bluuebunny/crossref_metadata_2025_split huggingface dataset:
Maternal lipid levels in early pregnancy as a predictor of childhood lipid levels: a prospective cohort study
Authors: Adank Maria C. , Johansen Anja K. , Benschop Laura , Van Streun Sophia P. , Smak Gregoor Anna M. , Øyri Linn K. L. , Mulder Monique T. , Steegers Eric A. P. , Holven Kirsten B. , Roeters van Lennep Jeanine E. 
Published: July 2022

AbstractBackgroundMaternal lipid levels in early pregnancy are associated with maternal health and foetal growth. It is however unclear if maternal lipids in early pregnancy can be used to predict childhood lipid levels. The aim of this study is to assess the association between maternal and offspring childhood lipid levels, and to investigate the influence of maternal BMI and diet on these associations.MethodsThis study included 2692 women participating in the Generation R study, an ongoing population-based prospective cohort study from early life onwards. Women with an expected delivery date between 2002 and 2006 living in Rotterdam, the Netherlands were included. Total cholesterol, triglycerides and high-density lipoprotein cholesterol (HDL-c) were measured in early pregnancy (median 13.2 weeks [90% range 10.6; 17.1]). Low-density lipoprotein cholesterol (LDL-c), remnant cholesterol and non-HDL-c were calculated. Corresponding lipid measurements were determined in 2692 children at the age of 6 (median 6.0 years [90% range 5.7; 7.5]) and 1673 children 10 years (median 9.7 years [90% range 9.5; 10.3]). Multivariate linear regression analysis was used to examine the association between maternal lipid levels in early pregnancy and the corresponding childhood lipid measurements at the ages of 6 and 10 years while adjusting for confounders.ResultsMaternal lipid levels in early pregnancy are positively associated with corresponding childhood lipid levels 6 and 10 years after pregnancy, independent of maternal body mass index and diet.ConclusionsMaternal lipid levels in early pregnancy may provide an insight to the lipid profile of children years later. Gestational lipid levels may therefore be used as an early predictor of children’s long-term health. Monitoring of these gestational lipid levels may give a window-of-opportunity to start early interventions to decrease offspring’s lipid levels and possibly diminish their cardiovascular risk later in life. Future studies are warranted to investigate the genetic contribution on maternal lipid levels in pregnancy and lipid levels of their offspring years later.
Vitamin B12 status and folic acid/vitamin B12 related to the risk of gestational diabetes mellitus in pregnancy: a systematic review and meta-analysis of observational studies
Authors: He Jin , Jiang Dongmei , Cui Xianwei , Ji Chenbo 
Published: July 2022

AbstractBackgroundThis review was conducted to investigate the association between serum vitamin B12 levels as well as folic acid/vitamin B12 during pregnancy and the risk of gestational diabetes mellitus (GDM).MethodsA comprehensive search of electronic databases (Embase, PubMed, and Web of Science) was performed. The odds ratios (ORs) with 95% confidence intervals (CIs) of GDM risk were summarized using a random effects model. We also performed subgroup analyses to explore the source of heterogeneity.ResultsA total of 10 studies, including 10,595 pregnant women were assessed. Women with vitamin B12 deficiency were at higher risk for developing GDM when compared with those who were vitamin B12 sufficient (OR, 1.46; 95% CI 1.21–1.79; I2: 59.0%). Subgroup analysis indicated that this association might differ based on sample size and geographical distribution. Elevated vitamin B12 levels may decrease the risk of GDM by 23%. The role of excess folic acid and low vitamin B12 levels in the occurrence of GDM is also controversial.ConclusionIn summary, vitamin B12 deficiency is associated with increased risk of GDM, it is necessary to pay more attention to the balance of vitamin B12 and folic acid. However, more in-depth studies across multiple populations are needed to verify these results.
Labor characteristics and intrapartum interventions in women with vaginal birth after cesarean section
Authors: Lan Yehui , Pan Shuangjia , Chen Baoyi , Peng Lingli , Chen Ruyang , Hua Ying , Ma Yanyan 
Published: July 2022

Abstract
Background
With the development of China’s two-child-policy, vaginal birth after cesarean section (VBAC) has aroused public concern. It is important to understand the labour characteristics and intrapartum management of women attempting VBAC to enhance the rates of successful VBAC. The purpose of our research was to investigate the differences in the characteristics of labor, intervention measures and perinatal outcomes between women who had a VBAC and primiparas or multiparas not undergoing VBAC, providing clinical references of intrapartum management for women who are planning a VBAC.

Material and methods
This observational retrospective study enrolled all women who laboured spontaneously and who had a VBAC (n = 139) at the Second Affiliated Hospital of Wenzhou Medical University in China between 2016 and 2019. They were allocated into VBAC group A (the previous cesarean section was performed before dilation of the cervix) and VBAC group B (the previous cesarean section was performed after dilation of the cervix). The primipara control group included 149 primiparae, and the multipara control group included 155 multiparae with second vaginal birth. Durations of labor, intervention measures and perinatal outcomes were compared among the groups.

Results
The durations of labor, intrapartum interventions and maternal and neonatal outcomes in VBAC group A were similar to those of the VBAC group B. However, all women who had a VBAC and those in VBAC group A had shorter first, second and the total stages of labor than primiparae. All women with VBAC and those in VBAC group B had longer second stage of labor, but shorter third stage of labor than multiparae. Oxytocin, labor analgesia and artificial rupture of membranes were administered less often in women with VBAC than in primiparae, while phloroglucinol was administered more often in women with VBAC than in multiparae. Women who had a VBAC were more likely to receive episiotomy and had higher incidences of postpartum hemorrhage than primipara and multipara women.

Conclusions
Labor characteristics, intrapartum interventions and perinatal outcomes in women who had a VBAC with cervical dilation were similar to those in women who had a VBAC without cervical dilation before the previous cesarean section, but differed significantly from those of multiparae and primiparae who did not undergo VBAC.
Metabolic activity determines survival depending on the level of lymph node involvement in cervical cancer
Authors: Martinez Alejandra , Chantalat Elodie , Angeles Martina Aida , Ferron Gwénaël , Ducassou Anne , Daix Manon , Attal Justine , Bétrian Sarah , Lusque Amélie , Gabiache Erwan 
Published: July 2022

Abstract
Background
To assess the impact of PET/CT functional parameters on survival, locoregional, and distant failure according to the most distant level of lymph node [18F]FDG uptake in patients with locally advanced cervical cancer (LACC).

Methods
Retrospective study including 148 patients with LACC treated with concurrent chemoradiotherapy after PET/CT and para-aortic lymph node (PALN) surgical staging. Two senior nuclear medicine physicians reviewed all PET/CT exams and retrieved tumor and lymph node metabolic parameters: SUVmax, MTV, TLG. Oncological outcomes according to metabolic parameters and level of lymph node spread on PET/CT were assessed.

Results
In patients without lymph node uptake on PET/CT, high MTV values of the cervical tumor were associated with DFS (HR = 5.14 95%CI = [2.15–12.31]), OS (HR = 6.10 95%CI = [1.89–19.70]), and time to distant (HR = 4.73 95%CI = [1.55–14.44]) and locoregional recurrence (HR = 5.18 95%CI = [1.72–15.60]). In patients with pelvic lymph node (PLN) uptake but without PALN uptake on [18F]FDG-PET/CT, high MTV values of the cervical tumor were associated with DFS (HR = 3.17 95%CI = [1.02–9.83]) and OS (HR = 3.46 95%CI = [0.96–12.50]), and the number of PLN fixations was associated with DFS (HR = 1.30 95%CI = [1.10–1.53]), OS (HR = 1.35 95%CI = [1.11–1.64]), and time to distant (HR = 1.35 95%CI = [1.08–1.67]) and locoregional recurrence (HR = 1.31 95%CI = [1.08–1.59]). There was no significant association between cervical tumor metabolic or lymph node metrics and survival outcome in patients with PALN uptake.

Conclusions
Cervical MTV is more accurate than SUVmax to predict survival outcome in patients with locoregional disease confined to the pelvis and should be implemented in routine clinical practice. Prognostic value of metabolic metrics disappears with PALN uptake, which is associated with distant failure in nearly half of patients.

Graphical Abstract
Prognostic value of CSN5 in patients with digestive system cancers: a systematic review and meta-analysis
Authors: Guo Yonghua , Gao Meng , Yao Ye , Li Jinghua , Chen Xi , Wang Xingxing , Chen Zhang , Yuan Yufeng , Ma Weijie 
Published: July 2022

Abstract
Background
Despite the understanding of the COP9 signalosome subunit 5 (CSN5) in tumor genesis, there is no conclusive evidence on its value to predict the survival and prognosis of digestive system tumor patients. Hence this study aimed to evaluate the impact of CSN5 levels on the survival and clinicopathological parameters of digestive system neoplasm patients.

Methods
First, a comprehensive search was conducted in four databases. We utilized the Hazard Ratio (HR) with a 95% confidence interval (CI) to evaluate the prognostic value of CSN5 for the overall survival (OS) and recurrence-free survival (RFS) of patients. Then, we estimated the connection between CSN5 and the clinicopathological parameters based on the Odds Ratio (OR) with the corresponding 95% CI.

Results
This meta-analysis included 22 studies and 2193 patients diagnosed with digestive system tumors. High expression of CSN5 was correlated to poorer OS (HR = 2.28, 95% CI: 1.71–3.03; p < 0.00001). Additionally, high CSN5 levels were correlated with worse invasion depth (OR = 0.49, 95% CI: 0.25–0.96, p = 0.04), positive lymphatic metastasis (OR = 0.28, 95% CI: 0.16–0.47, p = 0.00001), positive distant metastasis (OR = 0.32, 95% CI: 0.13–0.76, p = 0.01) and poorer differentiation degree (OR = 0.34, 95% CI: 0.19–0.60, p = 0.0003). However, we did not detect a correlation between CSN5 expression and age, gender, tumor stage, tumor size or vascular invasion. Furthermore, no significant publication bias was detected.

Conclusion
This meta-analysis demonstrated that the overexpression of CSN5 level might foresee poorer OS in digestive system cancer patients. Additionally, CSN5 levels might be related to the prognosis of digestive system tumors.
Novel mutations of the USH2A gene cause Usher syndrome in five Chinese families
Authors: Xing Dongjun , Yu Rongguo , Wang Linni , Hu Liying , Yang Yang , Li Chang , Li Zhiqing , Li Xiaorong 
Published: July 2022

Abstract
Background
Usher syndrome (USH) is a leading disorder of deaf–blindness. The phenotypic and genetic heterogeneity of USH makes the diagnosis of this disorder difficult. However, diagnosis can be facilitated by employing molecular approaches, especially for diseases without pronounced pathognomonic symptoms. Therefore, this study aimed to reveal the genetic defects in five USH patients using clinical targeted exome sequencing (TES).

Methods
USH patients and their family members from five unrelated Chinese USH families were recruited and subjected to TES. Ophthalmic information was obtained for all patients to ensure a meaningful interpretation. The TES data were analysed using an established bioinformatics pipeline to identify causative mutations. Further verification by Sanger sequencing and cosegregation analysis were performed on available family members.

Results
We identified genetic mutations in five USH patients using TES. Seven mutations, four of which were novel, were identified in the USH2A gene. One proband (F1-II-3) was found to have a homozygous mutation inherited from nonconsanguineous parents, and another proband (F5-III-1) was found to carry three USH2A gene mutations.

Conclusion
In conclusion, the study revealed the importance of TES in the clinical diagnosis of USH patients with variable phenotypes. The correlation between USH2A gene mutations and clinical phenotypes will help to refine the clinical diagnosis of USH.
Guideline for the management of pediatric off-label use of drugs in China (2021)
Authors: Meng Min , Liu Enmei , Zhang Bo , Lu Quan , Zhang Xiaobo , Ge Bin , Wu Ye , Wang Li , Wang Mo , Luo Zhengxiu , Hua Ziyu , Wang Xiaoling , Zhao Wei , Zheng Yi , Wu Xinan , Zhao Ruiling , Meng Wenbo , Xiang Li , Wang Gang , Jia Yuntao , Chen Yongchuan , Dong Xiaoyan , Hao Lina , Liu Chengjun , Lv Meng , Luo Xufei , Liu Yunlan , Shen Quan , Lei Wenjuan , Wang Ping , Sun Yajia , Zhang Juanjuan , Wang Ling , Lei Ruobing , Hou Tianchun , Yang Bo , Li Qiu , Chen Yaolong 
Published: July 2022

Abstract
Background
The "Law on Doctors of the People's Republic of China," which was officially implemented on March 1, 2022, emphasizes the requirements for rational drug use and the necessity for appropriate management of off-label drug use. The safety and ethical considerations related to off-label drug use are different in children than in adults. There is so far no management guideline for pediatric off-label use of drugs in China, and the applicability of foreign guidelines is limited. Establishing a localized evidence-based management guideline for pediatric off-label use of drugs to support the national legislation and clinical practice is of critical importance.

Methods
We established a guideline working group, including experts from a broad range of disciplines and developed recommendations following the guidance of the World Health Organization Handbook and the Chinese Medical Association. The following themes were identified by questionnaires and expert interviews to be of great concern in the management of off-label drug use in children: general principles and characteristics of management of pediatric off-label drug use; establishment of expert committees; evidence evaluation; risk–benefit assessment; informed consent; monitoring and assessment of the risk; and monitoring and patient education. Two rounds of Delphi surveys were organized to determine the final recommendations of this guideline. We graded the recommendations based on the body of evidence, referring to the evaluation tool of the Evidence-based management (EBMgt) and the Oxford Center for Evidence-Based Medicine: Level of Evidence (March 2009).

Results
We developed the first guideline for the management of pediatric off-label use of drugs in China.

Conclusions
The guideline is to offer guidance for pediatricians, pharmacists, medical managers, policymakers, and primary care physicians on how to manage off-label drug use in pediatrics and to provide recommendations for Chinese healthcare policy in the future.
Inequalities in caries among pre-school Italian children with different background
Authors: Campus Guglielmo , Cocco Fabio , Strohmenger Laura , Wolf Thomas Gerhard , Balian Araxi , Arghittu Antonella , Cagetti Maria Grazia 
Published: July 2022

Abstract
Background
The study was aimed to describe caries prevalence and severity and health inequalities among Italian preschool children with European and non-European background and to explore the potential presence of a social gradient.

Methods
The ICDAS (International Caries Detection and Assessment System) was recorded at school on 6,825 children (52.8% females). Caries frequency and severity was expressed as a proportion, recording the most severe ICDAS score observed. Socioeconomic status (SES) was estimated by mean a standardized self-submitted questionnaire filled-in by parents. The Slope Index of Inequality (SII) based on regression of the mid-point value of caries experiences score for each SES group was calculated and a social gradient was generated, children were stratified into four social gradient levels based on the number of worst options. Multivariate regression models (Zero-Inflated Negative Binomial logistic and logistic regression) were used to elucidate the associations between all explanatory variables and caries prevalence.

Results
Overall, 54.4% (95%CI 46.7–58.3%) of the children were caries-free; caries prevalence was statistically significant higher in children with non-European background compared to European children (72.6% vs 41.6% p < 0.01) and to the area of living (p = 0.03). A statistically significant trend was observed for ICDAS 5/6 score and the worst social/behavioral level (Z = 5.24, p < 0.01). Children in the highest household income group had lower levels of caries. In multivariate analysis, Immigrant status, the highest parents’ occupational and educational level, only one kid in the family, living in the North-Western Italian area and a high household income, were statistically significant associated (p = 0.01) to caries prevalence. The social gradient was statistically significant associated (p < 0.01) to the different caries levels and experience in children with European background.

Conclusions
Data show how caries in preschool children is an unsolved public health problem especially in those with a non-European background.
A Sri Lankan infant with immunoglobulin resistant incomplete Kawasaki disease with a vesicular psoriasiform rash, hypertension and late onset small joint arthritis: a case report
Authors: Hoole Thabitha Jebaseeli , Athapathu Arjuna Salinda , Abeygunawardene Anoma Damayanthi 
Published: July 2022

Abstract
Background
Kawasaki disease (KD) is a medium and small vessel vasculitis which usually has a good response to immunoglobulin therapy (IVIG). We present a case of incomplete KD with IVIG resistance associated with an unusual combination of vesicular guttate-psoriasiform rash, hypertension and late onset small joint arthritis.

Case presentation
A four-month-old male infant from Sri Lanka presented with high fever, conjunctival redness, pedal oedema and skin rash. He was found to have hypertension since admission with a high white cell count and high inflammatory markers. There was poor response to intravenous antibiotics and subsequent 2D echocardiogram revealed coronary artery aneurysms suggestive of KD. In the third week of illness he developed a vesiculo-papular rash involving face, trunk and limbs – which on biopsy revealed features of guttate psoriasis.
Fever spikes continued and the coronary arteries showed progressive dilatation despite timely intravenous immunoglobulin administered on day 6 and methylprednisolone administered on day 10-13. Therapeutic response by means of reduction of fever was seen only after initiation of intravenous infliximab on day 28 of illness for which the fever responded within 24 hours. He developed a small joint arthritis of hands and feet on day 40 of illness which responded only after initiating methotrexate therapy. The hypertension persisted for 4 months after the onset of the illness before complete resolution.

Conclusion
This case report depicts an unusual presentation of KD with a vesicular guttate-psoriasiform eruption, hypertension and late onset small joint arthritis. It highlights that clinicians should be aware of the fact that KD could present with such atypical manifestations and could develop unusual complications.
Patient expectations of and experiences with a suicide risk identification algorithm in clinical practice
Authors: Yarborough Bobbi Jo H. , Stumbo Scott P. , Schneider Jennifer L. , Richards Julie E. , Hooker Stephanie A. , Rossom Rebecca C. 
Published: July 2022

Abstract
Background
Suicide risk prediction models derived from electronic health records (EHR) and insurance claims are a novel innovation in suicide prevention but patient perspectives on their use have been understudied.

Methods
In this qualitative study, between March and November 2020, 62 patients were interviewed from three health systems: one anticipating implementation of an EHR-derived suicide risk prediction model and two others piloting different implementation approaches. Site-tailored interview guides focused on patients’ perceptions of this technology, concerns, and preferences for and experiences with suicide risk prediction model implementation in clinical practice. A constant comparative analytic approach was used to derive themes.

Results
Interview participants were generally supportive of suicide risk prediction models derived from EHR data. Concerns included apprehension about inducing anxiety and suicidal thoughts, or triggering coercive treatment, particularly among those who reported prior negative experiences seeking mental health care. Participants who were engaged in mental health care or case management expected to be asked about their suicide risk and largely appreciated suicide risk conversations, particularly by clinicians comfortable discussing suicidality.

Conclusion
Most patients approved of suicide risk models that use EHR data to identify patients at-risk for suicide. As health systems proceed to implement such models, patient-centered care would involve dialogue initiated by clinicians experienced with assessing suicide risk during virtual or in person care encounters. Health systems should proactively monitor for negative consequences that result from risk model implementation to protect patient trust.
The impact of the COVID-19 pandemic on the mental health of children with psychiatric diagnoses – multidimensional CCPCA Model
Authors: Kalenik Anna Maria , Topolski Mariusz , Górnik Justyna , Wolańczyk Tomasz 
Published: July 2022

Abstract
Background
The study aimed to assess the severity of symptoms of anxiety and depression in children with previously diagnosed psychiatric disorders during the COVID-19 pandemic in Poland.

Methods
Online questionnaires were used to investigate three groups of subjects: patients with a psychiatric diagnosis, primary school pupils, and children from children’s homes. A total of 167 children with their parents or guardians participated in the study. In addition to basic statistics, a multidimensional Centroid Class Principal Component Analysis (CCPCA) model was used.

Results
It was found that the strongest fear of the coronavirus was experienced by children from children’s homes, while the most severe depressive symptoms and state anxiety were observed among patients diagnosed with psychiatric disorders. Parental care by assisting with school education and lack of close contact with other people (less than two metres) at parents/guardians’ work had the most potent protective effect in reducing the fear of COVID-19.

Conclusions
There is a need for further research in children and adolescents to develop effective strategies for protecting their mental well-being when faced with social isolation or disease.