bluuebunny/crossref_metadata_2025_split huggingface dataset:
Luddite or technophile?—policy preferences for governing technology-driven economic change
Authors: Lee Jaewook 
Published: May 2024

Abstract
Recent robotics and artificial intelligence advancements have exacerbated fears of technology-driven unemployment and inequality. However, the relationship between automation risks and regulatory policy support remains inconclusive. Moreover, the role of institutional safety net in shaping this connection, and factors influencing preference shifts regarding automation, remain understudied. This study conducts an online survey experiment in the UK and Sweden to address these gaps. First, we find subjective concern, and occupational risks combined with perceived weaker labor market safeguards, lead to calls for automation restriction and job loss compensation. These trends are particularly pronounced in the UK, where institutional protection for workers is less robust. Second, people support accelerating technology-driven change when they see its benefits shared widely, but this shift is mainly observed among individuals relatively safer from automation risks. Our findings suggest strengthening the institutional safety net and envisioning equitable benefit-sharing are crucial for moderating public anxiety toward technology-driven economic change.
The role of YAP/TAZ on joint and arthritis
Authors: Lu Mingcheng , Zhu Mengqi , Wu Zuping , Liu Wei , Cao Chuwen , Shi Jiejun 
Published: May 2024

AbstractOsteoarthritis (OA) and rheumatoid arthritis (RA) are two common forms of arthritis with undefined etiology and pathogenesis. Yes‐associated protein (YAP) and its homolog transcriptional coactivator with PDZ‐binding motif (TAZ), which act as sensors for cellular mechanical and inflammatory cues, have been identified as crucial players in the regulation of joint homeostasis. Current studies also reveal a significant association between YAP/TAZ and the pathogenesis of OA and RA. The objective of this review is to elucidate the impact of YAP/TAZ on different joint tissues and to provide inspiration for further studying the potential therapeutic implications of YAP/TAZ on arthritis. Databases, such as PubMed, Cochran Library, and Embase, were searched for all available studies during the past two decades, with keywords “YAP,” “TAZ,” “OA,” and “RA.”
Fertility-Sparing Surgery for Stage I Epithelial Ovarian Cancer: A Population-Based Assessment in the United States [ID 2693178]
Authors: Song Bonnie B. , Anderson Zachary S. , Masjedi Aaron D. , Lee Matthew W. , Mandelbaum Rachel S. , Klar Maximilian , Roman Lynda D. , Wright Jason D. , Matsuo Koji 
Published: May 2024

INTRODUCTION:
The objective of this study was to assess population-level utilization and outcome of reproductive-aged patients with early epithelial ovarian cancer (EOC) who underwent fertility-sparing surgery (FSS) in the United States.

METHODS:
This population-based retrospective study queried the National Cancer Institute’s Surveillance, Epidemiology, and End Result Program. The study included 3,027 patients aged less than 50 years with stage I EOC receiving primary surgical therapy from 2007 to 2020. Fertility-sparing surgery was defined as preservation of one ovary and the uterus for unilateral lesion and preservation of the uterus for bilateral lesions. Temporal trend of FSS was assessed with linear segmented regression with log-transformation. Overall survival (OS) associated with FSS was assessed with Cox proportional hazard regression model.

RESULTS:
A total of 534 (17.6%) patients underwent FSS. At cohort level, the utilization of FSS was 13.4% in 2007 and 21.8% in 2020 (P-trend=.009). Non-Hispanic White individuals (2.8-fold), high-grade serous histology (2.2-fold), and stage IC disease (2.3-fold) had greater than 2-fold increase in FSS utilization during the study period (all, P-trend<.05). After controlling for the measured clinico-pathological characteristics, patients who received FSS had OS comparable to those who had nonsparing surgery (5-year rates, 93.6% versus 92.1%; adjusted hazard ratio, 0.87; 95% CI, 0.57–1.35). This survival association was consistent in high-grade serous (5-year rates, 92.9% versus 92.4%), low-grade serous (100% versus 92.2%), clear cell (97.5% versus 86.1%), mucinous (92.1% versus 86.6%), low-grade endometrioid (95.7% versus 97.7%), and mixed histology (93.3% versus 83.7%) (all, P>.05). In high-grade endometrioid tumor, FSS was associated with decreased OS (5-year rates, 71.9% versus 93.8%; adjusted-hazard ratio 2.90; 95% CI, 1.09–7.67). Among bilateral ovarian lesions, FSS was not associated with OS (5-year rates, 95.8% versus 92.5%; P=.364).

CONCLUSION:
Nearly one in five reproductive-aged patients with stage I EOC underwent FSS in recent years in the United States. The data suggest that FSS may not adversely affect OS, except for high-grade endometrioid tumors.
Increased Risk of Adverse Pregnancy Outcomes With Prior COVID-19 Infection [ID 2683650]
Authors: Soudah Chris , Karam Kathleen , Golovko George , Vincent Kathleen L. , Yaklic Jerome L. 
Published: May 2024

INTRODUCTION:
Prior retrospective studies found that COVID-19 infection during pregnancy is associated with an increased risk of adverse pregnancy outcomes such as preeclampsia, gestational diabetes, and preterm labor. Our study aims to investigate the risks of adverse pregnancy outcomes associated with COVID-19 infection acquired at least 3 months prior to pregnancy.

METHODS:
De-identified data was obtained from the TriNetX database. Population was stratified to compare women of childbearing age (15–45 years old) who contracted COVID-19 within 3–12 months prior to pregnancy to women without a history of COVID-19. Outcomes were measured within 1 year of pregnancy diagnosis to assess the effects of COVID-19. Statistical analyses used risk ratios (RRs) and P-values less than .05 to measure significance.

RESULTS:
This study identified 5,578 patients who contracted COVID-19 3–12 months prior to pregnancy and 970,218 patients without COVID-19 prior to matching for demographics and diagnoses. Cohorts were balanced (n=5,578 per cohort) using (1:1) propensity score matching for age, sex, race/ethnicity. Patients who contracted COVID-19 prior to pregnancy had a higher risk for preeclampsia (RR 1.428; P<.0001), fetal growth restriction (RR 5.613; P<.0001), and antepartum hemorrhage (RR 1.649; P<.0001). Preterm labor, death, and gestational diabetes were not significant.

CONCLUSION:
Patients who contracted COVID-19 between 3 and 12 months prior to pregnancy have an increased risk for preeclampsia, fetal growth restriction, and antepartum hemorrhage compared to patients without COVID-19. Further investigation is warranted to validate these findings in prospective studies and to guide peripartum care for this population.
Gender-Affirming Hysterectomies: Analysis of Temporal Trends and Characteristics Pre- and Post-Expansion of Health Care Coverage at a Large Integrated California Health Care System [ID 2683540]
Authors: Radoc Jeannie Gail G. , Zhao Yanting , Tucker Lue-Yen , Huynh Ashley , Ritterman Weintraub Miranda L. , Zaritsky Eve 
Published: May 2024

INTRODUCTION:
Despite expansion of gender-affirming health care coverage in 2013, few studies have investigated temporal trends in gender-affirming surgeries (GAS) including hysterectomies. Our study aims to investigate the temporal trends of hysterectomies for transgender men and gender-diverse persons (TGD) compared to cisgender women between 2010–2012 and 2013–2019, and annually from 2010 to 2019.

METHODS:
We conducted an observational retrospective cohort study on TGD and cisgendered patients, aged 18 and older, within Kaiser Permanente Northern California (KPNC) between 2010 and 2019. Data on demographics, surgical characteristics, concurrent procedures, and postoperative complications were extracted from electronic medical records. Bivariate comparisons were performed using chi-squared analysis for categorical variables and t-tests for continuous variables.

RESULTS:
This study included 41,341 hysterectomies performed within KPNC between 2010 and 2019. Among all hysterectomies, 461 (1.1%) were for TGD. TGD who underwent hysterectomies were more likely to be younger, White, and nulliparous compared to their cisgender counterparts (P<.05). The incidence of hysterectomies remained similar in cisgender women—from 3,750 (99.7%) in 2010 to 4,361 (98.4%) in 2019. For TGD, the incidence of hysterectomies increased gradually—from 10 (0.3%) in 2010 to 70 (1.6%) in 2019, with the largest increase occurring from 40 (1.0%) hysterectomies in 2014 to 62 (1.5%) in 2015. After expansion of GAS coverage, hysterectomy rates increased eightfold from 55 (0.5%) in 2010–2012 to 406 (1.4%) in 2013–2019.

CONCLUSION:
Gender-affirming hysterectomies have increased substantially because of changes in GAS policies. Future data will evaluate trends of ovarian conservation during concurrent GAS hysterectomy.
Vaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) for Gender Affirmation [ID 2683658]
Authors: Mohr-Sasson Aya , Hui Mason , Bonilla Moreno Miguel A. , Montealegre Alvaro I. 
Published: May 2024

INTRODUCTION:
The process of transitioning from female to male in transgender persons usually includes medical treatment as well as surgical interventions, including removal of the uterus and ovaries. Nulliparity and prolonged exposure of the vaginal mucosa to testosterone, which are common among transgender men, may present challenges to perform a vaginal hysterectomy with salpingo-oophorectomy. The aim of this study is to describe outcomes of vaginal-assisted natural orifice transluminal endoscopic surgery (vNOTES) approach to perform hysterectomy among transgender men as part of their gender-affirming care.

METHODS:
This is a case series observational study conducted at single tertiary medical center including all patients undergoing hysterectomy with bilateral salpingo-oophorectomy by vNOTES approach for gender-affirming care between February 2022 and April 2023. Primary outcome was defined as compound complication rate including intraoperative and postoperative. Patients' demographic and clinical charectaristics were collected from the electronic medical files. Pain at postoperative follow-up was evaluated using visual analog scores, which ranges from 0 (no pain) to 10 (worst pain possible).

RESULTS:
The study population included eight transgender men, all of whom were nulliparous and had undergone testosterone treatment for more than a year. Median age at surgery was 24 years and median body mass index was 30 kg/m2. Mean operative time of the surgery was 111 minutes (range: 91–143 minutes) and none required converting from vNOTES to an alternative approach. No extensive bleeding or organ damage was reported. For one patient, there was one small vaginal laceration requiring suture. All but one patient was discharged the same day. The patient requiring next-day discharge was complicated by postoperative urinary retention. On postoperative follow-up, median pain score was 3 (range: 1–5).

CONCLUSION:
Outcomes from this case series suggest that a vNOTES approach to hysterectomy among transgender men can be performed without surgical complications and with low self-reported pain.
Assessing Pregnant Patients' Postpartum Contraceptive Plans After the SCOTUS Dobbs Decision in a Highly Restrictive State [ID 2683439]
Authors: Mastronardi Alicia , Young Megan Lacy , Oyedeji Oluwafemifola , King Rylee , Maples Jill M. , Zite Nikki 
Published: May 2024

INTRODUCTION:
The June 2022 SCOTUS Dobbs decision removed federal protection to abortion access. In August 2022, a Tennessee trigger law made ending a pregnancy for any reason a felony. We hypothesized that this change would result in more pregnant patients desiring highly effective (long-acting or permanent) contraceptive methods after delivery.

METHODS:
This retrospective cohort analysis used electronic health records to capture demographic and pregnancy data for pregnant patients admitted for delivery in one East Tennessee hospital. Documented contraceptive plans chosen during pregnancy were categorized as highly effective (long acting or permanent) or moderate/least effective. Data were extracted from July 2019 to April 2020 (baseline) and compared to July 2022 to April 2023 (post-Dobbs). Chi-squared tests and binary logistic regression were conducted in SPSS.

RESULTS:
One-half (50.6%) of 7,489 records analyzed were post-Dobbs; 90.4% had a documented contraception plan upon hospital admission. Record of choosing a highly effective contraception plan during pregnancy decreased significantly baseline to post-Dobbs (47.2% to 39.6%; P<.001). Logistic regression was used to further analyze the relationship between the Dobbs decision and highly effective contraception plan desired postpartum. Patients who delivered after the Dobbs decision had lower odds (adjusted odds ratio 0.726; 95% CI [0.652, 0.809]; P<.001) of having highly effective contraception plans after controlling for age, number of living children, race/ethnicity, and insurance.

CONCLUSION:
A lower percentage of patients from the post-Dobbs cohort desired highly effective contraception after delivery. Further investigation should explore these surprising results. Regardless, patients should participate in patient-centered contraceptive counseling during prenatal care to make informed decisions after delivery.
Trends in Female Sterilization Since Dobbs v. Jackson at an Academic Institution [ID 2683460]
Authors: Kimble Blair A. , Shiber Linda 
Published: May 2024

INTRODUCTION:
The Dobbs v. Jackson United States Supreme Court decision, issued June 24, 2022, fundamentally altered options for addressing unintended pregnancy. This curtailing of access to abortion care may be an inflection point in how individuals capable of becoming pregnant select contraceptive options. We hypothesize that in the immediate wake of the Dobbs v. Jackson decision, those undergoing surgical sterilization will be younger in age and more likely to be nulliparous.

METHODS:
This was a retrospective chart review study. IRB approval was obtained for the study. Using CPT codes, we utilized Epic to identify all patients undergoing surgical sterilizations at an academic, tertiary care hospital during the 12 months preceding the Dobbs decision (June 24, 2021 to June 24, 2022) and the 12 months immediately after the Dobbs decision (June 25, 2022 to June 25, 2023). Charts were reviewed for age, insurance status, highest level of education, gravidity, parity, and type of sterilization procedure, as well as time between request for and completion of surgical sterilization.

RESULTS:
In the 12 months after the Dobbs v. Jackson decision, individuals undergoing female surgical sterilization via salpingectomy or tubal occlusion had a lower mean age and lower mean parity compared to those undergoing sterilization in the 12 months preceding Dobbs.

CONCLUSION:
This study demonstrates that, since the Dobbs v. Jackson decision, individuals seeking female surgical sterilization are younger and less likely to be multiparous. This implies that as access to abortion care in the United States becomes more tenuous, those who seek female surgical sterilization procedures as contraception are younger and lower parity individuals.
Assessment of Pregnancy Desires for Patients With Pregnancy of Unknown Location Seen in the Emergency Department [ID 2683447]
Authors: Doyle Alexis A. , Beshar Isabel , Henkel Andrea , Nief Corrine , Liu Serena , Shorter Jade 
Published: May 2024

INTRODUCTION:
Desire for pregnancy should be centered in all discussions surrounding pregnancy management, including management of pregnancy of unknown location (PUL). Little is known about the evaluation of pregnancy desires for patients presenting to the emergency department (ED) found to have PUL.

METHODS:
We performed a retrospective cohort study of patients presenting to a tertiary-care ED with a positive pregnancy test and previously unconfirmed intrauterine pregnancy in the first trimester between January 2020 and December 2022. We excluded patients with chief complaints regarding known intrauterine pregnancy. The primary outcome was documentation of pregnancy desire by the ED provider. The secondary outcome was assessment of pregnancy desiredness by consulting gynecologic providers. Chi-squared and Fisher exact tests assessed for demographic variables. Institutional review board approval was obtained.

RESULTS:
Four hundred ninety-seven patients were included. Overall, only 105 (21.1%) of all patients and 12 (13.5%) patients with PUL were asked about pregnancy desiredness by the ED provider. While not statistically significant, patients with PUL had the lowest rate of being asked their pregnancy desires, compared to patients with confirmed intrauterine pregnancy (22.7%), ongoing miscarriage (28.1%), or ectopic/adnexal pathology (20.0%) (P=.15). Of those asked, 11 patients (10.5%) reported the pregnancy was undesired and 7 (6.7%) were unsure. There were no significant associations between asking pregnancy desires and age, race, ethnicity, parity, insurance, and language. For patients added to the beta book and followed by gynecology, 59.3% of patients were asked about their pregnancy desires.

CONCLUSION:
This study highlights gaps in early pregnancy evaluation and counseling, with only one in five patients asked their pregnancy desires. Patients with adnexal pathology and PUL had among the lowest rates of counseling, compared to those with ongoing miscarriage. This research suggests a missed opportunity for comprehensive pregnancy options counseling and management in the ED and the potential for improvement of care for patients with undesired PUL.
A Descriptive Analysis of a Sample of Hispanic PCOS Patients Living in Puerto Rico [ID 2683511]
Authors: Seguinot-Tarafa Inevy I. , Rosado Torres Claudia S. , Romaguera Josefina , Gonzalez Loida A. 
Published: May 2024

INTRODUCTION:
Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies during the reproductive years. Research has shown that Hispanic women with PCOS have the most severe phenotype, in terms of hyperandrogenism and metabolic disturbances. Absence of detailed characterization of PCOS in Puerto Rican patients poses significant barriers to translating research findings into clinical practice. Our aim is to provide an in-depth exploration of the gynecological profile of this population.

METHODS:
This was a cross-sectional study involving 105 female participants aged 21–45 years who underwent clinical evaluation during their routine health visit at endocrinology and gynecology clinics at the UPR-RCM clinics. The study cohort comprised 79 individuals with PCOS and 26 individuals without PCOS. IRB approval number is 2290034657 (B0790117).

RESULTS:
Significant differences were found in the prevalence of oligomenorrhea (90%; P<.001), amenorrhea (94.5%; P<.0004), clinical hirsutism (90.7%; P<.0001), and smoking (97.3%; P<.0001) among PCOS patients. These results align with existing literature on PCOS patients. There were no significant differences in menarche, thelarche, metrorrhagia, menorrhagia, sociodemographic profile, or toxic habits between the two groups. Additionally, both groups exhibited similarly high body mass index, fasting blood sugar, and hemoglobin A1C levels.

CONCLUSION:
Our study population’s characteristics align with those reported in other studies. However, the observed metabolic disturbances in our control group may be attributed to unique factors prevalent within the Puerto Rican population. Although this research contributes valuable insights, it is essential to acknowledge the study’s limitations, particularly the relatively small sample size. Further investigation and broader sampling are warranted to substantiate and refine these initial findings.
Pain Without Prejudice: Examining Disparities in Endometriosis and Pelvic Pain Management Stratified by Race in an Integrative Health Care System [ID 2683558]
Authors: Hen Eden , Childs Aliyya , Zaritsky Eve , Wicks Carla , Ritterman Weintraub Miranda L. , Tucker Lue-Yen 
Published: May 2024

INTRODUCTION:
Approximately 10% of reproductive-aged women suffer from endometriosis; racial variations in prevalence and treatment are unknown. Black women are often undertreated for pain and medical conditions. This study assessed variations in pelvic pain and endometriosis management with particular emphasis on Black versus non-Black patients.

METHODS:
We conducted a retrospective cohort study of women 18 years and older with pelvic pain disorders, including endometriosis, pelvic pain, dysmenorrhea, and dyspareunia, coded within the Kaiser Permanente Northern California electronic medical record between 2012 and 2019. Demographic, clinical, and treatment characteristics were assessed overall and by patient race/ethnicity.

RESULTS:
Of 15,164 eligible study participants, 1,707 (11.3%) were Black, 6,735 (50.1%) White, 2,097 (15.6%) Asian, 3,762 (28%) Latinx, and 863 (6%) unknown. Black compared to non-Black women were younger (36 [interquartile range (IQR) 28–44] versus 37 [IQR 30–45]; P<.001), had a higher body mass index (29.8 [IQR 25.2–35.9] versus 26 [IQR 22.7–30.7] kg/m2; P<.001) and similar parity. A higher proportion of Black women received hormonal therapy (56.2% versus 51.9%; P<.001). When stratified by all races, this was explained by White women receiving the least amount of hormonal therapy (56.2% versus 49.8%; P<.001). Black women received more pain medications (55.4% versus 44.7%; P<.001), with no racial variations in rates of laparoscopic surgery (4.4 versus 4.9; P=.21). Fewer Black women received referrals to a pelvic pain specialist (14.5% versus 17.8%; P=.001), and when stratified by all races White women received more referrals (21%; P<.001). There were no racial variations in patients who received medical followed by surgical treatment.

CONCLUSION:
Black women received more hormonal, pain, and similar surgical management, in contrast to that reported in prior publications. However, all races had a lower pelvic pain specialist referral rate than White patients. These findings illustrate the need to better understand the allocation of care in patients with pelvic pain disorders, including endometriosis.
Immediate Compared With Deferred Treatment for Gestational Diabetes Mellitus: A Cost-Effectiveness Analysis [ID 2683592]
Authors: Prasad Ruhika , Arora Megha , Doshi Uma , Caughey Aaron B. 
Published: May 2024

INTRODUCTION:
Current recommendations for gestational diabetes mellitus (GDM) include screening and treatment at 24–28 weeks’ gestational age. Whether treatment prior to 24–28 weeks improves maternal and infant outcomes is unclear. A recent randomized trial found that immediate treatment of GDM at 20 weeks led to lower incidence of several adverse neonatal outcomes including respiratory distress syndrome (RDS) and shoulder dystocia with brachial plexus injury (BPI). We evaluated the clinical benefits and cost effectiveness of immediate versus deferred treatment in pregnant women with GDM.

METHODS:
We used TreeAge to construct a decision-analytic model comparing outcomes between those who received immediate versus deferred GDM treatment. Our theoretical cohort was 71,679, the approximate number of GDM cases diagnosed early in the United States annually. Outcomes were BPI, RDS with neonatal intensive care unit admission, neurodevelopmental delay (NDD), cost, and quality-adjusted life years (QALYs). Probabilities were derived from a recent randomized trial and other peer-reviewed literature. We used a discount rate of 3% and a willingness-to-pay of $100,000/QALY.

RESULTS:
In our theoretical cohort, immediate treatment led to fewer cases of BPI (25 versus 77), RDS (7,054 versus 12,176). There was no difference between either treatment for NDD. Despite increased costs, immediate treatment was a cost-effective strategy as it resulted in increased QALYs with an incremental cost-effectiveness ratio of $54,434/QALY.

CONCLUSION:
Immediate treatment was a clinically beneficial and cost-effective strategy to reduce cases of BPI and RDS. Given improvement of certain neonatal outcomes, it may be beneficial to screen and immediately treat early-onset GDM.