bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can adverse maternal and perinatal outcomes be predicted when blood pressure becomes elevated? Secondary analyses from the CHIPS (Control of Hypertension In Pregnancy Study) randomized controlled trial
Authors: Magee Laura A. , von Dadelszen Peter , Singer Joel , Lee Terry , Rey Evelyne , Ross Susan , Asztalos Elizabeth , Murphy Kellie E. , Menzies Jennifer , Sanchez Johanna , Gafni Amiram , Gruslin Andrée , Helewa Michael , Hutton Eileen , Lee Shoo K. , Logan Alexander G. , Ganzevoort Wessel , Welch Ross , Thornton Jim G. , Moutquin Jean Marie 
Published: February 2016

AbstractIntroductionFor women with chronic or gestational hypertension in CHIPS (Control of Hypertension In Pregnancy Study, NCT01192412), we aimed to examine whether clinical predictors collected at randomization could predict adverse outcomes.Material and methodsThis was a planned, secondary analysis of data from the 987 women in the CHIPS Trial. Logistic regression was used to examine the impact of 19 candidate predictors on the probability of adverse perinatal (pregnancy loss or high level neonatal care for >48 h, or birthweight <10th percentile) or maternal outcomes (severe hypertension, preeclampsia, or delivery at <34 or <37 weeks). A model containing all candidate predictors was used to start the stepwise regression process based on goodness of fit as measured by the Akaike information criterion. For face validity, these variables were forced into the model: treatment group (“less tight” or “tight” control), antihypertensive type at randomization, and blood pressure within 1 week before randomization. Continuous variables were represented continuously or dichotomized based on the smaller p‐value in univariate analyses. An area‐under‐the‐receiver‐operating‐curve (AUC ROC) of ≥0.70 was taken to reflect a potentially useful model.ResultsPoint estimates for AUC ROC were <0.70 for all but severe hypertension (0.70, 95% CI 0.67–0.74) and delivery at <34 weeks (0.71, 95% CI 0.66–0.75). Therefore, no model warranted further assessment of performance.ConclusionsCHIPS data suggest that when women with chronic hypertension develop an elevated blood pressure in pregnancy, or formerly normotensive women develop new gestational hypertension, maternal and current pregnancy clinical characteristics cannot predict adverse outcomes in the index pregnancy.
Long‐term outcome in apparently healthy children with increased nuchal translucency in the first trimester screening
Authors: Äyräs Outi , Eronen Marianne , Tikkanen Minna , Rahkola‐Soisalo Päivi , Paavonen Jorma , Stefanovic Vedran 
Published: February 2016

AbstractIntroductionIncreased nuchal translucency is known to be associated with chromosomal and structural defects and genetic syndromes. Little is known about the overall long‐term outcome of euploid children after increased nuchal translucency. The aims of this study were to assess the additional structural defects diagnosed after discharge from the delivery hospital and the long‐term overall outcome of euploid children after increased nuchal translucency and normal second trimester anomaly scan.Material and methodsAll children from singleton euploid pregnancies during 2002–2007 with increased nuchal translucency in the first trimester screening, normal second trimester anomaly scan, and discharged as apparently healthy were included. Data on the structural defects and genetic disorders diagnosed until 2012 were retrieved from hospital databases and national registers. Previously published data of structural defects diagnosed after birth but before discharge and of severe neurodevelopmental impairment and genetic syndromes was added.ResultsThe cohort included 733 children. During the follow‐up time (mean 6.5 years), major structural defects were observed in 10 (1.4%), genetic disorders in two (0.3%), and minor defects in 23 (3.1%) children. In addition, there were 42 previously published major structural defects and major neurodevelopmental impairment or genetic disorders. Adding these results together, major health problems were detected in 54 (7%) euploid children with increased fetal nuchal translucency and normal findings in second trimester anomaly scan.ConclusionAlthough only few additional major structural defects are diagnosed during the follow‐up after increased fetal nuchal translucency, 7% of fetuses assumed to be healthy after second trimester anomaly scan have a major health impairment.
The effects of preterm birth and its antecedents on the cardiovascular system
Authors: Bensley Jonathan G. , De Matteo Robert , Harding Richard , Black Mary J. 
Published: February 2016

AbstractIntroductionPreterm birth occurs in approximately 10% of all births worldwide. It prematurely exposes the developing cardiovascular system to the hemodynamic transition that occurs at birth and to the subsequent functional demands of life ex utero. This review describes the current knowledge of the effects of preterm birth, and some of its common antecedents (chorioamnionitis, intra‐uterine growth restriction, and maternal antenatal corticosteroid administration), on the structure of the myocardium.Material and methodsA thorough literature search was conducted for articles relating to how preterm birth, and its antecedents, affect development of the heart. Given that sheep are an excellent model for the studies of cardiac development, this review has focused on experimental studies in sheep as well as clinical findings.ResultsOur review of the literature demonstrates that individuals born preterm are at an increased risk of cardiovascular disease later in life, including increased mean arterial pressure, abnormally shaped and sub‐optimally performing hearts and changes in the vasculature. The review highlights how antenatal corticosteroids, intra‐uterine growth restriction, and exposure to chorioamnionitis also have the potential to impact cardiac growth in the preterm newborn.ConclusionsPreterm birth and its common antecedents (antenatal corticosteroids, intra‐uterine growth restriction, and chorioamnionitis) have the potential to adversely impact cardiac structure immediately following birth and in later life.
Maternal near‐miss at university hospitals with cesarean overuse: an incident case‐control study
Authors: Mohammadi Soheila , Essén Birgitta , Fallahian Masoumeh , Taheripanah Robabeh , Saleh Gargari Soraya , Källestål Carina 
Published: February 2016

AbstractIntroductionCesarean section carries a substantial risk of maternal near‐miss morbidity. The aim of this study was to determine the frequency, causes, risk factors, and perinatal outcomes of maternal near‐miss at three university hospitals with a high rate of cesarean section in Tehran, Iran.Material and methodsAn incident case‐control study was conducted from March 2012 to May 2014. The modified WHO near‐miss criteria were used to identify cases. A control sample of 1024 women delivering at the study hospitals was recruited to represent the source population. Near‐miss ratio, crude and adjusted odds ratios with confidence intervals were assessed.ResultsAmong 12 965 live births, 82 mothers developed near‐miss morbidities and 12 died. The maternal near‐miss ratio was 6.3/1000 live births. Severe postpartum hemorrhage (35%, 29/82), severe preeclampsia (32%, 26/82), and placenta previa/abnormally invasive placenta (10%, 8/82) were the most frequent causes of maternal near‐miss. Women with antepartum cesarean section (adjusted odds ratio 7.4, 95% confidence interval 3.7–15.1) and co‐morbidity (adjusted odds ratio 2.3, 95% confidence interval 1.4–3.8), uninsured Iranians (adjusted odds ratio 3.4, 95% confidence interval 1.7–7.1) and uninsured Afghans (adjusted odds ratio 4.7, 95% confidence interval 2.4–9.2) had increased risks of near‐miss morbidity. Stillbirth and extremely preterm birth were the most prominent adverse perinatal outcomes associated with maternal near‐miss.ConclusionsOverutilization of cesarean section clearly influenced the causes of maternal near‐miss. A lack of health insurance had a measurable impact on near‐miss morbidity. Tailored interventions for reducing unnecessary cesarean section and unrestricted insurance cover for emergency obstetric care can potentially improve maternal and perinatal outcomes.
Eclampsia in Finland; 2006 to 2010
Authors: Jaatinen Noora , Ekholm Eeva 
Published: February 2016

AbstractIntroductionEclampsia is a rare but serious threat to maternal and fetal well‐being. Magnesium sulfate was introduced in Finland as management of eclampsia in the late 1990s. The aim of this study was to assess the incidence of eclampsia in Finland after the increased use of magnesium sulfate.Material and methodsEclampsia diagnoses in Finland during 2006 to 2010 were retrieved from the national Medical Birth Register and the Care Register for Health Care. Medical records were reviewed.ResultsIn 2006–10, 295 447 deliveries were registered in Finland and 46 women with eclampsia were identified. Hence, the incidence of eclampsia was 1.5 per 10 000 deliveries. The median gestational age at the time of eclampsia was 38 gestational weeks. There were no maternal deaths due to eclampsia, but 46% of the women had severe complications. Eighty‐seven per cent received magnesium sulfate for treatment and 7% for prevention of eclampsia. The perinatal mortality rate was 8%. Thirty‐four per cent of the newborns were preterm and 15% were small‐for‐gestational‐age.ConclusionsThe incidence of eclampsia in Finland was very low. Increased use of magnesium sulfate probably contributed to the low incidence, as well as to the low number of recurrent seizures and prolonged complications. However, some women at risk of eclampsia still remain undetected and untreated. Seven percent had magnesium sulfate for prevention of eclampsia. Increased use of prophylactic magnesium sulfate might further reduce the incidence of eclampsia.
Fluctuations in anti‐Müllerian hormone levels throughout the menstrual cycle parallel fluctuations in the antral follicle count: a cohort study
Authors: Depmann Martine , van Disseldorp Jeroen , Broer Simone L. , Eijkemans Marinus J.C. , Laven Joop S.E. , Visser Jenny A. , de Rijke Yolanda B. , Mol Ben W. , Broekmans Frank J.M. 
Published: February 2016

AbstractIntroductionIn this prospective cohort study we aimed to investigate the hypothesis that fluctuations in anti‐Müllerian hormone levels stem from fluctuations in the number of antral follicles.Material and methodsRepeated measurements of anti‐Müllerian hormone and antral follicles (follicles 2–8 mm) were performed in 44 women with a regular cycle, during one menstrual cycle. If our hypothesis that anti‐Müllerian hormone fluctuations stem from fluctuations in the antral follicles is correct, a fluctuation in the antral follicles would result in an equal and parallel shift in anti‐Müllerian hormone. Hence, the difference between antral follicles and anti‐Müllerian hormone would remain constant over time. A mixed model analysis, assessing the stability between anti‐Müllerian hormone and antral follicles, was performed using the difference between logantral follicles and loganti‐Müllerian hormone. Cohen's D was calculated for the largest of fixed effects in order to assess stability in relative distance between antral follicles and anti‐Müllerian hormone. To assess if fluctuation in anti‐Müllerian hormone or antral follicles originated from between‐subject fluctuation, or from within subject fluctuation, the intra‐class correlation coefficient was calculated.ResultsMixed model analysis and Cohen's D (0.12) confirmed the stability of the difference between logantral follicles and loganti‐Müllerian hormone and so confirmed our hypothesis. The good intra‐class correlation coefficient (0.73) indicated a small contribution of within‐subject variation to anti‐Müllerian hormone fluctuations.ConclusionsFluctuations in anti‐Müllerian hormone levels parallel fluctuations in antral follicles, suggesting that anti‐Müllerian hormone levels are closely linked to variation in the antral follicles. This knowledge adds to the basic understanding of the origin of anti‐Müllerian hormone and could aid in interpretation of individual anti‐Müllerian hormone levels.
Conventional treatment of functional constipation has a positive impact on the behavioural difficulties in children with and without faecal incontinence
Authors: Modin Line , Jakobsen Ida Skytte , Jakobsen Marianne Skytte 
Published: February 2016

AbstractAimConstipation studies have only evaluated behavioural difficulties in children with faecal incontinence. This study evaluated changes in behavioural difficulties in childhood with functional constipation (FC) with and without faecal incontinence, based on treatment outcomes.MethodsChildren aged five to 16 years who fulfilled the Rome III criteria for FC received conventional treatment. The Strength and Difficulties Questionnaire was completed at inclusion and at the 12‐month follow‐up.ResultsWe included 116 children. The behaviour scores decreased in successfully treated boys (10.3 versus 7.9; p < 0.001) and girls (10.0 versus 7.4; p = 0.0001) with and without faecal incontinence. There was no decrease in the behaviour scores in children with unsuccessful outcomes. Unsuccessfully treated boys had significantly higher behaviour scores than successfully treated boys at inclusion (13.2 versus 10.3; p = 0.006) and after 12 months (11.4 versus 7.9; p = 0.02). No difference was found between unsuccessfully treated and successfully treated girls at inclusion (10.5 versus 10.0; p = 0.77) or after 12 months (10.3 versus 7.4; p = 0.18).ConclusionOur findings indicate that conventional treatment of FC had a positive impact on behavioural difficulties in constipated children with and without faecal incontinence. This study highlights the importance of proactive detection and treatment of FC in paediatric patients.
Chemical communication in the lacertid lizard Podarcis muralis: the functional significance of testosterone
Authors: Baeckens Simon , Huyghe Katleen , Palme Rupert , Van Damme Raoul 
Published: February 2016

AbstractChemical signals are essential for intersexual communication in many animals, including lizards. While faeces have been suggested to contain socially relevant chemical stimuli, epidermal gland secretions are generally believed to be the leading source of chemosignals involved in lizard communication. Early research has shown that sex hormones affect epidermal gland activity, with androgens stimulating gland/pore size and/or gland productivity. However, the functional significance of hormone‐induced glandular activity in lizard chemical communication remains unclear. In this study, we manipulated testosterone (T) concentrations in male Podarcis muralis lizards. While T‐supplementation did not change pore size, it did increase secretion production substantially. Chemosensory tests showed that female conspecifics tongue‐flick at a higher rate and more quickly towards the secretion of males with experimentally increased T levels than towards the secretion of control males, suggesting that females can discriminate between males with dissimilar T levels based on chemical cues of secretion alone. Based on the scent of faeces, however, females were unable to discriminate between males with differential T levels. Also, females reacted more quickly when offered larger amounts of secretion – irrespective of whether secretions were obtained from control or T‐increased males. This result indicates that secretion quantity affects chemosignal detectability in Podarcis muralis.
Birth Plans: What Matters for Birth Experience Satisfaction
Authors: Mei Jenny Y. , Afshar Yalda , Gregory Kimberly D. , Kilpatrick Sarah J. , Esakoff Tania F. 
Published: February 2016

AbstractBackgroundTo categorize individual birth plan requests and determine if number of requests and request fulfillment is associated with birth experience satisfaction.MethodsThis is a sub‐analysis of a prospective cohort study of 302 women with singleton pregnancies with and without birth plans. Women with a hard copy of their birth plans who completed a postdelivery satisfaction survey were included in this study. We described the number and type of birth plan requests and associated the number of requests and request fulfillment with overall satisfaction, expectations met, and sense of control. Differences between groups were analyzed using chi‐square, Spearman rank correlation, and logistic regression.ResultsOne hundred and nine women presented to Labor and Delivery with a hard copy of their prewritten birth plan. We identified 23 unique requests. The most common requests were no intravenous analgesia (82%) and exclusive breastfeeding (74%). The requests most fulfilled were avoidance of episiotomy (100%) and no operative vaginal delivery (89%). Having a higher number of requests fulfilled correlated with greater overall satisfaction (p = 0.03), higher chance of expectations being met (p < 0.01), and feeling more in control (p < 0.01). Having a high number of requests was associated with an 80 percent reduction in overall satisfaction with the birth experience (p < 0.01).ConclusionsHaving a higher number of requests fulfilled was positively associated with birth experience satisfaction, while having a high number of requests was inversely associated with birth experience satisfaction. Further research is needed to understand how to improve birth plan–related birth experience satisfaction.
A pilot study of the use of emerging computer technologies to improve the effectiveness of reading and writing therapies in children with Down syndrome
Authors: Felix Vanessa G. , Mena Luis J. , Ostos Rodolfo , Maestre Gladys E. 
Published: February 2016

AbstractDespite the potential benefits that computer approaches could provide for children with cognitive disabilities, research and implementation of emerging approaches to learning supported by computing technology has not received adequate attention. We conducted a pilot study to assess the effectiveness of a computer‐assisted learning tool, named “HATLE,” for children with Down syndrome. The tool helps to improve reading and writing abilities in Spanish, through mobile computing, multimedia design, and computer speech‐recognition techniques. An experimental design with nonequivalent groups was used to assess the effectiveness of HATLE. The treatment group was taught using HATLE; the control group received typical instructions with the same material. Individual literacy achievement was assessed for both groups, before and after therapy sessions. The dependent variables in all analyses were posttest scores, adjusted via Analysis of Covariance (ANCOVA) for pretest variance. Differences between treatment and control groups were statistically significant in favor of the HATLE group on measures of Single‐Word Reading (p = 0.048) and Handwriting‐Form (p = 0.046) with large effect sizes (d > 0.8). Results indicate that HATLE might be effective in supporting computer‐aided learning for children with intellectual disabilities. The results are discussed in terms of limitations and implications.
Pomalidomide in combination with dexamethasone results in synergistic anti‐tumour responses in pre‐clinical models of lenalidomide‐resistant multiple myeloma
Authors: Rychak Emily , Mendy Derek , Shi Tao , Ning Yuhong , Leisten Jim , Lu Ling , Miller Karen , Narla Rama K. , Orlowski Robert Z. , Raymon Heather K. , Bjorklund Chad C. , Thakurta Anjan , Gandhi Anita K. , Cathers Brian E. , Chopra Rajesh , Daniel Thomas O. , Lopez‐Girona Antonia 
Published: February 2016

SummaryPomalidomide is an IMiD® immunomodulatory agent, which has shown clinically significant benefits in relapsed and/or refractory multiple myeloma (rrMM) patients when combined with dexamethasone, regardless of refractory status to lenalidomide or bortezomib. (Schey et al, ; San Miguel et al, 2013; Richardson et al, 2014; Scott, ) In this work, we present preclinical data showing that the combination of pomalidomide with dexamethasone (PomDex) demonstrates potent anti‐proliferative and pro‐apoptotic activity in both lenalidomide‐sensitive and lenalidomide‐resistant MM cell lines. PomDex also synergistically inhibited tumour growth compared with single‐agent treatment in xenografts of lenalidomide‐resistant H929 R10‐1 cells. Typical hallmarks of IMiD compound activity, including IKZF3 (Aiolos) degradation, and the downregulation of interferon regulatory factor (IRF) 4 and MYC, seen in lenalidomide‐sensitive H929 MM cell lines, were also observed in PomDex‐treated lenalidomide‐resistant H929 MM cells. Remarkably, this resulted in strong, synergistic effects on the induction of apoptosis in both lenalidomide‐sensitive and resistant MM cells. Furthermore, gene expression profiling revealed a unique differential gene expression pattern in PomDex‐treated samples, highlighted by the modulation of pro‐apoptotic pathways in lenalidomide‐resistant cells. These results provide key insights into molecular mechanisms of PomDex in the lenalidomide‐resistant setting.
Implications of delayed bone marrow aspirations at the end of treatment induction for risk stratification and outcome in children with acute lymphoblastic leukaemia
Authors: Zuna Jan , Moericke Anja , Arens Mari , Koehler Rolf , Panzer‐Grümayer Renate , Bartram Claus R. , Fischer Susanna , Fronkova Eva , Zaliova Marketa , Schrauder André , Stanulla Martin , Zimmermann Martin , Trka Jan , Stary Jan , Attarbaschi Andishe , Mann Georg , Schrappe Martin , Cario Gunnar 
Published: February 2016

SummaryMinimal residual disease (MRD) at the end of induction therapy is important for risk stratification of acute lymphoblastic leukaemia (ALL), but bone marrow (BM) aspiration is often postponed or must be repeated to fulfil qualitative and quantitative criteria for morphological assessment of haematological remission and/or MRD analysis. The impact of BM aspiration delay on measured MRD levels and resulting risk stratification is currently unknown. We analysed paired MRD data of 289 paediatric ALL patients requiring a repeat BM aspiration. MRD levels differed in 108 patients (37%) with a decrease in the majority (85/108). This would have resulted in different risk group allocation in 64 of 289 patients (23%) when applying the ALL‐Berlin‐Frankfurt‐Münster 2000 criteria. MRD change was associated with the duration of delay; 40% of patients with delay ≥7 days had a shift to lower MRD levels compared to only 18% after a shorter delay. Patients MRD‐positive at the original but MRD‐negative at the repeat BM aspiration (n = 50) had a worse 5‐year event‐free survival than those already negative at first aspiration (n = 115) (86 ± 5% vs. 94 ± 2%; P = 0·024). We conclude that BM aspirations should be pursued as scheduled in the protocol because delayed MRD sampling at end of induction may result in false‐low MRD load and distort MRD‐based risk assessment.