bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prospective Risk of Stillbirth and Neonatal Complications in Twin Pregnancies: Systematic Review and Meta-analysis
Authors: Cheong-See Fiona , Schuit Ewoud , Arroyo-Manzano David , Khalil Asma , Barrett Jon , Joseph K. S. , Asztalos Elizabeth , Hack Karien , Lewi Liesbeth , Lim Arianne , Liem Sophie , Norman Jane E. , Morrison John , Combs C. Andrew , Garite Thomas J. , Maurel Kimberly , Serra Vicente , Perales Alfredo , Rode Line , Worda Katharina , Nassar Anwar , Aboulghar Mona , Rouse Dwight , Thom Elizabeth , Breathnach Fionnuala , Nakayama Soichiro , Russo Francesca Maria , Robinson Julian N. , Dodd Jodie M. , Newman Roger B. , Bhattacharya Sohinee , Tang Selphee , Mol Ben Willem J. , Zamora Javier , Thilaganathan Basky , Thangaratinam Shakila 
Published: January 2017

(Abstracted from BMJ 2016;354:i4353)
Twin pregnancies are at increased risk of stillbirth. Uncomplicated twin pregnancies are commonly delivered earlier to prevent stillbirth; however, there is a risk of neonatal complications associated with being born prior to 39 weeks’ gestation.
Noninvasive Prenatal Screening for Fetal Aneuploidy, 2016 Update: A Position Statement of the American College of Medical Genetics and Genomics
Authors: Gregg Anthony R. , Skotko Brian G. , Benkendorf Judith L. , Monaghan Kristin G. , Bajaj Komal , Best Robert G. , Klugman Susan , Watson Michael S. 
Published: January 2017

(Abstracted from Genet Med 2016;18(10):1056–1065)
Rapid advancements in genomic technologies led to the introduction in 2011 of noninvasive prenatal screening (NIPS) that used cell-free DNA (cfDNA) derived from the placenta and circulating in maternal blood. Noninvasive prenatal screening is addressed in this American College of Medical Genetics and Genomics (ACMG) guideline to assist patients who are in search of prenatal screening information and health care providers who are responsible for providing precise and up-to-date information to their patients.
fMRI with Central Vision Loss: Effects of Fixation Locus and Stimulus Type
Authors: Plank Tina , Frolo Jozef , Brandl-Rühle Sabine , Renner Agnes B. , Jägle Herbert , Greenlee Mark W. 
Published: January 2017

ABSTRACT

Purpose
In patients with central visual field scotomata, a large part of visual cortex is not adequately stimulated. Patients often use a new eccentric fixation area on intact peripheral retina (“preferred retinal locus”—PRL) that functions as a pseudo-fovea. We used functional magnetic resonance imaging (fMRI) to examine whether stimulating this pseudo-fovea leads to increased activation or altered activation patterns in visual cortex in comparison to stimulating a comparable peripheral area in the opposite hemifield (OppPRL).

Methods
Nineteen patients with binocular central scotomata caused by hereditary retinal dystrophies and an age-matched control group were tested. The center of the visual field, PRL, and OppPRL were stimulated with flickering checkerboard stimuli and object pictures during fMRI measurement.

Results
Results show that stimulation with pictures of everyday objects led to overall larger BOLD (blood oxygen level dependent) responses in visual cortex compared to that evoked by stimulation with flickering checkerboards. Patients showed this enhancement as early as in V1. When the PRL was directly stimulated with object pictures, the central representation area in early visual cortex was coactivated in the patients but not in the controls. In higher visual areas beyond retinotopic cortex, BOLD responses to stimulation of the PRL with object pictures were significantly enhanced in comparison to stimulation of the OppPRL area. Highly stable eccentric fixation with the PRL was associated with a higher BOLD signal in visual cortex in patients, and this effect was most pronounced in the conditions with object picture stimulation.

Conclusions
The observed results suggest that naturalistic images are more likely to trigger top-down processes that regulate activation in early visual cortex in patients with central vision loss.
Sudden Death Due to Unusual Complication of Takayasu Arteritis
Authors: Jedidi Maher , Chkirbene Youssef , Abdessayed Nihed , Masmoudi Tasnim , Mahjoub Mohamed , Mlayeh Souheil , Dhiab Mohamed Ben , Souguir Mohamed Kamel , Yacoubi Mohamed Taher 
Published: January 2017

Abstract
Takayasu arteritis is an uncommon inflammatory disease with usually a good prognosis. However, sometimes, the evolution can be fatal essentially by a coronary arteries involvement. We present a case of a 19-year-old woman who died suddenly from cardiogenic shock complicating an unknown Takayasu arteritis.
At the autopsy, the aorta showed a significant thickening of the wall. The coronary arteries were slightly thickened and did not show any occlusion. Microscopic examination of the aorta showed an abundant granulomatous and a lymphoplasmacytic infiltrate. Microscopic sections of other internal organs showed signs of cardiac hypertrophy and an extensive edema of the lung. Death was attributed to acute heart failure complicating a supravalvular aortic stenosis secondary to unknown Takayasu arteritis.
Takayasu arteritis can be life-threatening by an occlusion of the ascending aorta and its major branches, without any coronary arteries involvement.
Primary Outcome Measures in Pediatric Septic Shock Trials: A Systematic Review*
Authors: Menon Kusum , McNally James Dayre , Zimmerman Jerry J. , Agus Michael S. D. , O’Hearn Katie , Watson R. Scott , Wong Hector R. , Duffett Mark , Wypij David , Choong Karen 
Published: January 2017

Objective:
To evaluate all published pediatric randomized controlled trials of patients with septic shock from any cause to examine the outcome measures used, the strengths and limitations of these measurements and whether the trial outcomes met feasibility criteria.

Data Sources:
We used a previously published database of pediatric critical care randomized controlled trials (PICUtrials.net) derived from searches of MEDLINE, EMBASE, LILACS, and CENTRAL.

Study Selection:
We included randomized controlled trials of interventions to children admitted to a PICU with septic or dengue hemorrhagic shock which were published in English.

Data Extraction:
Study characteristics and outcomes were retrieved by two independent reviewers with disagreement being resolved by a third reviewer. We defined feasibility as 1) recruitment of at least 90% of the targeted sample size and agreement of the observed outcome rate in the control group with the rate used for the sample size calculation to within 10% or 2) finding of a statistically significant difference in an interim or final analysis.

Data Synthesis:
Nineteen of 321 identified articles were selected for review. Fourteen of 19 studies (74%) provided an a priori definition of their primary outcome measure in their “Methods section.” Mortality rate was the most commonly reported primary outcome (8/14; 57%), followed by duration of shock (4/14; 29%) followed by organ failure (1/14; 7%). Only three of 19 included trials met feasibility criteria.

Conclusions:
Our review found that use of mortality alone as a primary outcome in pediatric septic shock trials was associated with significant limitations and that long-term patient-centered outcomes were not used in this setting. Composite outcomes incorporating mortality and long-term outcomes should be explored for use in future pediatric septic shock trials.
Examination of Pediatric Radiation Dose Delivered After Cervical Spine Trauma
Authors: Somppi Laura K. , Frenn Kristin A. , Kharbanda Anupam B. 
Published: January 2017

Objectives
Pediatric cervical spine injuries (CSIs) are rare but potentially fatal injuries. Plain radiographs (x-rays) and computed tomography (CT) are used to diagnose CSIs. Given concerns related to radiation exposure, the utility of x-rays in diagnosing CSIs compared with other forms of imaging must be examined.

Methods
Patients younger than 19 years presenting with possible CSI to an urban tertiary care hospital who received imaging for possible CSI between January 1, 2011, and December 31, 2013, were included. The dose-length product was abstracted from the PACS system. Test performance for x-ray, CT, and MRI were calculated and effective radiation dose by age group was analyzed using the Kruskal-Wallis Test.

Results
A total of 671 patient charts were reviewed, 574 children were included in the study cohort. Median age of enrolled children was 9.70 (interquartile range, 4.78–13.83) years; 42.5% were female. Test performance of x-ray, CT, and MRI to detect CSI were calculated. Cervical x-rays performed only slightly inferior to CT. Sensitivity was 83% (95% confidence interval [CI], 36−99%), and specificity was 97% (95% CI, 96%–99%) versus 100% (95% CI, 96%–100%) for CT. Median effective dose of radiation for cervical CTs was 4.51 mSv (interquartile range, 3.84–5.59 mSv). Median dose significantly increased with age (2.94–5.10 mSv, P < 0.001).

Conclusions
Plain radiographs were largely sufficient to screen for CSIs, indicating their utility as a screening tool for CSIs. The incidence of CSIs in our sample was similar to prior reports. The effective radiation dose delivered during pediatric head and cervical CTs were lower than previously published estimates.
The Performance of Noncontrast Magnetic Resonance Angiography in Detecting Renal Artery Stenosis as Compared With Contrast Enhanced Magnetic Resonance Angiography Using Conventional Angiography as a Reference
Authors: Liang Keng-Wei , Chen Jhih-Wei , Huang Hsin-Hui , Su Chun-Hung , Tyan Yeu-Sheng , Tsao Teng-Fu 
Published: January 2017

Objective
The aims of this study were to evaluate the performance of noncontrast magnetic resonance angiography (NC MRA) for detecting renal artery stenosis (RAS) as compared with contrast-enhanced magnetic resonance angiography (CE MRA) and to evaluate the clinical feasibility, technical success rate, and performance of NC MRA for detecting RAS as compared with CE MRA.

Methods
Thirty-six subjects who underwent NC MRA and/or CE MRA were enrolled. Feasibility, technical success rate, and image quality scores were compared. Diagnostic ability was calculated using conventional angiography as a reference.

Results
Noncontrast MRA had higher feasibility and technical success rates than CE MRA did (100% and 97.2% vs 83.3% and 90%, respectively). Noncontrast MRA yielded significantly better image quality in motion artifact (P = 0.016). The diagnostic ability for detecting RAS is without significant difference between NC MRA and CE MRA.

Conclusion
Although NC MRA and CE MRA demonstrated comparable ability in diagnosing RAS, NC MRA achieved better technical success rates, feasibility, and image quality in motion artifacts than CE MRA did.
Estimation of Uterine Size: How Accurate Are We?
Authors: Hoke Tanya P. , Vakili Babak 
Published: January 2017

Objective
To evaluate the accuracy of gynecologic surgeons at estimating uterine dimensions and weight.

Methods
Six model uteri of various sizes were created to simulate the size and consistency of a uterus and displayed at 3 stations. The visual station (VS) comprised 2 specimens placed on an unmarked table. The laparoscopic station (LS) consisted of 2 model uteri, each placed in a separate simulated abdomen with a 0 degree laparoscope and 2 operative trocars with standard instruments. The blind weight station (BWS) consisted of blind palpation of 2 separately weighted models (heavy model [HM] and light model [LM]). Participants visually estimated the dimensions of each VS and LS models and blindly palpated the BWS models to estimate weight.

Results
Participants included 15 residents, 27 attendings, and 6 medical students. There was no difference in estimation accuracy regarding gender and age. For the VS and LS groups, participants underestimated all dimensions (VS variance = −15.0%; P < 0.001 and LS variance = −31.9%; P < 0.0001). Laparoscopic estimation was less accurate than direct vision (P < 0.0001). Attendings and residents equally underestimated the 3 dimensions visually (P = 0.46), but attendings were more accurate at estimating laparoscopic dimensions (−25.8% vs −41.1%; P = 0.0001). All groups overestimated model weights (HM variance, 92.5%; P < 0.001 and LM variance, 132.0%; P < 0.0001), with attendings more accurate than residents (39.7% vs 167.6%; P = 0.015 for HM and 52.0% vs 238.5%; P = 0.035 for LM).

Conclusions
Gynecologic surgeons at all levels of training are inaccurate at estimating dimensions and weights. With surgical decisions often predicated on estimates, education is needed to improve estimation methods.
Effect of Concurrent Prolapse Surgery on Stress Urinary Incontinence Outcomes After TVTO
Authors: Rapp David E. , Dolat Mary Ellen , Wiley Joshua , Rowe Bruce 
Published: January 2017

Objectives
A variety of pelvic organ prolapse (POP) surgeries are performed concomitant to midurethral sling (MUS) placement. It is unknown whether differing POP surgeries may affect stress urinary incontinence outcomes after MUS placement.

Methods
We performed a retrospective cohort analysis of patients undergoing TVT obturator system in conjunction with a variety of POP repair (cystocele with mesh graft, cystocele with cadaveric fascia, colpocleisis, and sacrocolpopexy). Primary outcomes included validated measures of stress urinary incontinence (International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms), measured preoperatively and at 6 week, 1 year, and 2 years postoperatively. Secondary outcomes included validated questionnaire items focused on obstructive and irritative symptoms. Multivariate analyses using mixed-effects regressions were used to assess for differences in outcomes based on POP repair type.

Results
A total of 102 patients were identified for study analysis (cystocele with mesh graft, n = 45; cystocele with cadaveric fascia, n = 37; sacrocolpopexy, n = 16; colpocleisis, n = 4). Four patients undergoing colpocleisis were excluded from primary analysis given lack of sufficient cohort size. When adjusted for effects of covariates, significant improvements in primary and secondary outcomes were seen throughout follow-up in comparison with baseline. In general, multivariate analysis demonstrated no significant differences between surgeries when assessing primary and secondary outcomes. The only statistically significant difference in change over time comprised CM, which demonstrated superior improvement in International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms (preoperative vs 2 year, P = 0.04).

Conclusions
Regardless of POP surgery type, patients demonstrate improvements in validated SUI outcomes through 2 years. Multivariate analysis suggests that there is little difference in SUI outcomes after TVT obturator system across several different POP repair types.
Trends in Ambulatory Management of Urinary Incontinence in Women in the United States
Authors: Forde James C. , Chughtai Bilal , Cea Meagan , Stone Benjamin V. , Te Alexis , Bishop Tara F. 
Published: January 2017

Objectives
Urinary incontinence (UI) is a common condition, but despite the availability of guidelines, variations exist in the care of patients. We sought to assess the changes in assessment and management of women with UI over time in the United States.

Methods
The National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey are annual surveys from a nationally representative sample of visits to physicians. From 1999 through 2010, we identified visits by women to physicians where the chief complaint was UI using reason-for-visit and International Classification of Diseases, Ninth Revision codes.

Results
Using 2-year intervals between 1999–2000 and 2009–2010, the number of visits by women with UI to physicians increased (5.3 million to 6.8 million). There was no difference in patient age, race/ethnicity, or physician specialty (primary care, urology, gynecology). The majority did not have their incontinence characterized (42.4%–47.4%). The use of urinalysis significantly decreased (53%–37.2%, P = 0.02), whereas antimuscarinic use significantly increased (16.7%–35%, P = 0.006). There was an overall increased trend in number of referrals to another physician (5.8%–14.7%, P = 0.06). Urologists had a significant increase in antimuscarinic use (23.5%–44.2%, P = 0.003). All physician specialties demonstrated a decreased trend in use of urinalysis between 1999 and 2010. Although imaging rates were low, they were at highest rates among urologists.

Conclusions
The majority of women do not have the type of UI characterized, whereas there is underutilization of urinalysis. Given the widespread prevalence of UI and its implications on quality of life, greater adherence to guidelines is warranted.
Neutrophil Gelatinase–Associated Lipocalin Biomarker and Urinary Tract Infections: A Diagnostic Case-Control Study (NUTI Study)
Authors: Price Jameca Renee , Guran Larissa , Lim Jeong Youn , Megli Christina J. , Clark Amanda L. , Edwards Sharon Renee , Denman Mary Anna , Gregory W. Thomas 
Published: January 2017

Objectives
Acute uncomplicated urinary tract infection (UTI) in women is often treated based on symptoms alone. Urinary tract infection symptoms are highly sensitive but lack specificity and result in overuse of antibiotics. We sought to determine if urine neutrophil gelatinase–associated lipocalin (uNGAL) levels in urine can accurately discriminate between UTI and healthy women.

Methods
We recruited adult women aged 18 to 85 years presenting in the ambulatory setting from November 2014 to January 2016. Cases were defined as women with Centers for Disease Control and Prevention–defined UTI symptoms and a positive urine culture of more than 105 organisms/mL on a midstream clean-catch specimen. Women without UTI symptoms were matched by age and menopausal status as control subjects. Exclusion criteria were no UTIs within 8 weeks, urinary tract anomalies, renal disease, pregnancy, or diabetes. Clean-catch urine samples were obtained for measuring uNGAL, prior to antibiotic treatment of cases. We used Mann-Whitney U test to compare the 2 groups. Receiver operating characteristic curves were plotted to compare the performance of uNGAL to established urinary markers.

Results
We enrolled 50 UTI cases and 50 control subjects. Urine NGAL levels were higher in the UTI group than in the control subjects (P < 0.0001). Using a cutoff of 23.9 ng/mL, NGAL achieved 98% sensitivity and 100% specificity. The receiver operating characteristic curve had an area under the curve of 0.97 (95% confidence interval, 0.93–1.00), which was significantly high and showed that uNGAL can identify UTI.

Conclusions
Urine NGAL has the potential as a biomarker for diagnosing UTIs in adult women.
Outcomes of Rectovaginal Fistula Repair
Authors: Byrnes Jenifer N. , Schmitt Jennifer J. , Faustich Benjamin M. , Mara Kristin C. , Weaver Amy L. , Chua Heidi K. , Occhino John A. 
Published: January 2017

Objectives
Rectovaginal fistulae (RVF) often represent surgical challenges, and treatment must be individualized. We describe outcomes after primary surgical repair stratified by fistula etiology and surgical approach.

Methods
This retrospective cohort study included women who underwent surgical management of RVF at a tertiary care center between July 1, 2001 and December 31, 2013. Cases were stratified according to the following etiology: cancer (RVF-C), inflammatory bowel disease or infectious (RVF-I), and other (RVF-O). Patients with prior surgical treatment of RVF were excluded. Surgical approaches included local (seton, plug), transvaginal or endorectal, abdominal, diversion alone, or definitive (completion proctocolectomy with permanent colostomy or pelvic exenteration). Recurrence-free survival was estimated using the Kaplan-Meier method, and comparisons between subgroups were evaluated based on fitting Cox proportional hazards models. Censoring occurred at last relevant clinical follow-up. Factors contributing to recurrence-free survival were evaluated including age, body mass index, smoking status, fistula etiology, ileostomy, and surgical approach.

Results
During the study period, 107 women underwent surgical repair of RVF. The most common fistula etiology was RVF-I (54.2%), followed by RVF-O (23.4%), and RVF-C (22.4%). Ninety-four women underwent fistula repair by the local (29.9%), transvaginal/endorectal (25.2%), abdominal approach (19.6%), or diversion alone (13.1%), whereas 13 underwent definitive surgery (12.2%). Recurrence-free survival was significantly different depending on surgical approach (P < 0.001), but not etiology (P = 0.71). Recurrence-free survival (95% confidence interval) at 1 year after surgery was 35.2% (21.8%–56.9%) for the local approach, 55.6% (37.0%–83.3%) for the transvaginal or endorectal approach, 95% (85.9%–100%) for the abdominal approach, and 33.3% (15%–74.2%) for those with diversion only.

Conclusions
Recurrence rates after RVF repair are high and did not differ by fistula etiology. Abdominal repair of RVF had significantly fewer recurrences.
Transurethral Polyacrylamide Hydrogel Injection Therapy in Women Not Eligible for Midurethral Sling Surgery
Authors: Altman Daniel , Ghilotti Francesca , Bellocco Rino , Zetterström Jan , Kopp Kallner Helena 
Published: January 2017

Objectives
This study aims to determine the effects of transurethral polyacrylamide hydrogel injection in patients considered ineligible for midurethral sling surgery.

Methods
In this prospective observational study, 81 patients received treatment with transurethral polyacrylamide hydrogel injection. Patients were considered ineligible for placement of a midurethral sling based on significant comorbidity (48%), 1 or more previously failed invasive treatments (16%), mixed urinary incontinence (27%), continuous incontinence (5%), or previous pelvic radiation therapy (4%). Longitudinal assessment of subjective treatment outcomes was performed using the validated Urinary Distress Inventory (UDI) and the Pelvic Floor Impact Questionnaire at baseline, 2, and 6 months. To deal with repeated measurements, mixed linear models were used to assess changes in the outcomes over time.

Results
There was a significant improvement in the overall UDI score from baseline to month 2 follow-up (FU) (P<0.001). No major differences between the month 2 and 6 FUs were observed. The largest difference in effect was observed for the irritative and stress subscales. Twenty-five patients (33%) requested a second injection at the month 2 FU visit. At month 6 FU, the UDI scores for patients having had only 1 injection were largely unchanged, whereas all UDI domains worsened further for patients having had a second injection at the month 2 visit. After the injection, there were 3 minor adverse events (3.7%) and no serious adverse events.

Conclusions
In patients considered ineligible for midurethral sling surgery, transurethral injection with polyacrylamide hydrogel may alleviate urinary incontinence symptoms. Repeat injections did not improve outcomes in this complicated group of patients.