bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mode of Delivery and Unplanned Cesarean: Differences in Rates and Indication by Race, Ethnicity, and Sociodemographic Characteristics
Authors: Williams Alexandria , Little Sarah E. , Bryant Allison S. , Smith Nicole A. 
Published: March 2022

Objective We aimed to examine the relationship of sociodemographic variables with racial/ethnic disparities in unplanned cesarean births in a large academic hospital system. Secondarily, we investigated the relationship of these variables with differences in cesarean delivery indication, cesarean delivery timing, length of second stage and operative delivery.
Study Design We conducted a retrospective cohort study of births >34 weeks between 2017 and 2019. Our primary outcome was unplanned cesarean delivery after a trial of labor. Multiple gestations, vaginal birth after cesarean, elective repeat or primary cesarean delivery, and contraindications for vaginal delivery were excluded. Associations between mode of delivery and patient characteristics were assessed using Chi-square, Fisher exact tests, or t-tests. Odds ratios were estimated by multivariate logistic regression. Goodness of fit was assessed with Hosmer Lemeshow test.
Results Among 18,946 deliveries, the rate of cesarean delivery was 14.8% overall and 21.3% in nulliparous patients. After adjustment for age, body mass index (BMI), and parity, women of Black and Asian races had significantly increased odds of unplanned cesarean delivery; 1.69 (95% CI: 1.45,1.96) and 1.23 (1.08, 1.40), respectively. Single Hispanic women had adjusted odds of 1.65 (1.08, 2.54). Single women had increased adjusted odds of cesarean delivery of 1.18, (1.05, 1.31). Fetal intolerance was the indication for 39% (613) of cesarean deliveries among White women as compared to 63% (231) of Black women and 49% (71) of Hispanic women (p <0.001).
Conclusion Rates of unplanned cesarean delivery were significantly higher in Black and Asian compared to White women, even after adjustment for age, BMI, parity, and zip code income strata, and rates of unplanned cesarean delivery were higher for Hispanic women self-identifying as single. Racial and ethnic differences were seen in cesarean delivery indications and operative vaginal deliveries. Future work is urgently needed to better understand differences in provider care or patient attributes, and potential provider bias, that may contribute to these findings.
Key Points
Maternal Body Mass Index and Risk of Bronchopulmonary Dysplasia in Extremely Preterm Infants
Authors: Mayor Reina , Mora Ariana , Carmona Carlos , Du Yuan , Pepe Julie , Fritz Kathy , Oh William 
Published: March 2022

Objective We evaluated the relationship between maternal body mass index (BMI) and death or bronchopulmonary dysplasia (BPD). We hypothesized that in extremely low birth weight (ELBW; BW < 1,000 g) infants, the risk of death or BPD would be greater if the maternal BMI deviated further from the ideal BMI of 24.
Study Design ELBW infants admitted to AdventHealth Neonatal Intensive Care Unit (NICU) between calendar years 2012 and 2017 were included in this retrospective observational study. BPD was defined as continuous supplemental oxygen use at 36 weeks post-menstrual age.
Result There was no association between the deviation of maternal BMI from the ideal of 24 and the composite outcome of death or BPD (6.9 ± 6.7 vs. 7.06 ± 6.6, pp = 0.966). However, there was a lower risk of death with a higher maternal BMI (p = 0.024). BPD was also associated with a higher maternal BMI (p = 0.045).
Conclusion Maternal BMI was not associated with the composite variable of death or BPD in ELBW infants. The lack of association was due to the contrast between high BMI and a lower risk of death and a higher risk for BPD.
Key Points
Association between Fetal Adrenal Gland Ultrasound Measurements in the 9th Month and Mode of Delivery
Authors: Kesrouani Assaad , Abdallah Wael , Hatoum Inaam , Khalil Khalil , Nagib Bernard , Choueiry Elie , Nasr Bernard 
Published: March 2022

Objective Several studies have previously assessed the value of changes in the fetal adrenal gland to predict preterm labor. The aim of this study is to evaluate the correlation between fetal adrenal gland measurements after 36 weeks and obstetrical outcomes.
Methods Abdominal two-dimensional (2D) ultrasound is used to measure in the transversal plane the length of fetal zone (D1), the width (D2), and the length (D3) of fetal adrenal gland, and, subsequently, the fetal zone enlargement (FZE), in 98 primigravida women after 36 weeks. Labor and delivery outcomes were assessed and compared with these measurements.
Results FZE changes had no association with spontaneous onset of labor. No association was found between all adrenal gland measurements and delivery onset. There was a significant relationship between D1, D2, and D3 and the delivery method. Patients delivered by cesarean section had smaller fetal adrenal gland dimensions, defining D1= 0.16 cm, D2 = 0.7 cm, and D3 = 2.37 cm as cutoff levels based on receiver operator characteristics curves.
Conclusion The 2D measurement of the fetal adrenal gland after 36 weeks seems to predict the delivery method in low-risk primigravida women.
Key Points
Placental Vascular and Inflammatory Findings from Pregnancies Diagnosed with Coronavirus Disease 2019: A Systematic Review and Meta-analysis
Authors: Hessami Kamran , Aagaard Kjersti M. , Castro Eumenia C. , Arian Sara E. , Nassr Ahmed A. , Barrozo Enrico R. , Seferovic Maxim D. , Shamshirsaz Alireza A. 
Published: March 2022

We aimed to perform a meta-analysis of the literature concerning histopathologic findings in the placentas of women with SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection during pregnancy. Searches for articles in English included PubMed, Web of Science, Google Scholar, and reference lists (up to April 2021). Studies presenting data on placental histopathology according to the Amsterdam Consensus Group criteria in SARS-CoV-2 positive and negative pregnancies were identified. Lesions were categorized into: maternal and fetal vascular malperfusion (MVM and FVM, respectively), acute placental inflammation with maternal and fetal inflammatory response (MIR and FIR, respectively), chronic inflammatory lesions (CILs), and increased perivillous fibrin deposition (PVFD). A total of 15 studies reporting on 19,025 placentas, n = 699 of which were derived from women who were identified as being infected with SARS-CoV-2 and 18,326 as SARS-CoV-2-negative controls, were eligible for analysis. No significant difference in incidence of MVM (odds ratio [OR]: 1.18, 95% confidence interval [CI]: 0.73–1.90), FVM (OR: 1.23, 95% CI: 0.63–2.42), MIR (OR: 0.66, 95% CI: 0.29–1.52) or FIR (OR: 0.85, 95% CI: 0.44–1.63), and CILs (OR: 0.97, 95% CI: 0.55–1.72) was found between placentae from gravida identified as being SARS-CoV-2 infected. However, placenta from gravida identified as being infected with SARS-CoV-2 were associated with significantly increased occurrence of PVFD (OR: 2.77, 95% CI: 1.06–7.27). After subgroup analyses based on clinical severity of COVID-19 infection, no significant difference was observed in terms of reported placental pathology between symptomatic or asymptomatic SARS-CoV-2 gravidae placenta. Current evidence based on the available literature suggests that the only pathologic finding in the placentae of women who are pregnant identified as having been infected with SARS-CoV-2 was an increased prevalence of PVFD.
Key Points
Histiocytic Sarcoma of Tibia: A Rare Case Report and Review of Literature
Authors: Kendre Ajita , Zade Bhooshan , Chandra Prasant 
Published: March 2022

Histiocytic sarcoma is a rare disorder and there has been a lot of confusion and debate regarding its diagnosis and treatment. The World Health Organization (WHO) in 2008 aided in the standardization of diagnosis of histiocytic sarcoma; however, the treatment protocols are still not clear and the treatment is on the line of other hematological malignancies.This study intends to report a rare case of histiocytic sarcoma and the treatment protocol used and analysis of available literature. The usual sites of histiocytic sarcoma are the lymphoreticular system, skin, and gastrointestinal tract, but solitary bone involvement is rare.This disease being a localized one was treated locally with surgical curettage followed by radical radiation therapy. Systemic therapy was not offered to this patient and has been reserved in case a patient gets a systemic recurrence as done in most cases of B cell lymphoma.Based on follow-up until now, the patient is disease-free and doing well. Thus, this treatment protocol appears apt for this concerned patient; however, there is a need for a large-scale analysis of various reported cases to establish a standardized treatment protocol for this rare and aggressive disease.
The HeartWare Ventricular Assist Device (HVAD): A Single Institutional 10-Year Experience
Authors: Morshuis Michiel , Schramm René , Gyoten Takayuki , Rojas Sebastian V. , Fox Henrik , Deutsch Marc-Andre , Ruiz-Cano Maria , Hakim-Meibodi Kavous , Gummert Jan F. 
Published: March 2022

Abstract
Objectives The aim of this study was to analyze our 10-year experience with the HVAD in a real-world scenario in a high-volume German heart center.
Methods We retrospectively analyzed outcomes of adults (≥18 years) with terminal heart failure (HF), who underwent HVAD implantation for durable LVAD therapy in our center between October 2009 and March 2020. Primary and secondary end points were all-cause death after implantation and LVAD-associated complications, respectively. We focused the distinct analyses on risk profiles at the time of implantation and implant strategies, i.e., bridge-to-transplant (BTT) or destination therapy (DT).
Results A total of 510 patients were included, with 229 and 281 individuals in Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) level 1 (45%) and 2 to 4, respectively. Median follow-up was 26 months (IQR: 5–54 months). Overall survival at 1, 3, and 5 years after HVAD implantation was 66% (95% CI; 61.7–70%), 49.4% (95% CI; 44.9–53.8%), and 37.4% (95% CI; 32.8–42%), not censored for LVAD exchange, LVAD explantation, or heart transplantation. INTERMACS level 1 and peri-operative temporary right heart assistance were independent risk factors for survival. Survival was best in BTT patients undergoing heart transplantation at any time during follow-up. The INTERMACS level at time of HVAD implantation did not affect survival after heart transplantation. Freedom from the combined end point of any device-associated severe complication and death was 44.5% (95% CI; 40–48.8%) at 1-year after implantation.
Conclusion The HVAD is a reliable pump for durable mechanical circulatory support even in high-risk patients. Still, heart transplantation outperforms durable MCS therapy for a superior long-term survival.
Larger Prior Tibial Tunnel Size Is Associated with Increased Failure Risk following Revision Anterior Cruciate Ligament Reconstruction
Authors: Leon Jacy , Flanigan David C. , Colatruglio Matthew , Ormseth Benjamin , Fitzpatrick Sean , Duerr Robert A. , Kaeding Christopher C. , Magnussen Robert A. 
Published: March 2022

AbstractWe hypothesize that larger prior tunnel size is associated with an increased risk of failure of single-stage revision anterior cruciate ligament reconstruction (ACLR) as defined by the performance of a re-revision (third) ACLR on the index knee. Retrospective review identified 244 patients who underwent single-stage revision ACLR at a single center with available preoperative radiographs. Patient and surgical factors were extracted by chart review. The maximum diameter of the tibial tunnel was measured on lateral radiographs and the maximum diameter of the femoral tunnel was measured on anteroposterior radiographs. Record review and follow-up phone calls were used to identify failure of the revision surgery as defined by re-revision ACLR on the index knee. One hundred and seventy-one patients (70%) were reviewed with a mean of 3.9 years follow-up. Overall, 23 patients (13.4%) underwent re-revision surgery. Mean tibial tunnel size was 12.6 ± 2.8 mm (range: 5.7–26.9 mm) and mean femoral tunnel size was 11.7 ± 2.8 mm (range: 6.0–23.0 mm). Re-revision risk increased with tibial tunnel size. Tibial tunnels 11 mm and under had a re-revision risk of 4.2%, while tunnels > 11 mm had a risk of 17.1% (relative risk: 4.1, p = 0.025). No significant association between femoral tunnel size and re-revision risk was noted. Patients with prior tibial tunnels > 11mm in diameter at revision surgery had significantly increased risk of re-revision ACLR. Further studies are needed to explore the relationship between prior tunnel size and outcomes of revision ACLR.
Telehealth Education via WeChat Improves the Quality of Life of Parents of Children with Type-1 Diabetes Mellitus
Authors: Huang Mei-Xia , Wang Mei-Chun , Wu Bi-Yu 
Published: March 2022

Abstract
Objective The purpose of this study was to explore the effect of telehealth education and care guidance via WeChat (Tencent Ltd., Shenzhen, China; a popular smartphone-based social media application) on improving the quality of life of parents of children with type-1 diabetes mellitus.
Methods A prospective randomized controlled study was conducted in our hospital from March 2019 to September 2020 to compare the quality of life of parents of children with type-1 diabetes mellitus in the intervention group and the control group.
Results Six months after discharge, the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) scores of parents in the intervention group were significantly lower than those in the control group (p < 0.05). Compared with the SAS and SDS scores at discharge time, those scores of parents at 6 months after discharge time in intervention group were significantly lower (p < 0.05), while those scores of parents at 6 months after discharge time in control was similar (p > 0.05). Six months after discharge, the scores of the physiological field, psychological field, social relationship field, and environmental field in the intervention group were significantly higher than those of the control group according to the result of the World Health Organization Quality of Life Brief Scale (WHOQOL-BREF; p < 0.05).
Conclusion Using WeChat to provide telehealth education and home care guidance to the parents of children with type-1 diabetes mellitus can effectively relieve the anxiety and depression of the parents and improve their quality of life.
Chronic Subdural Hematoma Caused by Calvarial and Dural Metastasis from Uterine Leiomyosarcoma
Authors: Soo Wai Tseung , Teo Eu Gene , Mohamad Noraini , Wong Albert Sii Hieng 
Published: March 2022

Abstract
Uterine Leiomyosarcoma (uLMS) is an aggressive tumor with poor clinical outcome. Skull and dural metastasis from uterine uLMS is exceptionally rare. We report a 60-year-old woman who had a 6 months' history of per vaginal bleed and abdominal pain who presented to us in a confused state and raised intracranial pressure symptoms with swelling over her right frontal-temporal region. She underwent excision of the right frontal-temporal tumor and evacuation of a right subdural hematoma (SDH), which greatly improved her condition. Postoperatively, she underwent adjuvant radiotherapy and chemotherapy. This case highlights the importance of clinical suspicion to diagnose patients with this rare metastasis to this region and the appropriate subsequent treatment. We herein report a rare case of metastatic uLMS with skull and dural metastasis that presented with SDH.
Increased Accuracy in Templating for Total Knee Arthroplasty Using 3D Models Generated from Radiographs
Authors: Klag Elizabeth A. , Lizzio Vincent A. , Charters Michael A. , Ayoola Ayooluwa S. , Wesemann Luke , Banka Trevor R. , North W. Trevor 
Published: March 2022

AbstractTemplating prior to total hip arthroplasty is a widely adopted practice that aims to improve operative efficiency and reduce clinical outliers. Predicting implant size before total knee arthroplasty (TKA), although less common, could increase operating room efficiency by reducing necessary equipment needed for the procedure. This study compared templating accuracy in TKA using two-dimensional (2D) digital radiographs to a novel imaging technology that generates a three-dimensional (3D) model from these 2D radiographs. Two hundred and two robotic-assisted primary TKA surgical cases using Persona Knee System (Zimmer Biomet, Warsaw, IN) were retrospectively analyzed. For all cases, 3D templating was completed preoperatively using a novel radiographic image acquisition protocol. Using the same radiographs, the knee was templated using a 2D digital templating program. All surgeons were blinded to the final implant sizes, and all templating was done independently. The accuracy of predictions within ± 1 from the final implant size was determined for the femoral and tibial components. The accuracy (within 1 size) of tibial size predictions was comparable between attending surgeons and residents (87 vs. 82%, p = 0.08), but attending surgeons more accurately predicted the femoral size (77 vs. 60%, p < 0.05). The 2D to 3D imaging technology more accurately predicted both tibial and femoral sizes compared with the attending surgeons (99.5 vs. 87%, p < 0.05; 84% vs. 77%, p < 0.05). However, the imaging technology, attending surgeons, and residents were all more likely to overestimate femur size (p < 0.05). Moreover, the 3D imaging technology predicted the exact tibial component size in 93.1% of cases, which was significantly greater compared with residents (40%, p < 0.01) and attending surgeons (53%, p < 0.01). The 2D to 3D imaging technology more accurately predicted tibial and femoral component sizes compared with 2D digital templating done by surgeons. All templating predictions were more accurate for the tibial implant size than for the femoral size. The increased accuracy of implant size predictions from this 3D templating technology has the potential to improve intraoperative efficiency and minimize costs and surgical time.
Wireless Telephones and Hearing Aids: An Overview
Authors: Ross Mark 
Published: March 2022

AbstractWireless telephones are becoming increasingly common and will be more so in the future. Unfortunately, many are unusable with hearing aids and may actively interfere with the normal use of hearing aids because of the electromagnetic interference (EMI) generated by wireless telephones. The EMI generated by digital wireless telephones is much greater than that of analog wireless telephones. More research and design work needs to be done before wireless telephones can be considered accessible to people who use hearing aids.
Abbreviations: CDMA = code division multiple access, EMI = electromagnetic interference, FCC = Federal Communications Commission, GSM = Global System for Mobile Communications, PCS = personal communication service, SHHH = Self Help for Hard of Hearing People, TDMA = time division multiple access
Possible Neuronal Refractory or Recovery Artifacts Associated with Recording the Mismatch Negativity Response
Authors: Walker Letitia J. , Carpenter Michael , Downs C. Renee , Cranford Jerry L. , Stuart Andrew , Pravica David 
Published: March 2022

AbstractThe mismatch negativity (MMN) is an event-related potential that involves a negative voltage shift of baseline electroencephalographic (EEG) activity in the approximate latency window of the N, and P2 cortical potentials in response to new or novel sounds. The MMN is present at birth and has been hypothesized to serve as an automatic preconscious detector of changes in the auditory environment. Research paradigms used to extract the MMN response from EEG activity have a potential problem related to neuronal refractoriness or recovery. Both N1 and P2 are known to increase in amplitude with longer interstimulus intervals (ISIs). The MMN extraction procedures involve mathematical subtraction of waveforms elicited by standard sounds (with short ISIs) from those recorded to rare deviant sounds (with longer ISIs). Any ISI-dependent amplitude changes in N, and/or P2 could therefore alter the morphology of the resulting difference wave and lead to misinterpretation of the nature of the underlying MMN generators. We tested 12 young females and found that the MMN can be influenced by ISI-dependent refractory effects that may modify the waveform morphology. This has important clinical implications since the MMN is being investigated as an assessment tool.
Abbreviations: ANOVA = analysis of variance, CNS = central nervous system, EEG = electroencephalographic, ERP = event-related potential, ISI = interstimulus interval, LAEP = late auditory evoked potential, MMN = mismatch negativity
Discretionary Grants and Distributive Politics: Evidence from Spain
Authors: Jarocinska Elena 
Published: March 2022

AbstractWe study empirically whether the allocation of discretionary grants across Spanish regions is related to the number of swing voters and loyal voters of the ruling party. We estimate the number of swing and loyal voters from survey data. When estimating the number of swing voters, we account in a novel way for the two-dimensional ideological space and multiparty competition. We find that regions with more loyal voters of the ruling party received more grants per capita. Partisan alignment of regional governments also matters over a part of the studied period since the regions where the socialist party of the central government was a member of the regional government received more grants.
Deforestation reduces fruit and vegetable consumption in rural Tanzania
Authors: Hall Charlotte M. , Rasmussen Laura Vang , Powell Bronwen , Dyngeland Cecilie , Jung Suhyun , Olesen Rasmus Skov 
Published: March 2022

Significance
Two billion people across the planet suffer from nutrient deficiencies. Dietary diversification is key to solving this problem, yet many food and nutrition security policies, especially in low- and middle-income countries, still focus on increasing agricultural production and access to sufficient calories as the main solution. But calories are not all equal. Here, we show how deforestation in Tanzania caused a reduction in fruit and vegetable consumption (of 14 g per person per day) and thus vitamin A adequacy of diets. Using a combination of regression and weighting analyses to generate quasi-experimental quantitative estimates of the impacts of deforestation on people’s food intake, our study establishes a causal link between deforestation and people’s dietary quality.