bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical outcomes of fetal selective reduction in dichorionic triplet pregnancies
Authors: Yang Yuezhou , Ye Xuping , Sun Xiaoxi 
Published: November 2023

Background:
It is recommended to reduce triplet pregnancy containing monochorionic (MC) twins to singleton. Given that some couples with infertility are eager to retain twins, better strategy is needed to avoid obstetrical risks and satisfy their strong wish. This retrospective observational study aimed to investigate the outcomes of triplet pregnancy reduction.

Methods:
Subjects with triplet pregnancies who underwent selective reduction between 2016 and 2019 at our hospital were enrolled. A total of 66 subjects with dichorionic triplet (DCT) with MC twins and an MC singleton were divided into two groups: group A (N = 38), reduced to dichorionic diamniotic (DCDA) twins; group B (N = 28), reduced to MC diamniotic (MCDA) twins. Obstetrical and perinatal outcomes were compared between groups.

Results:
Group A had significantly lower rates of early miscarriage (0% vs 14.3%, p = 0.028), cesarean section (81.6% vs 100%, p = 0.041), and late premature delivery (21.1% vs 45.4%, p = 0.047) than group B. Significantly higher rates of full-term delivery (71% vs 36.4%, p = 0.009) and take-home baby (100% vs 78.6%, p = 0.004), and higher gestational age at delivery (median: 38 [36.9, 39.0] vs 35.8 [34.4, 37.0] weeks, p < 0.001), total neonatal weight (2899.7 ± 647.6 vs 2354.4 ± 651.8 g, p < 0.001), weight of twins (2550 vs 2350 g, p = 0.039), and weight of larger neonate in twins (2790 vs 2500 g, p = 0.045) were observed in group A compared to group B.

Conclusion:
DCT reduced to DCDA twins confers better pregnancy outcomes than into MCDA twins. This might benefit for triplet pregnancy subjects who strongly want to retain fraternal twins.
Immediate Effect of Soft Lumbosacral Orthosis on Trunk Stability and Upper-Limb Functionality in Children with Cerebral Palsy
Authors: Uzun Asiye , Yakut Yavuz 
Published: November 2023

Abstract

Introduction
Lumbar lordosis is important for the spine and pelvis to work in harmony in providing trunk control and maintaining sagittal balance. Children with cerebral palsy (CP) have difficulties in providing trunk postural control and balance, which is critical for independence in daily living activities. This study was planned to examine the immediate effect of a lower-trunk orthosis supporting physiological lumbar lordosis on trunk control and upper-limb functionality in children with CP.

Objectives and Methods
A total of 30 children with CP, 13 diparetic, 11 hemiparetic, and 6 ataxic, 21 ambulatory (GMFCS I/II), and 9 nonambulatory (GMFCS III/IV) aged 3–16 years were included in the study. The Pediatric Functional Reach Test (PFRT) and the Seated Postural Control Measure (SPCM) were used to assess trunk control; the Pediatric Berg Balance Scale (PBBS) was used to assess balance; and the Box and Block Test (BBT) and the Nine-Hole Peg Test (9HPT) were used to evaluate upper-limb functions. All tests were performed with and without a soft lumbosacral brace. The braces were made of soft, elastic fabric with steel, and were made by the orthotic technician in four different sizes. The angle of lordosis was adjusted with steel underwires according to each child. The existing physiological lordosis of the child is supported by the brace. It is not intended to increase or decrease.

Results
In the study, the results of all evaluations with a brace were better than those without a brace (P < 0.05). No significant difference was found only in the functional part of the SPCM test (P > 0.05).

Conclusions
Our study revealed that soft lumbosacral orthosis, which supports physiological lordosis, has a positive effect on trunk stability and upper-limb functionality in children with CP.

Clinical Relevance
In children’s trunk stability and upper-limb functionality studies, the use of soft lumbosacral orthosis that supports physiological lordosis can be added to rehabilitation programs and daily living activities as a support.
Is Vulvodynia Associated With an Altered Vaginal Microbiota?: A Systematic Review
Authors: Sacinti Koray Gorkem , Razeghian Hosna , Awad-Igbaria Yaseen , Lima-Silva Joana , Palzur Eilam , Vieira-Baptista Pedro , Verstraelen Hans , Bornstein Jacob 
Published: November 2023

Introduction
Vulvodynia is defined as vulvar pain of at least 3 months' duration, without clear identifiable cause, which may have potential associated factors. It can have a significant impact on women's quality of life due to a combination of physical pain, emotional distress, and limited treatment options. Despite affecting a considerable number of women worldwide, the causes and underlying mechanisms of vulvodynia remain poorly understood. Given the recognized association of the vaginal microbiota with various gynecologic disorders, there has been growing interest in exploring the potential role of the vaginal microbiota in the etiology of vulvodynia. This systematic review aims to evaluate the current literature on the association between the vaginal microbiota and vulvodynia.

Material and Methods
A systematic search of multiple databases, including PubMed, Scopus, Web of Science, Cochrane Library, and Ovid MEDLINE, was conducted to identify relevant peer-reviewed studies up to May 12, 2023. The following search terms were used across these databases: “vulvodynia,” “vestibulodynia,” “vulvar vestibulitis,” “microbiome,” “microbiota,” and “flora.”

Results
A total of 8 case-control studies were included, the quality of which was assessed using the Newcastle-Ottawa Scale. Data extraction and synthesis were performed using a standardized protocol. In most studies, no major differences were found between the vaginal bacterial composition of women with vulvodynia and that of controls. No specific bacterial taxa were consistently associated with vulvodynia. The relationship between vaginal microbiota diversity and vulvodynia remains to be fully understood.

Conclusions
The role of vaginal microbiota in vulvodynia, if any, remains unclear. Because of the cross-sectional nature of the included studies, it is not possible to make any causal inferences. Further research, using larger and more diverse study populations and advanced sequencing techniques, is necessary to gain a better understanding of the potential relationship between the vaginal microbiota and vulvodynia.
Medical thoracoscopy for pleural diseases
Authors: So Matsuo , Chaddha Udit , Shojaee Samira , Lee Pyng 
Published: November 2023

Purpose of review
The purpose of this review is to elaborate on the role of medical thoracoscopy for various diagnostic and therapeutic parietal pleural interventions. The renewed interest in medical thoracoscopy has been boosted by the growth of the field of interventional pulmonology and, possibly, well tolerated and evolving anesthesia.

Recent findings
Medical thoracoscopy to obtain pleural biopsies is established largely as a safe and effective diagnostic procedure. Recent data suggest how a pragmatic biopsy-first approach in specific cancer scenarios may be patient-centered. The current scope of medical thoracoscopy for therapeutic interventions other than pleurodesis and indwelling pleural catheter (IPC) placement is limited. In this review, we discuss the available evidence for therapeutic indications and why we must tread with caution in certain scenarios.

Summary
This article reviews contemporary published data to highlight the best utility of medical thoracoscopy as a diagnostic procedure for undiagnosed exudative effusions or effusions suspected to be secondary to cancers or tuberculosis. The potentially therapeutic role of medical thoracoscopy in patients with pneumothorax or empyema warrants further research focusing on patient-centered outcomes and comparisons with video-assisted thoracoscopic surgery.
Overlooked and Damaging Impact of Structural Racism and Implicit Bias on US Health Care
Authors: Green Sybil R. , Cross Christopher N. 
Published: November 2023

AbstractMarginalized populations, including racial and ethnic minorities, have historically faced significant barriers to accessing quality health care because of structural racism and implicit bias. A brief review and analysis of past and historic and current policies demonstrate that structural racism and implicit bias continue to underscore a health system characterized by unequal access and distribution of health care resources. Although advances in cancer care have led to decreased incidence and mortality, not all populations benefit. New policies must explicitly seek to eliminate disparities and drive equity for historically marginalized populations to improve access and outcomes.
The Promise of Cancer Health Justice
Authors: Villamar Dario M. , Polite Blase N. 
Published: November 2023

Abstract
Disparities in outcomes and persistent barriers to adequate care in colorectal cancer are reflective of a system that has failed to achieve the ideals of health equity and health justice. In this review, we discuss that although much research has been done to improve upon gaps in screening, treatment, and supportive care in colorectal cancer, a concerted effort across multiple research, regulatory, and funding stakeholders with community-level organizations is essential in building a self-sustained system that effectively achieves health equity outcomes. We also highlight several examples of novel community-based interventions along the continuum of cancer care that demonstrate the potential of what can be accomplished when we invest in scaling up small-scale solutions to the state and national levels and offer ways in which stakeholders and the community may mutually benefit through a system of incentives, self-assessment tools, and attainable metrics.
Switching to Doravirine in cART-Experienced Patients: An Effective and Highly Tolerated Option With Substantial Cost Savings
Authors: Lanting Vincent R. , Oosterhof Piter , Ait Moha Daoud , van Heerde Roos , Kleene Marie José T. , Stalenhoef Janneke E. , de Regt Marieke J.A. , Vrouenraets Saskia M.E. , van den Berk Guido E.L. , Brinkman Kees ,   on behalf of the HIV-team OLVG
Published: November 2023

Background:
Doravirine is a non-nucleoside reverse transcriptase inhibitor with demonstrated efficacy as a third agent in treatment-naive and treatment-experienced people living with HIV (PLWH) in registration studies. However, limited real-world data are available.

Methods:
By searching electronic health care records, PLWH using doravirine-based regimens were selected with at least 1 year of follow-up after their first prescription. All stable PLWH who were switched to a doravirine-based regimen were included in the analysis. The primary outcome was the durability of a doravirine-based regimen 1 year after prescription. Reasons for stopping were also collected. Secondary outcomes for PLWH continuing a doravirine-based regimen after 1 year were routine laboratory assessment, body mass index, and differences in medication costs compared with their previous cART.

Results:
A total of 687 patients (92% men) were included from September 2019 to August 2022: 97.7% switched to doravirine/tenofovir/lamivudine (DOR/TDF/3TC). After 1 year, 94/687 (13.6%) PLWH stopped this therapy. The main reason for discontinuation was patient-reported adverse events in 70/687 (10.2%). Medical reasons for discontinuation included increased alanine tranaminase levels in 6/687 (0.9%), decreased estimated glomerular filtration rate in 3/687 (0.4%), and precautions after diagnosis of osteoporosis in 2/687 (0.3%) patients. Virologic failure occurred in 4/687 cases (0.6%), and 1 case demonstrated resistance mutations. The secondary outcomes demonstrated a statistically significant increase in alanine tranaminase levels and decrease in LDL-c levels. The switch to a doravirine-based regimen in the Netherlands reduced medication costs by 27%.

Conclusions:
This study demonstrated that switching to a doravirine-based regimen, mostly DOR/TDF/3TC, was highly effective and generally well tolerated, with substantial cost savings.
Extramedullary Plasmacytoma of the Retroperitoneum Detected on 18F-FDG PET/CT
Authors: Deng Yan , Deng Ying , Zhang Wei , Lei Xiaoping 
Published: November 2023

Abstract
Solitary retroperitoneal extramedullary plasmacytoma is a rare neoplasm. A 67-year-old man presented with abdominal pain and left leg weakness. Abdominal CT revealed a large mass in the left retroperitoneum, which demonstrated increased metabolic activity on subsequent 18F-FDG PET/CT imaging. Furthermore, the patient’s serum protein electrophoresis showed positive M-protein results. Pathological examination of the biopsied specimen confirmed the diagnosis of extramedullary plasmacytoma.
Article Factors Influencing Gender Disparities in Senior Authorship of Plastic Surgery Publications
Authors: Ngaage Ledibabari Mildred , Borrelli Mimi R. , Ketheeswaran Suvethavarshini , Shores Jaimie T. 
Published: November 2023

Introduction
Female plastic surgeons publish fewer and lower impact articles. To better understand how to address this gender gap, we explored the temporal trends in female senior authorship and evaluated predictive factors for female senior authorship.

Methods
A retrospective review of articles published in the 3 highest impact plastic surgery journals published from 2010 to 2020 was conducted. Trends with female senior authorship across time were analyzed with respect to study type, subspeciality, and geographical origin.

Results
Of the 5425 articles included, 13% (n = 720) had a female senior author, and female senior authorship increased across time (R = 0.84, P = 0.033). Over the decade, an increased proportion of cohort studies (R = 0.82, P = 0.045), systematic reviews (R = 0.96, P = 0.003), breast-related articles (R = 0.88, P = 0.022), and reconstruction-related articles (R = 0.83, P = 0.039) were published by female senior authors. Subspecialty and geography predicted female senior authorship; articles focused on aesthetic (odds ratio [OR] = 1.3, P = 0.046) and breast (OR = 1.7, P < 0.001) subspecialties or those originating from Canada (OR = 1.7 P = 0.019), Europe (OR = 1.5, P < 0.001), and Latin America (OR = 3.0, P < 0.001) were more likely to have a female senior author. Articles from East Asia were less likely to have female senior authors (OR = 0.7, P = 0.005).

Conclusion
Female senior authorship in plastic surgery has increased over the last decade, and the proportion of female plastic surgeons leading cohort studies and systematic reviews is increasing. Sex of the senior author is influenced by plastic surgery subspecialty and geographical origin, but article type did not impact the odds of female senior authorship.
Is nonoperative management of appendicitis inferior in the COVID-19 era?
Authors: Grimsley Emily A. , Rogers Michael P. , Janjua Haroon M. , Pietrobon Ricardo , Diaz Jose J. , Kuo Paul C. , Read Meagan D. ,   on behalf of the N3C Consortium
Published: November 2023

BACKGROUND
Previous studies on nonoperative management (NOM) of acute appendicitis (AA) indicated comparable outcomes to surgery, but the effect of COVID-19 infection on appendicitis outcomes remains unknown. Thus, we evaluate appendicitis outcomes during the COVID-19 pandemic to determine the effect of COVID-19 infection status and treatment modality. We hypothesized that active COVID-19 patients would have worse outcomes than COVID-negative patients, but that outcomes would not differ between recovered COVID-19 and COVID-negative patients. Moreover, we hypothesized that outcomes would not differ between nonoperative and operative management groups, regardless of COVID-19 status.

METHODS
We queried the National COVID Cohort Collaborative from 2020 to 2023 to identify adults with AA who underwent operative or NOM. COVID-19 status was denoted as follows: COVID-negative, COVID-active, or COVID-recovered. Intention to treat was used for NOM. Propensity score–balanced analysis was performed to compare outcomes within COVID groups, as well as within treatment modalities.

RESULTS
A total of 37,868 patients were included: 34,866 COVID-negative, 2,540 COVID-active, and 460 COVID-recovered. COVID-active and recovered less often underwent operative management. Unadjusted, there was no difference in mortality between COVID groups for operative management. There was no difference in rate of failure of NOM between COVID groups. Adjusted analysis indicated, compared with operative, NOM carried higher odds of mortality and readmission for COVID-negative and COVID-active patients.

CONCLUSION
This study demonstrates higher odds of mortality among NOM of appendicitis and near equivalent outcomes for operative management regardless of COVID-19 status. We conclude that NOM of appendicitis is associated with worse outcomes for COVID-active and COVID-negative patients. In addition, we conclude that a positive COVID test or recent COVID-19 illness alone should not preclude a patient from appendectomy for AA. Surgeon clinical judgment of a patient's physiology and surgical risk should, of course, inform the decision to proceed to the operating room.

LEVEL OF EVIDENCE
Therapeutic/Care Management; Level III.
Reduced threat avoidance but increased stress induced approach bias in women taking oral contraceptives
Authors: Thurley Jasmin , Buades-Rotger Macià , Serfling Georg , Howaldt Thessa , Reisch Nicole , Krämer Ulrike M. 
Published: November 2023

AbstractRecent research has increasingly acknowledged the impact of oral contraceptives on affective behavior and stress responses; however, the underlying mechanisms are still not well understood. Studies have previously shown that steroid hormones modulate automatic approach and avoidance behavior. Here, we thus investigated the effects of oral contraceptives on approach and avoidance behavior and whether these effects are modulated by stress. The study comprised 130 female participants, half of whom were using oral contraceptives, while the other half were not using any hormonal contraception (NC). The participants completed the Approach Avoidance Task (AAT), which measures automatic approach and avoidance behavior to socio-affective signals. The AAT was run once before and once after a stress manipulation using the Socially Evaluated Cold Pressor Test. OC users showed absent avoidance behavior to social threat signals and a stress-induced increase in approach behavior to positive social signals. The latter was found in particular in women taking androgenic acting OC, demonstrating that different OC preparations need to be taken into account in research on OC effects. However, OC and NC group did not differ in their cortisol stress response. Overall, the results suggest that OC usage impacts on approach and avoidance behavior to social signals, which might also contribute to the development of affective side effects.
The Shexiang Baoxin Pill Protects Myocardial Cells from Multiple Targets of MIRI through the PI3K/Akt/eNOS Signal Pathway
Authors: Na WEI , Siyuan LI , Yuan GAO , Zhenbing LIU 
Published: November 2023

AbstractBackgroundMyocardial ischemia-reperfusion injury (MIRI) can significantly aggravate myocardial injury in patients with ST-segment elevation myocardial infarction (STEMI). At present, there are few effective treatments for MIRI. The Shexiang Baoxin Pill (SBP) can reduce MIRI. The PI3K/Akt/eNOS signaling pathway, inflammation, oxidative stress, and apoptosis are all involved in the regulation of MIRI. SBP has multi-component, multi-target, and synergistic effects, but its mechanism of action on MIRI has not been reported.PurposeWe sought to explore whether SBP exerts a protective mechanism by inhibiting the inflammatory reaction, oxidative stress, and apoptosis, reducing MIRI through the PI3K/Akt/eNOS signal pathway.Materials and methodsHypoxia-reoxygenation (H/R) H9c2 cardiomyocytes were used as an in vitro model of MIRI. The active components of Shexiang Baoxin pills were extracted with water. The levels of phosphorylated proteins and genes related to the PI3K/Akt/eNOS pathway were measured by Western blotting and real-time fluorescence quantitative PCR. Cell viability, apoptosis rates, and apoptosis-related proteins (Bcl-2, Bax, Caspase-3) were detected by CCK-8, flow cytometry, and Western blotting. The expression of reactive oxygen species (ROS), homocysteine (Hcy), malondialdehyde (MDA), and gp91phoxwas detected by fluorescence probe, ELISA, TBA, and Western blotting. The levels of inflammatory factors (TNF-α, IL-6, IL-18) were measured by an ELISA method.ResultsSBP increased the cell survival rate of H/R cardiomyocytes, reduced the injury to H/R cardiomyocytes, and increased the protein phosphorylation levels of p-PI3KY607, p-AktSer473, p-eNOSSer1177, and mRNA of H/R cardiomyocytes. In addition, SBP increased the level of Bcl-2 protein and the Bcl-2/Bax ratio and decreased the apoptosis rate and Bax and Caspase-3 expression. It reduced the levels of oxidative stress indexes (ROS, HCY, MDA, and gp91phox) and inflammatory factors (TNF-α, IL-6, IL-18) and enhanced antioxidant stress, anti-apoptosis, and an anti-inflammatory reaction. The above effects were attenuated after the inhibition of the PI3K/Akt/eNOS signal pathway.ConclusionWe established that SBP extract inhibited oxidative stress, inflammatory response, and apoptosis through the PI3K/Akt/eNOS signal pathway and alleviated the injury of H9c2 cells induced by hypoxia-reoxygenation.
Key innovation abilities on capability and the performance of women entrepreneurs: the role of entrepreneurial education and proactive personality
Authors: Maziriri Eugine Tafadzwa , Nyagadza Brighton , Chuchu Tinashe 
Published: November 2023

PurposeThe purpose of the study was to ascertain the influence of innovation conviction, innovation mindset and innovation creed on the performance of women entrepreneurs in South African small and medium enterprises and their capacity for innovation. The study also examined how proactive personality and entrepreneurial education moderate the relationship between innovative capability and women entrepreneurs' performance.Design/methodology/approachThe study used a quantitative research design and administered a questionnaire to collect data from participants. Since there was no sampling frame available, purposive sampling, a non-probability sampling technique, was used to select suitable respondents who were identified as entrepreneurial women. Data were collected from 304 women entrepreneurs in the Gauteng province of South Africa. The data were analyzed using smart partial least squares.FindingsThe findings demonstrated that innovation conviction, innovation mindset and innovation creed have a positive impact on innovation capability. It was also discovered that innovation capability, proactive personality and entrepreneurial education all positively and significantly impact women entrepreneurs' performance. Furthermore, the results showed that entrepreneurial education and proactive personality had a positive and significant moderating effect on the nexus between innovation capability and the performance of women entrepreneurs.Originality/valueThis study will add to the body of knowledge on women's small business management and entrepreneurship in Africa, two topics that are typically ignored by academics in developing nations.