bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rap1 smallGTPaseis essential for maintaining pulmonary endothelial barrier function in mice
Authors: Yamamoto Kiyotake , Watanabe‐Takano Haruko , Oguri‐Nakamura Eri , Matsuno Hitomi , Horikami Daiki , Ishii Tomohiro , Ohashi Ryuji , Kubota Yoshiaki , Nishiyama Koichi , Murata Takahisa , Mochizuki Naoki , Fukuhara Shigetomo 
Published: November 2023

AbstractVascular permeability is dynamically but tightly controlled by vascular endothelial (VE)‐cadherin‐mediated endothelial cell–cell junctions to maintain homeostasis. Thus, impairments of VE‐cadherin‐mediated cell adhesions lead to hyperpermeability, promoting the development and progression of various disease processes. Notably, the lungs are a highly vulnerable organ wherein pulmonary inflammation and infection result in vascular leakage. Herein, we showed that Rap1, a small GTPase, plays an essential role for maintaining pulmonary endothelial barrier function in mice. Endothelial cell‐specificRap1a/Rap1bdouble knockout mice exhibited severe pulmonary edema. They also showed vascular leakage in the hearts, but not in the brains. En face analyses of the pulmonary arteries and 3D‐immunofluorescence analyses of the lungs revealed that Rap1 potentiates VE‐cadherin‐mediated endothelial cell–cell junctions through dynamic actin cytoskeleton reorganization. Rap1 inhibits formation of cytoplasmic actin bundles perpendicularly binding VE‐cadherin adhesions through inhibition of a Rho‐ROCK pathway‐induced activation of cytoplasmic nonmuscle myosin II (NM‐II). Simultaneously, Rap1 induces junctional NM‐II activation to create circumferential actin bundles, which anchor and stabilize VE‐cadherin at cell–cell junctions. We also showed that the mice carrying only one allele of eitherRap1aorRap1bout of the twoRap1genes are more vulnerable to lipopolysaccharide (LPS)‐induced pulmonary vascular leakage than wild‐type mice, while activation of Rap1 by administration of 007, an activator for Epac, attenuates LPS‐induced increase in pulmonary endothelial permeability in wild‐type mice. Thus, we demonstrate that Rap1 plays an essential role for maintaining pulmonary endothelial barrier functions under physiological conditions and provides protection against inflammation‐induced pulmonary vascular leakage.
Tranexamic Acid at Cesarean Delivery: Drug-error Deaths
Authors: Moran N.F. , Bishop D.G. , Fawcus S. , Morris E. , Shakur-Still H. , Devall A.J. , Gallos I.D. , Widmer M. , Oladapo O.T. , Coomarasamy A. , Hofmeyr G.J. 
Published: November 2023

(Am J Obstet Gynecol. 2023;228:1–4)
Tranexamic acid plays an important role in reducing bleeding experienced during postpartum hemorrhage. It is recommended by the World Health Organization that tranexamic acid is administered intravenously, over 10 minutes, within 3 hours of delivery to treat postpartum hemorrhage. However, tranexamic acid, although helpful in cases of postpartum hemorrhage, has caused other problems to arise. It has been found that tranexamic acid is toxic when administered intrathecally (IT). Tranexamic acid has components that are known to lead to neuronal excitation when mistakenly administered in the intrathecal space. This most often leads to generalized convulsions and malignant arrhythmias. This has been occurring more frequently secondary to tranexamic acid being stored in labor and delivery operating rooms on anesthetic drug carts for easy access for hemorrhage during cesarean delivery. Both tranexamic acid and the drugs used for spinal anesthesia are stored in look-alike glass vials making this risk even more likely. A review published in 2019 reported 21 cases of inadvertent intrathecal administration of tranexamic acid, 20 of these cases were life-threatening with ten resulting in patient deaths. The accidental administration of tranexamic acid intrathecally most likely occurs more often than it has been reported. The mistake of replacing spinal anesthesia drugs with tranexamic acid most commonly occurs in small hospitals and low-middle-income countries.
The Management of Pregnant Trauma Patients: A Narrative Review
Authors: Lopez C.E. , Salloum J. , Varon A.J. , Toledo P. , Dudaryk R. 
Published: November 2023

(Anesth Analg. 2023;136:830–840)
In the United States, trauma affects approximately 1 in 12 pregnancies and is the leading non-obstetric cause of maternal mortality. Although parturient patients should receive a comprehensive assessment in the event of trauma, studies suggest that fetal resuscitation is taking priority over maternal resuscitation.
Perioperative Care of Transgender and Gender-Diverse Patients: A Biopsychosocial Approach
Authors: Sanchez K.J. , Sanchez R.A. , Khallouq B.B. , Ellis D.B. 
Published: November 2023

(Anesth Analg. 2023;137:234–246)
Health care disparities exist across populations, and one group that has come to the forefront in recent years is transgender and gender diverse (TGD) individuals. In general, TGD people have less access to health care and fewer individuals in this population seek care due to systemic inequity. These disparities lead to greater disease burden, a greater likelihood of missed care for a chronic health condition, and other worrisome outcomes. TGD individuals are increasingly seeking gender-affirming care (GAC), and this often involves anesthesiology professionals participation in gender-affirming surgery (GAS). This article describes a biopsychosocial approach to GAC that offers holistic care for TGD individuals from anesthetic professionals in particular.
Shall We Rethink the Timing of Epidural Anesthesia in Anticoagulated Obstetrical Patients?
Authors: Legardeur H. , Cuenoud A. , Panchaud A. , Grandoni F. , Mesquita Sauvage A.B. , Alberio L. , Baud D. , Gavillet M. 
Published: November 2023

(Am J Obstet Gynecol. 2023;257–260)
Low–molecular-weight heparins (LMWH) are often used to induce prophylactic anticoagulation for patients who experience venous thromboembolism, thrombophilia, and obstetrical antiphospholipid syndrome. It is theorized that unfractionated heparin delivered intravenously may be a possible alternative for the use of LMWH in pregnant patients.
Is the Increasing Prevalence of Labor Induction Accompanied by Changes in Pregnancy Outcomes? An Observational Study of All Singleton Births at Gestational Weeks 37-42 in Norway During 1999-2019
Authors: Haavaldsen C. , Morken N.H. , Saugstad O.D. , Eskild A. 
Published: November 2023

(Acta Obstet Gynecol Scand. 2023;102:158–173)
While induction of labor (IOL) is implemented with the goal to reduce the risk of maternal and perinatal adverse outcomes, it is uncertain whether risks are decreased. The aim of this study was to determine whether prevalence of IOL in term pregnancies (37 to 42 wk gestation) is accompanied by adverse outcomes or delivery mode.
Maternal Mortality in Women With Previable Premature Rupture of Membranes: An Analysis From the French Confidential Enquiry into Maternal Deaths
Authors: Abrahami Y. , Saucedo M. , Rigouzzo A. , Deneux-Tharaux C. , Azria E. ,   ENCMM Group
Published: November 2023

(Acta Obstet Gynecol Scand. 2022;101:1395–1402)
Previable premature rupture of membranes (PvPROM) is a rare complication of pregnancy (<1% frequency) but can lead to severe maternal adverse outcomes including sepsis and death. Conservative management without fetal extraction is common, but the documented risk of maternal sepsis remains elevated and variable even with prophylactic antibiotic treatment. The data on maternal mortality is lacking, and underreporting is a concern. The aim of this study was to characterize the lethality of PvPROM to inform decision-making as to whether to prolong a ruptured pregnancy or recommend termination.
Ultrasound Assessment of Gastric Volume in Parturients After High-flow Nasal Oxygen Therapy
Authors: Zhou S. , Cao X. , Zhou Y. , Xu Z. , Liu Z. 
Published: November 2023

(Anesth Analg. 2023;137:176–181)
High-flow nasal oxygen (HFNO) therapy is a preferred method of respiratory support for pregnant women but concerns have been raised for gastric complications because of the positive airway pressure. Pregnancy causes physiological changes that can increase the risk of oxygen insufflation into the stomach, as well as the risk of aspiration. Aspiration risk can be determined by ultrasound assessment of gastric volume and antral cross-sectional area (CSA). This study was designed to assess the safety of HFNO therapy by examining changes in antral CSA and gastric volume via ultrasonography before and after HFNO administration, with a hypothesis that 20 minutes of HFNO therapy would increase gastric volume by 50%.
Echocardiography Findings in Amniotic Fluid Embolism: A Systematic Review of the Literature
Authors: Wiseman D. , Simard C. , Yang S.S. , Koolian M. , Abenhaim H.A. , Lipes J. 
Published: November 2023

(Can J Anesth/J Can Anesth. 2023;70:151–160)
Amniotic fluid embolism (AFE) is a rare obstetric complication with a mortality rate ranging 20% to 60%. The pathophysiology of AFE is not well-defined. This study aimed to define the echocardiography findings in patients who suffer from AFE.
Fetal Outcomes With and Without the Use of Sugammadex in Pregnant Patients Undergoing Nonobstetric Surgery: A Multicenter Retrospective Study
Authors: Noguchi S. , Iwasaki H. , Shiko Y. , Kawasaki Y. , Ishida Y. , Shinomiya S. , Ono Uokawa R. , Mazda Y. 
Published: November 2023

(Int J Obstet Anesth. 2023;53:103620)
Sugammadex (SGX) quickly and reliably reverses neuromuscular blockade. It also is known to bind progesterone and maintaining proper progesterone levels is critical during pregnancy, especially during the first trimester. Little is known about the impact of SGX exposure during pregnancy on pregnancy and fetal outcomes. This study aimed to compare fetal outcomes in pregnant patients who underwent nonobstetric surgery who were and were not exposed to SGX.
Buprenorphine-naloxone, Buprenorphine, and Methadone Throughout Pregnancy in Maternal Opioid Use Disorder
Authors: Kanervo Minna M. , Tupola Sarimari J. , Nikkola Eeva M. , Rantakari Krista M. , Kahila Hanna K. 
Published: November 2023

(Acta Obstet Gynecol Scand. 2023;102:313–322)
Maternal opioid use disorder (MOUD) is a global concern. It poses many complications and risk factors for mothers, fetuses, and infants. Mothers are at risk of experiencing negative effects on the nervous system, increased infection risk, and poor nutrition. Children are at risk for neonatal opioid withdrawal syndrome (NOWS) and other long-term health conditions. It is recommended that mothers obtain opioid maintenance treatment (OMT) to reduce these risks. This study aimed to compare the effects of buprenorphine-naloxone, buprenorphine, and methadone treatment plans on outcomes for pregnant women.
Perinatal Mortality and Neonatal and Maternal Outcome Per Gestational Week in Term Pregnancies: A Registry-based Study
Authors: Cornette J. , van der Stok C.J. , Reiss I.K.M. , Kornelisse R.F. , van der Wilk E. , Franx A. , Jacquemyn Y. , Steegers E.A.P. , Bertens L.C.M. 
Published: November 2023

(Acta Obstet Gynecol Scand. 2023;102:82–91)
The risks of maternal, fetal and neonatal adverse outcomes have a wide variance within the window of full-term gestation, 37+0/7 to 41+6/7 weeks. For uncomplicated pregnancies, the prevalence of complications is generally low. However, the optimal timing of delivery especially for pregnancies with added risk factors is open to debate. The strategy of expectant management has been challenged by studies showing increased favorable outcomes (fewer occurrences of stillbirth, adverse neonatal outcomes, cesarean deliveries, hypertensive events, and increased maternal satisfaction) when elective induction was employed between 39 and 41 weeks. This study examined the relationship between per week gestational age and adverse perinatal, neonatal and maternal outcomes, with regard to balancing risks and benefits of expectant management versus interventions at term.
Adverse Pregnancy Outcomes and Long-term Risk of Ischemic Heart Disease in Mothers: National Cohort and Co-sibling Study
Authors: Crump C. , Sundquist J. , McLaughlin M.A. , Dolan S.M. , Govindarajulu U. , Sieh W. , Sundquist K. 
Published: November 2023

(BMJ. 2023;380:e072112)
The leading cause of mortality among women globally is cardiovascular disease, and adverse perinatal outcomes have been associated with an increased risk of cardiovascular disease later in life. Despite this association, adverse perinatal outcomes are often overlooked as cardiovascular risk factors in women. The aim of this study is to determine associations between adverse pregnancy outcomes (ie, gestational diabetes, pre-eclampsia, preterm delivery, small for gestational age, and other hypertensive disorders of pregnancy) and the long-term risk of ischemic heart disease.
Prophylactic Antibiotics for Vaginal Delivery: Benefits and Possible Harms
Authors: Sheffield Jeanne S. 
Published: November 2023

(N Engl J Med. 2023;388:1221–1223)
Antiseptic techniques were discovered by Ignaz Semmelweis. Semmelweis was a physician in Hungary in the 1860s. His discovery wasn’t popular at the time he published his work, but it is now a standard practice in today’s modern healthcare facilities with procedures such as basic handwashing being used in everyday life outside of the hospital setting. Although this is now standard practice, maternal death is still often caused by infection. Infection during delivery is the third most leading cause of death among mothers, following hemorrhage and hypertension. It was reported that 810 individuals die during or following delivery every day from diseases that could be prevented by following simple antiseptic techniques. Ninety-four percent of these deaths occur in low and middle-income areas, such as Africa and Asia, with 10.7% of these deaths being directly related to infection or sepsis. The Global Maternal and Neonatal Sepsis Initiative was created by the WHO to reduce the overall rate of maternal mortality by the year 2030.
Randomized Trial of Early Detection and Treatment of Postpartum Hemorrhage
Authors: Gallos I. , Devall A. , Martin J. , Middleton L. , Beeson L. , Coomarasamy A. ,   et al
Published: November 2023

(N Engl J Med. 2023;389:11–21)
Postpartum hemorrhage (PPH) remains the leading cause of maternal death worldwide despite published recommendations from the World Health Organization (WHO) on prevention and treatment. There are challenges in implementing the PPH recommendations. Delay in detection as well as delay in treatment of PPH are 2 reasons the maternal death rate is high. One reason for the delay in detection is due to the ongoing use of visual estimation of blood loss, which often inaccurately underestimates the amount of lost blood. More aggressive interventions for PPH may be delayed until earlier approaches have failed in stopping the blood loss. In some cases, no effective treatment is administered at all. Finally, although the WHO has given these recommendations, not all hospitals and/or medical professionals are implementing them. This study sought to understand whether a treatment bundle referred to as E-MOTIVE could improve early detection and treatment of PPH in patients with a vaginal birth.
Early Detection and Bundled Treatment for Postpartum Hemorrhage
Authors: Boatin A. , Ngonzi J. 
Published: November 2023

(N Engl J Med. 2023;389;3)
It is a common complication after a woman has given birth, to have varying degrees of postpartum hemorrhage (PPH). Bleeding after birth is the leading cause of maternal death in many developing regions, accounting for more than 20% of postpartum deaths worldwide. Postpartum hemorrhage is defined as when more than 500 mL of blood loss occurs. Though highly preventable, a patient can escalate rapidly from moderate to severe in a matter of minutes if precautions and monitoring are not in place.
Testing Equivalence of Two Doses of Intravenous Iron to Treat Iron Deficiency in Pregnancy: A Randomized Controlled Trial
Authors: Froessler B. , Schubert K.O. , Palm P. , Church R. , Aboustate N. , Kelly T.L. , Dekker G.A. , Hodyl N.A. 
Published: November 2023

(BJOG. 2023;130:15–23)
The most common nutritional disorder worldwide is iron deficiency (ID). Iron is vital for many bodily functions, so when women who are pregnant suffer from ID they are more likely to experience complications during pregnancy as well as deliver babies at risk for neonatal complications. It is estimated that about 47% of women suffer from ID during pregnancy even though it is a treatable disorder. Intravenous iron (IVI) has been proven to help pregnant women who are nonresponsive to oral iron intake. This study compared the effects of 2 different doses of IVI in pregnant women.
Maternal mRNA COVID-19 Vaccination During Pregnancy and Delta or Omicron Infection or Hospital Admission in Infants: Test Negative Design Study
Authors: Jorgensen S.C.J. , Hernandez A. , Fell D.B. , Austin P.C. , D'Souza R. , Guttmann A. , Brown K.A. , Buchan S.A. , Gubbay J.B. , Nasreen S. , Schwartz K.L. , Tadrous M. , Wilson K. , Kwong J.C. ,   Canadian Immunization Research Network (CIRN) Provincial Collaborative Network (PCN) Investigators
Published: November 2023

(BMJ. 2023;380:e074035)
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) rates are higher in infants than in older children. Passive immunity has been shown to help prevent other infections, such as pertussis, in infants through the transfer of maternal antibodies following vaccination during pregnancy. SARS-CoV-2 antibodies are found to be present in breastmilk, umbilical cord blood, and infant serum specimens following maternal vaccination during pregnancy and infection, and emerging research suggests maternal COVID-19 vaccination reduces infant infection and hospital admission rates. This study aimed to determine whether maternal vaccination during pregnancy with 2 primary doses or 2 primary doses plus booster of the mRNA COVID-19 vaccine series reduces the infection of omicron and delta SARS-CoV-2 and hospital admission of infants within 6 months following delivery.
Pregnancy Outcomes and Vaccine Effectiveness During the Period of Omicron as the Variant of Concern, INTERCOVID-2022: A Multinational, Observational Study
Authors: Villar J. , Soto Conti C.P. , Gunier R.B. , Ariff S. , Craik R. , Cavoretto P.I. , Rauch S. , Gandino S. , Nieto R. , Winsey A. , Menis C. , Rodriguez G.B. , Savasi V. , Tug N. , Deantoni S. , Fabre M. , Martinez de Tejada B. , Rodriguez-Sibaja M.J. , Livio S. , Napolitano R. , Maiz N. , Sobrero H. , Peterson A. , Deruelle P. , Giudice C. , Teji J.S. , Casale R.A. , Salomon L.J. , Prefumo F. , Cheikh Ismail L. , Gravett M.G. , Vale M. , Hernández V. , Sentilhes L. , Easter S.R. , Capelli C. , Marler E. , Cáceres D.M. , Albornoz Crespo G. , Ernawati E. , Lipschuetz M. , Takahashi K. , Vecchiarelli C. , Hubka T. , Ikenoue S. , Tavchioska G. , Bako B. , Ayede A.I. , Eskenazi B. , Thornton J.G. , Bhutta Z.A. , Kennedy S.H. , Papageorghiou A.T. ,   INTERCOVID-2022 International Consortium
Published: November 2023

(Lancet. 2023;401:447–457)
In 2021, COVID-19 during pregnancy was reported to be associated with an increased risk of maternal and neonatal outcomes. The SARS-CoV-2 virus has undergone genetic mutations since then and the subsequent impact of the omicron variant on maternal and neonatal health wasunknown. This study aimed to analyze the effects on maternal and perinatal outcomes of omicron during pregnancy as well as vaccine efficacy.
Antiretroviral Therapy and Adverse Pregnancy Outcomes in People Living with HIV
Authors: Eke A.C. , Mirochnick M. , Lockman S. 
Published: November 2023

(N Engl J Med. 2023;388:344–356)
Human immunodeficiency virus (HIV) is detected in about 1.3 million pregnant individuals every year. The use of antiretroviral therapy (ART) is common in about 1.1 million (85%) of these cases. When ART is not prescribed, 15% to 30% of individuals born to those with HIV will develop HIV. Maternal zidovudine (ZDV), a 3-drug ART regimen, has been proven to reduce the number of infants who contract HIV from their mothers. ZDV decreases the rate of vertical transmission of HIV from 25.5% to 8.3%. This study aimed to show the key evidence in support of ART and to evaluate both contemporary and legacy methods of ART delivery to see how they compare.
Comparison of Labor Analgesia Efficacy Between Single-orifice and Multiorifice Wire-reinforced Catheters During Programmed Intermittent Epidural Boluses: A Randomized Controlled Clinical Trial
Authors: Yi J. , Li Y. , Yuan Y. , Xu Z. , Song Y. , Ye B. , Zhao Q. , Yang Y. , Du W. , Liu Z. 
Published: November 2023

(Reg Anesth Pain Med. 2023;48:61–66)
Programmed intermittent epidural bolus (PIEB) has been used since 2006 for labor analgesia. It is theorized that high-flow epidural catheters may be necessary for proper anesthetic spread dynamics within the epidural space. Epidural catheters have varying characteristics that may affect anesthesia administration. Studies show that multiorifice catheters were proven superior when compared with single-orifice catheters; however, due to flow dynamics, single-orifice catheters may be preferred to close-ended multiorifice catheters due to diffusion distance and area coverage. This study aimed to show a comparison between single-orifice and multiorifice catheters when used for intermittent high-rate bolus administration.
Labor Epidural Analgesia and Subsequent Risk of Offspring Autism Spectrum Disorder and Attention-deficit/Hyperactivity Disorder: A Cross-National Cohort Study of 4.5 Million Individuals and Their Siblings
Authors: Hegvik T.A. , Klungsøyr K. , Kuja-Halkola R. , Remes H. , Haavik J. , D'Onofrio B.M. , Metsä-Simola N. , Engeland A. , Fazel S. , Lichtenstein P. , Martikainen P. , Larsson H. , Sariaslan A. 
Published: November 2023

(Am J Obstet Gynecol. 2023;228:223.e1–233.e12)
Autism spectrum disorder (ASD) is a neurodevelopmental disorder that commonly occurs in children, and many of its causes are currently unknown. It is known that there is a large genetic component, but other components or contributors aren’t known, especially in the context of environmental factors. Recent studies have attempted to correlate ASD with a number of external factors; one such study connected a diagnosis of ASD with the use of labor epidural analgesia. That study has since had several other research teams try to replicate the findings, without success. The replication attempts, however, have been limited by small samples and insufficient statistical power. This study attempts again to replicate the findings of an association between ASD and labor epidural analgesia, while also overcoming the limitations present in previous attempts to do so.
Anesthetic Management of Patients With Class 3 Obesity Undergoing Elective Cesarean Delivery: A Single-Center Historical Cohort Study
Authors: van den Bosch O.F.C. , Fiset M. , Downey K. , Maxwell C. , Carvalho J.C.A. 
Published: November 2023

(Can J Anesth/J Can Anesth. 2023; 70:202–210)
Rising obesity rates have reached a high of one third or one fourth of adults in the United States and Canada, respectively. This leads to many individuals with this condition requiring medical care including anesthesia for labor and delivery. Obesity is known to be associated with complications in the administration and effectiveness of anesthesia as well as after cesarean delivery. Prior research has not focused on the nuances of specific categories of body mass index (BMI) and their association with outcomes, specifically for anesthesia during cesarean delivery. This study aimed to describe different techniques and outcomes for anesthesia in elective cesarean delivery in patients with class 3 obesity (BMI ≥40), specifically in groups with BMI 40.0 to 49.9, 50.0 to 59.9, and >60.0.