bluuebunny/crossref_metadata_2025_split huggingface dataset:
The reasons for termination of pregnancy in the third trimester
Authors: Dommergues Marc , Benachi Alexandra , Benifla Jean‐Louis , des Noëttes Richard , Dumez Yyves 
Published: August 2005

Objective
To analyse the process in making decisions leading to termination of pregnancy in the third trimester and to evaluate the maternal morbidity associated with this procedure.Design
Retrospective study.Setting
The Maternité Port Royal University Hospital, Paris, France.Population
A consecutive series of 956 terminations of pregnancy performed for fetal anomalies in singleton pregnancies, 305 of which were in the third trimester and 651 in the second.Main outcome measures
Indications for termination of pregnancy; process leading to late termination of pregnancy; maternal morbidity.Results
One hundred and thirteen (37%) third trimester terminations of pregnancy were associated with false negative resulted from the results of earlier screening tests. In 15 terminations (15%), the decision was postponed, although the poor fetal prognosis was established earlier. In 55 (18%) the diagnosis was not possible earlier than the third trimester, and in 122 (40%) the diagnosis was possible earlier but the poor prognosis for the fetus was not established until the third trimester. Maternal morbidity due to termination of pregnancy was similar in the second and third trimester.Conclusion
One‐third of late terminations of pregnancy could have been avoided by more efficient screening in the second trimester. However, because fetal prognosis is not always clear when a malformation is diagnosed, postponing the decision until fetal development allows more thorough evaluation and may avoid unnecessary termination of pregnancy in the second trimester. This could be the main beneficial aspect of not setting a limit to the gestational age for performing termination of pregnancy. To analyse the process in making decisions leading to termination of pregnancy in the third trimester and to evaluate the maternal morbidity associated with this procedure. The Maternit6 Port Royal University Hospital, Paris, France.
The effect of indomethacin tocolysis in preterm labour on perinatal outcome: a randomised placebo‐controlled trial
Authors: Panter Katerine R. , Hannah Mary E. , Amankwah Kofi S. , Ohlsson Arne , Jefferies Ann L. , Farine Dan 
Published: August 2005

Objective
To determine whether indomethacin tocolysis in preterm labour is associated with a better perinatal outcome than placebo.Design
A randomised placebo‐controlled trial.Setting
Two university teaching hospitals with level three neonatal intensive care units.Population
Women in preterm labour with intact membranes between 23 and 30 weeks of gestation.Methods
Random allocation to tocolysis with indomethacin (50 mg followed by 25 mg 6 hourly for 48 hours) or placebo in a double‐blind fashion.Main outcome measures
The primary outcome, perinatal mortality or severe neonatal morbidity, was defined as perinatal death, necrotising enterocolitis, bronchopulmonary dysplasia, intraventricular haemorrhage or pen‐ventricular leucomalacia. Data were analysed using odds ratios (OR) and 95% confidence intervals (95% CI).Results
Between March 1995 and February 1996, 34 women (39 babies) were recruited. The baseline characteristics of the two groups were similar. No patient was lost to follow up. In the indomethacin group, gestation was prolonged by > 48 hours in 13/16 (81%) of women vs 10/18 (56%) in the placebo group. The incidence of perinatal mortality or severe neonatal morbidity was not significantly different between the groups, but occurred in twice as many babies in the indomethacin group as in the placebo group d/l9 (32%) vs 3/20 (15%) OR (95% CI) 2.62 (0.44–18.8). There was one perinatal death, of a baby delivered at 24 weeks of gestation. This occurred in the indomethacin group.Conclusion
There is no evidence that indomethacin tocolysis is beneficial, and further trials are needed to assess the impact of indomethacin tocolysis in preterm labour.
Twin mothers, pregnancy hypertension and pre‐eclampsia
Authors: Thornton J. G. , Macdonald A. M. 
Published: August 2005

Objective
To estimate the maternal genetic contribution to the hypertensive diseases of pregnancy.Design
A cohort study of female twins with information on hypertensive diseases of pregnancy obtained by questionnaire screening, and verification of diagnosis from hospital or general practitioner records.Setting
A volunteer twin registry in the UK with recruitment through the media without reference to pregnancies or disease status.Population
Adult female, same‐sex twin pairs who completed a pregnancy history questionnaire and consented to record inspection.Main outcome measure
Self‐reported and hospital‐validated diagnosis of non‐proteinuric pregnancy hypertension and of pregnancy hypertension with proteinuria (pre‐eclampsia).Results
Self‐reported pre‐eclampsia had a heritability of 0.221 and non‐proteinuric hypertension of 0.198. However, none of the pairs who were self‐reported as concordant for pre‐eclampsia were confirmed from hospital records. Using hospital records, the heritability of pre‐eclampsia was 0 and 0.375 for non‐proteinuric hypertension. Using a model treating pre‐eclampsia as a separate disease from non‐proteinuric hypertension, and assuming that the next pair identified was both monozygotic and concordant for pre‐eclampsia, the estimated heritability of pre‐eclampsia remained 0 (95% CI 0–0.49). Using a threshold model in which non‐proteinuric hypertension is treated as a mild form of pre‐eclampsia, heritability is estimated at 0.247 (95% CI 0.23–4.454).Conclusion
Neither non‐proteinuric hypertension nor pre‐eclampsia are inherited in simple Mendelian fashion. The genetic contribution to multi‐factorial inheritance is smaller than hitherto believed.
Association of cerebral perfusion pressure with headache in women with pre‐eclampsia
Authors: Belfort Michael A. , Saade George R. , Grunewald Charlotta , Dildy Gary A. , Abedejos Pauline , Herd J. Allan , Nisell Henry 
Published: August 2005

Objective
To study estimated cerebral perfusion pressure and its relation to headache and scotomata in women with pre‐eclampsia.Design
Prospective, observational study.Setting
University teaching hospitals.Population
Seventy‐nine pre‐eclamptic women with (n= 42) and without (n= 37) headache. Patients with scotomata were also studied separately.Methods
Transcranial Doppler ultrasound was used to estimate the resistance index, pulsatility index, and estimated cerebral perfusion pressure in the middle cerebral artery. eCPP data were plotted on the same axes as the mean (and 5th and 95th% prediction limits) eCPP data from 63 normal pregnant women followed longitudinally through pregnancy. Data outside of the 95% prediction limits were regarded as abnormal. Data from the pre‐eclamptic women were also expressed in terms of the number of standard deviations from the mean value established for normal pregnancy (multiples of the standard deviation: MOS). All studies were prior to labour, under similar conditions, and before volume expansion or treatment. Analysis of data was performed using Student's t test, Mann‐Whitney U test, ANOVA, and Fisher's exact test with two‐tailed P < 0.05, and receiver operating characteristic curve analysis with a one‐tailed P < 0.05.Main outcome measures
Resistance index, pulsatility index, and eCPP.Results
Pre‐eclamptic women with headache were much more likely to have abnormal eCPP (34/42; 88%) than those without headache (18/37; 49%), P= 0.004, OR 4.5 (95% CI 1.5 to 13.9). There were no differences in terms of MOS in the resistance index or pulsatility index between the two groups, but estimated perfusion pressure, expressed as multiples of the standard deviation in the group with headache, was significantly higher than in the women without. Headache was noted in both over‐perfusion and under‐perfusion states. Only women with headache had scotomata, and their presence was not related to the severity of the headache or any difference in resistance indices or eCPP.Conclusions
Headache in women with pre‐eclampsia is strongly associated with the presence of abnormal cerebral perfusion pressure. This information may be of use in clinical management.
A feasibility study of adolescent sex education: medical students as peer educators in Edinburgh schools
Authors: Jobanputra James , Clack Alice R. , Cheeseman Giles J. , Glasier Anna , Riley Simon C. 
Published: August 2005

Objectives
To determine the feasibility of medical students being involved in sex education in secondary schools, as lesson leaders in peer group discussions.Design
1. Questionnaires and interviews to determine pupil and professional opinions about the present sex education provision and the possible involvement of medical students. 2. A pilot scheme in one school involving medical students as peer educators.Setting
Six central Edinburgh secondary schools; local sex education services; Edinburgh University.Sample
1. Thirty schoolteachers and 205 pupils returned questionnaires. From this, 18 teachers and 12 pupil groups (six to eight pupils each) were interviewed. 2. Pilot scheme involved three sessions with three groups of six to eight pupils per session. Twenty‐nine returns for the evaluative (pupil) questionnaire were received.Main outcome measures
Questionnaire analysis; anecdotal evidence from interviews; evaluative questionnaire given to pupils participating in pilot study.Results
Ninety‐four percent of teachers and 93% of pupils were in favour of medical student involvement in schools. Teachers identified large class size and lack of resources for small group work as factors limiting the effectiveness of present sex education. Pupils identified teacher embarrassment in certain issues as a barrier to communication, and 89% found communication to be easier with medical students.Conclusions
Response to the idea of medical student involvement was very favourable from all parties involved, and a continuation of the study has been integrated as an options course into the Edinburgh University undergraduate medical curriculum.
A randomised, controlled study of uterine exteriorization and repair at caesarean section
Authors: Wahab M. A. , Karantzis P. , Eccersley P. S. , Russell I. F. , Thompson J. W. , Lindow S. W. 
Published: August 2005

Objective
To determine the surgical and anaesthetic benefits and problems associated with the practice of routine exteriorisation of the uterus to facilitate repair at caesarean section.Design
A randomised controlled study of women undergoing caesarean section. After establishment of anaesthesia, women were randomised to either exteriorisation and uterine repair or suture of the uterus in the abdomen.Setting
A maternity hospital in the United Kingdom.Main outcome measures
Peri‐operative haemoglobin change, duration of operation, maternal morbidity and length of hospital stay. Intra‐operative pain, nausea, vomiting, pulling or tugging sensations were secondary outcome measures.Results
Three hundred and sixteen women were randomised, of whom 288 were subsequently analysed (139 women in whom the uterus was exteriorised and 149 where the uterus was not exteriorised). Exteriorisation of the uterus, an elective caesarean section and a spinal or general anaesthesia each had a statistically significant association with reduced blood loss (P < 0.05) There were no statistically significant differences between the two groups with regard to intra‐operative complications or pain, nor were there any statistically significant difference in post‐operative wound sepsis, pyrexia, deep vein thrombosis, blood transfusion or length of hospital stay.Conclusion
With effective anaesthesia, exteriorisation of the uterus for repair following caesarean delivery is not associated with significant problems and is associated with less blood loss.
D‐Dimer and Inflammatory Markers as Predictors of Functional Decline in Men and Women with and without Peripheral Arterial Disease
Authors: McDermott Mary M. , Ferrucci Luigi , Liu Kiang , Criqui Michael H. , Greenland Philip , Green David , Guralnik Jack M. , Ridker Paul M. , Taylor Lloyd M. , Rifai Nader , Tian Lu , Zheng Jane , Pearce William H. , Schneider Joseph R. , Vonesh Ed 
Published: August 2005

Objectives: To determine whether higher circulating levels of inflammatory and thrombotic markers are associated with greater decline in lower extremity performance.Design: Prospective cohort.Setting: Academic medical center.Participants: Three hundred thirty‐seven men and women with lower extremity peripheral arterial disease (PAD) and 215 without PAD.Measurements: Objective measures of leg function, including the 6‐minute walk and Short Physical Performance Battery (SPPB), were obtained at baseline and annually for 3 years. D‐dimer, high‐sensitivity C‐reactive protein, serum amyloid A, and fibrinogen levels were measured at baseline. Participants were categorized into one of three groups, ranging from low to high levels of inflammation, depending on the number of individual blood factors in the lowest and highest tertiles for each corresponding blood factor.Results: Adjusting for age, sex, race, ankle brachial index, comorbidities, and other confounders, greater inflammation was associated with greater decline in the SPPB (P=.008). Results were similar when repeated in participants with and without PAD separately (P for trend=.04 for participants with PAD and .07 for participants without PAD). In fully adjusted analyses, there were no significant associations between inflammation group and decline in 6‐minute walk performance.Conclusion: Higher baseline levels of inflammatory markers and D‐dimer were associated with greater decline in the SPPB at 3‐year follow‐up in persons with and without PAD.
Protective Influences of Families for Children Adopted From the Former Soviet Union
Authors: McGuinness Teena M. , Ryan Rebecca , Robinson Cheryl Broadus 
Published: August 2005

Purpose:

To (a) characterize the total competence of 9‐ to 12‐year old children adopted from the former Soviet Union who have resided in the United States at least 5 years, and (b) evaluate risks and protective influences of adoptive families and their relationships to competence.
Design:

Longitudinal, descriptive study.
Methods:

In the previously reported phase, the families of 105 internationally adopted children and their families from 23 U.S. states were assessed via telephone interviews and postal survey. In this phase, 3.5 years later, 46 of the families from 16 states were located and reassessed. Measures included: Total Competence scale of the Child Behavior Checklist (CBCL), Family Environment Scale (FES), and demographic information. Multivariate regression analysis was conducted to determine which risk and protective factors contributed to competence scores of the adopted children.
Findings:

Between Time 1 (mean age of children, 7.7 years) and Time 2 (mean age of children, 11 years), average scores on the Total Competence scale of the CBCL did not change significantly, despite impending challenges of early adolescence. Subdomain scores on the FES were more positive than norms. Results from the regression analysis showed that, of the risk and protective factors considered, only birth weight and the cohesion subscale of the FES were statistically significant in explaining variation in the competence score of the CBCL.
Conclusions:

Families continued to face challenges, but findings were consistent with other studies showing that, despite early adversities, these adopted children generally fared well developmentally with protective family environments of major importance.
Ultraviolette Strahlung – Quellen, Spektren, Umwelteinflüsse
Authors: Hölzle Erhard , Hönigsmann Herbert 
Published: August 2005

ZusammenfassungDie UV‐Strahlung in unserer Umwelt ist Teil der elektromagnetischen Strahlung, die von der Sonne ausgeht. Sie wird als optische Strahlung bezeichnet und umfasst an der Erdoberfläche den Bereich von 290 bis 4 000 nm. Die UV‐Strahlung wird aufgrund internationaler Konventionen in kurzwelliges UV‐C (200 – 280 nm), mittelwelliges UV‐B (280 – 320 nm) und langwelliges UV‐A (320 – 400 nm) eingeteilt. Die Sonnenstrahlung, welche an einem definierten Ort zu einer definierten Zeit auf die Erdoberfläche auftritt, wird als Globalstrahlung bezeichnet. Sie wird bei ihrem Durchtritt durch die Erdatmosphäre quantitativ und qualitativ verändert. Neben atmosphärischen Bedingungen, wie Ozonschicht und Luftverschmutzung, spielen geographische Breite, Höhenlage, Jahreszeit, Tageszeit, Bevölkungsgrad und der Einfluss von indirekter Strahlung durch Streuung in der Atmosphäre und Reflektion vom Untergrund eine Rolle bei der Modifikation der Globalstrahlung, welche schließlich die biologisch wirksame Strahlung darstellt. Die Strahlungsverteilung an der Körperoberfläche variiert mit dem Einfallswinkel der Sonnenstrahlung und der Körperstellung. Die kumulative UV‐Exposition wird hauptsächlich durch berufliche Tätigkeit im Freien und das Freizeitverhalten bestimmt sowie durch die Anwendung von Solarien und phototherapeutischen Maßnahmen zusätzlich erhöht.
Persistence of Zinc-Binding Bacterial Superantigens at the Surface of Antigen-Presenting Cells Contributes to the Extreme Potency of These Superantigens as T-Cell Activators
Authors: Pless Dorothy D. , Ruthel Gordon , Reinke Emily K. , Ulrich Robert G. , Bavari Sina 
Published: August 2005

ABSTRACTBacterial superantigen intoxication causes massive overactivation of T cells, which can result in potentially lethal toxic shock. Superantigens fall into two groups: superantigens such as staphylococcal enterotoxin B (SEB) that contain a single generic binding site for major histocompatibility complex class II (MHC-II) and more potent superantigens such as SEA with a second, zinc-dependent MHC-II binding site that enables them to cross-link adjacent MHC-II molecules. We found that although all superantigens bound rapidly to the surface of human B cells, zinc-binding superantigens largely remained at the cell surface for at least 40 h. In contrast, single-binding-site superantigens were greatly depleted from the surface by 4 h. Subcellular fractionation and confocal microscopy revealed that some SEB entered lysosomal compartments, but SEA remained almost undetectable inside cells at 20 h. SEA and SEB mutants that do not bind MHC-II were trafficked rapidly to lysosomal compartments. Our findings suggest that the persistence of SEA and other zinc-dependent, cross-linking superantigens on the surface of antigen-presenting cells contributes to their potency as T-cell activators.
Identification, Cloning, Expression, and Characterization of the Gene for
Plasmodium knowlesi
Surface Protein Containing an Altered Thrombospondin Repeat Domain
Authors: Mahajan Babita , Jani Dewal , Chattopadhyay Rana , Nagarkatti Rana , Zheng Hong , Majam Victoria , Weiss Walter , Kumar Sanjai , Rathore Dharmendar 
Published: August 2005

ABSTRACT

Proteins present on the surface of malaria parasites that participate in the process of invasion and adhesion to host cells are considered attractive vaccine targets. Aided by the availability of the partially completed genome sequence of the simian malaria parasite
Plasmodium knowlesi
, we have identified a 786-bp DNA sequence that encodes a 262-amino-acid-long protein, containing an altered version of the thrombospondin type I repeat domain (SPATR). Thrombospondin type 1 repeat domains participate in biologically diverse functions, such as cell attachment, mobility, proliferation, and extracellular protease activities. The SPATR from
P. knowlesi
(PkSPATR) shares 61% and 58% sequence identity with its
Plasmodium falciparum
and
Plasmodium yoelii
orthologs, respectively. By immunofluorescence analysis, we determined that PkSPATR is a multistage antigen that is expressed on the surface of
P. knowlesi
sporozoite and erythrocytic stage parasites. Recombinant PkSPATR produced in
Escherichia coli
binds to a human hepatoma cell line, HepG2, suggesting that PkSPATR is a parasite ligand that could be involved in sporozoite invasion of liver cells. Furthermore, recombinant PkSPATR reacted with pooled sera from
P. knowlesi
-infected rhesus monkeys, indicating that native PkSPATR is immunogenic during infection. Further efficacy evaluation studies in the
P. knowlesi
-rhesus monkey sporozoite challenge model will help to decide whether the SPATR molecule should be developed as a vaccine against human malarias.
Identification of a New Virulence Factor, BvfA, in
Brucella suis
Authors: Lavigne Jean-Philippe , Patey Gilles , Sangari Felix J. , Bourg Gisèle , Ramuz Michel , O'Callaghan David , Michaux-Charachon Sylvie 
Published: August 2005

ABSTRACT

We report the identification of BvfA (for
Brucella
virulence factor A), a small periplasmic protein unique to the genus
Brucella
, which is essential for the virulence of
Brucella suis
. A BvfA knockout mutant was highly attenuated both in in vitro macrophage infection assays and in vivo in the murine model of brucellosis. Fluorescence-activated cell sorting analysis with green fluorescent protein fusions showed that the expression of
bvfA
is induced within macrophages by phagosome acidification and coregulated with the
B. suis virB
operon, suggesting that it too may play a role in the establishment of the intracellular replication niche.
Optimization of Codon Usage Enhances the Immunogenicity of a DNA Vaccine Encoding Mycobacterial Antigen Ag85B
Authors: Ko Hyun-Jeong , Ko Sung-Youl , Kim Yeon-Jeong , Lee Eun-Gae , Cho Sang-Nae , Kang Chang-Yuil 
Published: August 2005

ABSTRACTIn spite of its many other benefits, DNA vaccine is limited in its application by its insufficient immunogenicity. One promising approach for enhancing its immunogenicity is to maximize its expression in the immunized host. In the current study, we investigated whether codon optimization of the mycobacterial antigen Ag85B gene could enhance the expression and immunogenicity of the Ag85B DNA vaccine. We generated a synthetic humanized Ag85B (hAg85B) gene in which codon usage was optimized for expression in human cells. DNA plasmids with codon-optimized hAg85B increased the level of protein expression in vitro and in vivo. DNA vaccine with hAg85B induced stronger Th1-like and cytotoxic T-cell immune responses in BALB/c mice and generated higher protective immunity in a BALB/c mouse model ofMycobacterium tuberculosisaerosol infection than did the DNA vaccine with wild-type Ag85B. Therefore, our results suggest that codon optimization of mycobacterial antigens (e.g., Ag85B) could improve protein expression and thereby enhance the immunogenicity of DNA vaccines againstM. tuberculosis.