bluuebunny/crossref_metadata_2025_split huggingface dataset:
Signature analysis of high-throughput transcriptomics screening data for mechanistic inference and chemical grouping
Authors: Harrill Joshua A , Everett Logan J , Haggard Derik E , Word Laura J , Bundy Joseph L , Chambers Bryant , Harris Felix , Willis Clinton , Thomas Russell S , Shah Imran , Judson Richard 
Published: August 2024

Abstract
High-throughput transcriptomics (HTTr) uses gene expression profiling to characterize the biological activity of chemicals in in vitro cell-based test systems. As an extension of a previous study testing 44 chemicals, HTTr was used to screen an additional 1,751 unique chemicals from the EPA’s ToxCast collection in MCF7 cells using 8 concentrations and an exposure duration of 6 h. We hypothesized that concentration-response modeling of signature scores could be used to identify putative molecular targets and cluster chemicals with similar bioactivity. Clustering and enrichment analyses were conducted based on signature catalog annotations and ToxPrint chemotypes to facilitate molecular target prediction and grouping of chemicals with similar bioactivity profiles. Enrichment analysis based on signature catalog annotation identified known mechanisms of action (MeOAs) associated with well-studied chemicals and generated putative MeOAs for other active chemicals. Chemicals with predicted MeOAs included those targeting estrogen receptor (ER), glucocorticoid receptor (GR), retinoic acid receptor (RAR), the NRF2/KEAP/ARE pathway, AP-1 activation, and others. Using reference chemicals for ER modulation, the study demonstrated that HTTr in MCF7 cells was able to stratify chemicals in terms of agonist potency, distinguish ER agonists from antagonists, and cluster chemicals with similar activities as predicted by the ToxCast ER Pathway model. Uniform manifold approximation and projection (UMAP) embedding of signature-level results identified novel ER modulators with no ToxCast ER Pathway model predictions. Finally, UMAP combined with ToxPrint chemotype enrichment was used to explore the biological activity of structurally related chemicals. The study demonstrates that HTTr can be used to inform chemical risk assessment by determining in vitro points of departure, predicting chemicals’ MeOA and grouping chemicals with similar bioactivity profiles.
A Survey of US Obstetric Anesthesiologists’ Perceived Value of Obstetric Anesthesiology Fellowship
Authors: Thomas C , Neumann KE , Smith C , Dominguez JE , Traynor A , Farber MK , Zakowski M , McCarthy RJ , Peralta FM 
Published: August 2024

(Int J Obstet Anesth. 2023;56:103930. doi: 10.1016/j.ijoa.2023.103930|)
In the United States, specialized training in obstetric anesthesiology is linked to better patient outcomes and lower risks during childbirth. A consensus statement from 2015, endorsed by major medical bodies, advocates for concentrating high-risk obstetric services to improve maternal health. The statement suggests specific staffing guidelines for different levels of perinatal centers, emphasizing the need for obstetric anesthesiologists at advanced facilities to handle complex cases and ensure quality care of high-risk patients. Despite efforts to centralize care, many high-risk patients still deliver in community, nonreferral hospitals. Furthermore, there continues to be increased demand for more fellowship-trained obstetric anesthesiologists. This scarcity might stem from various factors, including perceptions about the necessity of specialized training, financial concerns, and insufficient exposure during residency. Detailed information on the career paths of fellowship-trained individuals is limited but could potentially alter perceptions, increase interest in fellowships, and improve recruitment to this subspecialty. This study assesses the perceived benefits of obstetric anesthesiology training on career development, job satisfaction, quality of life, and professional autonomy.
Of Aspirin, Preeclampsia, and Racism
Authors: Sacks DA , Incerpi MH 
Published: August 2024

(N Engl J Med. 2024;390(11):968–969. doi: 10.1056/NEJMp2311019)
Being African American/Black was listed as a factor associated with a moderate level of preeclampsia risk in 2018 as outlined by the American College of Obstetricians and Gynecologists (ACOG) committee. This opinion was also re-affirmed in 2023. In 2021 and again in 2022, ACOG cited it as a proxy for the adverse effects of racism on health and mentioned that Black race on its own could be an indication for the need for aspirin. In general, if more than one moderate risk factor was present, a low dose of aspirin could be used to help prevent preeclampsia. This article investigates whether race itself is a risk factor, the potential role of structural racism contributing to preeclampsia, and whether aspirin helps prevent it in this demographic.
Immunosuppressant Medications in Pregnancy
Authors: Saad AF , Pacheco LD , Saade GR 
Published: August 2024

(Obstet Gynecol. 2024;143(4):e94–e106. doi: 10.1097/AOG,0000000000005512)
Pregnant patients often take immunosuppressant medications for solid organ transplant rejection prevention or autoimmune disorders. It is important that they adhere to prescribed regimens before and during pregnancy to avoid serious consequences. Close monitoring of organ function, signs of rejection, and immunosuppressant levels are vital. Counseling for reproductive patients should include discussions on how pregnancy may impact their condition, potential fetal effects of medications, and breastfeeding considerations. This review provides detailed guidance on managing common immunosuppressants during pregnancy and lactation, along with antenatal and postpartum care timelines.
RSV Prefusion F Protein-Based Maternal Vaccine—Preterm Birth and Other Outcomes
Authors: Dieussaert I , Kim JH , Luik S , Seidl C , Pu W , Stegmann JU , Swamy GK , Webster P , Dormitzer PR 
Published: August 2024

(N Engl J Med. 2024;390(11):1009–1021. doi: 10.1056/NEJMoa2305478)
Maternal immunization could protect infants from respiratory syncytial virus (RSV). GlaxoSmithKline (GSK) developed an RSV subunit vaccine for maternal use called RSVPreF3-Mat. However, during a phase 3 trial (RSV MAT-009) initiated in 2020, an imbalance in preterm births was observed in the vaccine group compared with the placebo group. Consequently, enrollment and vaccination were stopped in February 2022, prompting further investigation. This article presents the primary efficacy and safety findings from the trial, along with exploratory analyses examining the preterm birth safety signal.
Outcomes in Children After Mild Neonatal Hypoxic Ischemic Encephalopathy: A Population-Based Cohort Study
Authors: Törn AE , Hesselman S , Johansen K , Ågren J , Wikström AK , Jonsson M 
Published: August 2024

(BJOG. 2023;130(13):1602–1609. doi: 10.1111/1471-0528.17533)
The condition known as neonatal hypoxic ischemic encephalopathy (HIE) occurs when a term or near-term infant suffers asphyxiation during or near birth. The resulting signs and symptoms vary and may be classified as mild, moderate, or severe. Historically, infants diagnosed with mild HIE received alternative, and less intensive care given the understanding that outcomes were less severe compared with infants with the moderate or severe HIE diagnosis. However, recent studies have suggested young children (aged 2 to 5) who were diagnosed with mild HIE as infants are more likely to have a disability when compared with similar aged children without an HIE diagnosis. In addition, when examining mild HIE patients at neonatal discharge, abnormal results were found on amplitude-integrated electroencephalography, brain magnetic resonance imaging, and neurological exam. This population-based cohort study used register-based data to further understand how mild HIE relates to severe neurological outcomes, including death up to 6 years after birth.
High Neuraxial Block in Obstetrics: A 2.5-year Nationwide Surveillance Approach in the Netherlands
Authors: Beenakkers ICM , Schaap TP , van den Bosch OFC 
Published: August 2024

(Anesth Analg. 2024. doi: 10.1213/ANE.0000000000006866)
High neuraxial block (HNB) is rare but is the most common serious complication in obstetric anesthesiology. It can occur after the failure of labor epidural anesthesia to convert to cesarean delivery (CD) anesthesia and can lead to respiratory distress and cardiac arrest. The aim of this study was to learn more about the incidence and clinical features of HNB in the Netherlands, where there is a low rate of neuraxial analgesia for labor and a low rate of CD.
Case 1-2024: A 25-Year-Old Pregnant Woman With Bleeding After a Snakebite
Authors: Fai KN , Moustafa H , Esso L , Boum Y 
Published: August 2024

(N Engl J Med. 2024;390(2):166–173. doi: 10.1056/NEJMcpc2301033)
A case report of a 25-year-old pregnant woman with bleeding after a snakebite was presented as a special feature of the 100-year anniversary of the Case Records of the Massachusetts General Hospital.
Prenatal Care Utilization and Birth Outcomes After Expansion of the National Health Service Corps
Authors: Ma Yanlei , Baker Olesya , Zhang Fang , Cochran-McClain Carrie , Kaimal Anjali J. , Yu Hao 
Published: August 2024

OBJECTIVE:
The National Health Service Corps (NHSC) attracts clinicians to Health Professional Shortage Areas (HPSAs) through scholarships and loan repayments. Since 2009, the NHSC workforce, including maternity care clinicians, has substantially expanded. This study evaluates the association between NHSC expansion and prenatal care and birth outcomes.

METHODS:
In this quasi-experimental study, we adopted a generalized difference-in-differences design to compare changes in prenatal care and birth outcomes from 2005 to 2019 using birth certificate data. Counties designated as HPSAs without any NHSC maternity care clinicians throughout the study period were control counties, and those without such clinicians before 2009 but receiving them after 2009 were treated counties. Outcome measures include a count variable of number of prenatal visits and four dichotomous variables: prenatal care initiation in the first trimester, adequacy of prenatal care, preterm birth, and low birth weight. We estimated negative binomial models for number of prenatal visits and linear probability models for the dichotomous outcomes, adjusting for maternal characteristics, non-NHSC clinician density, and state-level policies. Stratified analyses were also conducted on the basis of birthing people's demographics and county-level characteristics.

RESULTS:
Our sample comprised 12,980,111 live births between 2005 and 2019 by individuals residing in 1,254 HPSA counties without any NHSC maternity care clinicians before 2009, including 222 counties that received such clinicians after 2009. Compared with control counties, pregnant people in treated counties experienced significant increases in prenatal visits (211 more prenatal visits relative to baseline of 11,226 visits per 1,000 births, P<.001) and in the likelihood of receiving adequate prenatal care (1.43 percentage point increase relative to baseline of 67.0 percentage points, P<.01). Although the NHSC expansion improved prenatal care use for all racial and ethnic groups, pregnant people residing in urban and high social vulnerability areas benefited most. Improvements in birth outcomes were observed only among certain subgroups such as a 0.91 percentage point reduction in preterm birth (relative to baseline of 12.6 percentage points, P<.001) and a 0.87 percentage point reduction in low birth weight (relative to baseline of 8.2 percentage points, P<.05) among pregnant people living in full-county HPSAs.

CONCLUSION:
The NHSC expansion since 2009 was associated with increases in prenatal care utilization, particularly among vulnerable populations. Although improvements were not observed in birth outcomes overall with NHSC expansion, modest reductions were observed in preterm birth and low birth weight in subsets of the population.
Intradermal Botulinum Toxin A on Skin Quality and Facial Rejuvenation: A Systematic Review and Meta-analysis
Authors: Rahman Eqram , Rao Parinitha , Philipp-Dormston Wolfgang , Webb William Richard , Garcia Patricia E. , Ioannidis Sotirios , Kefalas Nicola , Kajaia Albina , Friederich Lisa , Yu Nanze , Wang Keming , Parikh Apul , Almeida Ada R.T. , Carruthers Jean D.A. , Carruthers Alastair , Mosahebi Ash , Wu Woffles , Goodman Greg 
Published: August 2024

Background:
Botulinum toxin A (BTxA) has gained popularity as a nonsurgical aesthetic treatment for skin rejuvenation. However, previous studies on intradermal BTxA have shown inconsistent results. This systematic review and meta-analysis with trial sequential analysis aimed to assess the efficacy and safety of intradermal BTxA for facial rejuvenation.

Methods:
Following PRISMA guidelines, a comprehensive search was conducted in various databases from January 2008 to March 2023. Outcome measures included sebum production, pore size, skin hydration, skin texture, erythema index, facial wrinkles, and facelift. Eligible studies included human-based clinical trials and prospective cohort studies published in English, focusing on healthy populations requiring facial rejuvenation. Two authors independently screened the titles and abstracts, followed by a full-text review to determine study eligibility. Data extraction and quality assessment were performed by two authors using predefined criteria.

Results:
Ten studies met the inclusion criteria, including five randomized controlled trials and five prospective cohort studies with 153 participants. Studies revealed positive effects of intradermal BTxA on various outcome measures related to facial rejuvenation. These effects included improvements in sebum production, pore size, erythema index, facial wrinkles, skin texture and elasticity, and overall facelift but not skin hydration. All failed to reach the required information size in the trial sequential analysis.

Conclusions:
Findings suggest positive outcomes in multiple attributes of skin quality and facial rejuvenation. However, more high-quality research is needed to establish definitive conclusions. These findings contribute to the evidence base for nonsurgical aesthetic treatments, emphasizing the importance of ongoing research in this field.
Late-onset Total Necrosis in Deep Inferior Epigastric Perforator Flap after Contrast Enhanced Computed Tomography
Authors: Maitani Kosuke , Tomita Koichi , Kitamura Natsuko , Kadowaki Miki , Kubo Tateki 
Published: August 2024

Summary:
There seems to be an incessant debate regarding the duration of dependency of free flaps on pedicle vessels and the extent to which neovascularization from surrounding tissue contributes to the fortification of the free flaps. Although animal studies have suggested that pedicle vessels can be safely divided 5–8 days postoperatively without flap failure in fasciocutaneous flaps, recent clinical reports, particularly concerning the deep inferior epigastric perforator (DIEP) flap, cast doubt on this assumption. This report highlights a singular case of delayed-onset total necrosis in a DIEP flap following a contrast enhanced computed tomography (CECT) scan conducted 48 days post reconstructive surgery. The patient, a 56-year-old woman, had undergone a mastectomy for right breast cancer followed by immediate tissue expander placement. Subsequently, 6 months later, she underwent delayed reconstructive surgery with a DIEP flap. The postoperative course was uneventful, except that she had a CECT scan as part of follow-up care 48 days postoperatively and developed an abrupt yellow exudate from the right breast wound 2 days later, eventually leading to aggressive debridement of the totally necrotized flap 60 days postoperatively. This case marks the first instance of late-onset total necrosis of a DIEP flap following a CECT. The intensified endothelial damage induced by contrast media, in the context of the high dependency of the DIEP flap on the pedicle vessels with marginal blood supply from the surrounding wound bed, could be ascribed as the cause of this total loss of the flap.
A Composite Application Technique of Single-stage Dermal Templates to Improve Handling and Ease of Use
Authors: Maitz Joanneke , Carelli Lucas G. , Coady Elizabeth , Loi Duncan , Maitz Peter 
Published: August 2024

Summary:
The “work horse” for the treatment of full-thickness defects of any etiology, including chronic nonhealing wounds and traumatic injuries, is generally autologous split-thickness skin grafts (STSGs), meshed, hand-fenestrated, or a sheet graft. Advancements in skin tissue engineering have allowed for the integration of dermal substitutes to be combined with autologous STSGs, adding valuable options for restoring the skin’s complex multilayered structure. Although dermal templates offer a promising avenue for more nuanced reconstruction in certain cases, their application is not without challenges, particularly when they are made from delicate materials. The following technique simplifies the application technique of single-stage dermal templates by using a composite approach. To demonstrate this technique, MatriDerm, a 1-mm-thick bovine collagen-elastin dermal template, is used to enable an STSG to be applied in a one-stage procedure.
SPECTRAL-DOMAIN OPTICAL COHERENCE TOMOGRAPHY INSIGHTS INTO IDIOPATHIC EPIRETINAL MEMBRANE SURGERY OUTCOMES
Authors: Mansilla Raquel , Bande Manuel F. , Mera Purificación , Ruiz-Oliva Francisco , Marticorena Joaquin , Blanco-Teijeiro María José 
Published: August 2024

Purpose:
The aim of this study is to assess the prognostic value of a classification system that includes the presence of ectopic inner foveal layers and other anatomical variables identified in spectral-domain optical coherence tomography for idiopathic epiretinal membrane (ERM) surgery.

Methods:
A descriptive-analytic, longitudinal, retrospective study was conducted on patients with idiopathic ERMs treated with pars plana vitrectomy from January 2017 to December 2021. Clinical data and spectral-domain optical coherence tomography images were reviewed presurgery and 12 months postsurgery. The primary outcome measured was best-corrected visual acuity (BCVA) before and after surgery, analyzing the impact of anatomical factors on BCVA in patients undergoing ERM surgery.

Results:
This study included 342 eyes from 323 patients. Postsurgical evaluations showed significant reductions in central foveal thickness across all ERM stages, with most Stage 4 ERMs regressing to Stage 3. The mean improvement in BCVA was significant for all stages, with earlier stages showing better results. The presence of macular edema and ellipsoid zone disruption were significant predictors of postsurgical BCVA, while disorganization of the retinal inner layer showed an association with visual recovery but was not conclusively predictive.

Conclusion:
This study highlights the importance of spectral-domain optical coherence tomography in assessing retinal changes in idiopathic ERMs, demonstrating the prognostic value of ectopic inner foveal layers stage scheme and other anatomical variables such as ellipsoid zone disruption and macular edema presence on BCVA. These findings offer insights into surgical prognostication and the potential for personalized treatment strategies.
Analysis of Corneal Phenotypes in Japanese Patients With Myotonic Dystrophy Type 1
Authors: Kubo Kenya , Oie Yoshinori , Koto Ryota , Nishida Nozomi , Kai Chifune , Maeno Sayo , Kubota Tomoya , Nakamori Masayuki , Takahashi Masanori P. , Tsujikawa Motokazu , Nishida Kohji 
Published: August 2024

Purpose:To analyze the corneal phenotypes of Japanese patients with myotonic dystrophy type 1 (DM1).Methods:We included patients with DM1 who were diagnosed with clinical neuromuscular symptoms by neurologists and CTG trinucleotide repeat (TNR) expansion of the (myotonic dystrophy protein kinase)DMPKgene. We analyzed the corneal phenotype using slit-lamp examination, specular microscopy, and anterior segment optical coherence tomography. We evaluated TNR expansion in theTCF4gene of leukocyte-derived genomic DNA by fragment analysis using polymerase chain reaction and triplet-repeat primed polymerase chain reaction.Results:Nineteen eyes from 10 patients with DM1 (DM1 group) and 72 eyes from 37 healthy participants (control group) were analyzed. The average age was 49.3 ± 11.9 and 51.8 ± 12.9 years in the DM1 and control groups, respectively (P= 0.11). Slit-lamp examination demonstrated that 2 patients with DM1 had bilateral corneal guttae equivalent to modified Krachmer grade 1 of Fuchs endothelial corneal dystrophy. Dark areas on specular microscopy were observed in 4 of 19 eyes (21.1%) and 0 of 72 eyes (0%) in the DM1 and control groups, respectively, with statistically significant differences (P= 0.002). The average endothelial cell density in the DM1 group (3536 ± 722 cells/mm2) was significantly higher than that in the control group (3026 ± 412 cells/mm2) (P= 0.0006). TNR expansion inTCF4was not detected in eyes with corneal guttae or in the dark areas in the DM1 group.Conclusions:Japanese patients with DM1 without TNR expansion inTCF4have a mild phenotype equivalent to Fuchs endothelial corneal dystrophy. Endothelial cell density is higher in DM1 patients than in normal participants.
Influence of endovascular surgery on abdominal aortic aneurysm management strategies from a national health insurance database survey
Authors: Chen Wei-Ling , Kan Chung-Dann , Huang Yi-Ting , Shih Hsin-I 
Published: August 2024

Background:
Abdominal aortic aneurysm (AAA) is a significant global health concern, yet comprehensive population-based studies remain limited. This study aimed to evaluate the hospitalization rates, surgical trends, mortality, and reintervention rates for ruptured (r-AAA) and nonruptured (nr-AAA) AAA using data from a national health insurance database.

Methods:
A population-based retrospective cohort study was conducted utilizing data from the Taiwanese National Health Insurance Research Database from 2007 to 2018. The study included individuals aged 20 years and older with a newly diagnosed AAA.

Results:
Among 70 457 patients diagnosed with aortic aneurysm or dissection, 22 538 (32%) adult patients (≥20 years) were identified with AAA. The annual incidence of AAA ranged from 7.7 to 10.3 per 100 000 population, with r-AAA decreasing from 1.3 to 0.8 per 100 000 and nr-AAA from 9.0 to 6.8 per 100 000. Most patients with AAA were older adults (85%), with 15 392 (68%) hospitalized and 4885 (32%) undergoing surgery within 14 days of diagnosis. The use of endovascular aneurysm repair (EVAR) significantly increased from 28% to 96% over the study period. Long-term survival was higher in patients who underwent open surgical repair (OSR) compared to those who received EVAR or conservative management, irrespective of whether they had r-AAA or nr-AAA.

Conclusion:
AAA predominantly affects older individuals, and the annual incidence shows a declining trend. Since the introduction of EVAR, its use has steadily increased while OSR rates have decreased. Although both EVAR and OSR are associated with reduced mortality in patients with r-AAA, OSR is linked to superior long-term survival outcomes.