); p = 0.030) than those with ileorectal anastomosis.LIMITATIONS:The study was limited by its retrospective nature and small sample size.CONCLUSIONS:Contemporary patients selected to have intentional IPAA for Crohn’s colitis have disease characteristics very different from those selected to have ileorectal anastomosis. Long-term follow-up confirms intentional IPAA as an acceptable option in selected patients with Crohn’s colitis.
The Differential Diagnosis and Treatment of Catatonia in Children and Adolescents
Authors: Hauptman Aaron J. , Benjamin Sheldon 
Published: November 2016

Abstract

Learning objectives
After participating in this activity, learners should be better able to:
• Assess the etiologies associated with catatonia in children and adolescents
• Evaluate the differential diagnosis of pediatric catatonia
• Interpret the literature regarding the treatment of children and adolescents with catatonia

Objective
Pediatric catatonia is associated with many medical and psychiatric conditions. Mortality is high, and proper treatment can be lifesaving. Catatonia is increasingly recognized in pediatric populations, in which about 20% of cases are related to underlying medical conditions. To minimize morbidity, clinicians must rule out underlying disorders while simultaneously managing symptoms and causes. In our review we discuss (1) recommendations to aid rapid decision making, both diagnostic and therapeutic, (2) emergent conditions and management, (3) disorders associated with pediatric catatonia, including developmental, acquired, idiopathic, and iatrogenic etiologies, (4) available treatments, and (5) medicolegal considerations.

Methods
Initial PubMed search without date constraints using MeSH terms related to pediatric catatonia, with subsequent searches on pertinent subtopics using PubMed and Google Scholar.

Results
Pediatric catatonia is a dangerous but treatable neuropsychiatric condition. Psychiatrists need to be aware of differential diagnoses and to be able determine appropriate treatment within a short time frame. With prompt diagnosis and treatment, outcomes can be optimized.

Conclusion
Pediatric catatonia is underdiagnosed and requires rapid evaluation and management.