bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cypermethrin inhibits proliferation of Sertoli cells through AR involving DAB2IP/PI3K/AKT signaling pathway in vitro
Authors: Wang Qi , Wang Xu-Xu , Xie Jia-Fei , Yao Ting-Ting , Xu Lin-Lin , Wang Lu-Shan , Yu Yue , Xu Li-Chun 
Published: June 2022

Abstract
Cypermethrin (CP) exhibits anti-androgenic effects through antagonism on androgen receptor (AR) activation. This study was to identify whether AR-mediated disabled 2 interacting protein (DAB2IP)/phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT) pathway was involved in CP-induced mouse Sertoli cells (TM4) proliferation disorder. Real-Time Cell Analysis-iCELLigence system was to measure cell proliferation. Bioinformatic analyses were performed to identify AR-regulated genes. Quantitative Real-Time PCR and western blot were to detect the genes and proteins levels in AR-mediated DAB2IP/PI3K/AKT pathway. Results showed CP suppressed TM4 proliferation and the expression of AR. Activation of AR restored the inhibition efficacy of CP on TM4 proliferation. AR regulated DAB2IP expression and phosphorylation levels of PI3K and AKT in CP-exposed TM4 cells. In addition, knockdown of DAB2IP alleviated the inhibition efficacy of CP on cell proliferation and phosphorylation of PI3K and AKT. Taken together, AR was a modulator in CP-induced inhibition of Sertoli cells proliferation by negatively regulating DAB2IP/PI3K/AKT signaling pathway. The study may provide a new insight for the mechanisms of male reproductive toxicity induced by CP.
Obstetric Anesthesia and Heart Disease: Practical Clinical Considerations
Authors: Meng M.L. , Arendt K.W. 
Published: June 2022

(Anesthesiology. 2021;135:164–183)
Cardiovascular disease is the leading cause of maternal mortality in the United States. Patients with congenital heart disease have better outcomes than patients with other types of heart disease. While guidelines addressing the diagnosis and management of heart disease in the obstetric population, there is little data to guide anesthetic management of these patients. This clinical review is a nonsystematic literature review aiming to provide guidance for obstetric anesthesiologists and anesthesiologists who care for obstetric patients.
Placenta Accreta Spectrum Disorder: Updates on Anesthetic and Surgical Management Strategies
Authors: Einerson B.D. , Weiniger C.F. 
Published: June 2022

(Int J Obstet Anesth. 2021;46:102975)
Placenta accreta spectrum (PAS) is a leading cause of major obstetric hemorrhage [postpartum hemorrhage (PPH)], severe maternal morbidity and peripartum hysterectomy, and has become more prevalent over the last 70 years. This review aims to report updated information on PAS for obstetric anesthesiologists.
A Survey of USA Anesthesiology Residents Regarding Their Perceptions of, and Barriers to, Fellowship Training in Obstetric Anesthesia
Authors: Ende H.B. , Lozada M.J. , Micevych P.S. , Pennycuff J. , Vadhera R.B. , Peralta F.M. , Bauchat J.R. 
Published: June 2022

(Int J Obstet Anesth. 2021;46:103159)
There is a clear need for fellowship-trained obstetric anesthesiologists, who may improve maternal outcomes. However, far fewer residents are participating in obstetric fellowships than is needed to staff labor and delivery units in the United States. A recent survey aimed to understand reasons why residents lack interest in pursuing obstetric anesthesia fellowship training.
Women With Advanced Maternal Age Have Gastric Volume Similar to That of Nonpregnant Women: A Prospective Pilot Study Using Preoperative Gastric Ultrasound
Authors: Yuan X. , Zhou R.H. , Liu H.L. , Ye L. , Luo H. 
Published: June 2022

(J Clin Anesth. 2021;72:110270)
Contrary to conventional wisdom, previous studies have established the similarity of the gastric volume (GV) of women with full-term pregnancies to that of nonpregnant women. This finding is relevant to assessing the risk threshold for receiving anesthesia based on preoperative ultrasound determination of the quantity of gastric contents. Cut-off values for measurements of the antral cross-sectional area (CSA) indicate reliably if the stomach contents are too great for safe anesthesia administration. Incidence of advanced maternal age (AMA) pregnancy is also increasing, and with it the caseload of elective cesarean deliveries (CD) in the world-wide AMA population. Although it is not fully understood why, AMA pregnant women have lower GV than their younger counterparts. Further investigation is merited to assess the necessity of longer preoperative fasting times in AMA women undergoing CD. This study compares GV in nonpregnant women to women with AMA pregnancy to determine if there is elevated risk of aspiration as assessed by gastric ultrasound.
Closed Incision Negative Pressure Wound Therapy Versus Standard Dressings in Obese Women Undergoing Cesarean Section: Multicenter Parallel Group Randomized Controlled Trial
Authors: Gillespie B.M. , Webster J. , Ellwood D. , Thalib L. , Whitty J.A. , Mahomed K. , Clifton . , Kumar S. , Wagner A. , Kang E. , Chaboyer W. 
Published: June 2022

(BMJ. 2021;373:n893)
Cesarean deliveries (CD) lead to increased risk for adverse maternal outcomes, especially for obese women. Obesity during pregnancy is common and increases the risk of postoperative complications such as surgical site infection (SSI), hematoma and seroma, and wound dehiscence. Use of closed incision negative pressure wound therapy (NPWT) dressings has increased in an effort to decrease SSI. This trial aimed to analyze how closed incision NPWT dressings compare with standard dressings in obese women following CD.
Strategies for Improving Anesthesia Ready Time in the Obstetric Operating Room
Authors: Zbeidy R. , Franklin Dos Santos T. , Patel R. , Souki F.G. 
Published: June 2022

(J Clin Anesth. 2021;73:110302)
Operating room (OR) efficiency provides many benefits to patients, surgeons, staff, and hosting organizations including increased OR capacity. A previous retrospective study identified cases performed with neuraxial anesthesia at university hospitals as having the longest mean duration for OR use. Efficiencies and quality improvements are of interest to hospital administration and obstetric OR practice optimization, particularly in large academic hospitals in cases with neuraxial anesthesia. Herein causes of inefficiency are identified, along with improvement practices, and assessment of their efficacy.
A 20-Minute Decision-delivery Interval at Emergency Cesarean Section Using General Anesthesia: A Clinically Relevant Target
Authors: Kinsella S.M. 
Published: June 2022

(Anaesthesia. 2021;76:1021–1025)
The 30-minute decision-delivery interval for emergency cesarean is deeply embedded as a standard of quality of care in such cases in Europe and the United States. In extreme circumstances a shorter decision-delivery time of 20 minutes is supported where placental function or fetal circulation are severely and irreversibly compromised.
Decision-to-Delivery Interval and Neonatal Outcomes for Category-1 Cesarean Sections During the COVID-19 Pandemic
Authors: Bhatia K. , Columb M. , Bewlay A. , Tageldin N. , Knapp C. , Qamar Y. , Dooley A. , Kamath P. , Hulgur M. ,   Collaborators
Published: June 2022

(Anaesthesia. 2021;76:1051–1059)
Emergency or category-1 cesarean deliveries (CD) occur under immediate threat of the life of the fetus or the mother. Ideally, these deliveries should occur within 30 minutes from the decision to proceed with CD. New data from England compares category-1 CD during the April-July 2020 first wave of the COVID-19 pandemic to similar deliveries from the same timeframe in 2019. The investigation sought to describe if and how decision-to-delivery metrics were impacted by the pandemic, and if there were any differences in the anesthetic care during those 2 periods.
Oxytocin at Elective Cesarean Delivery: A Dose-finding Study in Women With Obesity
Authors: Peska E. , Balki M. , Maxwell C. , Ye X.Y. , Downey K. , Carvalho J.C.A. 
Published: June 2022

(Anaesthesia. 2021;76:918–923. [Epub November 23, 2020])
Worldwide, postpartum hemorrhage (PPH) continues to be a major cause of maternal mortality. Uterine atony is a leading cause of PPH in high-income countries and is known to be associated with obesity. Oxytocin is administered to achieve acceptable uterine tone following cesarean delivery (CD); however, it is unknown whether higher doses of oxytocin are required to accomplish this in women with obesity. This dose-finding study examined the oxytocin bolus dose required to initiate effective uterine tone in 90% of women with obesity (ED90) following CD under regional anesthesia.
Persistent Headache and Low Back Pain After Accidental Dural Puncture in the Obstetric Population: A Prospective, Observational, Multicenter Cohort Study
Authors: Niraj G. , Mushambi M. , Gauthama P , Patil A. , Kelkar A. , Hart E. , Nurmikko T. ,   on Behalf of the Accidental Dural Puncture Outcome Study Collaborative Group
Published: June 2022

(Anaesthesia. 2021;76:1068–1076)
A documented complication of epidural insertion for labor analgesia is accidental dural puncture (ADP), with an occurrence of 1.2% to 2.6%. Dural puncture and subsequent intracranial hypotension can stimulate the trigeminocervical complex, resulting in postdural puncture headache (PDPH). Although PDPH may cause temporary pain and morbidity, it is commonly accepted that the condition resolves without treatment, as corroborated by the International Headache Society’s PDPH definition. However, recent observational studies suggest that ADP may be associated with persistent headache (HA). In addition, limited evidence may suggest that ADP and its treatment with epidural blood patch (EBP) may exacerbate the emergence of postpartum low back pain (LBP). The purpose of this study was to investigate if ADP could be connected to persistent HA and LBP at 18 months postpartum when compared with matched case-control women.
Implementation of a Guideline of Early Administration of Tranexamic Acid for Severe Primary Postpartum Hemorrhage: A Retrospective Comparative Study
Authors: Watkins L. , Kearney L. , Kynn M. , Hodgman C. , Nugent R. 
Published: June 2022

(Aust N Z J Obstet Gynaecol. 2021;61:354–359. [Epub December 22, 2020])
Severe postpartum hemorrhage (PPH) is the leading cause of maternal death worldwide. Tranexamic acid (TXA) is commonly administered to nonobstetric patients to help manage hemorrhage. The World Maternal Antifibrinolytic (WOMAN) trial conducted in women with PPH reported that TXA had no effect on all-cause mortality; however, the trial mostly conducted in low-resource settings. This study aimed to determine whether administering 1 g of TXA intravenously during active PPH (blood loss ≥1000 mL) impacted the rate of maternal morbidity.
The Impact of Cardiovascular Diseases on Maternal Deaths in the Nordic Countries
Authors: Nyfløt L.T. , Johansen M. , Mulic-Lutvica A. , Gissler M. , Bødker B. , Bremme K. , Ellingsen L. , Vangen S. 
Published: June 2022

(Acta Obstet Gynecol Scand. 2021;100:1273–1279)
Between 2005 and 2017 cardiovascular diseases (CVD) accounted for the most common cause of maternal death in Nordic countries. This increased maternal mortality is likely associated with a rise in pregnant women with congenital and acquired CVD, but in nearly 60% of deaths, there was no known CVD. The current study objective was to identify the incidence and type of CVD contributing to the cause of maternal death, and identify points of substandard care to improve clinical management and reduce CVD-related mortality.
The Impact of Preeclampsia Definitions on the Identification of Adverse Outcome Risk in Hypertensive Pregnancy: Analyses From the CHIPS Trial (Control of Hypertension in Pregnancy Study)
Authors: Magee L.A. , Singer J. , Lee T. , Rey E. , Asztalos E. , Hutton E. , Helewa M. , Logan A.G. , Ganzevoort W. , Welch R. , Thornton J.G. , Woo Kinshella M.L. , Green M. , Tsigas E. , vonDadelszen P. ,   on behalf of the CHIPS Study Group
Published: June 2022

(BJOG. 2021;128:1373–1382)
Hypertensive disorders of pregnancy include preeclampsia, gestational hypertension (developing at or after 20 wk’ gestation), and chronic hypertension (diagnosed before 20 wk’ gestation, or before pregnancy). Of these, preeclampsia is associated with the highest risks for parturient and neonate. Gestational or chronic hypertension often develops into preeclampsia. Preeclampsia is typically defined by new proteinuria, though patients with chronic or gestational hypotension may face severe complications without the presence of proteinuria. Some countries have adopted a broader definition of preeclampsia, not requiring proteinuria for diagnosis and also using evidence of placental or maternal end-organ dysfunction. This secondary analysis of the Control of Hypertension in Pregnancy Study (CHIPS) aimed to compare the abilities of the traditional and broad definitions of preeclampsia to identify patients with chronic or gestational hypertension at risk of adverse outcomes.
Adverse Maternal and Perinatal Pregnancy Outcomes Related to Very Advanced Maternal Age in Primigravida and Multigravida in the Netherlands: A Population-based Cohort
Authors: Rademaker D. , Hukkelhoven C.W.P.M. , van Pampus M.G. 
Published: June 2022

(Acta Obstet Gynecol Scand. 2021;100:941–948)
The average age of women in the Netherlands delivering their first child has significantly increased over the last 50 years (31.2 in 2017, 24.3 in 1970). Advanced maternal age (AMA) carries increased likelihood of adverse maternal and perinatal outcomes. This study aimed to understand the association between adverse maternal and perinatal outcomes and AMA by comparing parturients ages 25 to 29 with pregnant women aged 40 and up.
Refining the Clinical Definition of Active Phase Arrest of Dilation in Nulliparous Women to Consider Degree of Cervical Dilation As Well As Duration of Arrest
Authors: Kawakita T. , Gold S. , Huang J. , Iqbal S. 
Published: June 2022

(Am J Obstet Gynecol. 2021;225:294.e1–294.e14)
Contemporary duration of labor is slower than historically recorded. Previous studies, including the Consortium on Safe Labor, concluded that 4 hours of oxytocin augmentation may increase vaginal delivery rates without increasing harm to the neonate. Current definitions of arrest of dilation do not examine the degree of cervical dilation and give recommendations for dilation beyond 4 hours. Using the Consortium on Safe Labor’s retrospective cohort study as a guideline, this study aimed to understand the impact on maternal and neonatal outcomes in nulliparous women in the active phase of labor in reference to time needed to achieve cervical dilation of 6, 7, 8, and 9 cm.
From Fragmented Levels of Care to Integrated Health Care: Framework Toward Improved Maternal and Newborn Health
Authors: Barnea E.R. , Nicholson W. , Theron G. , Ramasauskaite D. , Stark M.l. , Albini S.M. , Nassar Ar.H. ,   FIGO Safe Motherhood & Newborn Health Committee
Published: June 2022

(Int J Gynecol Obstet. 2021;152:155–164)
A country’s maternal mortality ratio (MMR) is the number of women per 100,000 live births who die from pregnancy related causes. These women may die while pregnant or within 42 days of pregnancy completion. The four most common reasons for MMR in high-income countries are severe preeclampsia, postpartum hemorrhage (PPH), cardiovascular pathologies, and sepsis. Even with limited resources, timely diagnosis and treatment of PPH can greatly minimize MMR.
Anesthetic Management of von Willebrand Disease in Pregnancy: A Retrospective Analysis of a Large Case Series
Authors: Reale S.C. , Farber M.K. , Lumbreras-Marquez M.I. , Connors J.M. , Carabuena J.M. 
Published: June 2022

(Anesth Analg. 2021;133:1244–1250)
Von Willebrand disease (vWD) affects 1% to 2% of the population and can complicate neuraxial anesthesia in obstetric patients. Currently, there are no clear guidelines for the pretreatment and timing of neuraxial anesthesia in pregnant patients with vWD. Previous reports suggest safe neuraxial anesthesia is attainable in these patients when appropriate precautions are taken. This study described the management of neuraxial techniques in pregnant patients with vWD over 20 years at a single tertiary center.
Effect of Different Positions During Surgical Preparation With Combined Spinal-Epidural Anesthesia for Elective Cesarean Delivery: A Randomized Controlled Trial
Authors: Liu T. , Zou S. , Guo L. , Niu Z. , Wang M. , Xu C. , Gao X. , Shi Z. , Guo X. , Xiao H. , Qi D. 
Published: June 2022

(Anesth Analg. 2021;133:1235–1243)
A lateral tilt of the uterus is used to reduce pressure on the inferior vena cava in pregnant patients undergoing cesarean delivery. This may improve the fetal blood and oxygen supply. This position has been thought to improve the fetal acid-base status, though this has been recently called into question. This study aimed to evaluate whether moving the patient into a 30 degrees left lateral tilt position before elective cesarean delivery with combined spinal-epidural anesthesia could better improve the fetal acid-base status compared with a 15 degrees left lateral tilt or supine position.
Granisetron or Ondansetron to Prevent Hypotension After Spinal Anesthesia for Elective Cesarean Delivery: A Randomized Placebo-controlled Trial
Authors: Aksoy M. , Dostbil A. , Aksoy A.N. , Ince I. , Bedir Z. , Ozmen O. 
Published: June 2022

(J Clin Anesth. 2021;75:110469. [Epub July 24, 2021])
5-HT3 receptor antagonists have received attention as a possible intervention for preventing spinal-anesthesia induced hypotension during cesarean section, which occurs in 55% to 100% of cases. The Bezold-Jarisch reflex (BJR) appears to govern this adverse response to spinal anesthesia and includes symptoms of hypotension, apnea, and bradycardia. These effects have been shown to be prevented by the use of 5-HT3 antagonists including ondansetron and granisetron. This prospective, double-blinded, randomized placebo-controlled trial tests the efficacy of high-dose administration of these drugs to prevent spinal anesthesia-induced hypotension in elective cesarean section.
Incidence of Accidental Awareness During General Anesthesia in Obstetrics: A Multicenter, Prospective Cohort Study
Authors: Odor P.M. , Bampoe S. , Lucas D.N. , Moonesinghe S.R. , Andrade J. , Pandit J.J. ,   Pan-London Peri-operative Audit and Research Network (PLAN), for the DREAMY Investigators Group
Published: June 2022

(Anaesthesia. 2021;76:759–776. [Epub January 12, 2021])
The occurrence of accidental awareness during general anesthesia (AAGA) for obstetric patients appears to be influenced by multiple factors. Underreporting may be at play when patients self-report AAGA while, conversely, overreporting may be happening following a “Brice” interview method due to potential oversensitivity of the tool. This study aimed to describe the occurrence, nature of, risk-factors, and psychological implications of AAGA for obstetric patients requiring surgery.
From Hypnos to Ephialtes: Waking Up to the Consequences of Accidental Awareness During Obstetric General Anaesthesia
Authors: Palanisamy A. , Paech M.J. 
Published: June 2022

(Anaesthesia. 2021;76:736–739. [Epub February 9, 2021])
This editorial discusses accidental awareness during general anesthesia (AAGA). A recent study on AAGA by Odor et al is not only praised for its thorough investigation of AAGS using a large sample size, but its findings are emphasized: AAGA occurrence was 3 times higher than self-reported rates have indicated. The study of interest also found posttraumatic stress disorder (PTSD) in one third of AAGA patients (42 times more likely than non-AAGA patients). The authors point out that future studies could include a larger-sample, international trial, however, the study investment may not be worth the study outcomes. Instead, a focus should be placed on changing health care management patterns associated with AAGA.
Quantifying the Incidence of Clinically Significant Respiratory Depression in Women With and Without Obesity Class III Receiving Neuraxial Morphine for Postcesarean Analgesia: A Retrospective Cohort Study
Authors: Ende H.B. , Dwan R.L. , Freundlich R.E. , Dumas S. , Sorabella L.L. , Raymond B.L. , Lozada M.J. , Shotwell M.S. , Wanderer J.P. , Bauchat J.R. 
Published: June 2022

(Int J Obstet Anesth. 2021;47:103187)
Although neuraxial morphine is commonly administered to patients for analgesia following cesarean delivery (CD), one recognized side effect is respiratory depression. According to The Society for Obstetric Anesthesia and Perinatology (SOAP), obesity [body mass index (BMI) ≥40 kg/m2] is a condition which increases the odds for respiratory depression and therefore necessitates enhanced respiratory monitoring for patients receiving neuraxial morphine. However, limited research has been carried out on the relationship between respiratory depression and obesity. To improve guidelines for respiratory monitoring for this patient population, the authors compared rates of respiratory depression in postpartum women with BMI ≥40 kg/m2 to those of BMI <40 kg/m2. Specifically, the authors investigated the hypothesis that clinically significant respiratory depression following neuraxial morphine occurs more commonly in obese patients.
Effect of Early Discharge After Planned Cesarean Section on Recovery and Parental Sense of Security: A Randomized Clinical Trial
Authors: Kruse A.R. , Lauszus F.F. , Forman A. , Kesmodel U.S. , Rugaard M.B. , Knudsen R.K. , Persson E.K. , Uldbjerg N. , Sundtoft I.B. 
Published: June 2022

(Acta Obstet Gynecol Scand. 2021;100:955–963)
Enhanced recovery (ERAC) programs aim to decrease the length of hospital stay (LOS) for patients who underwent cesarean delivery (CD). While it can be positive for some parents to be discharged early, it is unclear whether others find it difficult in regard to their sense of security. The aim of this study was to assess patients’ sense of security in association with different hospital discharge times: the day following CD combined with a midwife home visit versus 2 days following CD.
Is Bigger Better?
Authors: Sherry Tisamarie B. , Damberg Cheryl L. , DeYoreo Maria , Bogart Andy , Agniel Denis , Ridgely M. Susan , Escarce José J. 
Published: June 2022

Background:
Research on US health systems has focused on large systems with at least 50 physicians. Little is known about small systems.

Objectives:
Compare the characteristics, quality, and costs of care between small and large health systems.

Research Design:
Retrospective, repeated cross-sectional analysis.

Subjects:
Between 468 and 479 large health systems, and between 608 and 641 small systems serving fee-for-service Medicare beneficiaries, yearly between 2013 and 2017.

Measures:
We compared organizational, provider and beneficiary characteristics of large and small systems, and their geographic distribution, using multiple Medicare and Internal Revenue Service administrative data sources. We used mixed-effects regression models to estimate differences between small and large systems in claims-based Healthcare Effectiveness Data and Information Set (HEDIS) quality measures and HealthPartners’ Total Cost of Care measure using a 100% sample of Medicare fee-for-service claims. We fit linear spline models to examine the relationship between the number of a system’s affiliated physicians and its quality and costs.

Results:
The number of both small and large systems increased from 2013 to 2017. Small systems had a larger share of practice sites (43.1% vs. 11.7% for large systems in 2017) and beneficiaries (51.4% vs. 15.5% for large systems in 2017) in rural areas or small towns. Quality performance was lower among small systems than large systems (−0.52 SDs of a composite quality measure) and increased with system size up to ∼75 physicians. There was no difference in total costs of care.

Conclusions:
Small systems are a growing source of care for rural Medicare populations, but their quality performance lags behind large systems. Future studies should examine the mechanisms responsible for quality differences.