bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pregnancy outcomes following second‐trimester abortions: A comparison between medical and surgical management. A historic cohort study
Authors: Abokaf Hanaa , Korytnikova Elena , Yaniv‐Salem Shimrit , Shoham‐Vardi Ilana , Sergienko Ruslan , Sheizaf Boaz , Weintraub Adi Y. 
Published: October 2024

AbstractObjectiveTo compare perinatal outcomes in subsequent pregnancies following second‐trimester abortions, stratified by the method of abortion.MethodsA historic cohort study was conducted in a single tertiary hospital, including women who had second‐trimester abortions between 12+0 and 24+0 weeks and subsequent documented pregnancies within 3–60 months. Data were collected from hospitalization and perinatal databases. Composite outcome variables were constructed, and multivariable logistic regression was used to analyze associations, adjusting for confounders.ResultsAmong 771 women meeting the inclusion criteria, 83% had surgical abortions and 17% had medical abortions. Medical abortion was associated with a higher incidence of placenta‐associated pregnancy complications compared with surgical abortion. No significant differences were found in other perinatal outcomes.ConclusionThe study highlights the potential influence of the abortion method on subsequent pregnancy outcomes, particularly regarding placenta‐associated complications. This underscores the importance of considering the method of second‐trimester abortion in counseling women regarding potential risks to subsequent pregnancies. Adverse outcomes in subsequent pregnancies following second‐trimester abortion were associated with the medical method of abortion, warranting further research and careful counseling in clinical practice.
Association of gestational trophoblastic disease with subsequent development of non‐trophoblastic cancer
Authors: Munyakarama Blaise , Koushik Anita , Leduc Valérie , Healy‐Profitós Jessica , Auger Nathalie 
Published: October 2024

AbstractObjectiveTo evaluate the association between gestational trophoblastic disease and the subsequent risk of developing non‐trophoblastic cancer.MethodsWe conducted a retrospective cohort study of 3084 women with gestational trophoblastic disease and 1 415 812 women with obstetric deliveries in Quebec, Canada, between 1989 and 2021. The main exposure was gestational trophoblastic disease, including hydatidiform moles, invasive moles, and gestational choriocarcinoma. The outcome was development of non‐trophoblastic cancer during 33 years of follow‐up. We measured the association of gestational trophoblastic disease with non‐trophoblastic cancer using adjusted hazard ratios (HR) and 95% confidence intervals (CI), and tested whether associations were stronger for certain types of cancer or cancers with later onset.ResultsThe incidence of non‐trophoblastic cancer was greater for women with invasive moles (47.1/10 000 person‐years) and gestational choriocarcinoma (59.3/10 000 person‐years) than hydatidiform moles (18.4/10 000 person‐years) and no gestational trophoblastic disease (22.4/10 000 person‐years). Gestational choriocarcinoma (HR 2.33, 95% CI: 1.35–4.01; P = 0.002) and invasive moles (HR 1.97, 95% CI: 1.06–3.65; P = 0.033) were associated with an elevated risk of non‐trophoblastic cancer compared with no gestational trophoblastic disease, while hydatidiform moles were not. Gestational choriocarcinoma and invasive moles were mainly associated with gynecologic cancer. However, risk of cancer was limited to the short‐term period after pregnancy and became similar to no gestational trophoblastic disease by the end of follow‐up.ConclusionWhile invasive moles and gestational choriocarcinoma appear to be associated with the subsequent development of non‐trophoblastic cancer, the absolute risk is small and limited to the short‐term.
Novel risk factors associated with retained placenta after vaginal birth
Authors: Nasser Basel H. , Jadaon Jimmy E. , Awad‐Khamaisy Nibal , Lfoul Luna Abo , Hendler Israel 
Published: October 2024

AbstractObjectiveTo evaluate maternal and obstetric risk factors associated with retained placenta following singleton live vaginal births.MethodsWe conducted a retrospective cohort study of women diagnosed with retained placenta after singleton live vaginal birth at or after 24 weeks of gestation, compared in a 1:2 ratio with women who had uncomplicated vaginal deliveries. The study and control groups were matched for maternal age, gestational age, and parity. Multivariate regression analysis assessed potential risk factors related to retained placenta.ResultsIn all, 15,260 women who delivered at our medical center(both vaginal and non‐vaginal)between 2015 and 2022, 170 (1.1%) were diagnosed with retained placenta. Ninety‐nine women (0.65%) who met the inclusion criteria were matched with 198 controls (1.3%). Multivariate logistic regression identified potential risk factors not previously described for retained placenta, including in vitro fertilization (OR 3.8, 95% CI 1.3–11.7, P = 00.018), large‐for‐gestational‐age fetuses (OR 28.2, 95% CI 5.4–148.5, P = 00.029), and endometriosis (OR 8.2, 95% CI 0.92–20, P = 00.024). Additional risk factors included pre‐eclampsia, labor induction, vacuum‐assisted delivery, and prolonged second‐stage labor.ConclusionThis study identifies critical risk factors for retained placenta, highlighting the importance of early identification to improve maternal and neonatal outcomes.
Risk factors for relaparotomy after cesarean delivery
Authors: Hendin Natav , Seidman Liron , Geron Yossi , Zeevi Gil , Hadar Eran , Walfisch Asnat , Houri Ohad 
Published: October 2024

AbstractObjectiveTo identify and analyze risk factors associated with relaparotomy following cesarean delivery (CD), focusing on obstetric and surgical parameters.MethodsRetrospective case–control study conducted at a high‐volume tertiary obstetric center. We reviewed all women who underwent CD between 2013 and 2023. Patients who required a relaparotomy, defined as the reopening of the fascia, were included in the study group. Patient data were systematically reviewed to identify potential risk factors contributing to the need for post‐CD relaparotomy, compared with a control group that did not undergo a relaparotomy.ResultsOut of 11 465 women underwent CD, 59 (0.5%) required relaparotomy. Using a multivariate model for independent risk factors, we found the following to be associated with relaparotomy: emergency CD (adjusted odds ratio [aOR] 3.09, 95% confidence interval [CI] 1.78–5.38, P < 0.01), placenta previa (aOR 4.66, 95% CI 1.54–14.11, P < 0.01), and multiple gestation as indications for the CD (aOR 4.61, 95% CI 2.10–10.12, P < 0.01); estimated intraoperative blood loss of more than 1 L (aOR 5.98, 95% CI 2.79–12.80, P < 0.01); and intraoperative adhesions (aOR 7.12, 95% CI 4.06–12.48, P < 0.01).ConclusionsOur study underscores the multifactorial nature of relaparotomy after CD, emphasizing the significance of considering a broad array of risk factors. By identifying and understanding these factors, clinicians can optimize patient care and potentially reduce morbidity, particularly the need for subsequent surgical interventions.
M‐Net: A Skin Cancer Classification With Improved Convolutional Neural Network Based on the Enhanced Gray Wolf Optimization Algorithm
Authors: Xu Zhinan , Zhang Xiaoxia , Liu Luzhou 
Published: October 2024

ABSTRACTSkin cancer is a common malignant tumor causing tens of thousands of deaths each year, making early detection essential for better treatment outcomes. However, the similar visual characteristics of skin lesions make it challenging to accurately differentiate between lesion types. With advancements in deep learning, researchers have increasingly turned to convolutional neural networks for skin cancer detection and classification. In this article, an improved skin cancer classification model M‐Net is proposed, and the enhanced gray wolf optimization algorithm is combined to improve the classification performance. The gray wolf optimization algorithm guides the wolf pack to prey through a multileader structure and gradually converges through the encirclement and pursuit mechanism, so as to perform a more detailed search in the later stage. To further improve the performance of the gray wolf optimization, this study introduces the simulated annealing algorithm to avoid falling into the local optimal state and expands the search range by improving the search mechanism, thus enhancing the global optimization ability of the algorithm. The M‐Net model significantly improves the accuracy of classification by extracting features of skin lesions and optimizing parameters with the enhanced gray wolf optimization algorithm. The experimental results based on the ISIC 2018 dataset show that compared with the baseline model, the feature extraction network of the model has achieved a significant improvement in accuracy. The classification performance of M‐Net is excellent in multiple indicators, with accuracy, precision, recall, and F1 score reaching 0.891, 0.857, 0.895, and 0.872, respectively. In addition, the modular design of M‐Net enables it to flexibly adjust feature extraction and classification modules to adapt to different classification tasks, showing great scalability and applicability. In general, the model proposed in this article performs well in the classification of skin lesions, has broad clinical application prospects, and provides strong support for promoting the diagnosis of skin diseases.
HIF1A/PCDH7 axis mediates fatty acid synthesis and metabolism to inhibit lung adenocarcinoma anoikis
Authors: Yang Xiaoyan , Zhang Qingfeng , Wei Liyang , Liu Kui 
Published: October 2024

AbstractBackgroundAberrantly expressed PCDH7 participates in the malignant progression of many cancers. PCDH7 has been newly discovered as a risk factor in lung cancer, but its functional study in lung adenocarcinoma (LUAD) has not been conducted yet. This study aimed to investigate the functional role of PCDH7 in LUAD.MethodsBioinformatics analyzed the expression of PCDH7 and HIF1A in LUAD tissues, predicted the binding sites between the two, analyzed the clinicopathological relevance of PCDH7 and examined the pathway enrichment of PCDH7. Expression of PCDH7 and HIF1A in LUAD cells was analyzed by RT‐qPCR. A nude mouse transplantation tumor model was constructed to analyze the effect of PCDH7 on tumor growth in vivo. The binding relationship between PCDH7 and HIF1A was confirmed by chromatin immunoprecipitation experiments and the dual‐luciferase assay. Cell viability was detected with Cell Counting Kit‐8. Triglyceride content and Caspase3 activity were measured using corresponding reagent kits. FASN and ACC1 expression was determined utilizing western blot.ResultsPCDH7 was highly expressed in LUAD and correlated with patients' overall survival time and N stage. In vitro and in vivo experiments confirmed that PCDH7 could promote LUAD growth and anoikis resistance. Moreover, overexpression of PCDH7 markedly increased the content of triglycerides in cells and promoted the expression of FASN and ACC1 proteins to inhibit LUAD cell anoikis. Cell rescue experiment confirmed that HIF1A activated PCDH7 to suppress LUAD anoikis by promoting fatty acid (FA) synthesis and metabolism.ConclusionOur findings demonstrated that the HIF1A/PCDH7 axis suppressed LUAD anoikis by promoting FA synthesis and metabolism. The FA synthesis pathway might be a key pathway regulated by PCDH7 in LUAD anoikis.
A novel quinazoline derivative exhibits potent anticancer cytotoxicity via apoptosis and inhibition of angiogenesis in DMBA‐induced mammary gland carcinoma
Authors: Rani Soniya , Trivedi Rimjhim , Ansari Mohd. Nazam , Saeedan Abdulaziz S. , Kumar Dinesh , Singh Sunil Kumar , Mukherjee Alok , Singh Manjari , Kaithwas Gaurav 
Published: October 2024

AbstractMammary gland carcinoma is one of the most prevalent and deadly diseases among women globally. It is a type of solid malignant tumor. In this malignant tumor, the microenvironment becomes hypoxic in rapidly proliferating cancer cells. These cells undergo adaptive changes through the expression of hypoxia‐inducible factor‐1alpha (HIF‐1α) which is regulated by factor inhibiting HIF‐1α (FIH‐1). Considering this, we hypothesized that the chemical activation of FIH‐1 would inhibit the hypoxic activity of HIF‐1α in mammary gland carcinoma. A library of 67,609 chemical compounds was virtually screened against FIH‐1 based on Lipinski's rule from the ZINC database. The BBAP‐8 has been selected based on an excellent docking score (−8.352 Kcal/mol), favorable ADMET, and potential FIH‐1 activator profile. Further, its in‐vitro cytotoxicity and apoptotic activity were scrutinized against MCF‐7 cells and in‐vivo activity against 7,12‐dimethylbenz[a]anthracene (DMBA) induced mammary gland carcinoma in Wistar rats. It exhibited significant cytotoxicity (IC50 = 16.59 ± 0.49 μM) and activated apoptosis when scrutinized through DAPI, AO/EB, and JC‐1 staining. Also, oral administration of BBAP‐8 restored hemodynamic changes, normalized tissue architecture, and corrected metabolic abnormalities. The western blot analysis and mRNA expression analysis validated that BBAP‐8 has the potential to activate FIH‐1 with the downregulation of GLUT‐1, VEGF, and Twist‐1. Moreover, BBAP‐8 fostered apoptosis, when evaluated through BCL‐2, BAX, Caspase‐8, and Caspase‐3. Based on research findings, this implies that BBAP‐8 activates FIH‐1 and can be effective in chemotherapeutic treatment of mammary gland carcinoma.
Daidzein ameliorates experimental traumatic brain injury‐induced neurological symptoms by suppressing oxidative stress and apoptosis
Authors: Haider Tehreem , Khan Salman , Bibi Tehmina , Zahra Sana Ali , Ali Hussain , Din Fakhar ud , Shah Fawad Ali , Youn Isoo , Seo Eun Kyoung 
Published: October 2024

AbstractTraumatic brain injury (TBI) causes deficits in neurological function, induces pathological changes, and increases oxidative stress. The current investigation aimed to determine Daidzein's neuroprotective potential in experimental TBI. Initially, the HT‐22 cell line exposed to H2O2 underwent in vitro examination, and the results showed that Daidzein had a neuroprotective effect evident from enhanced cell viability and decreased NO generation. Using three different Daidzein doses—1 mg/kg, 5 mg/kg, and 10 mg/kg—in the in vivo experiment, the potential of Daidzein was evaluated against TBI. The neurological severity score (NSS), kondziela's screen test, and elevated plus maze showed improvements after treatment with Daidzein manifested by decreased score, enhanced motor coordination, and anti‐anxiety effects. Additionally, Daidzein improved mechanical allodynia and restored the breakdown of the blood‐brain barrier. The FTIR spectral analysis showed restoration of the biochemical compositional changes. Furthermore, H & E and Toluidine blue staining revealed an improvement in the histopathological alterations. The RT‐qPCR revealed an increase in mRNA expression level of Nrf2, HO‐1, and Bcl‐2 and the downregulation of Keap‐1, Bax and Cleaved caspase‐3 expressions. Thus, exhibiting its antioxidant and antiapoptotic potential. The RT‐qPCR also manifested a decrease in mRNA expression of GFAP and Iba‐1. Further immunohistochemistry results indicated Daidzein's antioxidant and antiapoptotic properties by upregulating Nrf2 and downregulating cleaved caspase‐3. Daidzein also lowered the apoptosis index and improved neuronal survival evidenced by flow cytometric analysis. In addition to this, Daidzein notably increased the antioxidant enzyme levels and decreased the oxidative stress markers. The current study's findings point to the neuroprotective potential of the phytoestrogen Daidzein as it lessened neurological abnormalities, decreased oxidative stress, and lowered proapoptotic protein expression.
Multimodal action of phosphodiesterase 5 inhibitors against neurodegenerative disorders: An update review
Authors: Singh Niraj Kumar , Singh Pranjul , Varshney Prachi , Singh Ashini , Bhushan Bharat 
Published: October 2024

AbstractPhosphodiesterase type 5 (PDE5) is an enzyme primarily found in the smooth muscle of the corpus cavernosum and also highly expressed in the substantia nigra, cerebellum, caudate, hippocampal regions and cerebellar purkinje cells, responsible for selectively breaking down cyclic guanosine monophosphate (cGMP) into 5′‐GMP and regulate intracellular cGMP levels. As a second messenger, cyclic GMP enhances signals at postsynaptic receptors and triggers downstream effector molecules, leading to changes in gene expression and neuronal responses. Additionally, cGMP signaling transduction cascade, present in the brain, is also essential for learning and memory processes. Mechanistically, PDE5 inhibitors share structural similarities with cGMP, competitively binding to PDE5 and inhibiting cGMP hydrolysis. This action enhances the effects of nitric oxide, resulting in anti‐inflammatory and neuroprotective effects. Neurodegenerative disorders entail the progressive loss of neuron structure, culminating in neuronal cell death, with currently available drugs providing only limited symptomatic relief, rendering neurodegeneration considered incurable. PDE5 inhibitors have recently emerged as a potential therapeutic approach for neurodegeneration, neuroinflammation, and diseases involving cognitive impairment. This review elucidates the principal roles of 3′,5′‐cyclic adenosine monophosphate (cAMP) and cGMP signaling pathways in neuronal functions, believed to play pivotal roles in the pathogenesis of various neurodegenerative disorders. It provides an updated assessment of PDE5 inhibitors as disease‐modifying agents for conditions such as Alzheimer's disease, Parkinson's disease, multiple sclerosis, cerebral ischemia, Huntington's disease, and neuroinflammation. The paper aims to review the current understanding of PDE5 inhibitors, which concurrently regulate both cAMP and cGMP signaling pathways, positing that they may exert complementary and synergistic effects in modifying neurodegeneration, thus presenting a novel direction in therapeutic discovery. Moreover, the review provides critical about biological functions, therapeutic potentials, limitations, challenges, and emerging applications of selective PDE5 inhibitors. This comprehensive overview aims to guide future academic and industrial endeavors in this field.
Microfracture for medium size to large knee chondral defects has limited long‐term efficacy: A systematic review
Authors: Gopinatth Varun , Jackson Garrett R. , Touhey Daniel C. , Chahla Jorge , Smith Matthew V. , Matava Matthew J. , Brophy Robert H. , Knapik Derrick M. 
Published: October 2024

AbstractPurposeTo evaluate clinical and radiographic outcomes, return to sport, failure rate, operations and complications in patients undergoing microfracture of the knee, including the femoral condyle, tibial plateau, patella and trochlea, at a mean 10‐year or greater follow‐up.MethodsA literature search was performed by querying SCOPUS, PubMed, Medline and the Cochrane Central Register for Controlled Trials from database inception through May 2023 according to the 2020 Preferred Reporting Items for Systematic Reviews and Meta‐Analyses statement. Inclusion criteria were level I‐IV human studies reporting on outcomes, reoperations and complications following microfracture of the knee at a mean 10‐year or greater follow‐up. Biomechanical and epidemiological studies, including patients undergoing concomitant realignment procedures, and studies with patients under 18 years old were excluded. Data regarding failure, as defined by each study, as well as reoperations were gathered. Study quality was assessed via the Methodological Index for Nonrandomized Studies criteria.ResultsNine studies from 2003 to 2018, consisting of 727 patients (mean age 38.9 ± 8.1 years; range 25.8–47.6) undergoing microfracture for chondral defects in the knee were identified. Mean follow‐up ranged from 10 to 17 years. Males composed 56.5% of patients, with a mean defect size ranging from 2.3 to 4.01 cm2. Based on radiographs at follow‐up, osteoarthritis progression occurred in 40%–48% of patients. Magnetic Resonance Observation of Cartilage Repair Tissue scores were low. Patient‐reported outcome measures showed significant improvement in postoperative scores at final follow‐up. Return‐to‐sport rate ranged from 17.2% to 20%. Longitudinal analysis revealed declining clinical outcomes and return‐to‐sport rates from short‐ and mid‐ to long‐term follow‐up. There was high variability in failure definition and reoperations, with 2.9%–41% of patients requiring total knee arthroplasty.ConclusionsAt a mean 10‐year or greater follow‐up, microfracture for chondral defects of the knee 2–4 cm2 in size demonstrated a high rate of osteoarthritis progression with poor healing of the chondral defect and low overall return‐to‐sport rates. Failure and reoperation rates ranged from 2.9% to 41%, with declining outcomes from short‐ and mid‐ to long‐term follow‐up. The advantages of microfracture relating to availability, complexity, and cost should be weighed against concerns about long‐term success, particularly with medium‐size and larger lesions.Level of EvidenceLevel IV systematic review.
Same same but different—Image‐based versus imageless robotic‐assisted total knee arthroplasty!
Authors: Hirschmann Michael T. , Avram George , Graichen Heiko , Tandogan Reha N. , Mengis Natalie , Zaffagnini Stefano 
Published: October 2024

AbstractRobotic‐assisted total knee arthroplasty (RTKA) has gained widespread acceptance due to its demonstrated ability to improve surgical accuracy compared to conventional total knee arthroplasty (CTKA). While the precise impact of RTKA on postoperative patient‐reported outcome measures (PROMs) remains inconclusive, the increased accuracy in alignment and joint kinematics suggests potential improvements in patient satisfaction and functional outcomes. Two primary RTKA systems exist: image‐based, which uses preoperative CT scans for detailed 3D modeling, and image‐less, which relies on intra‐operative digitization of anatomical landmarks. Both systems aim to achieve accurate implant placement and soft‐tissue balancing, yet they differ in methodology and reliance on preoperative data.Despite RTKA's theoretical advantages, there is ongoing debate about whether accuracy alone is sufficient to achieve optimal postoperative outcomes, particularly concerning joint kinematics and alignment strategies. Literature reveals no significant difference in coronal plane alignment between image‐based and image‐less systems, though image‐less systems may be more prone to varus errors due to the reliance on intra‐articular landmarks. Additionally, image‐free systems may face challenges in replicating native knee anatomy, especially in the sagittal plane, leading to potential limitations in achieving ideal tibial slope reconstruction.The future of RTKA may lie in refining implant positioning strategies that minimize postoperative alterations to pre‐arthritic knee kinematics, particularly with standardized off‐the‐shelf implants. As robotic technology evolves, there is potential to enhance surgical outcomes by combining accuracy with personalized alignment approaches that better address individual patient anatomy. Further research is needed to assess the long‐term clinical benefits of RTKA and its capacity to improve patient‐specific functional outcomes.Level of evidencelevel 5