bluuebunny/crossref_metadata_2025_split huggingface dataset:
Point-of-Care Lung Ultrasound Pattern in Healthy Parturients: Prevalence of Pulmonary Interstitial Syndrome Following Vaginal Delivery, Elective and Unplanned Intrapartum Cesarean Delivery
Authors: Macias P. , Wilson J.G. , Austin N.S. , Guo N. , Carvalho B. , Ortner C.M. 
Published: March 2022

(Anesth Analg. 2021;133:739–746. doi: 10.1213/ANE.0000000000005464)
The risk of pulmonary edema for parturient women increases near term, and factors during and post labor lead to even greater risk of pulmonary edema in the early postpartum period. Lung ultrasound (LUS) is a tool that helps to diagnose pulmonary edema earlier. Data on the effect of labor and early postpartum fluid shifts and hormonal changes on the occurrence of pulmonary interstitial syndrome is unknown. This exploratory study seeks to estimate the prevalence of pulmonary interstitial syndrome following vaginal delivery (VD), elective cesarean delivery (eCD), and unplanned intrapartum cesarean delivery (uCD). Secondary aims of the study include finding associations between positive lung regions found on lung ultrasound and several variables (eg, mode of delivery, duration) and estimating the prevalence of positive lung regions.
Major Adverse Cardiovascular Events and Anaesthetic Management in Pregnant Women in Cardiac Disease: A Retrospective, Single-center Study
Authors: Roue M. , Lung B. , Bourgeois-Moine A. , Montravers P. , Kantor E. 
Published: March 2022

(Br J Anaesth. 2021;127:e8–e10. doi: 10.1016/j.bja.2021.03.032. Epub May 7, 2021)
Pregnancies in women with cardiac disease are on the rise in Western countries, in part due to older maternal ages, an increase in cardiovascular risk factors, and advances in care for patients with congenital heart disease. Cardiovascular disease is associated with increased risk of maternal morbidity and mortality. Cardiovascular issues are the leading cause of maternal death during pregnancy in the United States, representing more than a quarter of cases. Managing care for pregnant patients with cardiovascular disease or cardiovascular physiological adaptations in pregnancy can be challenging for anesthesiologists, and there are few recent data to guide them.
Cardiovascular Severe Maternal Morbidity in Pregnant and Postpartum Women: Development and Internal Validation of Risk Prediction Models
Authors: Malhamé I. , Danilack V.A. , Raker C.A. , Hardy E.J. , Spalding H. , Bouvier B.A. , Hurlburt H. , Vrees R. , Savitz D.A. , Mehta N. 
Published: March 2022

(BJOG. 2021;128:922–932. doi: 10.1111/1471-0528.16512. Epub November 4, 2020)
Cardiovascular diseases are a leading cause of maternal mortality. Severe maternal morbidity can drastically reduce quality of life, increase hospital lengths of stay, adversely impact finances, and lead to maternal mortality. Thus, it is critical to identify women at high risk for cardiovascular severe maternal morbidity (CSMM) during pregnancy and postpartum and develop strategies to mitigate its adverse effects. This study aims to create and validate risk prediction models so high-risk women can be more accurately identified.
Pregnancy-specific Continuous Reference Intervals for Haematology Parameters from an Australian Dataset: A Step Toward Dynamic Continuous Reference Intervals
Authors: Markus C. , Flores C. , Saxon B. , Osborn K. 
Published: March 2022

(Aust N Z J Obstet Gynaecol. 2021;61:223–231)
Reference intervals (RIs) in pregnancy are usually only reported in terms of trimesters or for specific weeks gestational age. RIs are also usually treated in a static manner, while pediatric growth charts and now fetal growth charts use smoothed centile curves to detect growth issues. This study aimed to derive continuous centile curves for 6 hematological parameters in pregnancy and compare the indirect RIs from those curves to previously published direct RIs.
How Collaborative Position Paper on the Management of Thrombocytopenia in Pregnancy
Authors: Eslick R. , Cutts B. , Merriman E. , McLintock C. , McDonnell N. , Shand A. , Clarke L. , Ng S. , Kando I. , Curnow J. 
Published: March 2022

(Aust N Z J Obstet Gynaecol. 2021;61:195–204)
Up to one in 10 pregnant women develop thrombocytopenia (TCP) defined as a platelet (PLT) count of <150×109/L. More severe TCP with PLT <100×109/L, affect 1-2% of pregnant patients, and may increase risk of postpartum hemorrhage (PPH). There are no randomized trials studying this issue and clinicians must use retrospective reviews and guidelines for decision making. This paper by members of the Haematology in Obstetrics and Women’s Health (HOW) Collaborative provides evidence-based guidelines for the management of TCP in Australia and New Zealand. Following independent literature review, all authors reached consensus on the final version. The recommendations are National Health and Medical Research Council grade C as there is a lack of high-quality evidence.
The Risk of Complications in Second Pregnancy by Maternal BMI: The Role of First-pregnancy Complications, Pregestational Diabetes and Chronic Hypertension
Authors: Sormunen-Harju H. , Koivusalo S. , Gissler M. , Metsälä J. 
Published: March 2022

(Acta Obstet Gynecol Scand. 2021;100:489–496. doi: 10.1111/aogs.14028. Epub November 2, 2020)
Obesity, increased pregnancy body mass index (BMI), and past pregnancy complications are associated with future pregnancy complications and adverse short- and long-term maternal and neonatal outcomes. Gestational diabetes (GDM), gestational hypertension (GH), and preeclampsia (PE) are common pregnancy-associated complications. Recurrence of these complications increases when pregestational DM and/or chronic hypertension (cHTN) are present, though little research has been done on how adiposity and prior-pregnancy complications impact the risk of second-pregnancy complications. This study analyzes how complications in the first pregnancy and chronic conditions impact subsequent pregnancy complications and the role of maternal BMI.
Randomized Trial of Fetal Surgery for Moderate Left Diaphragmatic Hernia
Authors: Deprest J.A. , Benachi A. , Gratacos E. , Nicolaides K. , Berg C. , Persico N. , Belfort M. , Gardener G.J. , Ville Y. , Johnson A. , Morini F. , Wielgoś M. , Van Calster B. , DeKoninck P.L.J. 
Published: March 2022

(N Engl J Med. 2021;385:119–129)
Congenital diaphragmatic hernia (CDH) can lead to pulmonary hypoplasia and is associated with serious neonatal complications and death. In infants with severe left diaphragmatic hernia, fetoscopic endoluminal tracheal occlusion (FETO) has been associated with greater survival rates but also higher rates of premature birth. This study aimed to determine the effects of FETO on pregnancies affected by moderate CDH compared with expectant prenatal care.
Difficulty in Advancing Flexible Epidural Catheters When Establishing Labor Analgesia: An Observational Open-label Randomized Trial
Authors: Pancaro C. , Purtell J. , LaBuda D. , Saager L. , Klumpner T.T. , Dubovoy T. , Rajala B. , Singh S. , Cassidy R. , Vahabzadeh C. , Maxwell S. , Manica V. , Eckmann D.M. , Mhyre J.M. , Engoren M.C. 
Published: March 2022

(Anesth Analg. 2021;133:151–159. doi: 10.1213/ANE.0000000000005526)
Flexible epidural catheters have a lower incidence of both paresthesias and intravascular catheter placement. This study aimed to compare and analyze the efficacy of 2 commercially available epidural kits: kit “A” (single-end hole wire-reinforced polyurethane epidural catheter; n=135) and kit “B” (multi-orifice wire-reinforced polyamide nylon blend epidural catheter; n=122).
Temporal Trends in the Incidence of Postdural Puncture Headache Following Labor Neuraxial Analgesia in the United States, 2006-2015
Authors: Guglielminotti J. , Landau R. , Ing C. , Li G. 
Published: March 2022

(Int J Obstet Anesth. 2021;45:90–98)
Postdural puncture headache (PDPH) following neuraxial analgesia for labor is associated with several adverse postpartum outcomes including delayed discharge, persistent backache and neurological complications. Thankfully, over the past 2 decades, anesthesia care has improved and anesthesia-related complications have declined. This study examined the temporal trends in the incidence of PDPH following neuraxial analgesia procedures in the United States from 2006 to 2015.
Epidural Analgesia, Intrapartum Hyperthermia, and Neonatal Brain Injury: A Systematic Review and Meta-Analysis
Authors: Morton S. , Kua J. , Mullington C.J. 
Published: March 2022

(Br J Anaesth. 2021;126:500–515)
Neonatal brain injury, a spectrum of diseases including neonatal encephalopathy and cerebral palsy, is caused by a number of factors. Intrapartum hypoxia and chorioamnionitis have both been associated with cerebral palsy. Evidence also suggests that epidural analgesia (EA) is associated with an increased risk of intrapartum hyperthermia. However, previous systematic reviews have shown that EA does not increase the risk of intrapartum infection, suggesting that epidural analgesia is a distinct condition. Growing evidence linking intrapartum hyperthermia and neonatal brain injury and recognizing epidural analgesia as a distinct condition has raised questions of whether EA is an independent risk factor of neonatal brain injury. This systematic review and meta-analysis was conducted to determine (1) if epidural analgesia is a cause of intrapartum hyperthermia, (2) if intrapartum hyperthermia is associated with neonatal brain injury and (3) if epidural analgesia is associated with neonatal brain injury.
Effect of Preoperative Oral Carbohydrate Loading on Body Temperature During Combined Spinal-epidural Anesthesia for Elective Cesarean Delivery
Authors: Yang C. , Cheng Y. , Liu S. , Huang S. , Yu X. 
Published: March 2022

(Anesth Analg. 2021;133:731–738. doi: 10.1213/ANE.0000000000005447)
Hypothermia is common after neuraxial blockade during cesarean delivery (36% to 85%). Preoperative oral carbohydrate loading has been shown to mitigate this complication. This objective of this study was to assess the impact of preoperative oral carbohydrate loading on body temperature during elective cesarean delivery under combined spinal-epidural anesthesia (CSEA).
Maternal and Fetal Anaesthesia for Fetal Surgery
Authors: Dick J.R. , Wimalasundera R. , Nandi R. 
Published: March 2022

(Anaesthesia. 2021;76(suppl 4):63–68)
Over the past 3 decades, great advances have been made in fetal surgery. While many procedures require only local anesthesia, additional maternal and/or fetal anesthesia can be needed. Multidisciplinary planning is needed to ensure success in these procedures. This article reviews three fetal surgical procedures and the anesthetic considerations for each.
Whole-Person Development of Undergraduate Nursing Students: A Multi-University Study
Authors: Cruz Jonas Preposi , Alquwez Nahed , Alshammari Farhan , Alabdulaziz Hawa , Alsharari Abdalkarem F. , Alqahtani Friyal Mubarak , Tork Hanan M. M. , Almazan Joseph U. 
Published: March 2022

Abstract

AIM
This study examines how nursing students in Saudi Arabia view their holistic development during university study and the association between their perceptions and academic performance.

BACKGROUND
Holistic nursing education fosters broad development and emphasizes students’ cognitive, emotional, social, physical, and spiritual potentials.

METHOD
This descriptive and correlational study utilizes the Whole Person Development Inventory to collect data from 998 student nurses enrolled in six governmental universities in Saudi Arabia.

RESULTS
The professional dimension recorded the highest mean, followed by the intellectual, spiritual, physical, and psychological dimensions. The social dimension received the lowest overall mean. Intellectual, psychological, social, and spiritual development has an association with high academic performance.

CONCLUSION
This study encourages policymakers and various stakeholders concerned with nursing education in the country and worldwide to be intentional and systematic in adapting the whole-person development approach in nursing education.
The Affordable Care Act and its Effects on Trauma Care Access, Short- and Long-term Outcomes and Financial Impact
Authors: Newsome Kevin , Autrey Cody , Sen-Crowe Brendon , Ang Darwin , Elkbuli Adel 
Published: March 2022

Objective:
The purpose of this study is to evaluate the current evidence regarding the impact of the ACA on trauma outcomes and the financial impact on trauma patients and trauma systems.

Background:
Traumatic injuries are the leading cause of death and disability between the ages of 1 to 47 years. Uninsured status has been associated with worse outcomes and higher financial strain. The Affordable Care Act (ACA) was signed into law with the aim of increasing health insurance coverage. Despite improvements in insured status, it is unclear how the ACA has affected trauma.

Methods:
We conducted a literature search using PubMed and Google Scholar for peer-reviewed studies investigating the impact of the ACA on trauma published between January 2017 and April 2021.

Results:
Our search identified 20 studies that evaluated the impact of ACA implementation on trauma. The evidence suggests ACA implementation has been associated with increased postacute care access but not significant changes in trauma mortality. ACA implementation has been associated with a decreased likelihood of catastrophic health expenditures for trauma patients. ACA was also associated with an increase in overall reimbursement and amount billed for trauma visits, but a decrease in Medicaid reimbursement.

Conclusions:
Some improvements on the financial impact of ACA implementation on trauma patients and trauma systems have been shown, but studies are limited by methods of calculating costs and by inconsistent pre-/post-ACA timeframes. Further studies on cost-effectiveness and cost-benefit analysis will need to be conducted to definitively determine the impact of ACA on trauma.
Treatment of Critical-Sized Bone Defects Involving the Ankle Joints: Staged Tibiotalocalcaneal Arthrodesis With Induced Membrane Technique and Intramedullary Nail
Authors: Choi Wonseok , Park Kyeong-Hyeon , Oh Chang-Wug , Kim Joon-Woo , Son Whee Sung , Cho Jae-Woo , Abdel-Baki Sharkawy Wagih , Oh Jong-Keon 
Published: March 2022

Objectives:
To report the outcomes of staged tibiotalocalcaneal (TTC) arthrodesis for critical-sized bone defects involving the ankle joints.

Design:
Retrospective review of case series.

Setting:
Two academic Level 1 trauma centers.

Patients/Participants:
The study included 20 patients with critical-sized (≥2 cm) segmental bone defects around the ankle joints.

Intervention:
Staged TTC arthrodesis was performed with induced membrane technique and retrograde intramedullary nail.

Main Outcome Measurements:
We investigated the radiological evaluation, including modified radiographic union scale for tibia fractures score, time to union, and leg length discrepancy, and functional outcomes using foot and ankle outcome score and American Orthopaedic Foot and Ankle Society ankle–hindfoot score.

Results:
The average bone defect was 6.4 cm (range: 2.4–12.3). Two of the 20 (10%) patients developed recurrence of infection. Fifteen patients (75%) achieved primary healing. Three patients (15%) were treated with repeated bone grafting and additional plating. The average time to union and leg length discrepancy were 10 months (range: 5–21) and 9 mm (range: 0–31), respectively. The mean foot and ankle outcome score and American Orthopaedic Foot and Ankle Society ankle–hindfoot score were 63 (range: 52–71) and 74 (range: 64–81), respectively.

Conclusions:
Staged TTC arthrodesis with induced membrane technique and intramedullary nail can be an effective treatment method for critical-sized bone defects involving the ankle joints.

Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Knee Disarticulation Versus Transfemoral Amputation: The Prosthetist's Perspective
Authors: Parry Joshua A. , Neufeld Eric 
Published: March 2022

Objectives:
The objective of this study was to survey a broad group of prosthetists on their experience with amputees with knee disarticulation (KD) and transfemoral amputation (TFA) to determine their preference of amputation level, opinions on patient preference, and common problematic issues to guide decision-making for patients and surgeons faced with the decision of a high-level lower extremity amputation.

Design:
This is a survey-based study.

Intervention:
A blinded electronic mail survey was completed by 102 prosthetists.

Main Outcome Measurements:
Each prosthetist was asked (1) what amputation level (KD or TFA) do they prefer and why and (2) which amputation level do they believe patients prefer and why

Results:
There was no consensus among prosthetists regarding amputation level preference. Fifty-four (53%) prosthetists preferred KD and 48 (47%) preferred TFA. Fifty-five (54%) prosthetists believed patients preferred TFA and 47 (46%) believed patients preferred KD. Amputation level preference often depended on age, functional goals, and concerns with cosmesis. The most common benefits given for KD over TFA included distal-end weight-bearing (n = 53), a lower subischial socket (n = 43), and better function (n = 30). The most common disadvantages given for KD over TFA included component limitations due to space available below amputation (n = 56), poor cosmesis (n = 49), an asymmetrical knee axis (n = 42), and difficulties with sitting/standing (n = 13).

Conclusion:
No consensus exists between prosthetists regarding preference for KD versus TFA. The advantages and disadvantages of KD reported in this study, along with the associated decision tree, can be used for future counseling of patient's faced with high-level lower extremity amputations.
Preoperative and Intraoperative Considerations Using Intramedullary Nails for the Treatment of Tibial Shaft Fractures Below Total Knee Arthroplasty
Authors: Stevens Nicole M. , Tyler Andrew F. , Mitchell Phillip M. , Stinner Daniel J. 
Published: March 2022

Summary:
Periprosthetic tibial shaft fractures below total knee arthroplasty (TKA) are relatively rare, with an incidence of approximately 1%. However, as the rates of arthroplasty increase, orthopaedic surgeons are likely to see a corresponding increase in these types of fractures. Native tibial shaft fractures are routinely treated with either nails or plates, and the success of intramedullary nailing of tibial shaft fractures has been well described in the literature. In this article, we seek to describe a case series of tibial shaft fractures in patients with ipsilateral TKA treated with infrapatellar intramedullary nailing. We will focus on preoperative considerations including templating and measurement of the anterior cortical implant distance on the lateral radiograph to ensure space for safe nail passage. We will also discuss intraoperative technical tricks, including Kirschner wire insertion for sounding the start point, utilization of the curved awl, use of hand reamers, and rotation of the nail to bypass the implant. Using meticulous preoperative planning and technical intraoperative tricks, patients with tibial shaft fractures below TKA may be successfully treated with intramedullary nailing.
The Third Wave: Comparing Seasonal Trends in COVID-19 Patient Data at a Large Hospital System in New York City
Authors: Tandon Pranai , Leibner Evan S. , Hackett Anna , Maguire Katherine , Mashriqi Nazia , Kohli-Seth Roopa 
Published: March 2022

IMPORTANCE:
The third wave of COVID-19 is unique in that vaccines have been widely available; however, the highly transmissible Delta variant has been the predominant strain. Temporal changes of hospitalized patient characteristics should continue to be analyzed as COVID-19 progresses.

OBJECTIVES:
Compare the demographics and outcomes of hospitalized patients during New York City’s third wave of COVID-19 to the first two waves.

DESIGN, SETTING, AND PARTICIPANTS:
Retrospective cohort study across five hospitals within Mount Sinai Health System, a quaternary academic medical system in New York City. Participants were adult inpatients admitted with COVID-19 identified by positive severe acute respiratory syndrome coronavirus 2 polymerase chain reaction at admission or clinical documentation of infection during the three waves of COVID-19.

MAIN OUTCOMES AND MEASURES:
Patient demographics, comorbidities, vaccination status, and outcomes of COVID-19 patients hospitalized at Mount Sinai Health System were examined. Patients admitted during the third wave were notably younger than the first two, were mostly unvaccinated against COVID-19, and there was a higher rate of patients who self-report as Black or African American as compared with the first two waves. The rate of patients requiring ICU level of care remained consistent throughout all three periods; however, the rate of patients requiring invasive mechanical ventilation decreased and inhospital mortality has trended down. Unvaccinated patients in the third wave are significantly younger with lower comorbidity burden than fully vaccinated patients.

RESULTS:
A total of 13,036 patients were included between the 3 waves. In the 3rd wave patients were notably younger, with a lower intubation rate and lower inhospital death rate. In the 3rd wave, 400 (62.9%) were unvaccinated, 236 (37.1%) were fully vaccinated, and 34 (4.8%) were partially vaccinated. Unvaccinated patients had similar rates of intubation and invasive mechanical ventilation compared with vaccinated patients, though inhospital mortality was lower in unvaccinated patients compared with vaccinated patients which may be expected given their lower age and burden of comorbidities.

CONCLUSIONS AND RELEVANCE:
We continue to see improved outcomes in hospitalized COVID-19 patients. Patients that are unvaccinated against COVID-19 are younger and have less reported comorbidities.
Hepatitis D: advances and challenges
Authors: Miao Zhijiang , Xie Zhenrong , Ren Li , Pan Qiuwei 
Published: March 2022

Abstract
Hepatitis D virus (HDV) infection causes the most severe form of viral hepatitis with rapid progression to cirrhosis, hepatic decompensation, and hepatocellular carcinoma. Although discovered > 40 years ago, little attention has been paid to this pathogen from both scientific and public communities. However, effectively combating hepatitis D requires advanced scientific knowledge and joint efforts from multi-stakeholders. In this review, we emphasized the recent advances in HDV virology, epidemiology, clinical feature, treatment, and prevention. We not only highlighted the remaining challenges but also the opportunities that can move the field forward.