bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predicting Route of Delivery Using Quantification of Maternal Expulsive Efforts in the Second Stage of Labor
Authors: Lee Derek , Duong Lisa , Ross Michael G. 
Published: June 2022

OBJECTIVE:
To investigate the association between the number of pushing contractions and the likelihood of spontaneous vaginal delivery, operative vaginal delivery, cesarean delivery and maternal and neonatal complications.

METHODS:
This was a retrospective analysis of patients who entered the second stage of labor with singleton, term pregnancies at Harbor-UCLA Medical Center from January 1, 2017, to December 31, 2019. Probabilities of spontaneous vaginal delivery, operative vaginal delivery, and cesarean delivery were calculated for each hour of pushing and for every 10 maternal pushing contractions. Maternal and neonatal morbidities were assessed in relation to second-stage pushing contractions.

RESULTS:
Four hundred thirty-nine nulliparous and 424 multiparous patients who entered the second stage of labor were included. Nulliparous patients had significantly more pushing contractions than multiparous patients (20.3±1.8 vs 7.8±1.0 pushes, P<.001). In nulliparous patients, 91.8% (326/355 patients) of spontaneous vaginal deliveries and 50.0% (12/24 patients) of cesarean deliveries occurred by 40 pushing contractions. In multiparous patients, 94.3% (369/391) of spontaneous vaginal deliveries and 50.0% of cesarean deliveries (4/8) occurred by 20 pushing contractions. The probabilities of cesarean delivery were at their highest after 80 pushing contractions in nulliparous patients and after 50 pushing contractions in multiparous patients. In both nulliparous and multiparous patients, there was no significant change in maternal and neonatal composite morbidities as the number of pushing contractions increased.

CONCLUSION:
Results from this study suggest that pushing contractions may be a viable alternative method for prediction of the likelihood of spontaneous vaginal delivery and probabilities of operative vaginal delivery and cesarean delivery for patients reaching the second stage of labor. Providing patients with a goal for expected number of pushing contractions may be of motivational benefit.
Influence of height on ED95 of intrathecal 2-chloroprocaine for knee arthroscopy
Authors: Guntz Emmanuel , Jeanne Gaelle , Gouwy Jonathan , M’rini Mehdi , Saxena Sarah , Fils Jean-François , Kapessidou Yota 
Published: June 2022

BACKGROUND
Plain 2-chloroprocaine , a rapid acting amino-ester-type local anaesthetic, is used in short ambulatory procedures under spinal anaesthesia. The ED95 of 2-chloroprocaine for lower limb surgery has not yet been defined. Moreover, patients’ body height could influence the effects of the administered dose.

OBJECTIVES
The aim of this study was to determine the ED95 of plain 2-chloroprocaine based on the height of patients undergoing ambulatory knee arthroscopy under spinal anaesthesia using the continual reassessment statistical method (CRM).

DESIGN
Prospective, dose-response, double blind, controlled, bi-center, clinical trial.

SETTING
One university teaching hospital in Brussels and one general teaching hospital, Braine l’Alleud, Belgium. Université libre de Bruxelles,

PATIENTS
ASA I-III (120 patients) scheduled for day-case knee arthroscopy under spinal anaesthesia

INTERVENTIONS
Patients were divided into three groups of 40, each comprising 10 cohorts of 4 patients, according to their respective heights (Group 1: 150–165 cm, Group 2: 166–180 cm, Group 3: 181–195 cm). Each patient enrolled into one of the 3 groups received an intrathecal dose of plain 2-chloroprocaine determined by the CRM. The starting doses for the first cohorts of four were 40 mg in group 1, 45 mg in group 2 and 50 mg in group 3. The doses for subsequent cohorts were determined by CRM of outcomes in all patients in the previous competed cohorts. Anaesthesia was considered successful when there was a lack of pinprick or cold sensation up to T12, the visual analogue scale score for tourniquet pain was < 2 and no pain during surgery.

MAIN OUTCOMES
The primary outcome was the success or failure of the block. Side effects were also recorded.

RESULTS
ED95 of 2-chloroprocaine is 40 mg in group 1, 35 mg in group 2, 45 mg in group 3. Groups were different in terms of height and gender (P < 0.05) and similar in terms of body mass index and age (P > 0.05).

CONCLUSION
The ED95 of intrathecal 2-chloroprocaine for patients undergoing ambulatory knee arthroscopy is between 35 and 45 mg. Height could be a factor involved in the calculation, and patient sex could partly explain the nonlinear relation between height and dose.

TRIAL REGISTRY NUMBER
Clinicaltrials.gov NCT03882489.
Systematic detection of keratoconus in OCT: corneal and epithelial thickness maps
Authors: Yücekul Burcu , Dick H. Burkhard , Taneri Suphi 
Published: June 2022

Purpose:
To detect keratoconus (KC) only by analyzing the corneal and epithelial map parameters and patterns in optical coherence tomography (OCT).

Setting:
Tertiary care refractive surgery center.

Design:
Retrospective data collection.

Methods:
Corneal and epithelial thickness maps of normal, manifest, and subclinical keratoconic eyes (according to the Belin-Ambrosio display, Pentacam) were evaluated using spectral-domain OCT (Zeiss Cirrus 5000 HD). A new 2-step decision tree was developed based on previous studies with another OCT device. In the first step, if at least 1 of the 4 independent parameters (pachymetry minimum, pachymetry minimum-median, pachymetry superonasal-inferotemporal, and epithelial superonasal-inferotemporal) overruns the cutoff values, the eye was suspicious for KC. In the second step, if the epithelial map showed concentric thinning and the thinnest point of the cornea and epithelium is coincident, the eye was classified as keratoconic.

Results:
172 manifest keratoconic eyes (108 patients), 21 subclinical keratoconic eyes (20 patients), and 172 normal eyes (90 age-matched participants) were included in this study. Step 1 captured 100% of manifest and subclinical keratoconic eyes. Step 2 ruled out all suspicious but normal cases and, falsely, 2 subclinical keratoconic eyes. Our 2-step decision tree reached 100% specificity, 100% sensitivity in manifest KC, and 90.4% sensitivity in subclinical KC.

Conclusions:
Pachymetric and epithelial map parameters and patterns in OCT can be used in the diagnosis of KC, including subclinical cases, yielding a high level of agreement with the commonly used diagnostic reference, the Belin-Ambrosio display. Further improvements by refining our algorithm and including an automated evaluation in the software are desirable.
An Injustice to the Justice-Involved
Authors: Nguyen Monica , Mead Julia , St. Ivany Amanda 
Published: June 2022

ABSTRACT
Traumatic brain injury (TBI) is one of the leading causes of death and long-term disability among young adults worldwide and in the United States. TBIs are often associated with a high prevalence of morbidity, mortality, and other behavioral and cognitive problems. Several studies have shown that women living with TBIs have significantly higher odds of committing criminal acts, yet the impact of TBI on incarcerated women remains an underresearched area. By contrast, the effect of TBI on men is more prevalent in current literature, particularly relating to sports-related injuries. Given that an estimate of 80% of incarcerated women are mothers, we conducted a literature review in two phases focused on TBI in incarcerated mothers. The initial search of TBI in incarcerated mothers returned no results, so we proceeded in two phases. Phase 1 searched maternal outcomes of TBI, using the terms “maternal health” and “traumatic brain injury,” whereas Phase 2 searched “traumatic brain injury” and “incarcerated women.” Because so little information is available regarding TBI in incarcerated mothers, we used what we could find in these two phases to highlight the scarcity of knowledge about this population. This brief report addresses the knowledge gap that exists for incarcerated mothers living with TBI to encourage regular TBI screening to raise awareness and advocate for accommodated care. Correctional forensic nurses are perfectly placed to do TBI screening and to provide continuous rehabilitation after release to prevent reoffending.
Proprotein convertase subtilisin/kexin type 9 inhibition after acute coronary syndrome or prior myocardial infarction
Authors: Schwartz Gregory G. , Giugliano Robert P. 
Published: June 2022

Purpose of review
Lowering low-density lipoprotein cholesterol (LDL-C) with statins or ezetimibe reduces major adverse cardiovascular events (MACE) in patients with coronary heart disease. Additional treatment with proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors may lower LDL-C to levels not achievable with conventional lipid-lowering agents. This review summarizes findings from two large, placebo-controlled trials that evaluated the cardiovascular efficacy of monoclonal antibodies directed against PCSK9, added to background statin therapy, in patients with established atherosclerotic cardiovascular disease (ASCVD) or recent acute coronary syndrome (ACS) and persistent elevation of atherogenic lipoproteins despite statin treatment.

Recent findings
The FOURIER trial with evolocumab and the ODYSSEY OUTCOMES trial with alirocumab demonstrated 15% overall reductions in MACE compared to placebo, associated with average achieved LDL-C levels as low as 30–40 mg/dl. Alirocumab treatment was associated with fewer deaths after ACS. Subgroups with large absolute treatment benefit included those with baseline LDL-C ≥100 mg/dl, diabetes, polyvascular or peripheral artery disease, prior coronary bypass surgery, statin intolerance, or elevated lipoprotein(a) levels. No safety concerns arose with use of PCSK9 monoclonal antibodies, even in patients who achieved LDL-C levels below 20 mg/dl.

Summary
In selected patients with established ASCVD or recent ACS, PCSK9 inhibitors can play an important role in reducing the risk of MACE, and may also reduce the risk of death after ACS.
Practicing What We Preach: An Effort to Improve Safe Sleep of Hospitalized Infants
Authors: Salada Katherine O. , Arzu Jennifer , Unti Sharon M. , Tanz Robert R. , Badke Colleen M. 
Published: June 2022

Introduction:
To prevent sudden unexpected infant death, pediatric providers recommend the ABCs of infant sleep: Alone, on the Back, and in an empty Crib. This study’s objective was to document sleep practices of infants admitted to a large children’s hospital, examine adherence to American Academy of Pediatrics safe sleep guidelines, and develop interventions to improve guideline adherence.

Methods:
We conducted a pre/post quality improvement study at a single quaternary care medical center from 2015 to 2019. Infants 0 to younger than 12 months were observed in their sleeping environment pre- and post-implementation of multiple hospital-wide interventions to improve the sleep safety of hospitalized infants.

Results:
Only 1.3% of 221 infants observed preintervention met all ABCs of safe sleep; 10.6% of 237 infants met the ABCs of safe sleep postintervention. Significant improvements in the post-intervention cohort included sleeping in a crib (94% versus 80% preintervention; P < 0.001), avoidance of co-sleeping (3% versus 15% preintervention; P < 0.001), absence of supplies in the crib (58% versus 15% preintervention; P < 0.001), and presence of an empty crib (13% versus 2% preintervention; P < 0.001).

Conclusions:
Most infants hospitalized at our institution do not sleep in a safe environment. However, the implementation of a care bundle led to improvements in the sleep environment in the hospital. Further research is necessary to continue improving in-hospital safe sleep and to assess whether these practices impact the home sleep environment.
Improving Follow-Up Skeletal Survey Completion in Children with Suspected Nonaccidental Trauma
Authors: Ashraf Iram J. , Faivus Ackley Danielle , Razawich Kristin , Botash Ann , Schafer Melissa , Pekarsky Alicia 
Published: June 2022

Introduction:
The skeletal survey (SS) is used to evaluate and diagnose bone abnormalities, including fractures caused by child abuse. The American Academy of Pediatrics recommends initial SS for all children younger than 24 months old who are suspected victims of abuse and a follow-up skeletal survey (FUSS) 2 weeks later. The latter can further characterize abnormal or equivocal findings, detect ongoing trauma, or fractures too acute for visualization upon initial assessment.

Methods:
Preintervention review at our hospital for FUSS completion of children younger than 36 months old yielded a low 40% average monthly completion rate. We reviewed charts of children who underwent SS during the study period for FUSS completion. There were several barriers to FUSS completion, including lack of provider knowledge regarding FUSS importance, lack of an order for FUSS before hospital discharge, absent chart documentation regarding FUSS decision, loss to follow-up, and parental refusal. Interventions targeting the barriers included provider education, protocolizing FUSS scheduling, standardizing documentation, and community pediatrician outreach. The goal was to increase the average monthly FUSS completion rate from 40% to 90% over 1 year.

Results:
After interventions implementation, the average monthly FUSS completion rate rapidly increased from 40% to 80%. There was sustained improvement over the subsequent 12 months.

Conclusions:
Interventions were implemented sequentially, targeting barriers at various levels of workflow. Provider education was key and helped increase the reliability of intervention implementation. The most effective intervention was protocol change. This approach led to significant improvement in FUSS completion and sustained improvement.
Predictive Value of Different Computed Tomography Perfusion Software Regarding 90-Day Outcome of Acute Ischemic Stroke Patients After Endovascular Treatment: A Comparison With Magnetic Resonance Imaging
Authors: Li Ling , Jiang Yun , Wang Junjie , Chen Yuhui , Cao Ruoyao , Lu Yao , Wang Guoxuan , Chen Juan 
Published: June 2022

Objective
This study compared ischemic core and penumbra volumes obtained using different computed tomography perfusion (CTP) software and evaluated the predictive value of CTP and magnetic resonance imaging (MRI) results for 90-day outcomes.

Methods
In total, 105 acute ischemic stroke patients who underwent endovascular treatment from January 2016 to December 2020 were included. Patients were divided into good and poor outcome groups by a modified Rankin Scale score. Computed tomography perfusion core and penumbra volumes were obtained using OleaSphere and Vitrea software to assess the volumetric relationship with MRI using the Spearman correlation test, intraclass correlation coefficient (ICC), and Bland-Altman plot. Three multivariable models were developed: baseline variables with MRI infarct volume, baseline variables with OleaSphere core volume, and baseline variables with Vitrea core volume. The area under the receiver operating characteristic curve of the 3 models was compared using the DeLong test.

Results
Median core volumes were 27.5, 26.9, and 31.1 mL for OleaSphere, Vitrea, and MRI, respectively. There was substantial correlation and excellent agreement between OleaSphere and MRI core volume (ρ = 0.84, P < 0.001; ICC = 0.84) and Vitrea and MRI core volume (ρ = 0.80, P < 0.001; ICC = 0.83). The areas under curve for MRI volume, OleaSphere, and Vitrea were 0.86, 0.84, and 0.83, respectively. There were no significant differences (P = 0.18) between the predictive value of the 3 models.

Conclusions
Computed tomography perfusion core volumes showed substantial correlation and excellent agreement with MRI. There was no significant difference in the predictive value of the 3 models, suggesting that core volumes measured using CTP software can predict patient prognosis.
A Case of Infective Endocarditis Associated With Patent Ductus Arteriosus in Which PET/CT Was Useful for Diagnosis
Authors: Miyagami Taiju , Kushiro Seiko , Arikawa Mari , Murakami Koji , Naito Toshio 
Published: June 2022

Abstract
A 33-year-old woman presented to our hospital with a 4-month history of fever of unknown origin. Physical examination revealed a vascular murmur in the left subclavian region. Blood culture revealed bacteria and PET/CT revealed tracer accumulation in the patent ductus arteriosus area, leading to the diagnosis of infective endocarditis in this area. This case report may aid in diagnosing this disease in the future, as infective endocarditis in a patent ductus arteriosus is rare and difficult to diagnose.
Delayed [18F]-FDG PET Imaging Increases Diagnostic Performance and Reproducibility to Differentiate Recurrence of Brain Metastases From Radionecrosis
Authors: Otman Hosameldin , Farce Julien , Meneret Pierre , Palard-Novello Xavier , Le Reste Pierre-Jean , Lecouillard Isabelle , Vauleon Elodie , Chanchou Marion , Carsin Nicol Beatrice , Bertaux Marc , Devillers Anne , Mariano-Goulart Denis , Cachin Florent , Girard Antoine , Le Jeune Florence 
Published: June 2022

Purpose
Differentiating brain metastasis recurrence from radiation necrosis can be challenging during MRI follow-up after stereotactic radiotherapy. [18F]-FDG is the most available PET tracer, but standard images performed 30 to 60 minutes postinjection provide insufficient accuracy. We compared the diagnostic performance and interobserver agreement of [18F]-FDG PET with delayed images (4–5 hours postinjection) with the ones provided by standard and dual-time-point imaging.

Methods
Consecutive patients referred for brain [18F]-FDG PET after inconclusive MRI were retrospectively included between 2015 and 2020 in 3 centers. Two independent nuclear medicine physicians interpreted standard (visually), delayed (visually), and dual-time-point (semiquantitatively) images, respectively. Adjudication was applied in case of discrepancy. The final diagnosis was confirmed histologically or after 6 months of MRI follow-up. Areas under the receiver operating characteristic curves were pairwise compared.

Results
Forty-eight lesions from 46 patients were analyzed. Primary tumors were mostly located in the lungs (57%) and breast (23%). The median delay between radiotherapy and PET was 15.7 months. The final diagnosis was tumor recurrence in 24 of 48 lesions (50%), with histological confirmation in 19 of 48 lesions (40%). Delayed images provided a larger area under the receiver operating characteristic curve (0.88; 95% confidence interval [CI], 0.75–0.95) than both standard (0.69; 95% CI, 0.54–0.81; P = 0.0014) and dual-time-point imaging (0.77; 95% CI, 0.63–0.88; P = 0.045), respectively. Interobserver agreement was almost perfect with delayed images (κ = 0.83), whereas it was moderate with both standard (κ = 0.48) and dual-time-point images (κ = 0.61).

Conclusions
[18F]-FDG PET with delayed images is an accurate and reliable alternative to differentiate metastasis recurrence from radiation necrosis in case of inconclusive MRI after brain stereotactic radiotherapy.
Potential Utility of SPECT/CT for Early Detection of Spontaneous Osteonecrosis of the Knee
Authors: Yoo Min Young , Shin Young-Soo , Song Ok Kyu , Kim Bom Sahn , Kang Seo Young , Moon Byung Seok , Yoon Hai-Jeon 
Published: June 2022

Abstract
Spontaneous osteonecrosis of the knee (SONK) is the most common phenotype of osteonecrosis of knee joints in older adults. Early diagnosis with appropriate management is crucial for improving the prognosis of the SONK. We present SONK in bone scintigraphy and SPECT/CT in 65-year-old man with sudden worsening knee pain and normal radiographs. SPECT/CT revealed intense uptake in subchondral area of left femoral medial condyle, which can be differed from progressed osteoarthritic change of the knee joints suspected on planar scintigraphy. Subsequently performed MRI showed characteristic finding of SONK. Total knee replacement arthroplasty was performed with final histological diagnosis of SONK.
Differentiation of Reversible Hemichorea Due to Vitamin B12 Deficiency From Huntington Disease Via FDG PET
Authors: Schroeter Tabea , Gühne Falk , Schwab Matthias , Drescher Robert , Axer Hubertus 
Published: June 2022

Abstract
Vitamin B12 deficiency may present with diverse symptoms, complicating the differential diagnosis. Extrapyramidal movement disorders, for instance, are a rare manifestation of vitamin B12 deficiency. MRI of the brain frequently remains without conclusive findings. However, 18F-FDG PET/CT may reveal characteristic changes in the metabolism of the basal ganglia and thus contribute to an accurate diagnosis. We demonstrate the case of a woman with left-sided hemichoreatic movements due to vitamin B12 deficiency showing a contralateral putaminal hypermetabolism, which normalized after vitamin B12 supplementation, ruling out other deviating causes, particularly Huntington disease.
Iterative evolution of supergene-based social polymorphism in ants
Authors: Kay Tomas , Helleu Quentin , Keller Laurent 
Published: June 2022

Species commonly exhibit alternative morphs, with individual fate being determined during development by either genetic factors, environmental cues or a combination thereof. Ants offer an interesting case study because many species are polymorphic in their social structure. Some colonies contain one queen while others contain many queens. This variation in queen number is generally associated with a suite of phenotypic and life-history traits, including mode of colony founding, queen lifespan, queen–worker dimorphism and colony size. The basis of this social polymorphism has been studied in five ant lineages, and remarkably social morph seems to be determined by a supergene in all cases. These ‘social supergenes’ tend to be large, having formed through serial inversions, and to comprise hundreds of linked genes. They have persisted over long evolutionary timescales, in multiple lineages following speciation events, and have spread between closely related species via introgression. Their evolutionary dynamics are unusually complex, combining recessive lethality, spatially variable selection, selfish genetic elements and non-random mating. Here, we synthesize the five cases of supergene-based social polymorphism in ants, highlighting interesting commonalities, idiosyncrasies and implications for the evolution of polymorphisms in general.
This article is part of the theme issue ‘Genomic architecture of supergenes: causes and evolutionary consequences’.