bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pregnancy-Associated Stroke and Outcomes Related to Timing and Hypertensive Disorders
Authors: Bitar G. , Sibai B.M. , Chen H.Y. , Neff N. , Blackwell S. , Chauhan S.P. , Fishel Bartal M. 
Published: February 2024

(Obstet Gynecol. 2023;142:393–401)
Pregnancy-associated stroke has been occurring with increasing frequency in recent years, both antepartum and postpartum. It is associated with a high rate of maternal mortality along with a short-term morbidity of seizures, infections, mechanical ventilation, and venous thromboembolism. There is also a recorded association of stroke during pregnancy with fetal morbidity. Research is lacking, however, in powerful statistics; most studies up to this point have been limited by a very small sample size or a focus on specific risk groups, age groups, or epidemiology. This study was designed to address these shortcomings by assessing the temporal trend of pregnancy-associated stroke between 2016 and 2019, the relationship between timing of stroke (antepartum or postpartum) and adverse outcomes, and the relationship between hypertensive disorders and adverse outcomes.
External Validation of a Multivariable Prediction Model for Placenta Accreta Spectrum
Authors: Singh S. , Carusi D. , Wang P. , Reitman-Ivashkov E. , Landau R. , Fields K. , Weiniger C. , Farber M. 
Published: February 2024

(Anesth Analg. 137(3):537–547)
Placenta accreta spectrum (PAS) encompasses various forms of abnormal placental attachment and uterine invasion. PAS is a leading cause of severe postpartum hemorrhage and often leads to an emergency hysterectomy. Managing PAS and its associated complications, such as preterm birth, maternal morbidity, and neonatal intensive care unit admissions, is best achieved in tertiary-level hospitals equipped with specialized multidisciplinary care. To ensure the highest quality of care, proactive planning is essential. This involves identifying risk factors associated with PAS, facilitating rapid transfers to appropriate delivery facilities, efficient resource allocation, and minimizing the occurrence of life-threatening postpartum hemorrhage and its associated complications.
The sFlt1/PIGF Ratio Predicts Faster Fetal Deterioration in Early Fetal Growth Restriction: A Historical Cohort Study
Authors: Palma Dos Reis C.R. , Brás S. , Meneses T. , Cerdeira A.S. , Vatish M. , Martins A.T. 
Published: February 2024

(Acta Obstet Gynecol Scand. 2023;102:635–643)
Both placental growth factor (PlGF) and tyrosine kinase 1 (sFlt1) are predicted to be factors in impaired placentation, which is known to lead to diseases such as pre-eclampsia and fetal growth restriction (FGR). Previous studies have shown fluctuations in the levels of PlGF and sFlt1 in patients with these diseases. This study aimed to determine the effects that high levels of PlGF and sFlt1 have on the deterioration of FGR in neonates.
Vacuum Extraction or Cesarean Section in the Second Stage of Labor: A Systematic Review
Authors: Thierens S. , van Binsbergen A. , Nolens B. , van den Akker T. , Bloemenkamp K. , Rijken M.J. 
Published: February 2024

(BJOG. 2023;130(6):586–598)
Prolonged second-stage labor poses a significant risk for increased perinatal and maternal adverse outcomes. Two common interventions to expedite delivery during this stage are vacuum extraction (VE) and second-stage cesarean section (SSCS). The occurrence of each intervention procedure varies globally. This systematic review aimed to compare outcomes for both mother and baby associated with VE and SSCS.
Fentanyl in the Labor Epidural Impacts the Results of Intrapartum and Postpartum Maternal and Neonatal Toxicology Tests
Authors: Siegel M.R. , Mahowald G.K. , Uljon S.N. , James K. , Leffert L. , Sullivan M.W. , Hernandez S.J. , Gray J.R. , Schiff D.M. , Bernstein S.N. 
Published: February 2024

(Am J Obstet Gynecol. 2023;228(6):741.e1–741.e7)
In obstetrics, toxicology testing is often used to gather data about maternal substance use. A positive maternal or neonatal toxicology test can result in significant consequences, including referrals to child protective services, dismissal from substance use treatment programs, and possibly incarceration. The aim of this study was to evaluate the impact of administering neuraxial fentanyl during labor on toxicology test outcomes for mothers and neonates.
Clinical and Ultrasonographic Assessment of Airway Indices Among Nonpregnant, Normotensive Pregnant, and Pre-eclamptic Patients: A Prospective Observational Study
Authors: Bala R. , Budhwar D. , Kumar V. , Singhal S. , Kaushik P. , Sharma J. 
Published: February 2024

(Int J Obstet Anesth. 2023:54:103637)
Improper airway management is one of the leading causes of death for pregnant individuals. An ultrasound of the airway is a noninvasive tool that can be used to assess a patient’s airway and evaluate the risk of severe complications. This study aimed to compare the airways of pregnant and nonpregnant individuals using both a physical exam and an ultrasound exam.
Maternal Opioid Treatment After Delivery and Risk of Adverse Infant Outcomes: A Population-Based Cohort Study
Authors: Zipursky J.S. , Gomes T. , Everett K. , Calzavara A. , Paterson J.M. , Austin P.C. , Mamdani M.M. , Ray J.G. , Juurlink D.N. 
Published: February 2024

(BMJ. 2023;380:e074005)
The use of opioids for pain relief following delivery is common; however, there is increasing concern that opioids are being passed to infants in large quantities during breastfeeding. This study aimed to determine if maternal postpartum use of opioids is associated with long-term side effects and complications in breastfeeding infants.
Validation of a Tool to Evaluate Nursing Students’ Electronic Health Record Competency in Simulation
Authors: McBride Susan , Thomas Laura , Decker Sharon , Pierce Matthew , Burson Shelley , Song Huaxin , Haerling (Adamson) Katie 
Published: February 2024

Abstract

AIM
The aim of the study was to establish reliability and validity of the Competency Assessment in Simulation of Electronic Health Records (CASE) tool.

BACKGROUND
Effective teaching and learning practices, including valid and reliable assessment of students’ electronic health record (EHR) competency, contribute to safe, high-quality, efficient nursing care.

METHOD
The study used a mixed-methods design to test reliability and validity of the CASE tool.

RESULTS
A nationally representative sample of faculty from universities representing 27 states provided scores for videos using the CASE tool. Forty-seven participants completed the first scoring survey; 22 of the 47 participants (47%) completed the second-round scoring. Intraclass correlation for the final score between the first and second responses shows the consistency of test-retest reliability (ICC = .78, p < .001).

CONCLUSION
The CASE tool provided evidence of validity and reliability in evaluating EHR competency in simulation.
The Interdisciplinary Doula Project
Authors: Vignato Julie , Horak Teresa , Goodrich Amber , Shier Emily , Coleman Lastasica , Nicholson Anita , Thompson Meagan 
Published: February 2024

Abstract
People giving birth report overwhelmingly positive experiences with nursing students acting as doulas. However, no programs report on improving diversity among students, pregnant people, and curricula. This article describes the Interdisciplinary Doula Project, a program to enhance diverse perspectives and clinical skills of university students. Nursing (n = 21, 77.8%) and other health students (n = 6, 22.2%) completed doula training, diversity seminars, and 36 hours of intrapartum care. Seven nursing students were hired to work on labor and delivery upon graduation. This innovative program may increase registered nurses trained to provide culturally congruent labor support for vulnerable pregnant populations.
Formal Radiologist Interpretations of Intraoperative Spine Radiographs Have Low Clinical Value
Authors: Lin Ryan T. , Dalton Jonathan F. , Como Christopher J. , Chang Audrey Y. , Tang Melissa Yunting , Oyekan Anthony A. , Sadhwani Shaan , Wawrose Richard A. , Lee Joon Y. , Shaw Jeremy D. 
Published: February 2024

Study Design.
Retrospective cohort.

Objective.
To evaluate the clinical relevance, usefulness, and financial implications of intraoperative radiograph interpretation by radiologists in spine surgery.

Summary of Background Data.
Due to rising health care costs, spine surgery is under scrutiny to maximize value-based care. Formal radiographic analysis remains a potential source of unnecessary health care costs, especially for intraoperative radiographs.

Materials and Methods.
A retrospective cohort analysis was performed on all adult elective spine surgeries at a single institution between July 2020 and July 2021. Demographic and radiographic data were collected, including intraoperative localization and post-instrumentation radiographs. Financial data were obtained through the institution’s price estimator. Radiographic characteristics included time from radiographic imaging to completion of radiologist interpretation report, completion of radiologist interpretation report before the conclusion of surgical procedure, clinical relevance, and clinical usefulness. Reports were considered clinically relevant if the spinal level of the procedure was described and clinically useful if completed before the conclusion of the procedure and deemed clinically relevant.

Results.
Four hundred eighty-one intraoperative localization and post-instrumentation radiographs from 360 patients revealed a median delay of 128 minutes between imaging and completion of the interpretive report. Only 38.9% of reports were completed before the conclusion of surgery. There were 79.4% deemed clinically relevant and only 33.5% were clinically useful. Localization reports were completed more frequently before the conclusion of surgery (67.2% vs. 34.4%) but with lower clinical relevance (90.1% vs. 98.5%) and clinical usefulness (60.3% vs. 33.6%) than post-instrumentation reports. Each patient was charged $32 to $34 for the interpretation fee, cumulating a minimum total cost of $15,392.

Conclusions.
Formal radiographic interpretation of intraoperative spine radiographs was of low clinical utility for spine surgeons. Institutions should consider optimizing radiology workflows to improve timeliness and clinical relevance or evaluate the necessity of reflexive consultation to radiology for intraoperative imaging interpretation to ensure that value-based care is maximized during spine surgeries.

Level of Evidence.
3.
Toward Equitable Kidney Function Estimation in Critical Care Practice. Guidance From the Society of Critical Care Medicine’s Diversity, Equity, and Inclusion in Renal Clinical Practice Task Force
Authors: Miano Todd A. , Barreto Erin F. , McNett Molly , Martin Niels , Sakhuja Ankit , Andrews Adair , Basu Rajit K. , Ablordeppey Enyo Ama 
Published: February 2024

Objectives:
Accurate glomerular filtration rate (GFR) assessment is essential in critically ill patients. GFR is often estimated using creatinine-based equations, which require surrogates for muscle mass such as age and sex. Race has also been included in GFR equations, based on the assumption that Black individuals have genetically determined higher muscle mass. However, race-based GFR estimation has been questioned with the recognition that race is a poor surrogate for genetic ancestry, and racial health disparities are driven largely by socioeconomic factors. The American Society of Nephrology and the National Kidney Foundation (ASN/NKF) recommend widespread adoption of new “race-free” creatinine equations, and increased use of cystatin C as a race-agnostic GFR biomarker.

Data Sources:
Literature review and expert consensus.

Study Selection:
English language publications evaluating GFR assessment and racial disparities.

Data Extraction:
We provide an overview of the ASN/NKF recommendations. We then apply an Implementation science methodology to identify facilitators and barriers to implementation of the ASN/NKF recommendations into critical care settings and identify evidence-based implementation strategies. Last, we highlight research priorities for advancing GFR estimation in critically ill patients.

Data Synthesis:
Implementation of the new creatinine-based GFR equation is facilitated by low cost and relative ease of incorporation into electronic health records. The key barrier to implementation is a lack of direct evidence in critically ill patients. Additional barriers to implementing cystatin C-based GFR estimation include higher cost and lack of test availability in most laboratories. Further, cystatin C concentrations are influenced by inflammation, which complicates interpretation.

Conclusions:
The lack of direct evidence in critically ill patients is a key barrier to broad implementation of newly developed “race-free” GFR equations. Additional research evaluating GFR equations in critically ill patients and novel approaches to dynamic kidney function estimation is required to advance equitable GFR assessment in this vulnerable population.
Mortality, morbidity, and care practices for 1750 very low birth weight infants, 2016–2021
Authors: He Yang , Zhang Meng , Tang Jun , Liu Wanxiu , Hu Yong , Shi Jing , Wang Hua , Xiong Tao , Zhang Li , Ying Junjie , Mu Dezhi 
Published: February 2024

Abstract

Background:
Very low birth weight (VLBW) infants are the key populations in neonatology, wherein morbidity and mortality remain major challenges. The study aimed to analyze the clinical characteristics of VLBW infants.

Methods:
A retrospective cohort study was conducted in West China Second Hospital between January 2016 and December 2021. Neonates with a birth weight of <1500 g were included. Mortality, care practices, and major morbidities were analyzed, and compared with those of previous 7 years (2009–2015).

Results:
Of the total 1750 VLBW, 1386 were infants born with birth weight between 1000–1499 g and 364 infants were born with weight below 1000 g; 42.9% (751/1750) required delivery room resuscitation; 53.9% (943/1750) received non-invasive ventilation only; 38.2% (669/1750) received invasive ventilation; 1517 VLBW infants received complete treatment. Among them, 60.1% (912/1517) of neonates had neonatal respiratory distress syndrome (NRDS), 28.7% (436/1517) had bronchopulmonary dysplasia (BPD), 22.0% (334/1517) had apnea, 11.1% (169/1517) had culture-confirmed sepsis, 8.4% (128/1517) had pulmonary hemorrhage, 7.6% (116/1517) had severe intraventricular hemorrhage (IVH)/periventricular leukomalacia (PVL), 5.7% (87/1517) had necrotizing enterocolitis (NEC), and 2.0% (31/1517) had severe retinopathy of prematurity. The total and in-hospital mortality rates were 9.7% (169/1750) and 3.0% (45/1517), respectively. The top three diagnoses of death among those who had received complete treatment were sepsis, NRDS, and NEC. In 2009–2015, 1146 VLBW were enrolled and 895 infants received complete treatment. The proportions of apnea, IVH, and IVH stage ≥3/PVL, were higher in 2009–2015 compared with those in 2016–2021, while the proportions of NRDS and BPD were characterized by significant increases in 2016–2021. The total and in-hospital mortality rates were 16.7% (191/1146) and 5.6% (50/895) respectively in 2009–2015.

Conclusion:
Among VLBW infants born in 2016–2021, the total and in-hospital mortality rates were lower than those of neonates born in 2009–2015. Incidences of NRDS and BPD increased in 2016–2021, which affected the survival rates and long-term prognosis of VLBW.
Aged females unilaterally hypersensitize, lack descending inhibition, and overexpress alpha1D adrenergic receptors in a murine posttraumatic chronic pain model
Authors: Hirsch Silke J. , Budig Alexandra , Husam Sanar , Birklein Frank 
Published: February 2024

Abstract
Vulnerability to chronic pain is found to depend on age and sex. Most patients with chronic pain are elderly women, especially with posttraumatic pain after bone fracture that prevails beyond the usual recovery period and develops into a complex regional pain syndrome (CRPS). There, a distal bone fracture seems to initiate a pathophysiological process with unknown mechanism. To investigate whether sex, age, and alpha adrenergic receptors also contribute to a CRPS-like phenotype in animals, we performed experiments on tibia-fractured mice. Those mice commonly are resilient to the development of a CRPS-like phenotype. However, we found them to be vulnerable to long-lasting pain after distal bone fracture when they were of old age. These mice expressed mechanical and thermal hypersensitivity, as well as weight-bearing and autonomic impairment following bone trauma, which persisted over 3 months. Site-specific and body side–specific glycinergic and α1D-noradrenergic receptor expression in the spinal cord and the contralateral locus coeruleus were misbalanced. Aged female tibia-fractured mice lost descending noradrenergic inhibition and displayed enhanced spinal activity on peripheral pressure stimuli. Together, changes in the noradrenergic, hence, glycinergic system towards excitation in the pain pathway—ascending and descending—might contribute to the development or maintenance of long-lasting pain. Conclusively, changes in the noradrenergic system particularly occur in aged female mice after trauma and might contribute to the development of long-lasting pain. Our data support the hypothesis that some patients with chronic pain would benefit from lowering the adrenergic/sympathetic tone or antagonizing α1(D).
Differences in coronary angiographic findings and outcomes between men and postmenopausal women with stable chest pain
Authors: Kang In Sook , Shin Mi-Seung , Lee Hye Ah , Kim Mi-Na , Kim Hack-Lyoung , Yoon Hyun-Ju , Park Seong-Mi , Hong Kyung-Soon , Kim Myung-A 
Published: February 2024

Background
Despite the significant increase in cardiovascular events in women after menopause, studies comparing postmenopausal women and men are scarce.

Methods
We analyzed data from a nationwide, multicenter, prospective registry and enrolled 2412 patients with stable chest pain who underwent elective coronary angiography. Binary coronary artery disease (b-CAD) was defined as the ≥50% stenosis of epicardial coronary arteries, including the left main coronary artery.

Results
Compared with the men, postmenopausal women were older (66.6 ± 8.5 vs. 59.5 ± 11.4 years) and had higher high-density lipoprotein cholesterol levels (49.0 ± 12.8 vs. 43.6 ± 11.6 mg/dl, P < 0.01). The prevalence of diabetes did not differ significantly (P = 0.40), and smoking was more common in men than in postmenopausal women (P ≤ 0.01). At enrollment, b-CAD and revascularization were more common in men than in postmenopausal women (50.3% vs. 41.0% and 14.4% vs. 9.7%, respectively; both P < 0.01). However, multivariate analyses revealed that revascularization [odds ratio (OR): 0.72; 95% confidence interval (CI): 0.49–1.08] was not significantly related to sex and a similar result was found in age propensity-matched population (OR: 0.80; 95% CI: 0.52–1.24). During the follow-up period, the secondary composite cardiovascular outcomes were lower in postmenopausal women than in men (OR: 0.55; 95% CI: 0.31–0.98), also consistent with the result using the age propensity-mated population (OR: 0.33; 95% CI: 0.13–0.85).

Conclusion
Postmenopausal women experienced coronary revascularization comparable to those in men at enrollment, despite the average age of postmenopausal women was 7 years older than that of men.
Postmenopausal women exhibit better clinical outcomes than those of men if optimal treatment is provided.
Can quantitative surface antigen levels and systemic immune-inflammation index be predictive as a new indicator for the initiation of treatment in chronic hepatitis b?
Authors: Koroglu Mehmet , Ayvaz Muhammed Ali , Bakan Suat Baran , Sirin Abdullatif , Akyuz Umit 
Published: February 2024

Objectives
The natural history of chronic HBV infection (CHB) is generally divided into four phases: HBeAg-positive chronic HBV infection (EPCI) and –hepatitis (EPCH), HBeAg-negative chronic HBV infection (ENCI) and –hepatitis (ENCH). This study aimed to investigate changes in serum quantitative surface antigen (qHBsAg), systemic immune-inflammation index (SII) and systemic inflammatory response index (SIRI) in a large number of CHB patients.

Method
Three hundred seventy-two CHB patients who underwent liver biopsy between January 2015 and February 2020 were evaluated.

Results
The SII-values were strongly significant between EPCI–EPCH (P = 0.002), however, there was significant difference between ENCI–ENCH (P = 0.025). Considering the SIRI results, there was a significant difference between both EPCI–EPCH (P = 0.009) and ENCI-ENCH (P = 0.118). In HBeAg-positive patients HBV-DNA, qHBsAg, and SII were found to be predictive (P = 0.029, P = 0.039, P = 0.027, respectively) while in HBeAg-negative patients, age, AST, HBV-DNA, qHBsAg, SII, and SIRI were found to be predictive (P = 0.047, P = 0.084, P = <0.001, P = 0.001, P = 0.012, P = 0.002, respectively). In EPCH phase, whereby accuracy rate results of HBV-DNA, qHBsAg, and SII were 75.3%, 73.4%, and 60.4%, respectively, while in the ENCH phase the accuracy rates of age, AST, HBV-DNA, qHBsAg, SII, and SIRI values were 57.8%, 65.6%, 68.3%, 63.8%, 57.3% and 53.2%, respectively.

Conclusion
HBV-DNA, qHBsAg, and SII are predictive in EPCH patients. Age, AST, HBV-DNA, qHBsAg, SII and SIRI are all predictive in ENCH patients. In patients with CHB, we recommend using SII to distinguish between EPCI-EPCH and ENCI-ENCH. Based on its sensitivity and features, we believe that qHBsAg and SII are suitable measuring instruments in discrimination both of EPCI-EPCH and ENCI-ENCH.
Performance assessment of a new G12/A1 antibody-based rapid ELISA using commercially available and gluten-spiked food samples
Authors: Verma Anil K. , Monachesi Chiara , Catassi Giulia N. , Franceschini Elisa , Gatti Simona , Lionetti Elena , Catassi Carlo 
Published: February 2024

Objective
Food products with <20 mg/kg gluten can be labeled ‘gluten-free’ according to international regulations. Several antibodies-based ELISAs have been develop to track gluten traces in food products. Among them, R5 and G12 antibody-based ELISAs are the frequently used methods. However, these antibodies have certain limitations. We evaluated the accuracy of G12/A1 antibody-based ‘Glutentox ELISA Rapid G12’ and compared the results with the current reference method i.e., R5 antibody-based ‘Ridascreen R5 ELISA’.

Methods
In the first step, the performance of Glutentox ELISA Rapid G12 kit was inspected by determination of the threshold value i.e., > or <20 mg/kg gluten in different food products. In the second step, quantification accuracy was assessed by quantification of gluten in gluten-free food products spiked with gliadin reference material.

Results
In total 47 food products (naturally and labeled gluten-free, and food with traces of gluten) were included. Of them, 29 products were quantified with <20 mg/kg, and 18 with a low level of gluten by both the kits. Six out of 29 gluten-free products were used for the recovery test at different spike levels. Gluten concentration and mean recovery rates of individual kits showed consistency.

Conclusion
GlutenTox Rapid G12 ELISA could be an appropriate choice for detecting gluten in food products but needs more in-house validation and collaborative tests.