tbuckley/cabot-search huggingface dataset:
Safety and Efficacy of a 3-Dimensional Stent Retriever With Aspiration-Based Thrombectomy vs Aspiration-Based Thrombectomy Alone in Acute Ischemic Stroke Intervention
Authors: Raul G. Nogueira, Donald Frei, Jawad F. Kirmani, Osama Zaidat, Demetrius Lopes, Aquilla S. Turk, Donald Heck, Brian Mason, Diogo C. Haussen, Elad I. Levy, Siddhart Mehta, Marc Lazzaro, Michael Chen, Arnd Dörfler, Albert J. Yoo, Colin P. Derdeyn, Lee Schwamm, David Langer, Adnan Siddiqui
Journal: JAMA Neurology (2018)

The treatment effects of individual mechanical thrombectomy devices in large-vessel acute ischemic stroke (AIS) remain unclear.To determine whether the novel 3-dimensional (3-D) stent retriever used in conjunction with an aspiration-based mechanical thrombectomy device (Penumbra System; Penumbra) is noninferior to aspiration-based thrombectomy alone in AIS.This randomized, noninferiority clinical trial enrolled patients at 25 North American centers from May 19, 2012, through November 19, 2015, with follow-up for 90 days. Adjudicators of the primary end points were masked to treatment allocation. Patients with large-vessel intracranial occlusion AIS presenting with a National Institutes of Health Stroke Scale (NIHSS) score of at least 8 within 8 hours of onset underwent 1:1 randomization to 3-D stent retriever with aspiration or aspiration alone. The primary analyses were conducted in the intention-to-treat population.Mechanical thrombectomy using intracranial aspiration with or without the 3-D stent retriever.The primary effectiveness end point was the rate of a modified Thrombolysis in Cerebral Infarction (mTICI) grade of 2 to 3 with a 15% noninferiority margin. Device- and procedure-related serious adverse events at 24 hours were the primary safety end points.Of 8082 patients screened, 198 patients were enrolled (111 women [56.1%] and 87 men [43.9%]; mean [SD] age, 66.9 [13.0] years) and randomized, including 98 in the 3-D stent retriever with aspiration group and 100 in the aspiration alone group; an additional 238 patients were eligible but not enrolled. The median baseline NIHSS score was 18.0 (interquartile range, 14.0-23.0). Eighty-two of 94 patients in the 3-D stent retriever and aspiration group (87.2%) had an mTICI grade of 2 to 3 compared with 79 of 96 in the aspiration alone group (82.3%; difference, 4.9%; 90% CI, -3.6% to 13.5%). None of the other measures were significantly different between the 2 groups. Device-related serious adverse events were reported by 4 of 98 patients in the 3-D stent retriever with aspiration group (4.1%) vs 5 of 100 patients in the aspiration only group (5.0%); procedure-related serious adverse events, 10 of 98 (10.2%) vs 14 of 100 (14.0%). A 90-day modified Rankin Scale score of 0 to 2 was reported by 39 of 86 patients in the 3-D stent retriever with aspiration group (45.3%) vs 44 of 96 patients in the aspiration only group (45.8%).The present study provides class 1 evidence for the noninferiority of the 3-D stent retriever with aspiration vs aspiration alone in AIS. Future trials should evaluate whether these results can be generalized to other stent retrievers.clinicaltrials.gov Identifier: NCT01584609.
Resolution of organ fibrosis
Authors: Joon-Il Jun, Lester F. Lau
Journal: Journal of Clinical Investigation (2018)

Fibrosis is the excessive accumulation of extracellular matrix that often occurs as a wound healing response to repeated or chronic tissue injury, and may lead to the disruption of organ architecture and loss of function. Although fibrosis was previously thought to be irreversible, recent evidence indicates that certain circumstances permit the resolution of fibrosis when the underlying causes of injury are eradicated. The mechanism of fibrosis resolution encompasses degradation of the fibrotic extracellular matrix as well as elimination of fibrogenic myofibroblasts through their adaptation of various cell fates, including apoptosis, senescence, dedifferentiation, and reprogramming. In this Review, we discuss the present knowledge and gaps in our understanding of how matrix degradation is regulated and how myofibroblast cell fates can be manipulated, areas that may identify potential therapeutic approaches for fibrosis.
An RNA-Based Digital Circulating Tumor Cell Signature Is Predictive of Drug Response and Early Dissemination in Prostate Cancer
Authors: David T. Miyamoto, Richard J. Lee, Mark Kalinich, Joseph A. LiCausi, Yu Zheng, Tianqi Chen, John D. Milner, Erin Emmons, Uyen Ho, Katherine Broderick, Erin Silva, Sarah Javaid, Tanya Todorova Kwan, Xin Hong, Douglas M. Dahl, Francis J. McGovern, Jason A. Efstathiou, Matthew R. Smith, Lecia V. Sequist, Ravi Kapur, Chin-Lee Wu, Shannon L. Stott, David T. Ting, Anita Giobbie-Hurder, Mehmet Toner, Shyamala Maheswaran, Daniel A. Haber
Journal: Cancer Discovery (2018)

Abstract Blood-based biomarkers are critical in metastatic prostate cancer, where characteristic bone metastases are not readily sampled, and they may enable risk stratification in localized disease. We established a sensitive and high-throughput strategy for analyzing prostate circulating tumor cells (CTC) using microfluidic cell enrichment followed by digital quantitation of prostate-derived transcripts. In a prospective study of 27 patients with metastatic castration-resistant prostate cancer treated with first-line abiraterone, pretreatment elevation of the digital CTCM score identifies a high-risk population with poor overall survival (HR = 6.0; P = 0.01) and short radiographic progression-free survival (HR = 3.2; P = 0.046). Expression of HOXB13 in CTCs identifies 6 of 6 patients with ≤12-month survival, with a subset also expressing the ARV7 splice variant. In a second cohort of 34 men with localized prostate cancer, an elevated preoperative CTCL score predicts microscopic dissemination to seminal vesicles and/or lymph nodes (P &amp;lt; 0.001). Thus, digital quantitation of CTC-specific transcripts enables noninvasive monitoring that may guide treatment selection in both metastatic and localized prostate cancer. Significance: There is an unmet need for biomarkers to guide prostate cancer therapies, for curative treatment of localized cancer and for application of molecularly targeted agents in metastatic disease. Digital quantitation of prostate CTC-derived transcripts in blood specimens is predictive of abiraterone response in metastatic cancer and of early dissemination in localized cancer. Cancer Discov; 8(3); 288–303. ©2018 AACR. See related commentary by Heitzer and Speicher, p. 269. This article is highlighted in the In This Issue feature, p. 253
Copper 64–labeled daratumumab as a PET/CT imaging tracer for multiple myeloma
Authors: Enrico Caserta, Junie Chea, Megan Minnix, Erasmus K. Poku, Domenico Viola, Steven Vonderfecht, Paul Yazaki, Desiree Crow, Jihane Khalife, James F. Sanchez, Joycelynne M. Palmer, Susanta Hui, Nadia Carlesso, Jonathan Keats, Young Kim, Ralf Buettner, Guido Marcucci, Steven Rosen, John Shively, David Colcher, Amrita Krishnan, Flavia Pichiorri
Journal: Blood (2018)
Repeat doses of antibody to serum amyloid P component clear amyloid deposits in patients with systemic amyloidosis
Authors: Duncan B. Richards, Louise M. Cookson, Sharon V. Barton, Lia Liefaard, Thirusha Lane, David F. Hutt, James M. Ritter, Marianna Fontana, James C. Moon, Julian D. Gillmore, Ashutosh Wechalekar, Philip N. Hawkins, Mark B. Pepys
Journal: Science Translational Medicine (2018)

Repeat cycles of miridesap, to deplete circulating serum amyloid P component (SAP), followed by the anti-SAP antibody, dezamizumab, cleared visceral amyloid deposits in patients with systemic amyloidosis.
Expression of the Steroidogenic Enzyme, CYP11A1, Identifies Peanut-Allergic Children at Risk for Developing Life-Threatening Anaphylaxis
Authors: Meiqin Wang, Bruce J. Lanser, Carah B. Santos, Kreso Bendelja, Jennifer Fish, Elizabeth A. Esterl, Jordan Abbott, Erwin W. Gelfand
Journal: Journal of Allergy and Clinical Immunology (2018)
A Randomized, Open-Label, Blinded Outcome Assessment Trial Evaluating the Efficacy and Safety of LMWH/Edoxaban Versus Dalteparin for Venous Thromboembolism Associated with Cancer: Hokusai VTE-Cancer Study
Authors: Gary E. Raskob, Nick Van Es, Peter Verhamme, Marc Carrier, Marcello Di Nisio, David A. Garcia, Michael A. Grosso, Ajay K. Kakkar, Michael J. Kovacs, Michele F. Mercuri, Guy Meyer, Annelise Segers, Minggao Shi, Tzu-Fei Wang, Erik Yeo, George Zhang, Jeffrey I. Zwicker, Jeffrey I. Weitz, Harry R. Büller
Journal: Blood (2017)
Abstract 19439: Adeno-Associated Virus Mediated Gene Delivery: Implications for Scalable in vivo Cardiac Models of Optogenetics
Authors: Christina M Ambrosi, Aleksandra Klimas, Gouri Sadananda, Emilia Entcheva
Journal: Circulation (2016)

The growing use of adeno-associated viruses (AAVs) as transgene delivery vehicles in clinical trials requires comprehensive assessment of their performance. Their serotype-mediated ability to target specific tissues, as well as their low immunogenicity, make them prime candidates for gene therapy. Here we quantify transgene expression and explore the mechanisms of virus uptake in rat cardiomyocytes (CMs)  in vitro  and  in vivo  by the cardiac specific AAV serotypes 1, 6, and 9.  In vitro  syncytia of neonatal rat ventricular CMs (n=7 per serotype) were infected with AAVs containing the transgene for eGFP. Adult rats (n=6 each serotype) were intravenously injected with 0.1-0.5x10 12  AAV particles containing the transgene for channelrhodopsin-2 (ChR2-mCherry). Open chest functional testing of optical excitability was performed on the rat heart  in situ  3-4 weeks after infection.  In vitro  expression profiles revealed that AAV 1 and 6 (6±0.4 and 32±1.7 a.u. respectively) outperformed AAV9, which had no detectable levels of eGFP expression. In contrast, intact hearts expressed significantly higher levels of the transgene using AAV9. Hearts infected at the highest viral titer were optically excitable (4.8 mW/mm 2 ). We further tested the mechanism of virus uptake, focusing on purported receptor-mediators for AAV1/6 (cell surface sialic acid) and AAV9 (the 37/67 kDa lamininR receptor).  In vitro  desialyzation of the neonatal CMs with neuraminidase treatment (25μL/mL) significantly decreased eGFP expression. We showed robust lamininR expression in the adult rat heart via immunostaining, but no expression in cultured neonatal CMs, in line with the observed differential AAV9 expression. The combined transgene expression and cell surface receptor data explain the preferential efficiency of AAV1/6  in vitro  and AAV9  in vivo  in the rat heart. Furthermore, AAV9 systemic delivery with a generic promoter resulted in preferred cardiac expression of the delivered opsins.
Unifying in vitro and in vivo IVT mRNA expression discrepancies in skeletal muscle via mechanotransduction
Authors: Sushma M. Bhosle, Kristin H. Loomis, Jonathan L. Kirschman, Emmeline L. Blanchard, Daryll A. Vanover, Chiara Zurla, Damien Habrant, Darin Edwards, Patrick Baumhof, Bruno Pitard, Philip J. Santangelo
Journal: Biomaterials (2018)
Subsequent nonmelanoma skin cancers and impact of immunosuppression in liver transplant recipients
Authors: Pamela Funk-Debleds, Emilie Ducroux, Olivier Guillaud, José Ursic-Bedoya, Evelyne Decullier, Mélanie Vallin, Sylvie Euvrard, Georges-Philippe Pageaux, Olivier Boillot, Jérôme Dumortier
Journal: Journal of the American Academy of Dermatology (2018)
Bio-inspired redox-cycling antimicrobial film for sustained generation of reactive oxygen species
Authors: Huan Liu, Xue Qu, Eunkyoung Kim, Miao Lei, Kai Dai, Xiaoli Tan, Miao Xu, Jinyang Li, Yangping Liu, Xiaowen Shi, Peng Li, Gregory F. Payne, Changsheng Liu
Journal: Biomaterials (2018)
Corollary Discharge and Psychosis—Origin of the Model—Reply
Authors: Andrea Raballo, Eva Gebhardt, Michele Poletti
Journal: JAMA Psychiatry (2018)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Psychiatry HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Psychiatry journal
Family history of cardiovascular disease and cardiovascular comorbidities risk in a pediatric cancer population.
Authors: Thomas Patrick Curtin, Wendy Kohlmann, Luke Devon Maese, Zhe Yu, Karen Curtin, Joshua David Schiffman
Journal: Journal of Clinical Oncology (2017)

10518 Background: Survival rates for childhood cancer patients have improved dramatically, but the growing survivor population suffers from increased treatment-related toxicity including high risk for cardiovascular disease (CVD). While the link between chemotherapy and radiation to cardiotoxicity is well established, few studies seek to determine if an underlying familial risk for cardiovascular disease contributes or predicts this risk. The Utah Population Database (UPDB) is a genealogical resource linked to statewide cancer diagnoses and electronic medical data in which family history is objectively determined. Methods: We calculated the risk of subsequent CVD (ICD-9 401-449) in relatives of 5602 pediatric cancer patients diagnosed at ages 0-19 in Utah from 1966-2013 with no congenital CVD-related anomalies (ICD-9 745-747, 758-759). We identified 964 patients with subsequent CVD diagnoses. Cox models provided recurrence-risk estimates in first-degree relatives of patients compared to relatives of 5:1 matched controls. Results: Pediatric cancer patients were at 5-fold risk of CVD compared to controls ( P&lt; 10 -15 ). In pediatric patients with subsequent CVD, first-degree relatives were at 30% increased CVD risk compared to relatives of cancer-free controls (HR = 1.31, 95%CI 1.16-1.47; P&lt; 10 -5 ). In pediatric patients without CVD, only parents exhibited slight CVD risk (HR = 1.08, 95%CI 1.03-1.14; P= 0.002). In 685,000 individuals with a non-congenital CVD history, pediatric cancers among their first-degree relatives were associated with a similar increased risk of subsequent CVD, compared to pediatric cancers among relatives of controls with no CVD events (HR = 1.39, 95%CI 1.18-1.64, P&lt; 10 -4 ). Conclusions: The UPDB is powerful for investigating comorbidities in cancer patients and their families without recall bias from self-reported family medical history. A family history of CVD may increase risk of CVD-related comorbidities among pediatric cancer patients by 30-40% beyond that observed in patients without a CVD family history. This finding suggests that in addition to a cancer family history, a CVD-related family history should be assessed in children diagnosed with cancer.
Kidney Transplantation in a Patient Lacking Cytosolic Phospholipase A <sub>2</sub> Proves Renal Origins of Urinary PGI-M and TX-M
Authors: Jane A. Mitchell, Rebecca B. Knowles, Nicholas S. Kirkby, Daniel M. Reed, Matthew L. Edin, William E. White, Melissa V. Chan, Hilary Longhurst, Magdi M. Yaqoob, Ginger L. Milne, Darryl C. Zeldin, Timothy D. Warner
Journal: Circulation Research (2018)

The balance between vascular prostacyclin, which is antithrombotic, and platelet thromboxane A
The Composite Asthma Severity Index: A Tool for Assessing Impact of Omalizumab Treatment in Children with Moderate-to-Severe Persistent Allergic Asthma
Authors: Stanley J. Szefler, Tmirah Haselkorn, Benjamin Ortiz, Benjamin L. Trzaskoma, Ahmar Iqbal, William W. Busse
Journal: Journal of Allergy and Clinical Immunology (2018)
Neuromedicine Service and Science Hub Model
Authors: Michael S. Okun, Adolfo Ramirez-Zamora, Kelly D. Foote
Journal: JAMA Neurology (2018)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Neurology HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Neurology journal
Epithelial Properties of the Second Heart Field
Authors: Claudio Cortes, Alexandre Francou, Christopher De Bono, Robert G. Kelly
Journal: Circulation Research (2018)

The vertebrate heart tube forms from epithelial progenitor cells in the early embryo and subsequently elongates by progressive addition of second heart field (SHF) progenitor cells from adjacent splanchnic mesoderm. Failure to maximally elongate the heart results in a spectrum of morphological defects affecting the cardiac poles, including outflow tract alignment and atrioventricular septal defects, among the most common congenital birth anomalies. SHF cells constitute an atypical apicobasally polarized epithelium with dynamic basal filopodia, located in the dorsal wall of the pericardial cavity. Recent studies have highlighted the importance of epithelial architecture and cell adhesion in the SHF, particularly for signaling events that control the progenitor cell niche during heart tube elongation. The 22q11.2 deletion syndrome gene Tbx1 regulates progenitor cell status through modulating cell shape and filopodial activity and is required for SHF contributions to both cardiac poles. Noncanonical Wnt signaling and planar cell polarity pathway genes control epithelial polarity in the dorsal pericardial wall, as progenitor cells differentiate in a transition zone at the arterial pole. Defects in these pathways lead to outflow tract shortening. Moreover, new biomechanical models of heart tube elongation have been proposed based on analysis of tissue-wide forces driving epithelial morphogenesis in the SHF, including regional cell intercalation, cell cohesion, and epithelial tension. Regulation of the epithelial properties of SHF cells is thus emerging as a key step during heart tube elongation, adding a new facet to our understanding of the mechanisms underlying both heart morphogenesis and congenital heart defects.
Glucagon like peptide 1 analogue, Liraglutide, reduces adipose insulin resistance and hepatic de novo lipogenesis in Nonalcoholic Steatohepatitis: Sub-study results of a phase II randomised-control clinical trial
Authors: M J Armstrong, D Hull, K Guo, D Barton, J M Hazlehurst, M Nasiri, L L Gathercole, J Yu, P Gaunt, S Gough, J W Tomlinson, P N Newsome
Journal: Hepatology (2013)
BMI and Mortality in Patients With New-Onset Type 2 Diabetes: A Comparison With Age- and Sex-Matched Control Subjects From the General Population
Authors: Jon Edqvist, Araz Rawshani, Martin Adiels, Lena Björck, Marcus Lind, Ann-Marie Svensson, Sofia Gudbjörnsdottir, Naveed Sattar, Annika Rosengren
Journal: Diabetes Care (2018)

OBJECTIVE Type 2 diabetes is strongly associated with obesity, but the mortality risk related to elevated body weight in people with type 2 diabetes compared with people without diabetes has not been established. RESEARCH DESIGN AND METHODS We prospectively assessed short- and long-term mortality in people with type 2 diabetes with a recorded diabetes duration ≤5 years identified from the Swedish National Diabetes Register (NDR) between 1998 and 2012 and five age- and sex-matched control subjects per study participant from the general population. RESULTS Over a median follow-up of 5.5 years, there were 17,546 deaths among 149,345 patients with type 2 diabetes (mean age 59.6 years [40% women]) and 68,429 deaths among 743,907 matched control subjects. Short-term all-cause mortality risk (≤5 years) displayed a U-shaped relationship with BMI, with hazard ratios (HRs) ranging from 0.81 (95% CI 0.75–0.88) among patients with diabetes and BMI 30 to &amp;lt;35 kg/m2 to 1.37 (95% CI 1.11–1.71) with BMI ≥40 kg/m2 compared with control subjects after multiple adjustments. Long-term, all weight categories showed increased mortality, with a nadir at BMI 25 to &amp;lt;30 kg/m2 and a stepwise increase up to HR 2.00 (95% CI 1.58–2.54) among patients with BMI ≥40 kg/m2, that was more pronounced in patients &amp;lt;65 years old. CONCLUSIONS Our findings suggest that the apparent paradoxical findings in other studies in this area may have been affected by reverse causality. Long-term, overweight (BMI 25 to &amp;lt;30 kg/m2) patients with type 2 diabetes had low excess mortality risk compared with control subjects, whereas risk in those with BMI ≥40 kg/m2 was substantially increased.
Safety, Efficacy and MRD Negativity of a Combination of Venetoclax and Obinutuzumab in Patients with Previously Untreated Chronic Lymphocytic Leukemia - Results from a Phase 1b Study (GP28331)
Authors: Ian W. Flinn, John G. Gribben, Martin J.S. Dyer, William G Wierda, Michael B. Maris, Richard R. Furman, Peter Hillmen, Jeffrey Jones, Swami P. Iyer, Surai Jones, Yanwen Jiang, Daniela Soriano Pignataro, Kathryn Humphrey, Mehrdad Mobasher, Thomas J. Kipps
Journal: Blood (2017)
Prevalence and Trends in Prepregnancy Normal Weight — 48 States, New York City, and District of Columbia, 2011–2015
Authors: Nicholas P. Deputy, Bhanuja Dub, Andrea J. Sharma
Journal: MMWR Morbidity and Mortality Weekly Report (2018)

Women who enter pregnancy at a weight above or below normal weight, defined as a body mass index (BMI) of 18.5-24.9 (calculated as weight in kg/height in m2), are more likely to experience adverse pregnancy outcomes and to have infants who experience adverse health outcomes. For example, prepregnancy underweight (BMI <18.5) increases the risk for small-for-gestational-age births, whereas prepregnancy overweight (BMI 25.0-29.9) and obesity (BMI ≥30.0) increase risks for cesarean delivery, large-for-gestational-age births, and childhood obesity (1). Given these outcomes, Healthy People 2020 includes an objective to increase the proportion of women entering pregnancy with a normal weight from 52.5% in 2007 to 57.8% by 2020.* Because recent trends in prepregnancy normal weight have not been reported, CDC examined 2011-2015 National Vital Statistics System (NVSS) natality data, which included prepregnancy BMI. In 2015, for 48 states, the District of Columbia (DC), and New York City (NYC) combined, the prevalence of prepregnancy normal weight was 45.0%; prevalence ranged from 37.7% in Mississippi to 52.2% in DC. Among 38 jurisdictions with prepregnancy BMI data during 2011-2015, normal weight prevalence declined from 47.3% to 45.1%; declines were observed in all jurisdictions but were statistically significant for 27 jurisdictions after standardizing to the 2011 national maternal age and race/ethnicity distribution. Screening women's BMI during routine clinical care provides opportunities to promote normal weight before entering pregnancy.