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Roberto Romero

Bio: Roberto Romero is an academic researcher from National Institutes of Health. The author has contributed to research in topics: Amniotic fluid & Chorioamnionitis. The author has an hindex of 151, co-authored 1516 publications receiving 108321 citations. Previous affiliations of Roberto Romero include University of Michigan & Weizmann Institute of Science.


Papers
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Journal ArticleDOI
TL;DR: It is anticipated that algorithms developed to image specific cardiac structures with 3or 4-dimensional volume data sets may eventually become automated by computer software (automated multiplanar imaging) and reduce the operator dependency of prenatal ultrasonography.
Abstract: patiotemporal image correlation (STIC) is a recent technological advance in ultrasonographic imaging that allows dynamic multiplanar slicing and surface rendering of the fetal heart.1–5 In a previous study, a technique was developed to systematically visualize the outflow tracts from volume data sets acquired with STIC.3,4 The addition of color and power Doppler imaging to STIC technology made it possible to dynamically display rendered views of the outflow tracts with minimal manipulation of the volume data set.5 Prenatal diagnosis of transposition of the great arteries (TGA) is associated with a significant reduction in both preoperative and postoperative mortality, a decrease in the rate of metabolic acidosis and multiorgan failure during the neonatal period, reduced need for ventilatory support, and shorter hospitalization time.6,7 Unfortunately, prenatal detection rates for TGA have been low in most of the studies published to date.8–15 Among the reasons for failure to prenatally detect most cases of TGA are the absence of risk factors to identify a target population for screening and the need to systematically examine the outflow tracts to establish the diagnosis.6,16 Despite recommendations by scientific societies such as the American Institute of Ultrasound in Medicine to extend the basic fetal cardiac examination to include visualization of the outflow tracts whenever technically feasible,17 this examination remains a technical challenge for many sonographers.6,18 Four-dimensional volume data set acquisition followed by a systematic approach to image the outflow tracts may reduce the operator dependency of prenatal ultrasonography. Volume acquisition is still operator dependent with current commercially available technology. However, once a good-quality volume data set is acquired, the outflow tracts can be systematically imaged by following algorithms developed for gray scale,3,4 color, or power Doppler5 imaging. It is anticipated that algorithms developed to image specific cardiac structures with 3or 4-dimensional volume data sets may eventually become automated by computer software (automated multiplanar imaging).19 Received April 22, 2004, from the Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan USA (L.F.G., B.B., M.C.T.); Perinatology Research Branch, National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland USA (L.F.G., J.E., R.R.); Division of Fetal Imaging, William Beaumont Hospital, Royal Oak, Michigan USA (W.L.); and Division of Cardiology, Children’s Hospital of Michigan, Wayne State University, Detroit, Michigan USA (R.H.). Revision requested May 24, 2004. Revised manuscript accepted for publication June 1, 2004. Address correspondence and reprint requests to Roberto Romero, MD, Perinatology Research Branch, National Institute of Child Health and Human Development, Department of Obstetrics and Gynecology, Wayne State University/Hutzel Hospital, 4707 St Antoine Blvd, Detroit MI 48201 USA. E-mail: warfiela@mail.nih.gov. Abbreviations STIC, spatiotemporal image correlation; TGA, transposition of the great arteries

47 citations

Journal ArticleDOI
TL;DR: The goals were to introduce fractional arm volume (AVol) as a new soft tissue parameter of fetal growth assessment and to develop individualized growth standards, based on Rossavik models, for AVol, midarm circumference, and humeral diaphysis length.
Abstract: Objective. The goals were to introduce fractional arm volume (AVol) as a new soft tissue parameter of fetal growth assessment and to develop individualized growth standards, based on Rossavik models, for AVol, midarm circumference (ArmC), and humeral diaphysis length (HDL). Methods, A prospective longitudinal study of 22 fetuses was conducted using 2- and 3-dimensional sonography. Three new growth parameters (HDL, ArmC, and AVol) were used to establish individualized standards for arm growth with the use of Rossavik functions [P = c(t) k + s ( t ) , where P is the anatomic parameter; c, k, and s are model coefficients; and t is the time variable]. Second-trimester models were specified from the linear slopes of growth curves before approximately 28.0 menstrual weeks. For a given fetus, normal third-trimester trajectories were predicted for each parameter. Observed and predicted measurements were compared by percent deviations. Results. Rossavik functions fit all parameter trajectories extremely well (R 2 = 95.7%-99.4%). By fixing coefficients k at their mean values, their respective fits did not change, and the variabilities of both coefficients c and s were reduced. Coefficient c was also significantly related to second-trimester slope, as was s to c, for all 3 parameters (R 2 = 97.7%-98.7%; P <.0001). Mean percent deviations between observed and predicted third-trimester HDL, ArmC, and AVol measurements were -0.1% ′ 2.9%, 0.5% ′ 4.6%, and 0.4% ′ 8.5%, respectively. Conclusions. Individualized growth assessment, using HDL and ArmC, can accurately predict normal arm growth during the third trimester of pregnancy. AVol may also allow earlier detection and improved monitoring of soft tissue abnormalities that can occur in fetuses with growth disturbances.

47 citations

Journal ArticleDOI
TL;DR: SNPs of the PRLR gene 5' UTR and promoter region are associated with increased risk for GDM in a population of Chilean subjects.
Abstract: Aims: Human placental lactogen (hPL) acts via the prolactin receptor (PRLR) on maternal β-cells to mediate increases in β-cell mass and function during normal pregnancy. This interaction between hPL and PRLR is essential to maintain normal glucose homeostasis and to address the increased metabolic demands of pregnancy. Given the importance of the PRLR-hPL axis in pancreatic islet cell adaptation to pregnancy, we hypothesized that genetic variation in the PRLR gene could influence risk of development of gestational diabetes mellitus (GDM). DNA samples from 96 mothers affected by GDM and 96 unaffected cases were genotyped for 8 selected single nucleotide polymorphisms (SNPs) in PRLR. Results: Significant associations were identified in two SNPs analyzed. The minor alleles of PRLR SNPs rs10068521 and rs9292578 were more frequently observed in GDM cases than controls and were associated with a 2.36-fold increased risk for GDM in those carrying the minor allele. Conclusion: SNPs of the PRLR gene 5′ UTR and promoter region are associated with increased risk for GDM in a population of Chilean subjects.

46 citations

Journal ArticleDOI
25 Jul 2011-PLOS ONE
TL;DR: ABO blood group can alter PP13-bioavailability in blood, and it may also be a key determinant for other lectins' bioavailability in the circulation.
Abstract: Background: Placental Protein 13 (PP13), an early biomarker of preeclampsia, is a placenta-specific galectin that binds betagalactosides, building-blocks of ABO blood-group antigens, possibly affecting its bioavailability in blood. Methods and Findings: We studied PP13-binding to erythrocytes, maternal blood-group effect on serum PP13 and its performance as a predictor of preeclampsia and intrauterine growth restriction (IUGR). Datasets of maternal serum PP13 in Caucasian (n=1078) and Hispanic (n=242) women were analyzed according to blood groups. In vivo, in vitro and in silico PP13-binding to ABO blood-group antigens and erythrocytes were studied by PP13-immunostainings of placental tissuemicroarrays, flow-cytometry of erythrocyte-bound PP13, and model-building of PP13 - blood-group H antigen complex, respectively. Women with blood group AB had the lowest serum PP13 in the first trimester, while those with blood group B had the highest PP13 throughout pregnancy. In accordance, PP13-binding was the strongest to blood-group AB erythrocytes and weakest to blood-group B erythrocytes. PP13-staining of maternal and fetal erythrocytes was revealed, and a plausible molecular model of PP13 complexed with blood-group H antigen was built. Adjustment of PP13 MoMs to maternal ABO blood group improved the prediction accuracy of first trimester maternal serum PP13 MoMs for preeclampsia and IUGR. Conclusions: ABO blood group can alter PP13-bioavailability in blood, and it may also be a key determinant for other lectins’ bioavailability in the circulation. The adjustment of PP13 MoMs to ABO blood group improves the predictive accuracy of this test.

46 citations

Journal ArticleDOI
TL;DR: Pregnancies complicated by the delivery of an SGA neonate are characterized by a higher activation of maternal peripheral leukocytes than in normal pregnancies, but lower than in pregnancies complicated by preeclampsia.
Abstract: Objective. Preeclampsia and pregnancies complicated by small-for-gestational age (SGA) neonates share several underlying mechanisms of disease. However, while an exaggerated systemic maternal inflammatory response is regarded as one of the hallmarks of the pathogenesis of preeclampsia, the presence of a similar systemic intra-vascular inflammation in mothers of SGA neonates without hypertension is controversial. The aim of this study was to determine phenotypic and metabolic changes in granulocytes and monocytes of women who develop preeclampsia and those who deliver an SGA neonate, compared to normal pregnant women.Methods. This cross-sectional study included patients with a normal pregnancy (n = 33), preeclampsia (n = 33), and an SGA without preeclampsia (n = 33), matched for gestational age at blood sample collection. Granulocyte and monocyte phenotypes were determined by flow cytometry, using monoclonal antibodies against selective cluster of differentiation (CD) antigens. The panel of antibodies incl...

46 citations


Cited by
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Journal ArticleDOI
TL;DR: The philosophy and design of the limma package is reviewed, summarizing both new and historical features, with an emphasis on recent enhancements and features that have not been previously described.
Abstract: limma is an R/Bioconductor software package that provides an integrated solution for analysing data from gene expression experiments. It contains rich features for handling complex experimental designs and for information borrowing to overcome the problem of small sample sizes. Over the past decade, limma has been a popular choice for gene discovery through differential expression analyses of microarray and high-throughput PCR data. The package contains particularly strong facilities for reading, normalizing and exploring such data. Recently, the capabilities of limma have been significantly expanded in two important directions. First, the package can now perform both differential expression and differential splicing analyses of RNA sequencing (RNA-seq) data. All the downstream analysis tools previously restricted to microarray data are now available for RNA-seq as well. These capabilities allow users to analyse both RNA-seq and microarray data with very similar pipelines. Second, the package is now able to go past the traditional gene-wise expression analyses in a variety of ways, analysing expression profiles in terms of co-regulated sets of genes or in terms of higher-order expression signatures. This provides enhanced possibilities for biological interpretation of gene expression differences. This article reviews the philosophy and design of the limma package, summarizing both new and historical features, with an emphasis on recent enhancements and features that have not been previously described.

22,147 citations

Journal ArticleDOI
TL;DR: The latest version of STRING more than doubles the number of organisms it covers, and offers an option to upload entire, genome-wide datasets as input, allowing users to visualize subsets as interaction networks and to perform gene-set enrichment analysis on the entire input.
Abstract: Proteins and their functional interactions form the backbone of the cellular machinery. Their connectivity network needs to be considered for the full understanding of biological phenomena, but the available information on protein-protein associations is incomplete and exhibits varying levels of annotation granularity and reliability. The STRING database aims to collect, score and integrate all publicly available sources of protein-protein interaction information, and to complement these with computational predictions. Its goal is to achieve a comprehensive and objective global network, including direct (physical) as well as indirect (functional) interactions. The latest version of STRING (11.0) more than doubles the number of organisms it covers, to 5090. The most important new feature is an option to upload entire, genome-wide datasets as input, allowing users to visualize subsets as interaction networks and to perform gene-set enrichment analysis on the entire input. For the enrichment analysis, STRING implements well-known classification systems such as Gene Ontology and KEGG, but also offers additional, new classification systems based on high-throughput text-mining as well as on a hierarchical clustering of the association network itself. The STRING resource is available online at https://string-db.org/.

10,584 citations

01 Jun 2012
TL;DR: SPAdes as mentioned in this paper is a new assembler for both single-cell and standard (multicell) assembly, and demonstrate that it improves on the recently released E+V-SC assembler and on popular assemblers Velvet and SoapDeNovo (for multicell data).
Abstract: The lion's share of bacteria in various environments cannot be cloned in the laboratory and thus cannot be sequenced using existing technologies. A major goal of single-cell genomics is to complement gene-centric metagenomic data with whole-genome assemblies of uncultivated organisms. Assembly of single-cell data is challenging because of highly non-uniform read coverage as well as elevated levels of sequencing errors and chimeric reads. We describe SPAdes, a new assembler for both single-cell and standard (multicell) assembly, and demonstrate that it improves on the recently released E+V-SC assembler (specialized for single-cell data) and on popular assemblers Velvet and SoapDeNovo (for multicell data). SPAdes generates single-cell assemblies, providing information about genomes of uncultivatable bacteria that vastly exceeds what may be obtained via traditional metagenomics studies. SPAdes is available online ( http://bioinf.spbau.ru/spades ). It is distributed as open source software.

10,124 citations

01 Jan 2014
TL;DR: These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, treatment goals, and tools to evaluate the quality of care.
Abstract: XI. STRATEGIES FOR IMPROVING DIABETES CARE D iabetes is a chronic illness that requires continuing medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications. Diabetes care is complex and requires that many issues, beyond glycemic control, be addressed. A large body of evidence exists that supports a range of interventions to improve diabetes outcomes. These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, treatment goals, and tools to evaluate the quality of care. While individual preferences, comorbidities, and other patient factors may require modification of goals, targets that are desirable for most patients with diabetes are provided. These standards are not intended to preclude more extensive evaluation and management of the patient by other specialists as needed. For more detailed information, refer to Bode (Ed.): Medical Management of Type 1 Diabetes (1), Burant (Ed): Medical Management of Type 2 Diabetes (2), and Klingensmith (Ed): Intensive Diabetes Management (3). The recommendations included are diagnostic and therapeutic actions that are known or believed to favorably affect health outcomes of patients with diabetes. A grading system (Table 1), developed by the American Diabetes Association (ADA) and modeled after existing methods, was utilized to clarify and codify the evidence that forms the basis for the recommendations. The level of evidence that supports each recommendation is listed after each recommendation using the letters A, B, C, or E.

9,618 citations

Journal ArticleDOI
TL;DR: A short cervical length and a raised cervical-vaginal fetal fibronectin concentration are the strongest predictors of spontaneous preterm birth.

6,275 citations