bluuebunny/crossref_metadata_2025_split huggingface dataset:
Aktuelle ERAS-Implementierung in der Thoraxchirurgie an deutschen Kliniken
Authors: Andreas Marco Nicolas , Dziodzio Tomasz , Hillebrandt Karl-Herbert , Elsner Aron , Strauchmann Julia , Aydin Mustafa , Pratschke Johann , Rückert Jens-Carsten , Neudecker Jens 
Published: March 2022

Zusammenfassung
Einleitung In den letzten Jahren haben sich zunehmend ERAS-Behandlungspfade in vielen chirurgischen Bereichen etabliert, da sie allgemeine Komplikationen reduzieren und die Genesung
von Patienten erheblich beschleunigen können. Für die Thoraxchirurgie wurden 2019 erstmals ERAS-Guidelines von der ERAS Society in Zusammenarbeit mit der European Society of Thoracic
Surgeons (ESTS) veröffentlicht. Inwieweit sich ERAS-Maßnahmen im klinischen Alltag in der Thoraxchirurgie in Deutschland etabliert haben, wurde anhand eines Online-Fragebogens evaluiert.
Material und Methoden Es wurde eine Onlineumfrage zur aktuellen ERAS-Implementierung an deutschen Kliniken durchgeführt. Zeitraum der Umfrage war vom 12.05.2021 bis zum 01.06.2021.
Im Fragebogen, der 22 Fragen umfasste, wurde die aktuelle Umsetzung verschiedener perioperativer Maßnahmen (u. a. Mobilisation, Thoraxdrainagen-Management, Schmerzmanagement) als wesentliche
Items des ERAS-Pathways erfragt. Anschließend wurden die Resultate zusammengefasst, beschreibend analysiert und in den Kontext der aktuellen Literatur gesetzt.
Ergebnisse Von 155 angeschriebenen leitenden Thoraxchirurgen beantworteten 32 den Fragebogen. Bei 28,1% (n = 9) der Kliniken war ein ERAS-Kernteam etabliert, eine Datenbank zur
Erfassung der ERAS-Items gab es in 15,6% (n = 5). Zudem bekamen die Patienten meist kein ERAS-Tagebuch (96,9%, n = 31) ausgehändigt. Ein präoperatives Carboloading wurde von 15,6% (n = 5)
durchgeführt. Eine PONV-Prophylaxe wurde bei 59,4% (n = 19) der Befragten standardmäßig durchgeführt. In der Regel wurde bei elektiven anatomischen Resektionen eine Thoraxdrainage (84,4%,
n = 27) eingelegt. Bei 3% (n = 1) der Zentren wurden 2 Drainagen eingelegt, bei 12,5% (n = 4) wurde keine Drainage intraoperativ eingebracht. Meist wurden digitale Drainagesysteme verwendet
(90,6%, n = 29). Der am häufigsten angewendete initiale Drainagensog war –10 cm H2O (75%, n = 24). Einen Sog von ≤ 2 cmH2O verwendeten lediglich 2 Befragte. Die
Drainageentfernung erfolgte in 50% (n = 16) der Fälle am 1. oder 2. postoperativen Tag (POD), in 34,4% (n = 11) am 3. und 4. POD und bei 9,4% (n = 3) verblieb die Drainage über den 4. Tag
hinaus. Bei 71,9% (n = 23) der Befragten erfolgte die erste Mobilisation postoperativ noch am OP-Tag.
Diskussion Die Implementierung der ERAS-Guidelines ist in Deutschland interindividuell noch sehr variabel. Bestimmte perioperative Prozesse werden bereits gut abgedeckt, allerdings
ist eine vollständige Umsetzung von ERAS-Items noch nicht gänzlich in der klinischen Praxis angekommen. Erste Schritte in diese Richtung wurden bereits gemacht und legen die Grundlage für
eine weitere zentrumsübergreifende Zusammenarbeit.
Indication Creep of Antenatal Late Preterm Steroids
Authors: McElwee Eliza R. , Wilkinson Kyla , Crowe Rebecca , Newman Jill C. , Alkis Mallory , Wineland Rebecca , Finneran Matthew M. 
Published: March 2022

Objective While antenatal corticosteroids (ACS) administered in the late preterm period have been shown to reduce respiratory morbidity, this finding was demonstrated in a well-designed randomized controlled trial (the Antenatal Betamethasone for Women at Risk for Late Preterm Delivery [ALPS]) with strict inclusion/exclusion criteria that may differ from clinical practice. The aim of this study was to investigate whether there has been indication creep since use of late preterm ACS became standard of care.Study Design Retrospective cohort study of pregnant women who received late preterm ACS between 2016 and 2019 were identified and separated into epochs of 2016 to 2017 and 2018 to 2019 based on year of exposure. The primary outcome was rate of inappropriate ACS exposure, defined as nonadherence to the inclusion/exclusion criteria of the ALPS trial. Secondary outcomes were rates of nonoptimal ACS exposure (delivery >7 days from ACS or term delivery). Logistic regression was used to generate adjusted odds ratios (aORs) between epochs for the primary outcome adjusting for confounders.Results There were 660 women who received late preterm ACS during the study period with 229 (34.6 %) deemed inappropriate exposures. The most common reason for inappropriate treatment was preterm premature rupture of membrane (PPROM; 29.0%) with exclusionary cervical examination or contraction frequency. No difference was observed in inappropriate ACS exposure between epochs (aOR = 0.83, 95% confidence interval [CI]: 0.59–1.2). However, there was a reduction in nonoptimal exposure over time (aOR = 0.67, 95% CI: 0.47–0.97) . Women receiving inappropriate ACS were more likely to deliver at term if indicated for maternal/fetal status (50.0 vs. 19.5%, p < 0.001) and preterm labor (66.0 vs. 41.9%; p = 0.015). Further, inappropriate exposure in preterm labor had higher rates of exposure latency >7 days (62.3 vs. 39.1%, p = 0.006) with a longer latency to delivery (3 vs. 16 days; p < 0.001).Conclusion Over one-third of women received late preterm ACS for an indication that could be classified as indication creep. Depending on indication, inappropriate administration is associated with higher rates of nonoptimal exposure.Key Points
On the Copper-Promoted Backbone Arylation of Histidine-Containing Peptides Using Triarylbismuthines
Authors: Gagnon Alexandre , Chan Hwai-Chien 
Published: March 2022

AbstractWe report herein our detailed investigation on the histidine-directed backbone arylation of histidine-containing peptides using triarylbismuth reagents. The reaction proceeds on the backbone NH of the amino acid that precedes the histidine, the so-called n–1 position. The protocol is applicable to dipeptides where the histidine is located at the C-terminus and to tripeptides where the histidine occupies the central position. The transformation is promoted by copper(II) acetate in the presence of phenanthroline (Phen) and diisopropylethylamine in dichloromethane at 50 °C under oxygen. An excellent scope was observed for the triarylbismuthines. In all cases, the imidazole ring of the histidine is protected with a trityl group to prevent the arylation of the side chain. An ATCUN-like model is proposed to explain the observed results.
Bleeding Complications in Neonates Receiving Extracorporeal Membrane Oxygenation and Controlled Hypothermia
Authors: Joshi Swosti , Cardona Vilmaris Quinones , Poletto Erica , Menkiti Ogechukwu 
Published: March 2022

Objective Safety and efficacy data on controlled hypothermia (CH) for neonates with moderate to severe hypoxic ischemic encephalopathy has been extrapolated to a subgroup of these patients who also require extracorporeal membrane oxygenation for refractory persistent pulmonary hypertension of the newborn (PPHN). However, safety data on the concomitant use of CH and extracorporeal membrane oxygenation (ECMO) are lacking.
Methods This is a single-center retrospective study of neonates ≥35 weeks' gestation with refractory PPHN who required ECMO between January 2010 and December 2020. Study groups were divided into those receiving CH/ECMO versus ECMO only. Baseline characteristics, short-term outcomes, and brain magnetic resonance imaging (MRI) data were compared.
Results A total of 36 neonates who received ECMO for refractory PPHN were included. Of these, 44.4% (n = 16) received CH/ECMO and 55.6% (n = 20) received ECMO only. Bleeding complications were more common in CH/ECMO group 50% (n = 8) versus ECMO only 15% (n = 3, p = 0.023). T1 brain MRI severity scores were higher in CH/ECMO group versus ECMO only group, however, there were no statistical difference in T2 and diffusion-weighted image scores. Functional status and survival to discharge were comparable between groups.
Conclusion In our cohort, neonates who received CH/ECMO had higher bleeding complications than ECMO only group with comparable functional status and survival at discharge.
Key Points
Formal Syntheses of Dictyodendrins B, C, and E by a Multi-Substituted Indole Synthesis
Authors: Yamaguchi Junichiro , Kabuki Akira 
Published: March 2022

AbstractThe dictyodendrins are a family of marine alkaloids, which possess a highly substituted pyrrolo[2,3-c]carbazole core. This core structure can be regarded as a multi-substituted indole and aniline moiety. To achieve a concise synthesis of dictyodendrins, we planned to capitalize on our previously developed multi-substituted indole synthesis. By using this method along with two C–H functionalizations, formal syntheses of dictyodendrins B, C, and E were achieved.
The Conceptual Development of a Conjunctive Olefination
Authors: Silvi Mattia , Filippini Dario 
Published: March 2022

AbstractWe recently discovered a functional group tolerant and transition-metal-free conjunctive olefination reaction with applications in late-stage functionalization chemistry. In this Synpacts contribution, we analyze the conceptual background that has stimulated the discovery of this reactivity and reflect on the key aspects of its development.1	Introduction2	Conceptual Background2.1	Photoredox-Mediated Giese Reaction2.2	Photoredox Radical-Polar Reactivity3	The Development of the Process4	Conclusion
Phosphorus(III)-Promoted 1,2-Boronate Migration and Application to Stereoselective gem-C,B-Glycosylation
Authors: He Zhi-Tao 
Published: March 2022

AbstractModifications of glycosidic linkers are valuable in medicinal chemistry and natural-product synthesis. Whereas considerable attention has been paid to the development of methods for monoglycosylation, the corresponding geminal diglycosylation has almost been ignored. Little work has focused on exploring new routes for stereoselective gem-diglycosylation, presumably due to challenges in controlling selectivity and activity on a confined quaternary carbon center. Highlighted herein is a recent advance in stereoselective C,B-glycosylation through an unprecedented PPh3-promoted 1,2-boronate-migration process.
Resveratrol Attenuates Hyperoxia Lung Injury in Neonatal Rats by Activating SIRT1/PGC-1α Signaling Pathway
Authors: Yang Kun , Yang Menghan , Shen Yunchuan , Kang Lan , Zhu Xiaodan , Dong Wenbin , Lei Xiaoping 
Published: March 2022

Objectives Our previous study showed that resveratrol (Res) attenuates apoptosis and mitochondrial dysfunction in alveolar epithelial cell injury induced by hyperoxia by activating the SIRT1/PGC-1α signaling pathway. In the present study, we investigated whether Res protects against hyperoxia-induced lung injury in neonatal rats by activating SIRT1/PGC-1α signaling pathway.
Methods Naturally delivered neonatal rats were randomly divided into six groups: normoxia + normal saline, normoxia + dimethyl sulfoxide (DMSO), normoxia + Res, hyperoxia + normal saline, hyperoxia + DMSO, and hyperoxia + Res. Lung tissue samples were collected on postnatal days 1, 7, and 14. Hematoxylin and eosin staining was used to evaluate lung development. Dual-immunofluorescence staining, real-time polymerase chain reaction, and western blotting were used to evaluate the levels of silencing information regulator 2-related enzyme 1 (SIRT1), peroxisome proliferator-activated receptor γ co-activator 1α (PGC-1α), nuclear respiratory factor 1 (Nrf1), Nrf2, transcription factor A (TFAM) and citrate synthase, the number of mitochondrial DNA (mtDNA) and mitochondria, the integrity of mtDNA, and the expression of TFAM in mitochondria.
Results We found that hyperoxia insulted lung development, whereas Res attenuated the hyperoxia lung injury. Res significantly upregulated the levels of SIRT1, PGC-1α, Nrf1, Nrf2, TFAM, and citrate synthase; promoted TFAM expression in the mitochondria; and increased the copy number of ND1 and the ratio of ND4/ND1.
Conclusion Our data suggest that Res attenuates hyperoxia-induced lung injury in neonatal rats, and this was achieved, in part, by activating the SIRT1/PGC-1α signaling pathway to promote mitochondrial biogenesis.
Key Points
Characteristics and Outcomes of Pregnant Women with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in New York City: A Matched Cohort Study
Authors: Khoury Rasha S. , Fazzari Melissa , Lambert Calvin , Debolt Chelsea , Stone Joanne , Bianco Angela , Nathan Lisa , Dolan Siobhan M. , Bernstein Peter S. 
Published: March 2022

Abstract
Objective The aim of this study was to examine the association between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and preterm birth, cesarean birth, and composite severe maternal morbidity by studying women with and without SARS-CoV-2 infection at the time of delivery hospitalization from similar residential catchment areas in New York City.
Study Design This was a retrospective cohort study of pregnant women with laboratory-confirmed or laboratory-denied SARS-CoV-2 on nasopharyngeal swab under universal testing policies at the time of admission who gave birth between March 13 and May 15, 2020, at two New York City medical centers. Demographic and clinical data were collected and follow-up was completed on May 30, 2020. Groups were compared for the primary outcome and preterm birth, in adjusted (for age, race/ethnicity, nulliparity, body mass index) and unadjusted analyses.
Results Among this age-matched cohort, 164 women were positive and 247 were negative for SARS-CoV-2. Of the positive group, 52.4% were asymptomatic and 1.2% had critical coronavirus disease 2019 (COVID-19). The groups did not differ by race and ethnicity, body mass index, or acute or chronic comorbidities. Women with SARS-CoV-2 were more likely to be publicly insured. Preterm birth, cesarean birth, and severe maternal morbidity did not differ between groups. Babies born to women with SARS-CoV-2 were more likely to have complications of prematurity or low birth weight (7.7 vs. 2%, p = 0.01).
Conclusion Preterm and cesarean birth did not differ between women with and without SARS-CoV-2 across disease severity in adjusted and unadjusted analysis among this cohort during the pandemic peak in New York City.
Cord Blood Cell-Free DNA Concentration: A Novel Marker for Neonatal Wellbeing
Authors: Imterat Majdi , Erez Offer , Tirosh Dan , Gelkop Yael Miller , Benshalom-Tirosh Neta , Ben-Tabo Maor , Douvdevani Amos 
Published: March 2022

Objective Cord gas values and Apgar scores, currently used as markers for newborn wellbeing and postpartum complications, provide rough estimates, and their use remains elusive. Circulating cell-free DNA (cfDNA) may better represent newborn status at birth and the effect of parturition on the fetus. This pilot study investigates the association between cord blood (CB) cfDNA and neonatal outcomes.
Study Design In a prospective cohort study, cfDNA concentration was measured in immediately following delivery collected CB sera of newborns using our rapid fluorescent assay.
Results During the study period, blood samples from umbilical cords of 100 newborns were collected. Vaginal delivery was associated with a higher median CB cfDNA than cesarean delivery (277 [95% confidence interval [CI] 199–377] vs. 100 [95% CI 43–265] ng/mL, p < 0.01). cfDNA levels were significantly associated with gestational age at delivery (rho = 0.308, p = 0.002) and CB base deficit (BD, r = 0.252, p = 0.017). According to maternal and fetal complications, CB cfDNA was elevated in fetuses with category II of heart rate tracing (p < 0.05), with maternal positive vaginal culture (p < 0.01), and with premature rupture of membranes (PROM, p < 0.001). Logistic regression models of CB cfDNA fourth quartiles demostrate a double odds ratio for elevated BD (>3mmol/L) and for worse heart rate tracing category.
Conclusion Serum CB cfDNA concentration reflects the newborn's status and hazards with an excellent association with CB BD, fetal heart rate category, and maternal risk factors for infection (positive vaginal culture and PROM). This preliminary observation suggests that cfDNA can serve as a point of care biomarker for newborn status at the time of delivery.
Key Points
Is Amniocentesis after CVS Risky?
Authors: Cagino Kristen , Chasen Stephen T. 
Published: March 2022

Objective Approximately, 2% of women who undergo chorionic villi sampling (CVS) will subsequently undergo amniocentesis due to placental mosaicism or sampling/laboratory issues. Our objective was to compare obstetric outcomes in women who underwent both procedures with those who had CVS alone.
Study Design Retrospective case-control study of patients with singleton pregnancies undergoing invasive testing from 2010 to 2020 was performed. All women who underwent CVS followed by amniocentesis were compared with a control group who underwent CVS alone matched (2:1) for age and year of pregnancy. Women with pregnancy loss at <16 weeks were excluded from the control group. Pregnancies terminated for genetic abnormalities were excluded. Obstetric outcomes were compared between cases and controls. Student t-test and Fisher's exact test were used for statistical comparison.
Results During the study period 2,539 women underwent CVS, and 66 (2.6%) subsequently underwent amniocentesis. The 66 cases were compared with 132 age-matched controls who underwent CVS alone. Mean maternal age was 36.8 ± 3.4 years, and 43% of women were nulliparous. Amniocentesis was performed due to sampling or laboratory issues in 33% of cases, placental mosaicism in 44%, and further diagnostic testing in 23%. There were no pregnancy losses or stillbirths in either group. Those who had two invasive procedures delivered at similar gestational ages and birthweights and did not have higher rates of adverse outcomes compared with those who underwent CVS alone.
Conclusion Patients considering CVS who are concerned about the possibility that a second invasive procedure could be required should be reassured that this does not appear to be associated with higher rates of adverse outcomes. Due to study size, we cannot exclude the possibility of small differences in uncommon outcomes, such as pregnancy loss or stillbirth.
Key Points
Fetal Growth Biometry as Predictors of Shoulder Dystocia in a Low-Risk Obstetrical Population
Authors: Newman Roger B. , Stevens Danielle R. , Hunt Kelly J. , Grobman William A. , Owen John , Sciscione Anthony , Wapner Ronald J. , Skupski Daniel , Chien Edward K. , Wing Deborah A. , Ranzini Angela C. , Porto Manuel , Grantz Katherine L. 
Published: March 2022

Objective This study aimed to evaluate fetal biometrics as predictors of shoulder dystocia (SD) in a low-risk obstetrical population.
Study Design Participants were enrolled as part of a U.S.-based prospective cohort study of fetal growth in low-risk singleton gestations (n = 2,802). Eligible women had liveborn singletons ≥2,500 g delivered vaginally. Sociodemographic, anthropometric, and pregnancy outcome data were abstracted by research staff. The diagnosis of SD was based on the recorded clinical impression of the delivering physician. Simple logistic regression models were used to examine associations between fetal biometrics and SD. Fetal biometric cut points, selected by Youden's J and clinical determination, were identified to optimize predictive capability. A final model for SD prediction was constructed using backward selection. Our dataset was randomly divided into training (60%) and test (40%) datasets for model building and internal validation.
Results A total of 1,691 women (98.7%) had an uncomplicated vaginal delivery, while 23 (1.3%) experienced SD. There were no differences in sociodemographic or maternal anthropometrics between groups. Epidural anesthesia use was significantly more common (100 vs. 82.4%; p = 0.03) among women who experienced SD compared with those who did not. Amniotic fluid maximal vertical pocket was also significantly greater among SD cases (5.8 ± 1.7 vs. 5.1 ± 1.5 cm; odds ratio = 1.32 [95% confidence interval: 1.03,1.69]). Several fetal biometric measures were significantly associated with SD when dichotomized based on clinically selected cut-off points. A final prediction model was internally valid with an area under the curve of 0.90 (95% confidence interval: 0.81, 0.99). At a model probability of 1%, sensitivity (71.4%), specificity (77.5%), positive (3.5%), and negative predictive values (99.6%) did not indicate the ability of the model to predict SD in a clinically meaningful way.
Conclusion Other than epidural anesthesia use, neither sociodemographic nor maternal anthropometrics were significantly associated with SD in this low-risk population. Both individually and in combination, fetal biometrics had limited ability to predict SD and lack clinical usefulness.
Key Points
Social Determinants of Health: The Fifth Vital Sign
Authors: Pardo Christina , McLaren Rodney , Minkoff Howard 
Published: March 2022

Introduction Since the last decade, social determinants of health (SDOH) have become a vital component of the liturgy of public health. From that time, the number of articles on SDOH cited in PubMed has increased from approximately 775 to over 4,700.
Issue In obstetrics, social determinants of health have particular resonance in discussions of maternal mortality and health disparities and the number of articles on SDOH in obstetrics has increased sixfold during the same interval. However, while most obstetricians are now aware of SDOH, many are unsure about how to address them within the context of their own practice.
Summary In this piece, we will discuss the importance of SDOH in obstetrics, the reasons why most obstetricians have not engaged with it and suggest steps to help bridge the gap between merely accepting SDOH's importance and implementing strategies to mitigate their effects.
Key Points
Umbilical Artery Cord Gas Abnormalities in the Presence of a Nuchal Cord in Term Singleton Pregnancies: A Cohort Study
Authors: Zahedi-Spung Leilah Deborah , Raghuraman Nandini , Carter Ebony B. , Cahill Alison G. , Rosenbloom Joshua I. 
Published: March 2022

Objective The clinical significance of nuchal cord (NC) at the time of delivery is unclear. Studies have found that NC is associated with lower umbilical artery (UA) pH. Since fetal hypercarbia precedes respiratory acidosis, we hypothesize UA pCO2 is elevated in neonates with NC at the time of delivery.
Study design This is a secondary analysis of a prospective cohort study of women with full-term singleton pregnancies admitted in labor or for induction of labor at an institution with a universal umbilical cord gas policy. We compared patients with NC at the time of delivery to those without NC. Women were excluded if they did not have validated UA gases, had a major fetal anomaly, or had an intrauterine fetal demise. The primary outcome of the study was UA pCO2. Secondary outcomes were other components of UA gas and neonatal morbidity composite. Baseline characteristics were compared utilizing chi-square or Fisher's exact test or the Student's t-test. UA gas parameters were compared using the Kruskal–Wallis test. Multivariable logistic regression was utilized to adjust for confounders.
Results Of the 8,580 study participants, 7,608 had validated umbilical cord gases. The incidence of NC in the population was 24.15% (n = 1,837). UA pCO2 was higher in those with NC than without (58 mm Hg [53–64] vs. 55 mm Hg [50–60], p < 0.01). There was a greater odds of hypercarbia in the NC group (pCO2 > 65 mmHg; adjusted odds ratio [aOR]: 1.97, 95% confidence interval [CI]: 1.72–2.25, p < 0.01). Additionally, the NC group was more likely to be mildly acidemic (pH < 7.2, aOR: 1.74, 95% CI: 1.51–2.01, p < 0.01). There was no difference in composite neonatal morbidity between the groups.
Conclusion NC is associated with an increased risk of hypercarbia and acidemia. However, this is not associated with increased risk of neonatal morbidity.
Key Points