Objective To identify candidate genes and genetic variants for preeclampsia using a bioinformatic approach to extract and organize genes and variants from the published literature. Methods Semantic data mining and natural language processing were used to identify articles from the published literature meeting criteria for potential association with preeclampsia. Articles were manually reviewed by trained curators. Cluster analysis was used to aggregate the extracted genes into gene sets associated with preeclampsia or severe preeclampsia, early or late preeclampsia, maternal or fetal tissue sources, and concurrent conditions (i.e., fetal growth restriction (FGR), gestational hypertension, or hemolysis, elevated liver enzymes, and low platelet count). Gene ontology was used to organize this large group of genes into ontology groups. Results From more than 22 million records in PubMed, with 28,000 articles on preeclampsia, our data mining tool identified 2,300 articles with potential genetic associations with preeclampsia-related phenotypes. After curation, 729 articles were “accepted” that contained ‘statistically significant’ associations with 535 genes. We saw distinct segregation of these genes by severity and timing of preeclampsia, by maternal or fetal source, and with associated conditions (e.g., gestational hypertension, fetal growth restriction, or hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome). Conclusion The gene sets and ontology groups identified through our systematic literature curation indicate that preeclampsia represents several distinct phenotypes, with distinct and overlapping maternal and fetal genetic contributions.

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Background Use of PICCs has been rising since 2001. They are used when long-term intravenous access is needed and for blood draws in patients with difficult venous access. Objective To determine which risk factors contribute to inappropriate PICC line insertion defined as removal of a PICC within five days of insertion for reasons other than a PICC complication. Design Retrospective, observational study. Setting Tertiary-care, Level 1 trauma center. Patients Adult patients with a PICC removed 1/1/2017 to 5/4/2020. Measurements Frequency of PICC removal within five days of insertion and associated risk factors for early removal. Results Between 1/1/2017 and 5/4/2020, 995 of 5348 PICCs inserted by the IV nursing team were removed within five days (19%). In 2017, 5 of 429 PICCs developed a central line-associated infection (1.2%) and 29 of 429 PICCs developed symptomatic venous thromboembolism (6.7%). Patients with PICCs whose primary service was in an ICU were independently at higher risk of early removal (OR 1.44, 95% CI 1.14, 1.83); weekday insertion was independently associated with a lower likelihood of early removal compared to weekend insertion (OR 0.60; 95% CI 0.49, 0.75). Limitation PICC removal after discharge was not assessed and paper records were likely incomplete and biased. Conclusion Nearly one in five PICCs were removed within five days. Patients whose primary team was in an ICU and PICCs ordered on weekends were at independently higher risk of early removal.