pinecone/core-2020-05-10-deduplication huggingface dataset:
Anxiety, depression, and attachment before and after the first-trimester screening for Down syndrome: comparing couples who undergo ART with those who conceive spontaneously.

OBJECTIVES: This study's aim was to describe the emotional status of parents to be before and after the first-trimester combined prenatal screening test.
METHODS: One hundred three couples participated, of which 52 had undergone an in vitro fertilization/intracytoplasmic sperm injection treatment [assisted reproductive technology (ART)] and 51 had conceived spontaneously. Participants completed the state scale of the State-trait Anxiety Inventory, the Edinburgh Depression Scale, and the Maternal and Paternal Antenatal Attachment Questionnaire before the first-trimester combined prenatal screening test at around 12 weeks of gestational age (T1) and just after receiving the results at approximately 14 weeks of gestational age (T2).
RESULTS: We observed a significant decrease in anxiety and depression symptoms and a significant increase in attachment from T1 to T2. Results showed no differences between groups at either time point, which suggests that ART parents are more similar to than different from parents conceiving spontaneously. Furthermore, given the importance of anxiety during pregnancy, a subsample of women with clinical anxiety was identified. They had significantly higher rates of clinical depression and lower attachment.
CONCLUSIONS: These results indicate that, regardless of whether conception was through ART or spontaneous, clinical anxiety in women over the prenatal testing period is associated with more vulnerability during pregnancy (i.e. clinical depression and less attachment to fetus). © 2015 John Wiley &amp; Sons, Ltd
Optimal First Trimester Preeclampsia Prediction: a Comparison of Multimarker Algorithm, Risk Profiles and Their Sequential Application

OBJECTIVE:
To compare performance of multimarker algorithm, risk profiles and their sequential application in prediction of preeclampsia and determining potential intervention targets.
STUDY DESIGN:
Maternal characteristics, ultrasound variables and serum biomarkers were collected prospectively at first trimester. Univariate analysis identified preeclampsia associated variables followed by logistic regression analysis to determine the prediction rule. Combined characteristics of the cardiovascular, metabolic and the personal risk factors were compared to the multimarker algorithm and the sequential application of both methods.
RESULTS:
Out of 2433 women, 108 developed preeclampsia (4.4%). Probability scores considering nulliparity, prior preeclampsia, body mass index, diastolic blood pressure and placental growth factor had an area under the receiver operating characteristic curve 0.784 (95% CI = 0.721-0.847). While the multimarker algorithm had the lowest false negative rate, sequential application of cardiovascular and metabolic risk profiles in screen positives reduced false positives by 26% and identified blood pressure and metabolic risk in 49/54 (91%) women with subsequent preeclampsia as treatable risk factors.
CONCLUSION:
Sequential application of a multimarker algorithm followed by determination of treatable risk factors in screen positive women is the optimal approach for first trimester preeclampsia prediction and identification of women that may benefit from targeted metabolic or cardiovascular treatmentinfo:eu-repo/semantics/publishedVersio
Nuchal translucency distributions for different chromosomal anomalies in a large unselected population cohort

This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1002/pd.4711Objective
To describe the distribution of the fetal nuchal translucency thickness (NT) according to type of chromosomal aberration in a large unselected population.
Methods
Data on pregnancies with an NT measurement performed at gestational age 11+3 – 13+6 weeks from 2008–2011 were retrieved from the Danish National Fetal Medicine Database. Information on any genetic analysis for aneuploidy performed pre- or postnatally was also obtained. The abnormal results were grouped into 14 types of chromosomal anomalies. Distributions of NT measurements were summarized by aberration and compared with the normal/no karyotype group.

Results
215,223 singleton pregnancies were included in the cohort. 10,548 had a normal karyotype and 1,286 had an aberration. Plots of the NT measurements showed that like trisomy 21,18, and 13 and monosomy X, the distribution for the unbalanced translocations was shifted towards larger NTs. The distributions for the balanced translocations, the uncommon trisomies and the triploidies more closely resembled that of the normal/no karyotype population.
Conclusion
Fetuses with aneuploidies have NT distributions visually different from normal fetuses, with the exception of triploidies and uncommon autosomal trisomies. The distributions differ in shape according to type of chromosomal anomaly
Implementation of non-invasive prenatal testing by semiconductor sequencing in a genetic laboratory

Objectives: To implement non-invasive prenatal testing (NIPT) for fetal aneuploidies with semiconductor sequencing in an academic cytogenomic laboratory and to evaluate the first 15-month experience on clinical samples. 
Methods: We validated a NIPT protocol for cell-free fetal DNA sequencing from maternal plasma for the detection of trisomy 13, 18 and 21 on a semiconductor sequencing instrument. Fetal DNA fraction calculation for all samples and several quality parameters were implemented in the workflow. One thousand eighty-one clinical NIPT samples were analysed, following the described protocol. 
Results: Non-invasive prenatal testing was successfully implemented and validated on 201 normal and 74 aneuploid samples. From 1081 clinical samples, 17 samples showed an abnormal result: 14 trisomy 21 samples, one trisomy 18 and one trisomy 16 were detected. Also a maternal copy number variation on chromosome 13 was observed, which could potentially lead to a false positive trisomy 13 result. One sex discordant result was reported, possibly attributable to a vanishing twin. Moreover, our combined fetal fraction calculation enabled a more reliable risk estimate for trisomy 13, 18 and 21. 
Conclusions: Non-invasive prenatal testing for trisomy 21, 18 and 13 has a very high specificity and sensitivity. Because of several biological phenomena, diagnostic invasive confirmation of abnormal results remains required
An exploration of the potential utility of fetal cardiovascular MRI as an adjunct to fetal echocardiography

OBJECTIVES: Fetal cardiovascular magnetic resonance imaging (MRI) offers a potential alternative to echocardiography, although in practice, its use has been limited. We sought to explore the need for additional imaging in a tertiary fetal cardiology unit and the usefulness of standard MRI sequences. METHODS: Cases where the diagnosis was not fully resolved using echocardiography were referred for MRI. Following a three-plane localiser, fetal movement was assessed with a balanced steady-state free precession (bSSFP) cine. Single-shot fast spin echo and bSSFP sequences were used for diagnostic imaging. RESULTS: Twenty-two fetal cardiac MRIs were performed over 12 months, at mean gestation of 32 weeks (26-38 weeks). The majority of referrals were for suspected vascular abnormalities (17/22), particularly involving the aortic arch (n = 10) and pulmonary vessels (n = 4). Single-shot fast spin echo sequences produced 'black-blood' images, useful for examining the extracardiac vasculature in these cases. BSSFP sequences were more useful for intracardiac structures. Real-time SSFP allowed for dynamic assessment of structures such as cardiac masses, with enhancement patterns also allowing for tissue characterisation in these cases. CONCLUSIONS: Fetal vascular abnormalities such as coarctation can be difficult to diagnose by using ultrasound. Fetal MRI may have an adjunctive role in the evaluation of the extracardiac vascular anatomy and tissue characterisation. © 2016 The Authors. Prenatal Diagnosis published by John Wiley & Sons, Ltd
A novel translational model for fetoscopic intratracheal delivery of nanoparticles in piglets

Objectives: The aim of this study was to assess the feasibility of fetal tracheal injection in the late-gestational pig to target the airways. 
Methods: Following laparotomy and hysterotomy, fetoscopy was performed in pregnant sows to access the fetal trachea. Two volumes of fluospheres were injected (1 and 3 mL). Fluospheres distribution to the different lung lobes was investigated by microscopy. Possible fetal airway injury, caused by the surgical procedure or intratracheal injection, was investigated. Lung morphology and fetal lung volumes were calculated by micro computed tomography (µCT). 
Results: Intratracheal administration was successfully performed in 20/21 fetuses. Analysis by confocal microscopy demonstrated that 3 mL, and not 1 mL, most efficiently targeted all lung lobes. On high-resolution µCT, total airway volume was estimated at 2.9 mL, strengthening that 3 mL is appropriate to target all lung lobes. No procedural damage was evidenced in the lungs or trachea. 
Conclusions: Intratracheal injection of nanoparticles is feasible in the pregnant pig and does not cause procedural lung damage. Using an injection volume of 3 mL, all lung lobes were efficiently targeted. This nanoparticle delivery model to fetal airways opens perspectives for therapeutic interventions.status: publishe
Trial by Dutch laboratories for evaluation of non-invasive prenatal testing. Part II-women's perspectives

Contains fulltext :
                  171863.pdf (publisher's version ) (Open Access)OBJECTIVE: To evaluate preferences and decision-making among high-risk pregnant women offered a choice between Non-Invasive Prenatal Testing (NIPT), invasive testing or no further testing. METHODS: Nationwide implementation study (TRIDENT) offering NIPT as contingent screening test for women at increased risk for fetal aneuploidy based on first-trimester combined testing (>1:200) or medical history. A questionnaire was completed after counseling assessing knowledge, attitudes and participation following the Multidimensional Measure of Informed Choice. RESULTS: A total of 1091/1253 (87%) women completed the questionnaire. Of these, 1053 (96.5%) underwent NIPT, 37 (3.4%) invasive testing and 1 (0.1%) declined testing. 91.7% preferred NIPT because of test safety. Overall, 77.9% made an informed choice, 89.8% had sufficient knowledge and 90.5% had positive attitudes towards NIPT. Women with intermediate (odds ratio (OR) = 3.51[1.70-7.22], p < 0.001) or high educational level (OR = 4.36[2.22-8.54], p < 0.001) and women with adequate health literacy (OR = 2.60[1.36-4.95], p = 0.004) were more likely to make an informed choice. Informed choice was associated with less decisional conflict and less anxiety (p < 0.001). Intention to terminate the pregnancy for Down syndrome was higher among women undergoing invasive testing (86.5%) compared to those undergoing NIPT (58.4%) (p < 0.001). CONCLUSIONS: The majority of women had sufficient knowledge and made an informed choice. Continuous attention for counseling is required, especially for low-educated and less health-literate women. (c) 2016 The Authors. Prenatal Diagnosis published by John Wiley & Sons, Ltd
The validity of the observed-to-expected lung-to-head ratio in congenital diaphragmatic hernia in an era of standardized neonatal treatment; a multicenter study

Objective: To assess the predictive value of observed-to-expected lung-to-head ratio (O/E LHR) for survival and chronic lung disease (CLD) in survivors of left-sided congenital diaphragmatic hernia (CDH) in an era of standardized neonatal treatment, and to evaluate the predictive value of the O/E LHR trajectory for survival. Methods: This retrospective cohort study was performed in two high-volume CDH centers in the Netherlands in prenatally detected, isolated left-sided CDH patients born between 2008 and 2014. O/E LHR and liver position were determined using 2D-ultrasonography at three time points during gestation from 19 weeks onwards. Ultrasound measurements were performed on stored ultrasound data by one single experienced operator blinded to postnatal outcome. Results: Of the 122 included cases, 77.9% survived of whom 38.9% developed CLD. A significant association was found between the first measured O/E LHR and survival and development of CLD in survivors. Prenatal liver position did not have additional predictive value. No significant association was found between the trajectory of the O/E LHR and survival. Conclusion: In an era of standardized neonatal treatment for neonates with CDH, the first measured O/E LHR per patient significantly predicts survival and development of CLD in survivors in isolated left-sided CDH infants
Mild fetal cerebral ventriculomegaly as a prenatal sonographic marker for Kartagener syndrome

Primary ciliary dyskinesia (PCD), also referred to as immotile-cilia syndrome or Kartagener syndrome, is a group of genetic disorders caused by defective cilia leading to chronic sinupulmonary infection, situs inversus and reduced fertility. Some PCD patients also have cerebral ventriculomegaly or hydrocephalus. We report here two fetuses and one newborn with mild cerebral ventriculomegaly and a suspected and/or confirmed diagnosis of PCD. These cases demonstrate that mild fetal cerebral ventriculomegaly can be a prenatal sonographic marker of PCD, certainly in fetuses with situs inversus or a history of a previous sib with PCD. Copyrigh
Screening and diagnosing diabetes in optometrists’ practices : an evaluation of perceptions, attitudes and beliefs.

In the UK, optometrists examine 17 million people yearly, many of whom will not have consulted a doctor and may have undiagnosed diabetes. Selective testing in optometry practices presents a new detection strategy. \ud
The purpose of this research was to ascertain optometrists' perceptions, attitudes and beliefs towards diabetes and screening, prior to evaluating a pilot service. \ud
Focus groups and interviews were conducted with 21 optometrists in Northern England. Analysis was based on grounded theory.\ud
Four themes emerged: varying awareness of diabetes and its early diagnosis, a reluctance in accepting a screening role, organisational barriers in implementing such a service, and controversies around the changing roles of optometrists. Although optometrists' awareness of diabetes was varied, all had seen patients they suspected of having diabetes and felt that the public under‐estimated risks of diabetes. Some felt that diagnosis of asymptomatic diabetes was unnecessary, although most felt that early diagnosis would be beneficial. Optometrists believed that the public and doctors had mixed attitudes to their possible involvement in screening. Specific barriers included additional cost, time, remuneration and litigation fears. However, optometrists felt that their professional role has evolved and that a greater, extended clinical involvement would be positive. \ud
In conclusion, optometrists are willing to carry out capillary blood glucose tests, provided that the scheme is simple, is supported by other health care professionals and is properly funded. There is a clear advantage in identifying undiagnosed diabetes in people attending optometry practices who are not accessing other health care providers
Epidemiology of anxiolytic and hypnotic drug use in the general population in Norway

Background<br>
Drugs for mental disorders have been on the market for more than 50 years, but there is still a need for more knowledge about the use and impact of these drugs in real-life conditions. Appropriate use of anxiolytics or hypnotics may relieve or reduce severe problems, whereas inappropriate use may represent problems of personal or public health.<br><br>

Aims<br>
This thesis aims to study the epidemiology of anxiolytic and hypnotic drug use and, to a lesser extent, antidepressant drug use in the general population in Norway - in both cross-sectional and prospective cohort studies.<br><br>

Material and methods<br>
This thesis is based on data from 1) four health surveys done by the National Health Screening Service (now the Norwegian Institute of Public Health) in the counties of Østfold in 1985/1988 and Aust-Agder in 1986/1989, and in Oslo and Oppland/Hedmark in 2000-2001 and 2) the Norwegian Prescription Database (NorPD). Information on drug use was at first collected from health surveys, later from NorPD. Mental health status was measured by the screening tool “Hopkins symptom checklist” (HSCL-10) that was part of the health surveys. Information on deaths was obtained from the Norwegian Causes of Death Register.<br><br>

Results<br>
- Daily users of anxiolytics or hypnotics showed higher crude mortality than non-users. However, after adjustment the difference was markedly reduced.<br>
- The majority of incident users of hypnotics received prescriptions for z-hypnotics (benzodiazepine related drugs) rather than benzodiazepines, the choice of benzodiazepines predicted most strongly by previous use of anxiolytics and male gender.<br>
- The main factor associated with use of anxiolytics or hypnotics among people with mental distress was the use of analgesics.<br>
- The main factor associated with use of antidepressants among people with mental distress was not participating in the labour market.<br>
- Mental distress was a predictor of later use of anxiolytic drugs.<br>
- Women showed a higher proportion of use of psychotropic drugs than men, and there were also gender differences when studying mortality and incidence rates.<br><br>

Conclusion<br>
The health surveys offered selection bias and information bias that was eliminated when data were retrieved from NorPD. The health survey study populations were large enough to minimize random error, and from NorPD complete data were collected. The finding encourage general practitioners to be observant on mental distress as this is related to later anxiolytic drug use, that for selected populations is further associated with increased mortality. The gender differences observed for mortality, prevalence and incidence rates may lead us to question whether women suffer from more anxiety and depression than men, if they complain more, or if the truth is a combination of the two arguments
Use of herbal products during pregnancy

Background: The use of herbal remedies is gaining popularity in the western world
though little scientific documentation for safety and efficacy is available. Women are
found to be more frequent users of herbs than men and studies from North America,
Australia and Europe have shown widespread use among pregnant women.
Objective: The major aim of the work was to study use of herbal remedies during
pregnancy in two different populations and by different methods.
Methods: One study was performed as a survey among 578 pregnant women at the
Norfolk and Norwich University Hospital between November 2007 and February
2008. Use of herbal remedies and treatment of various ailments were studied. Six
women from this study population also participated in a focus group discussion about
the results of the survey and their reasons for herb use in pregnancy. Another study
was performed in the Swedish Medical Birth Register. Data on the use of herbal
remedies during pregnancy were obtained from 860215 pregnant women during the
period 1st July 1995 to end of 2004. Outcome variables studied were prematurity,
birth weight, Apgar score, number of infants in delivery and congenital
malformations.
Results: The usage of herbal remedies during pregnancy was 57.8% in the UK study
and 0.9% in the Swedish study. This very big difference is probably mainly due to the
different methods of data collection. Ginger, cranberry and raspberry leaf were the
most commonly used herbal remedies in the UK study while Floradix®, ginseng and
valerian were most commonly reported in the Swedish study. Family and friends were the most used source of information about herbs used in
pregnancy in the UK study and 75% of the herb users did not inform their doctor or
midwife about the herb use. Potentially harmful herbs or herbs for which the
documentation for safety in pregnancy is inadequate were used by 41.2% of the
participants. Forty one different herbs were reported used and 96 different indications
were given for the use but 46 of those indications could not be confirmed in literature
as “traditional use”.
The focus group discussion showed that users of herbal remedies expected health care
personnel to disapprove of herb use and thus did not reveal use to them. They found
it difficult to find a reputable alternative practitioner but they wanted the National
Health Services to include alternative therapists in the public healthcare system.
Conclusion: Use of herbal remedies is common among pregnant women while
documentation of safety and efficacy is limited. Health care personnel should be able
to give evidence based information about herbs but more research is necessary to
enable this
Drug information for patients - an update of long-term results: type of enquiries and patient characteristics

PURPOSE: To analyse the type of enquiries to a drug information service in Germany, available exclusively for patients. METHODS: Sociodemographic characteristics of the patients who used the service, number and kind of drugs taken, existing diseases, reasons for enquiry as well as type of answers provided were recorded. For the present evaluation we analysed all enquiries to the service from August 2001 to January 2007. RESULTS: A total of 5587 enquiries were received. 5013 enquiries from 4091 patients were available for further analysis in detail. The patient group using the service most frequently were women between 61 and 70 years (23.3%). 1457 enquiries (29.1%) were made by patients who had contacted the information service once or several times before. The group of drugs most often asked about were cardiovascular drugs (33.4%), followed by drugs for the nervous system (16.2%) and for the alimentary tract and metabolism (12.4%). On average, each patient had questions about 2.6 (median 1; 1-22) drugs simultaneously. Common reasons for contacting the service were adverse drug reactions (22.1%), the need for general information about the drug (19.9%), information about therapy (12.4%) and drug interactions (10.2%). CONCLUSIONS: A lot of patients need additional information about their medication, especially concerning drug groups that are frequently prescribed. The presented drug information service can be one helpful tool to counteract these information deficits and to increase patients' knowledge about their drugs
What does validation of cases in electronic record databases mean? The potential contribution of free text

Electronic health records are increasingly used for research. The definition of cases or endpoints often relies on the use of coded diagnostic data, using a pre-selected group of codes. Validation of these cases, as ‘true’ cases of the disease, is crucial. There are, however, ambiguities in what is meant by validation in the context of electronic records. Validation usually implies comparison of a definition against a gold standard of diagnosis and the ability to identify false negatives (‘true’ cases which were not detected) as well as false positives (detected cases which did not have the condition). We argue that two separate concepts of validation are often conflated in existing studies. Firstly, whether the GP thought the patient was suffering from a particular condition (which we term confirmation or internal validation) and secondly, whether the patient really had the condition (external validation). Few studies have the ability to detect false negatives who have not received a diagnostic code. Natural language processing is likely to open up the use of free text within the electronic record which will facilitate both the validation of the coded diagnosis and searching for false negatives