bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety, Pharmacodynamic Response, and Treatment Satisfaction With OnabotulinumtoxinA 40 U, 60 U, and 80 U in Subjects With Moderate to Severe Dynamic Glabellar Lines
Authors: Joseph John H , Maas Corey , Palm Melanie D , Lain Edward , Glaser Dee Anna , Bruce Suzanne , Yoelin Steven , Cox Sue Ellen , Fagien Steven , Sangha Sara , Maltman John , Lei Xiaofang , Brin Mitchell F 
Published: June 2022

Abstract

Background
OnabotulinumtoxinA 20 U reduces glabellar line (GL) severity at maximum frown for approximately 3 to 4 months. Small studies have suggested that &gt;20-U doses may increase the efficacy and duration of response for GLs.

Objectives
The aim of this study was to evaluate safety, pharmacodynamic response, and treatment satisfaction with onabotulinumtoxinA doses ≥20 U for GLs.

Methods
This 48-week, double-blind study compared 40, 60, and 80 U onabotulinumtoxinA vs 20 U and placebo in women with moderate or severe dynamic GLs on the Allergan Facial Wrinkle Scale. The following parameters were evaluated: the percentage of subjects with investigator-assessed ≥1-grade Facial Wrinkle Scale improvement from baseline at maximum frown (responders) at Week 24; the estimated median duration of response; the proportion of mostly/very satisfied responders on the Facial Line Satisfaction Questionnaire follow-up Items 1 to 5; and treatment-emergent adverse events.

Results
The modified intent-to-treat population (N = 226) had a mean age of 48.0 years, with similar baseline GL severity between treatment groups. Week 24 responder rates were 0% for placebo and 16.0%, 32.0%, 30.6%, and 38.5% for onabotulinumtoxinA 20, 40, 60, and 80 U, with significant (P &lt; 0.05) differences for 40 and 80 U vs 20 U. Median duration of response was longer with all higher doses vs 20 U (≥24.0 vs 19.7 weeks; P &lt; 0.05 vs 20 U at Week 24). Facial Line Satisfaction Questionnaire results indicated high subject satisfaction. The incidence and severity of treatment-emergent adverse events did not exhibit a dose-response effect.

Conclusions
GL treatment with onabotulinumtoxinA doses &gt;20 U demonstrated longer duration of response and higher patient-reported satisfaction vs the on-label 20-U dose with no apparent impact on safety variables.

Level of Evidence: 2
Fat Grafting With Expanded Adipose-Derived Stromal Cells for Breast Augmentation: A Randomized Controlled Trial
Authors: Vester-Glowinski Peter V , Herly Mikkel , Ørholt Mathias , Rasmussen Bo S , Müller Felix C , Elberg Jens J , Thomsen Carsten , Drzewiecki Krzysztof T 
Published: June 2022

AbstractBackgroundThe main challenge with fat grafting is loss of some of the graft to postsurgery resorption. Previous studies suggest that adipose-derived stromal cells (ASCs) can improve the volume retention of fat grafts but there is a lack of randomized trials to support the use of ASCs in clinical practice.ObjectivesThis trial aimed to investigate whether ASCs improve fat graft volume retention in patients undergoing breast augmentation with lipofilling.MethodsThis was a double-blind, randomized controlled trial of breast augmentation with ASC-enriched fat grafting. Healthy women aged 30 to 45 years were enrolled. First, the participants underwent liposuction to obtain fat for culture expansion of ASCs. Then, the participants were randomly assigned to undergo a 300- to 350-mL breast augmentation with ASC-enriched fat grafting (10 × 106 ASCs/mL fat graft) to 1 of their breasts and placebo-enriched fat grafting of identical volume to the contralateral breast. The primary outcome was fat graft volume retention after a 1-year follow-up measured with MRI. The trial is registered at www.clinicaltrialsregister.eu (EudraCT-2014-000510-59).ResultsTen participants were included in the trial; all completed the treatment and follow-up. No serious adverse events occurred. Fat graft volume retention after 1 year was 54.0% (95% CI, 30.4%-77.6%) in the breasts treated with ASC-enriched fat grafting (n = 10) and 55.9% (95% CI, 28.9%-82.9%) in the contralateral breasts treated with placebo-enriched fat grafting (n = 10) (P = 0.566).ConclusionsThe findings of this trial do not support that ASC-enriched fat grafting is superior to standard fat grafting for breast augmentation.Level of Evidence: 2
Inhibition of citral nanoemulsion to growth, spoilage ability and AI-2/luxS quorum sensing system of Shewanella putrefaciens CN-32: a study on bacteriostasis from in vitro culture and gene expression analysis
Authors: Hu Zhiheng , Chin Yaoxian , Huang Jiayin , Zhou Jiaying , Li Gaoshang , Hu Yaqin , Yuan Chunhong , Chen Jianchu 
Published: June 2022

Abstract

Objectives
The bacteriostatic effects of a citral nanoemulsion against Shewanella putrefaciens CN-32 (SHP CN-32) were investigated using in vitro culture and gene expression analysis, for building a potential application in spoilage microorganism control and aquatic products quality maintenance.

Materials and Methods
SHP CN-32 was treated by prepared citral nanoemulsion when the minimal inhibitory concentration (MIC) was verified. The growth curve, membrane integrity, scanning electron microscope (SEM) observation, biofilm formation and quorum sensing (QS) signaling molecule AI-2 content were evaluated in different MIC treatment groups (0 to 1.00 MIC). The gene expression status of SHP CN-32 in 0 and 0.50 MIC groups were compared using transcriptome sequencing and quantitative polymerase chain reaction (PCR).

Results
The in vitro culture revealed that the citral nanoemulsion could inhibit the growth of SHP CN-32 with MIC of approximately 200 μg/mL. Images of membrane integrity, SEM and biofilm formation suggested significant biological structure damage in bacteria after treatment. Meanwhile, the QS signaling molecule AI-2 content showed a decline with increasing treatment concentration. Transcriptome sequencing and quantitative PCR revealed that the majority genes related diversified functional metabolic pathways of SHP CN-32 were downregulated at varying degree.

Conclusion
A significant bacteriostasis of citral nanoemulsion against SHP CN-32 was verified via the results of growth inhibition, structural destruction, signal molecular decrease and gene expression downregulation of strains. These synergies significantly affect the characteristic expression of SHP CN-32, revealing the application potential as bacteriostat, QS inhibitor and preservative in aquatic products.
RISE: A Conceptual Model of Integrated and Restorative Elder Abuse Intervention
Authors: Burnes David , Connolly Marie-Therese , Salvo Erin , Kimball Patricia F , Rogers Geoff , Lewis Stuart 
Published: June 2022

Abstract
Despite a growing number of elder abuse (EA) cases nationwide, response programs such as adult protective services (APS) lack a defined, prolonged intervention phase to address these complex situations. This article presents RISE, a model of EA intervention that works alongside APS or other systems that interact with at-risk older adults. Informed by an ecological-systems perspective and adapting evidence-based modalities from other fields (including motivational interviewing, teaming, restorative justice, and goal attainment scaling), the RISE model intervenes at levels of the individual older adult victim, individual harmer, their relationship, and community to address EA risk and strengthen systems of support surrounding the victim-harmer dyad. The RISE model addresses an intervention gap in existing systems to better meet the needs of EA victims and others in their lives, leading to more sustainable outcomes.
A Decade of GigaScience: The Challenges of Gigapixel Pathology Images
Authors: Litjens Geert , Ciompi Francesco , van der Laak Jeroen 
Published: June 2022

Abstract
In the last decade, the field of computational pathology has advanced at a rapid pace because of the availability of deep neural networks, which achieved their first successes in computer vision tasks in 2012. An important driver for the progress of the field were public competitions, so called ‘Grand Challenges’, in which increasingly large data sets were offered to the public to solve clinically relevant tasks. Going from the first Pathology challenges, which had data obtained from 23 patients, to current challenges sharing data of thousands of patients, performance of developed deep learning solutions has reached (and sometimes surpassed) the level of experienced pathologists for specific tasks. We expect future challenges to broaden the horizon, for instance by combining data from radiology, pathology and tumor genetics, and to extract prognostic and predictive information independent of currently used grading schemes.
Stop Suffering! Economic Downturns and Pentecostal Upsurge
Authors: Costa Francisco , Marcantonio Angelo , Rocha Rudi 
Published: June 2022

AbstractThis paper estimates the effects of economic downturns on the expansion of Pentecostal Evangelicalism in Brazil. Regions more exposed to economic distress experienced a persistent rise both in Pentecostal affiliation and in the vote share of candidates connected to Pentecostal churches in national legislative elections. Once elected, these politicians carry out an agenda with greater emphasis on issues that are sensitive to fundamental religious principles. We, therefore, find that recessions led to the rise of religious fundamentalism in tandem with the transfer of political capital to elected Pentecostal leaders.
Effect of Baseline Simple Ovarian Cyst on Ovulation Induction/Intrauterine Insemination Cycle Outcomes [A326]
Authors: Bethel Karen , Warwar Rachel , Thakore Suruchi , Hurley Emily 
Published: June 2022

INTRODUCTION:
A simple ovarian cyst at baseline ultrasound for ovulation induction/intrauterine insemination (OI/IUI) is a finding of unclear clinical significance, and its effect on achieving pregnancy remains undetermined. Establishing the effects of a baseline ovarian cyst(s) is necessary to optimize OI/IUI cycle outcomes.

METHODS:
A retrospective cohort analysis of OI/IUI cycles from 2011-2021 at the UC Health Center for Reproductive Health was performed with institutional review board approval. The exposure variable was a simple appearing ovarian cyst(s) diagnosed at baseline ultrasound measuring >10 mm with estradiol level <75 ng/ml. The primary outcome analyzed was an ultrasound-confirmed intrauterine pregnancy. Secondary outcomes included positive pregnancy test and live birth. STATA was used to perform unpaired t-tests for continuous variables, Chi-square tests for dichotomous variables and a generalized linear model for regression analysis.

RESULTS:
A total of 161 cycles with inactive cysts were compared to 300 control cycles. Polycystic ovarian syndrome was more common in the control group and diminished ovarian reserve was more common in the baseline cyst group. Other specific diagnoses were similar between groups. The clinical pregnancy rate was higher in cycles without a baseline cyst compared to those with a cyst present, (15% vs. 9.3%, RR 0.63 [0.36–1.1]). After adjusting for body mass index and age, cycles with baseline cyst(s) were 35% less likely to result in a clinical pregnancy (adjusted RR=0.65 [0.37–1.1]).

CONCLUSION:
A baseline ovarian cyst is associated with a lower clinical pregnancy rate in OI/IUI cycles. This finding is clinically significant and patients should be counseled accordingly.
The Impact of Mandated Insurance Coverage on Early Care Discontinuation in Assisted Reproductive Technology [A329]
Authors: Lee Jacqueline C. , DeSantis Carol E. , Yartel Anthony K. , Kissin Dmitry M. , Kawwass Jennifer 
Published: June 2022

INTRODUCTION:
Given the high cost of assisted reproductive technology (ART) in the United States, we assessed the association between state-mandated insurance coverage for fertility services with rates of care discontinuation after an initial ART cycle that did not result in a live birth.

METHODS:
This retrospective cohort study using data from the National ART Surveillance System included patients who began their first autologous ART cycle between 2016-2017 and did not have a live birth. Patients were divided into those that continued and discontinued ART care within 12 months. Multivariable analyses were conducted to evaluate factors associated with discontinuation, including categories of state-mandated insurance coverage. Institutional review board approval was obtained.

RESULTS:
Among 91,234 patients who underwent their first autologous ART cycle that did not result in live birth, 24,072 (26%) discontinued care. Compared to patients who lived in states with comprehensive mandated insurance coverage (≥3 ART cycles), states with mandated insurance coverage excluding ART, or states with no mandated insurance coverage, were 46% (adjusted relative risk [aRR] 1.46; 95% CI, 1.31–1.63) and 26% (aRR 1.26; 95% CI, 1.15–1.39) more likely to discontinue care, respectively, after controlling for patient and cycle characteristics. Increasing patient age, distance from clinic >50 miles, prior live birth, fewer oocytes retrieved, and not having embryos cryopreserved were also associated with higher rates of discontinuation. Non-Hispanic Black, non-Hispanic Asian, and Hispanic patients had higher rates of care discontinuation compared to non-Hispanic White patients for any insurance coverage level.

CONCLUSION:
Comprehensive mandated insurance coverage for ART is associated with lower rates of ART care discontinuation.
Differences in Congenital Anomalies in In-Vitro Fertilization (IVF) Versus Non-IVF Dichorionic-Diamniotic Twin Pregnancies [A333]
Authors: Schwartz Hannah , McCabe Meaghan G. , Koelper Nathanael C. , Dugoff Lorraine 
Published: June 2022

INTRODUCTION:
The aim of this study was to evaluate the incidence of congenital anomalies in dichorionic-diamniotic twins conceived with in-vitro fertilization (IVF) versus non-IVF in a large geographically diverse population.

METHODS:
This is a secondary analysis of data from a retrospective cohort study of twin pregnancies seen at 17 centers between 12/2011-2/2020. Institutional review board approval was obtained. Monochorionic, vanishing twins, triplets, and cases with chromosomal abnormalities or incomplete follow-up were excluded. Neonates with an abnormal newborn exam were evaluated for having a major or minor congenital anomaly, and anomalies were further classified by organ system (cardiac, renal/genitourinary, gastrointestinal, and musculoskeletal). Chi-squared, Fisher’s exact tests, and multivariate logistic regression were used.

RESULTS:
Of the 1,112 dichorionic-diamniotic twin pregnancies included, 523 (47.0%) were conceived with IVF and 589 (53.0%) were conceived spontaneously or with other assisted reproductive technology (ART). Congenital anomalies were found in 91 pregnancies (8.18%). Of those, 42 were found in IVF pregnancies (8.03%) versus 49 non-IVF pregnancies (8.32%; P=.86). There were no significant differences between IVF and non-IVF for major anomalies (P=.57) or minor anomalies (P=.62). There was no significant difference between IVF and non-IVF pregnancies when classifying anomalies by system, and this held true when adjusting for maternal age, race, BMI, and parity.

CONCLUSION:
In this large cohort of twin pregnancies, there is no significant difference in the incidence of anomalies for pregnancies conceived by IVF versus non-IVF. Given that previous data has shown increased incidence of congenital heart defects in IVF pregnancies, this should be further evaluated specifically in dichorionic-diamniotic twin pregnancies.
Developmental Expression of Bone Morphogenetic Protein 2 (BMP2)-Induced Genes in Fetal Mouse Ovaries [A335]
Authors: Anderson Rebecca L. , Chakraborty Prabuddha , Roy Shyamal 
Published: June 2022

INTRODUCTION:
Granulosa cells (GCs) and oocytes assemble to form the primordial follicle (PF) reserve. Reduced PF reserve results in consequential infertility and menopause-related disorders. Ovarian transcriptome analysis was done to understand the mechanism of bone morphogenetic proteins (BMPs) or estradiol-17β (E2)induced PF formation.

METHODS:
RNA from fetal (E16-E19) and postnatal (P1 and P2) mouse ovaries and E16 ovaries cultured with or without BMP2 or E2 for 24 hours were analyzed by RNA sequencing and bioinformatics. In vivo and in vitro expression of selected candidate genes and spatio-temporal expression of corresponding proteins were examined using real-time quantitative reverse transcription polymerase chain reaction (RT-qPCR) and immunofluorescence localization, respectively.

RESULTS:
Remarkable increases in Gata2, Gata4, Egr2 and Hepsin mRNA were evident on E18 (one day prior to PF formation). Protein immunosignal was present in somatic cells (SC) but the intensity was higher in GCs on E18 through P1. BMP2 or E2 upregulated gene expression in vivo and in vitro; however, the effect of E2 was less for Gata4 and Egr2. BMP2 significantly upregulated all proteins in GCs, whereas E2 upregulated GATA2 and HEPSIN proteins in SCs as well.

CONCLUSION:
In summary, Gata2, Gata4, Egr2 and Hepsin mRNA levels increase around PF formation. Correspondingly, intensities of immunosignal increase in differentiating GCs. BMP2 or E2 may induce differentiation of ovarian SCs into GCs by cell-specific activation of Gata2, Gata4 and/or Egr2. Hepsin, a serine proteinase, may participate in ovary remodeling. We conclude that BMP2-induced GATA2, GATA4, EGR2 and Hepsin may regulate SC to GC transition, leading to the formation of PFs.
Cardiac Arrest Management in Pregnancy: Review of Team Performance in High-Fidelity Simulations [A337]
Authors: Buttle Rae A. , Detlefs Sarah , Crump Cade , Goffman Dena , Foley Michael R. , Deering Shad 
Published: June 2022

INTRODUCTION:
Management of cardiac arrest during pregnancy has several unique components when compared to resuscitation of non-pregnant patients. These interventions are not emphasized in current national training courses but are critical to optimizing outcomes for the mother and fetus. The objective of the current study was to evaluate team performance during high-fidelity maternal cardiac arrest simulations to identify areas of focus for future training.

METHODS:
At a national course, multidisciplinary teams participated in high-fidelity simulation cases of obstetric emergencies to include maternal cardiac arrest. Critical actions were determined by review of evidence-based recommendations for care. Trained facilitators completed standardized checklist assessments for each team’s performance, with each action documented as “not done”, “poorly done”, or “well done”. Descriptive statistics for all elements of performance were evaluated. The study was reviewed and determined to be exempt by the hospital institutional review board.

RESULTS:
One hundred thirty multidisciplinary teams with complete data participated in simulations from 2014-2019. Less than two-thirds of teams were rated “well done” for standard resuscitation skills such as airway management, defibrillation, and chest compressions. Pregnancy specific modifications, such as left uterine displacement, was rated as “poorly done” or “not done” by 23.8% of teams.

CONCLUSION:
Overall resuscitation skills by teams during high-fidelity simulations were suboptimal for both routine and pregnancy-specific interventions. This cohort of providers routinely care for pregnant women, so we expect that other providers may be even less familiar with these interventions and suggest there is a gap in education and training that needs to be addressed.
Maternal Race and Ethnicity and Risk of Cesarean Delivery in Large for Gestational Age Pregnancies [A343]
Authors: Gould Alexander J. , Esposito Matthew A. , Lord Megan G. 
Published: June 2022

INTRODUCTION:
To compare the rate of Cesarean delivery in pregnancies complicated by large for gestational age (LGA) fetuses in non-Hispanic White (NHW) patients to patients who identified as non-White and/or Hispanic.

METHODS:
This secondary analysis of a large institutional review board-approved retrospective cohort study included deliveries of live singleton fetuses at a tertiary-care hospital from 2007-2019. Deliveries of LGA fetuses, defined by an estimated fetal weight at 90th percentile or greater for gestational age on third trimester ultrasound, were identified and maternal characteristics and mode of delivery extracted. The primary outcome was Cesarean delivery for any indication.

RESULTS:
Of 3,593 eligible patients, 1,314 self-identified as NHW and 1,913 as non-White and/or Hispanic. NHW patients were older, taller, more likely to have type 1 diabetes and/or commercial insurance, and less likely to have gestational diabetes (P<.01 for all). Rates of type 2 diabetes were similar between groups (P=0.41). Overall, 48.1% of LGA pregnancies delivered by Cesarean, with a higher rate of Cesarean among NHW patients (50.88% vs. 45.32%; relative risk [RR] 1.11; 95% CI, 1.05–1.18). This relationship persisted after adjusting for differences in maternal age (adjusted RR [aRR] 1.10; 95% CI, 1.03–1.17), height (aRR 1.16; 95% CI, 1.07–1.26), payor status (aRR 1.08; 95% CI, 1.003–1.16]), and prevalence of diabetes (aRR 1.13; 95% CI, 1.05–1.22]) between groups.

CONCLUSION:
Among LGA pregnancies, NHW patients were more likely to undergo Cesarean delivery than patients who identified as non-White and/or Hispanic. This stands in contrast to existing data showing that NHW patients are less likely to deliver by Cesarean overall.
A Clinical–Community Partnership to Improve Home Visiting Referrals and Engagement [A298]
Authors: Backus-Walzer Michelle , Gorby Jammie , Peterman Jennifer , Boughey Shauna , VanderMuelen Peggy , Raffo Jennifer E. 
Published: June 2022

INTRODUCTION:
A Michigan integrated health system used clinical–community partnerships to promote health equity and improve population health by increasing referrals and participation in a Medicaid-sponsored enhanced prenatal care (EPC) home visiting program. The statewide program is federally designated and evidence based for reducing the risk for adverse birth outcomes, with a quarter of eligible women enrolled. The objective of this study was to explore early implementation of a quality-improvement initiative to increase EPC referral and enrollment in 16 obstetrics and gynecology practices in eight counties.

METHODS:
The strategies used were dashboard tracking, shared goals, engagement of OB nurse educators/social workers, and electronic medical records. Referrals and enrollments were tracked from January 1, 2021 to September 30, 2021 in nine obstetrics and gynecology practices, with the goal of referring all Medicaid-insured women and enrolling 50% of eligible referrals, especially women of color at greater risk, to the health system's internal EPC program. From June 1, 2021 to September 30, 2021, seven practices in six counties linked to external health department EPC programs and targeted a 50% referral rate.

RESULTS:
Overall, practices connected to internal EPC services achieved the 50% enrollment target (1,247 referrals, 744 eligible [60%], with 394 enrolled [53%]). Enrollment ranged from 24% to 62% by site; of these, 49.5% of participants were women of color. Practices connected to external EPC programs achieved a 51% referral rate (568 eligible, 289 referrals).

CONCLUSION:
The health system increased referral and enrollment of Medicaid-insured pregnant women, many of whom were women of color, into prenatal home visiting. Clinical–community linkages, aligned with Alliance for Innovation on Maternal Health Community Care Initiative goals, can help practices address equity in maternal morbidity and mortality.