bluuebunny/crossref_metadata_2025_split huggingface dataset:
Experiencing Psychosis and Shame: A Systematic Review and Meta-analysis of the Strength and Patterns of Association
Authors: Davies Kimberley , Lappin Julia M , Gott Chloe , Steel Zachary 
Published: August 2024

Abstract

Background and Hypothesis
Shame has been linked to the experience of psychosis, with implications for clinical outcomes, however, a meta-analysis of the relationship has not yet been conducted. This systematic review and meta-analysis aimed to examine the strength of the association between shame and psychosis, and any variations between clinical and non-clinical populations and shame type (internal vs external shame).

Study Design
Searches were conducted in CINAHL, EMBASE, PsycInfo, PubMed, Scopus, and Web of Science from the inception of the e-databases until July 2023. For inclusion, studies reported a quantitative association between psychosis and shame, or data that could be used to identify a relationship. From 11 372 unique retrieved records, 40 articles met the inclusion criteria and 38 were included in the meta-analyses.

Study Results
A significant large pooled estimate of the psychosis-shame association was identified (Zr = 0.36, [95% CI: 0.28, 0.44], P &lt; .001), indicating that higher levels of shame were associated with greater severity of psychotic symptoms. The strength of the association was similar across clinical and non-clinical populations, however, differed by type of shame and psychosis symptom measured. External shame was strongly associated with paranoia suggesting possible confounding. Only a minority of studies met the highest quality criteria.

Conclusions
Shame is strongly associated with the severity of psychotic symptoms in clinical and non-clinical populations. Given the overlap with paranoia, measurement of external shame alone is not advised. Larger studies in clinical populations, with measures of a range of psychosis symptoms, are needed to better understand the relationship between shame and specific symptoms.
Maternal RSV Vaccine—Weighing Benefits and Risks
Authors: Rasmussen SA , Jamieson DJ 
Published: August 2024

(N Engl J Med. 2024;390(11):1050–1051. doi:10.1056/NEJMe2401072)
Respiratory syncytial virus (RSV) is an infection with detrimental effects, especially for infants. In fact, it is the leading cause of hospitalization for infants in the United States. The Food and Drug Administration (FDA) approved the first RSV vaccine for pregnant mothers. It is based on the RSV prefusion F protein (RSVPreF). This article discusses a phase 3 trial that assessed the effects of a maternal RSV vaccine (RSVPreF3-Mat) on extreme RSV-type cases in young infants.
Feasibility of Focused Cardiac Ultrasound Performed by Trainees During Cesarean Delivery
Authors: Ortner CM , Sheikh M , Waseem Athar M , Padilla C , Guo N , Carvalho B 
Published: August 2024

(Anesth Analg. 2023 Dec 21. doi: 10.1213/ANE.0000000000006747)
Cardiovascular diseases are the primary cause of maternal deaths in developed nations. The improved survival of children with congenital heart issues and the rising risk factors among women of childbearing age have led to a growing population of pregnant women with heart conditions. Due to factors like increasing maternal age, comorbidities, and assisted reproductive technologies, experts in anesthesiology advocate for formal training in maternal critical care, including the use of focused cardiac ultrasound (FCU) in high-risk obstetric units. Although expert-performed FCU has been well-documented, there is limited evidence of its feasibility when done by trainees or less-experienced physicians. Pregnancy's physiological changes make FCU optimal, but challenges arise in intraoperative settings, prompting a need for standardized FCU training in obstetric anesthesia residency and fellowship programs.
Association of Labor Neuraxial Analgesia With Maternal Blood Transfusion
Authors: Guglielminotti J , Landau R , Daw J , Friedman AM , Li G 
Published: August 2024

(Anesthesiology 2023;139(6):734–745. doi: 10.1097/ALN.0000000000004743)
Labor neuraxial analgesia is used in about 70% of births in the United States. It may help lower the risk of postpartum hemorrhage, which is the strongest indication for a mother requiring a blood transfusion during childbirth. This study analyzed the link between labor neuraxial analgesia with maternal blood transfusion using data from birth certificates from the Natality File of the National Vital Statistics System for vaginal (VD) and intrapartum cesarean (CD) deliveries between January 2015 to December 2018 in all 50 states and the District of Columbia. Data were excluded if they had missing information in any of the following categories: labor neuraxial analgesia, maternal outcome, maternal ethnicity, or residence or hospital county and race. Other exclusion criteria were if the mother did not live in the United States or if a child was not birthed in a hospital.
The Association Between Labour Epidural Analgesia and Postpartum Depression in Primiparous Patients: A Historical Cohort Study
Authors: Jin S , Munro A , George RB 
Published: August 2024

(Can J Anaesth. 2023;70(12):1909–1916. doi: 10.1007/s12630-023-02568-2)
Postpartum depression (PPD) poses a significant public health concern, impacting ~6.5% to 12.9% of postpartum patients. There is a known link between peripartum pain and PPD, with labor epidural analgesia (LEA) potentially playing a role in mitigating this risk. Recent meta-analyses have yielded varying results: 2 found no correlation between LEA and PPD, whereas a third reported a decreased risk of PPD with LEA in a high-prevalence subgroup and an increased risk in a low-prevalence subgroup. Considering these findings, the current study sought to investigate the association between LEA and PPD specifically among primiparous patients.
Inadequate Neuraxial Anaesthesia During Caesarean Delivery: A Survey of Practitioners
Authors: Patel R , Russell R , Plaat F , Bogod D , Lucas N 
Published: August 2024

(Int J Obstet Anesth. 2023;56:103905. doi:10.1016/j.ijoa.2023.103905)
Inadequate neuraxial anesthesia during cesarean delivery can result in intraoperative pain and poor maternal mental health, as well as possible litigation. This cross-sectional study explored many facets including consent, neuraxial block assessment, and intraoperative pain management by surveying obstetric anesthetic practitioners. The questionnaire was given live at the virtual Obstetric Anaesthetists’ Association (OAA) Annual Scientific Meeting in 2021 using an audience response system, but was first assessed for validity using the Content Validity Index.
Opioid-Sparing Multimodal Analgesia Use After Cesarean Delivery Under General Anesthesia: A Retrospective Cohort Study in 729 U.S. Hospitals
Authors: Zanolli NC , Fuller ME , Krishnamoorthy V , Ohnuma T , Raghunathan K , Habib AS 
Published: August 2024

(Anesth Analg. 2023;137(2):256–266. doi: 10.1213/ANE,00000000000069428)
Current guidelines recommend multimodal analgesia (MMA) for patients who have had a cesarean delivery (CD) under neuraxial anesthesia but not as much is known about how the same approach could work for patients who had CD under general anesthesia (GA). CDs under GA make up only 6% of CDs and studies show that these patients have higher postoperative pain and higher opioid use compared with patients receiving neuraxial anesthesia. MMA consists of using non-steroidal anti-inflammatory drugs (NSAIDs), acetaminophen, opioids as needed, and regional anesthetic techniques.
A Quality Improvement Project to Reduce Unplanned Extubations in the Neonatal Intensive Care Unit
Authors: Caprio Adelaide B. , Niewinski Krystle N. , Murphy Sara , Geistkemper Anne , Seske Laura M. 
Published: August 2024

Background:
Unplanned extubations (UEs) continue to be one of the most common adverse events in the neonatal intensive care unit (NICU). Management of endotracheal tubes (ETTs) can be particularly challenging in neonates due to the unique needs and physical characteristics of this patient population.

Purpose:
The purpose of this quality improvement project was to decrease the rate of UEs from 0.76 to less than 0.5 per 100 ventilator days in an urban level III NICU in the Midwest, United States.

Methods:
A newly formed interprofessional team created an evidence-based, standardized, bedside nurse-led care bundle for intubations and ETT care in the NICU. This project also created standardized, clear, closed-loop communication for the transition of bedside staff at shift change.

Results:
The UE rate decreased from 0.76 to 0 per 100 ventilator days, reaching the goal of less than 0.5 per 100 ventilator days, during the 10-week project implementation period from December 2021 to February 2022.

Implications for Practice and Research:
Many NICUs focus on reducing UEs due to the impact on healthcare resource utilization, acute complications, and long-term outcomes for infants. The development of a standardized, nurse-led care bundle for ETTs decreased the rate of UEs. Future research is needed to study the potential for generalization to different units and beyond the scope of the neonatal population.
Pregnancy Outcomes in Patients With Hepatitis C Virus Infection
Authors: Hughes Brenna L. , Sandoval Grecio J. , Saade George R. , Clifton Rebecca G. , Reddy Uma M. , Bartholomew Anna , Salazar Ashley , Chien Edward K. , Tita Alan T.N. , Thorp John M. , Metz Torri D. , Wapner Ronald J. , Sabharwal Vishaka , Simhan Hyagriv N. , Swamy Geeta K. , Heyborne Kent D. , Sibai Baha M. , Grobman William A. , El-Sayed Yasser Y. , Casey Brian M. , Parry Samuel , Macones George A. , Prasad Mona ,   for the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network
Published: August 2024

OBJECTIVE:
To evaluate the risks of adverse maternal and neonatal outcomes associated with pregnancies complicated by hepatitis C virus (HCV) infection.

METHODS:
This is a secondary analysis of a multicenter prospective cohort study of HCV infection in pregnancy. Participants were screened for HCV infection with serum antibody tests, and each participant with a positive HCV result (case group) was matched with up to two individuals with negative HCV results (control group) prospectively by gestational age (±2 weeks) at enrollment. Maternal outcomes included gestational diabetes, abruption, preeclampsia or gestational hypertension, cholestasis, and preterm delivery. Neonatal outcomes included hyperbilirubinemia, admission to neonatal intensive care (NICU); small-for-gestational-age (SGA) birth weight; and neonatal infection, defined as sepsis or pneumonia. Models were adjusted for maternal age, body mass index, injection drug use, and maternal medical comorbidities.

RESULTS:
The 249 individuals in the case group were prospectively matched to 486 individuals in the control group who met eligibility criteria. There were significant differences in demographic characteristics between the groups, including race, socioeconomic markers, education, insurance status, and drug and tobacco use. The frequencies of maternal outcomes of gestational diabetes, preeclampsia, and abruption were similar between the case and control groups. Preterm birth was similar between groups, but neonates born to individuals in the case group were more likely to be admitted to the NICU (45.1% vs 19.0%, adjusted odds ratio [aOR] 2.6, 95% CI, 1.8–3.8) and to have SGA birth weights below the 5th percentile (10.6% vs 3.1%, aOR 2.9, 95% CI, 1.4–6.0). There were no increased odds of hyperbilirubinemia or neonatal infection.

CONCLUSION:
Despite no increased odds of preterm birth or other adverse maternal outcomes in adjusted analyses, maternal HCV infection was associated with twofold increased odds of NICU admission and nearly threefold increased odds of SGA birth weight below the 5th percentile.
Utility and Outcomes of Ovarian Tissue Cryopreservation and Transplantation for Gynecologic Cancers
Authors: Erden Murat , Gayete-Lafuente Sonia , Vural Nazli Aylin , Oktay Kutluk H. 
Published: August 2024

OBJECTIVE:
To evaluate the utility, success, and safety of ovarian tissue cryopreservation and autologous cryopreserved ovarian tissue transplantation for fertility preservation in patients with gynecologic cancers.

DATA SOURCES:
A comprehensive search was performed of the MEDLINE, EMBASE, ClinicalTrials.gov, and Cochrane Library databases to identify relevant studies on the utility and outcomes of ovarian tissue cryopreservation and autologous cryopreserved ovarian tissue transplantation for gynecologic cancers from inception until January 23, 2024.

METHODS OF STUDY SELECTION:
Two reviewers independently performed the study selection, data extraction, and risk-of-bias assessment, and the results were then reviewed together. Twenty-three studies were included in the current systematic review.

TABULATION, INTEGRATION, AND RESULTS:
The resultant data were meta-analyzed to produce a pooled-effect estimate of the utility of ovarian tissue cryopreservation and autologous transplantation in gynecologic cancers as a proportion of all indications. We found that 7.5% and 9.6% of women undergoing ovarian tissue cryopreservation and autologous transplantation, respectively, had gynecologic cancers. In comparison, hematologic malignancies and breast cancer accounted for approximately 66.0% of all indications for these procedures. The return rate for autologous cryopreserved ovarian tissue transplantation in gynecologic cancers (6.0%) was not statistically different from those for other indications. Among women with gynecologic cancer who underwent ovarian stimulation, 27.3% had at least one child, and the ovarian endocrine function was restored in 78.1% of the women after autologous transplantation. The median graft longevity was 32 months, and no graft-site recurrence was reported after autologous transplantation in women with gynecologic cancer.

CONCLUSION:
Our results suggest that ovarian tissue cryopreservation and autologous transplantation are feasible options for preserving ovarian function in women with gynecologic cancers, although ovarian tissue cryopreservation is underutilized, and further studies are needed to determine the longer-term outcomes of autologous transplantation.

SYSTEMATIC REVIEW REGISTRATION:
PROSPERO, CRD42024498522.
Cross-tissue organization of myeloid cells in scleroderma and related fibrotic diseases
Authors: Odell Ian D. 
Published: August 2024

Purpose of review
Scleroderma and other fibrotic diseases have been investigated using single-cell RNA sequencing (scRNA-Seq), which has demonstrated enrichment in myeloid cell populations in multiple tissues. However, scRNA-Seq studies are inconsistent in their nomenclature of myeloid cell types, including dendritic cells, monocytes, and macrophages. Using cell type-defining gene signatures, I propose a unified nomenclature through analysis of myeloid cell enrichment across fibrotic tissues.

Recent findings
scRNA-Seq of human blood and skin identified a new subset of dendritic cells called DC3. DC3 express similar inflammatory genes to monocytes, including FCN1, IL1B, VCAN, S100A8, S100A9, and S100A12. DC3 can be distinguished from monocytes by expression of EREG and Fc receptor genes such as FCER1A and FCGR2B. scRNA-Seq analyses of scleroderma skin and lung, idiopathic pulmonary fibrosis (IPF), COVID-19 lung fibrosis, myelofibrosis, and liver, kidney, and cardiac fibrosis all showed enrichment in myeloid cell types. Although they were called different names, studies of scleroderma skin and lung as well as liver cirrhosis datasets demonstrated enrichment in DC3. By contrast, lung, heart, and kidney fibrosis were enriched in SPP1 macrophages. High numbers of DC3 in the skin was associated with worse SSc skin and lung fibrosis severity.

Summary
scRNA-Seq of multiple diseases showed enrichment of DC3 in fibrotic skin, lung, and liver, whereas SPP1 macrophages occurred in fibrotic lung, heart, and kidney. Because DC3 and SPP1 macrophages showed organ-specific enrichment, understanding their signaling mechanisms across tissues will be important for future investigation.
“Ultralow-dose” CT Without Sedation in Pediatric Patients With Neuromuscular Scoliosis
Authors: Yee Nicholas J. , Iorio Carlo , Shkumat Nicholas , Rocos Brett , Lebel David , Camp Mark 
Published: August 2024

Background:
Children with neuromuscular scoliosis undergoing scoliosis surgery face substantial rates of complications. To mitigate surgical risks such as blood loss in pediatric patients with neuromuscular scoliosis, this study focuses on enabling instrumentation planning for their abnormal vertebral and pelvic anatomy and osteopenia. This study assessed the feasibility of an “ultralow-dose” CT (ULD CT) protocol without sedation in pediatric patients with neuromuscular scoliosis who often have comorbid movement disorders. Our prospective quality improvement study aims: (1) to determine if ULD CT without sedation is feasible in this patient group; (2) to quantify the radiation dose from ULD CT and compare it with preoperative spine radiographs (XR); and (3) to assess if ULD CT allows accurate anatomical assessment and intraoperative navigation given the prevalence of movement disorders.

Methods:
Children with neuromuscular scoliosis underwent spine XR and ULD CT scans. Chart reviews assessed disease etiology and comorbidities. Radiation dose was quantified through Monte-Carlo simulations giving dose indices and effective dose, with statistical analysis done using a paired student’s t-test (α=0.05). CT image quality was assessed for its use in preoperative planning and intraoperative navigation.

Results:
Fourteen patients (5 males, 9 females, average age 14±3 y) participated. One patient needed sedation due to autism spectrum disorder and global developmental delay. The radiation dose for spine XR was 0.5±0.2 mSv, and ULD CT was 0.6±0.1 mSv. There was no statistically significant difference in radiation doses between methods. All ULD CT scans had adequate quality for preoperative assessment of pedicle diameter and orientation, obstacles impeding pedicle entry, S2 Alar-Iliac screw orientation, and intraoperative navigation.

Conclusions:
ULD CT without sedation is feasible for children with neuromuscular scoliosis. Radiation doses were comparable to standard radiographs. ULD CT provided accurate anatomical assessments and supported intraoperative navigation, proving beneficial despite movement disorders in these patients.

Level of Evidence:
Level 2—Development of diagnostic criteria on basis of consecutive patients (with universally applied reference widely accepted standard).
Tuberculosis in infertility and in vitro fertilization-embryo transfer
Authors: Gai Xiaoyan , Chi Hongbin , Li Rong , Sun Yongchang 
Published: August 2024

AbstractTuberculosis (TB) is a prominent infectious disease globally that imposes a substantial health burden. Genital TB (GTB), an extrapulmonary manifestation, leads to complications such as tubal adhesions, blockage, and diminished ovarian function, culminating in infertility, and is recognized as a prevalent cause of infertility in nations with high-burden TB. In regions with low TB rates, infertility and active TB during pregnancy have been reported to be most common among female immigrants from countries with high-burden TB. In the context of TB, pregnant women often exhibit exacerbated symptoms afterin vitrofertilization-embryo transfer (IVF-ET), heightening the risk of dissemination. Miliary pulmonary TB and tuberculous meningitis pose a serious threat to maternal and fetal health. This article integrates recent epidemiological data and clinical research findings, delineating the impact of TB on infertility and assisted reproduction and particularly focusing on the diagnosis and treatment of GTB, underscored by the imperative of TB screening before IVF-ET. Our objective is to increase awareness among respiratory and reproductive health professionals, promoting multidisciplinary management to enhance clinical vigilance. This approach seeks to provide patients with judicious reproductive plans and scientifically rigorous pregnancy management, thereby mitigating adverse pregnancy outcomes related to TB activity.
Management of Ulcers and Lymphorrhea in Lower Limbs after Charles Procedure via Supermicrosurgery
Authors: Zhou Zhegang , Yu Longbiao , Meng Fanbin , Wen Jingjing , Li Aikang , Xiao Yingfeng , Wan Shengxiang , Zeng Hui , Yu Fei 
Published: August 2024

Summary:
An 80-year-old female patient was admitted to the hospital due to recurrent lymphedema, ulcers, and lymphorrhea in the right lower limb for 7 years. The physical examination revealed changes after the Charles procedure below the right knee joint plane, with a 7 × 7 cm2 lymphorrhea area in the lower one-third plane of the anterior tibia area. Continuous lymphatic exudation and scattered ulcers could be seen. The dorsal artery of the foot could not be reached due to the thickening and fibrosis of the dorsal skin of the foot. The peripheral blood circulation was favorable. The glycated hemoglobin test revealed that blood sugar was not high and could be controlled. The color Doppler ultrasound of lower limb blood vessels revealed no obvious stenosis of arteries, with normal venous return. In addition, no varicose veins or deep venous thrombosis were observed. Based on these findings, the patient was diagnosed with primary lymphedema combined with lymphorrhea after the Charles procedure, complicated with diabetes. After admission, the patient underwent lymphaticovenous anastomosis on the right lower limb under general anesthesia. During the follow-up of 2 months after surgery, it was found that the lymphorrhea was alleviated, the ulcer basically healed, and the swelling on the right lower limb decreased. At the follow-up of 6 months after surgery, the lymphorrhea was eliminated and the ulcer was healed. There were 1-cm reduction in leg and back circumference and 10% volume reduction. The lymphedema quality-of-life score of this patient was 57 points after surgery.
Early Experience with Mesh Suture for DIEP Flap Abdominal Site Closures
Authors: Hackenberger Paige N. , Stockslager Caitlin , Selimos Brianna , Teven Chad , Fracol Megan , Howard Michael 
Published: August 2024

Background:
The gold standard of microsurgical breast reconstruction is the deep inferior epigastric perforator (DIEP) free flap. As techniques have evolved, DIEP flaps have significantly reduced the morbidity previously caused by transverse rectus abdominis muscle (TRAM) and muscle-sparing TRAM flaps. However, abdominal wall complications continue to persist after DIEP flap surgery, with bulge rates reported as high as 33%.

Methods:
The first 25 patients undergoing DIEP flap surgery with the use of Duramesh (MSI, Chicago, Ill.) by the senior author were identified. A retrospective chart review of patient and surgical details was performed. Charts were reviewed for outcomes, including surgical site infections, surgical site events, incisional hernia formation, and/or bulge. Standard descriptive summary statistics were used for patient characteristics, surgical details, and primary and secondary outcomes.

Results:
Twenty-five patients were reviewed. Average follow-up duration was 216 ± 39 days. One patient (4%) developed a surgical site infection, and four patients (16%) developed a surgical site event. One patient developed a bulge, but no patients developed an incisional hernia.

Conclusions:
Duramesh mesh suture provides a promising opportunity for DIEP surgeons to minimize both abdominal wall morbidity and mesh-related complications. Mesh suture can be used in a similar fashion as other sutures to perform primary closure of the anterior rectus sheath while also providing force-distribution benefits typically unique to planar mesh. This pilot study suggests that Duramesh is a safe, simple alternative to existing techniques in DIEP flap surgery and can be considered by microsurgeons to reduce fascial dehiscence, bulge, and/or hernia formation.