bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sexual Aspects of Pelvic Floor Disturbances/Disorders
Authors: Westerik-Verschuuren Liesbeth , Lutke Holzik-Mensink Marjolijn , Wieffer-Platvoet Marleen , van der Velde Minke 
Published: March 2023

AbstractThis chapter will pay attention to the disturbances related to the pelvic floor, focusing on their sexuality-related consequences. It will start with the troubles during pregnancy, followed by the problems after childbirth. At the end of each topic, it will offer treatment recommendations.The urinary disorders will cover stress urinary incontinence (SUI), urgency urinary incontinence (UUI), climacturia (losing urine during orgasm), and urinary tract infections. The defecation disorders will cover anal incontinence, flatal incontinence, and constipation. Pelvic organ prolapse (POP) does usually not happen in the first pregnancy, though the primigravid woman can have similar complaints.Pelvic girdle pain (PGP) tends to start during pregnancy.Pregnancy and vaginal birth are the most common risk factors for postpartum PF disorders: stress urinary incontinence, overactive bladder syndrome, pelvic organ prolapse, and anal incontinence. On the one hand, that may sound like pathologizing childbirth. On the other hand, healthcare providers should be aware that they tend to underestimate the rates of (anal) obstetric injuries, and most textbooks do not mention levator ani avulsion.Aspects of pelvic floor muscle training (PFMT) receive ample attention in the treatment recommendations. In the postpartum part, the chapter pays extra attention to perineal pain, vaginal laxity, and overactive pelvic floor. Those are disruptive elements for intimacy and sexuality, just like all the other mentioned disturbances.This chapter is part of ‘Midwifery and Sexuality’, a Springer Nature open-access textbook for midwives and related healthcare professionals.
Sexual Aspects of Mental Health Disturbances in Pregnancy and Young Parenthood
Authors: van den Berg Mijke Lambregtse- , Pastoor Hester 
Published: March 2023

AbstractThis chapter will address the various mental health disturbances that can happen in the period between aiming at conception, pregnancy, childbirth, and the first postpartum year. Whereas some women with a psychiatric disease would like to become mothers, other women develop mental health disturbances as a direct result of reproductive changes. The important ones are depression during pregnancy, peripartum anxiety and tocophobia, postpartum blues, postpartum depression, and, in some women, postpartum psychosis.Those mental health disturbances impact the woman’s sexuality, her partner’s sexuality, and the relationship. When drug therapy is required, we must pay extra attention to the risks for the unborn and breastfed baby. On the other hand, psychiatric medication has extensive sexual side effects.The chapter uses several case histories to demonstrate the clinical impact and potential solutions for these challenging situations.This chapter is part of ‘Midwifery and Sexuality’, a Springer Nature open-access textbook for midwives and related healthcare professionals.
Effects on Sexuality of Medication Used in Pregnancy and Childbirth
Authors: Beers Erna , Jaeken Annelies 
Published: March 2023

AbstractThis chapter focuses on the sexual side effects of various medications used in midwifery and obstetric practice. The chapter will start with background information on pharmacokinetics and pharmacodynamics geared to pregnancy and the changing pregnant body. During pregnancy, the increased cardiac output causes a shorter time to metabolise and eliminate medication. In addition, the blood plasma volume and the total amount of the ‘watery environment’ increase, causing a lower plasma concentration of hydrophilic drugs. Lipophilic drugs take longer to be eliminated because residing longer in the increased ‘fatty environment’ and not in the blood plasma.During pregnancy, the binding of drugs to plasma proteins decreases as well, meaning that a higher amount of the drug can bind to the target with increased therapeutic or undesired side effects.The chapter will give detailed information on the potential sexual implications of medication.Finally, the chapter will indicate how to deal with actual or potential sexual side effects.It is part of ‘Midwifery and Sexuality’, a Springer Nature open-access textbook for midwives and related healthcare professionals (HCPs).
Relevant Sexual Anatomy, Physiology and Endocrinology
Authors: Simetinger Gabrijela 
Published: March 2023

AbstractThis chapter will give more insights into the anatomical, endocrinological and physiological aspects of (female) sexual functioning. And, although less extensively, also on aspects of relevant male sexual functioning. There are many similarities between (elements of) female sexuality and pregnancy. The physical expressions of female sexual arousal resemble circulatory changes in pregnancy, and orgasm contractions resemble, in many ways, labour contractions.The relevant physiological and anatomical changes that occur over the stages of pregnancy and post-partum will get attention, as well as the hormonal changes. This chapter lays the foundation for understanding the rest of the book for pregnancy professionals and birth professionals.Though they are also relevant transition phases in the woman’s life, the chapter will not deal with puberty and menopause.This chapter is part of ‘Midwifery and Sexuality’, a Springer Nature open-access textbook for midwives and related healthcare professionals.
Contraception and Sexuality
Authors: Bitzer Johannes 
Published: March 2023

AbstractIn some countries, midwives play a large part in contraceptive care. In many other countries, contraception is not a part of the midwife’s scope of practice till the baby is born. They then have to counsel about contraception and eventually about intervals between pregnancies. For healthy motherhood and good parenthood, the young mother should not become pregnant within a year and a half after childbirth. So counselling or prescribing contraception is an integral part of good postpartum care and falls under the midwife’s responsibility.Every contraceptive method has advantages and disadvantages, whether physical, emotional, relational, or sexual. This chapter will address the sexual consequences of various contraceptive methods with up-to-date information on the pros and cons of each method. In the context of this book, contraception during postpartum and breastfeeding will get extra attention.The chapter will include information on emergency contraception and the situation when contraception has failed.This chapter is part of ‘Midwifery and Sexuality’, a Springer Nature open-access textbook for midwives and related healthcare professionals.
Sexual Effects of Trauma Experience on Pregnancy and Labour
Authors: Slavič Tanja Repič 
Published: March 2023

AbstractSexual abuse can affect various areas of a person’s life. One is motherhood, with related factors like the decision to have a child, getting pregnant, pregnancy experience, delivery, and the postpartum period. In this chapter, we want to present how these areas may be related to the plight of women who have experienced the trauma of sexual abuse. Many aspects of this trauma are comparable to physical and emotional abuse. First, we theoretically explain how memories can affect the present, and then, based on clinical experience with sexually abused clients, we highlight the importance of the facts that should be known to anyone who encounters survivors in their work. Finally, we will add for health care professionals (HCPs) statements of women who shared what would be the most soothing to hear, with examples of specific sentences for HCPs to help promote emotional security and positive experiences.This chapter is part of ‘Midwifery and Sexuality’, a Springer Nature open-access textbook for midwives and related healthcare professionals.
Talking Sexuality
Authors: Borms Ruth , Geuens Sam 
Published: March 2023

AbstractEvery day more midwives and other healthcare practitioners (HCPs) realise that good care has to consider their clients’ sexual well-being. Still, many find it challenging to breach the topic during a consultation by talking to their clients about sexuality. This chapter explores the thresholds midwives and other healthcare practitioners experience when it comes down to talking about sex with their clients. Drawing on existing models of health and well-being, such as the biopsychosocial model of health, and existing models for communication in clinical settings, such as the ICE model, the chapter offers a simple and easy to use four-step communication model—starting with raising the issue of sexuality pro-actively and ending by making the client an offer. This approach can help healthcare practitioners to integrate sexuality into their daily practice.“Talking sexuality” is a part of the more extensive publication “Sexuality & Midwifery”, an open access textbook published by Springer Nature, geared at midwives and related healthcare professionals, providing an overview of the current scientific knowledge on sexuality and midwifery, presented in a practice-oriented way.
From Midwifery Competencies on Sexual Wellbeing to Teaching and Training Midwives on Sexuality
Authors: Geuens Sam , Vermeulen Joeri 
Published: March 2023

AbstractAll around the world, midwives are educated to assist women through the reproductive phase of their lives. Their curricula aim to enable women to be happy and healthy women, mothers, and partners before, during, and after pregnancy. Though modern society increasingly recognises sexual well-being as an intricate part of general health and well-being, midwifery schools struggle worldwide with integrating sexuality into their curriculum.This chapter offers the building blocks for easily integrating sexuality and sexual well-being, theoretically and practically, into existing midwifery curricula. It presents a tool for screening the current curriculum on sexuality-related topics already addressed, and it describes content for theoretical and practical lessons. It also connects content to existing international midwifery competence profiles and provides practical guidelines for identifying suitable midwifery tutors to teach sexuality and concrete examples for building practicals concerning sexuality within midwifery contexts.This chapter is a part of ‘Midwifery and Sexuality’, an open-access textbook published by Springer Nature, geared at midwives and related healthcare professionals. It provides an overview of the current scientific knowledge on sexuality and midwifery, presented in a practice-oriented way.
Various Sexual Consequences of Interventions in Midwifery Practice
Authors: Gianotten Woet L. , Polona Mivšek Ana , Geuens Sam 
Published: March 2023

AbstractMany different elements influence sexuality and intimacy. Whereas some elements are entirely outside obstetric care, others are directly related to what happens in contact with the midwife. This chapter deals with the consequences (the ‘sexual side effects’) of what the midwife is doing or not doing. It focuses more on behaviour and attitude than on the ‘medical or technical’ aspects. The chapter will discuss possible sexual implications of the midwife’s daily work, incorporating the sexuality theme with attention to body integrity, boundaries, and respect. The chapter will provide part of the information in the form of questions for exercises related to the professional attitude in daily midwife practice.It will also include some aspects of personal involvement in the care of the woman and the couple. A midwife is also a person with sexual feelings, most probably with a sexual life and maybe a sexual relationship. Many HCPs tend not to consider those realities related to their work. However, they can significantly impact when the positive and negative aspects of their clients’ intimacy and sexuality intensely or repeatedly confront the midwife.This chapter is part of ‘Midwifery and Sexuality’, a Springer Nature open-access textbook for midwives and related healthcare professionals.
How Sex Works (and When it’s not Working)
Authors: Geuens Sam , Polona Mivšek Ana 
Published: March 2023

AbstractTo have a sexual experience, one does not need to know ‘how sex works’. Besides, the more you think about it at that moment, the greater the risk that it might not ‘work’. However, such knowledge is relevant and essential in the daily practice of the heathcare professional (HCP).This chapter describes the stages of sexual response, from desire, via arousal, to orgasm, and then resolution (and the range of variety). It will indicate some of the changes occurring during pregnancy.The chapter then explores the types and reasons for sexual problems or dysfunctions. The chapter highlights the common problems with sexual desire, sexual arousal and sexual pain problems. Such problems are highly relevant to midwifery practice. They can negatively impact the couple’s or the woman’s general wellbeing and even be a reason for impaired fertility. The ‘3-conditions framework for satisfying sexual experiences’, a simple diagnostic tool to help midwives and other non-sexologist-HCPs structure their clinical reasoning about their client’s sexual problems, is described and applied to sexual problems commonly encountered by midwives. Using this framework to better understand how things can go wrong can help HCPs provide care for women and couples struggling with sexual problems.This chapter is part of ‘Midwifery and Sexuality’, a Springer Nature open-access textbook for midwives and related healthcare professionals.
Experimental analysis on the influence of the tool micro geometry on the wear behavior in gear hobbing
Authors: Kühn Felix , Hendricks Steffen , Troß Nico , Brimmers Jens , Bergs Thomas 
Published: March 2023

Abstract
Gear hobbing is a well-established manufacturing process for cylindrical spur gears. The cutting edge of a hobbing tool is, among others, characterized by the cutting edge radius and the form-factor K. The magnitude of these parameters is ideally chosen based on the machining conditions given by the workpiece and cutting material and the cutting parameters as well as the gear and tool geometry. However, the influence of the cutting edge geometry on tool life and wear behavior is hardly known, which complicates an optimized tool design. Furthermore, the preparation process regarding the coating thickness distribution on the wear behavior is equally relevant. Therefore, the objective was to identify the influence of the cutting edge radius, the form-factor K, and the preparation process on the wear behavior of gear hobbing tools made of powder metallurgical high-speed steel (PM-HSS). Fly-cutting trials were performed as an analogy process for gear hobbing in order to study the wear behavior and identify the respective tool lives. The trials indicated that the form-factor K influences the wear behavior, while a variation of the cutting edge radius did not have a significant effect. A homogenous coating thickness could extend the tool life significantly.
A mixture of 13 pesticides, contaminants, and food additives below individual NOAELs produces histopathological and organ weight changes in rats
Authors: Dinca Viorica , Docea Anca Oana , Drocas Andrei Ioan , Nikolouzakis Taxiarchis Konstantinos , Stivaktakis Polychronis D. , Nikitovic Dragana , Golokhvast Kirill S. , Hernandez Antonio F. , Calina Daniela , Tsatsakis Aristidis 
Published: March 2023

AbstractThe current approach for the risk assessment of chemicals does not account for the complex human real-life exposure scenarios. Exposure to chemical mixtures in everyday life has raised scientific, regulatory, and societal concerns in recent years. Several studies aiming to identify the safety limits of chemical mixtures determined hazardous levels lower than those of separate chemicals. Following these observations, this study built on the standards set by the real-life risk simulation (RLRS) scenario and investigated the effect of long-term exposure (18 months) to a mixture of 13 chemicals (methomyl, triadimefon, dimethoate, glyphosate, carbaryl, methyl parathion, aspartame, sodium benzoate, EDTA, ethylparaben, butylparaben, bisphenol A and acacia gum) in adult rats. Animals were divided into four dosing groups [0xNOAEL (control), 0.0025xNOAEL (low dose—LD), 0.01xNOAEL (medium dose—MD) and 0.05xNOAEL (high dose-HD) (mg/kg BW/day)]. After 18 months of exposure, all animals were sacrificed, and their organs were harvested, weighed, and pathologically examined. While organ weight tended to be higher in males than in females, when sex and dose were taken into account, lungs and hearts from female rats had significantly greater weight than that of males. This discrepancy was more obvious in the LD group. Histopathology showed that long-term exposure to the chemical mixture selected for this study caused dose-dependent changes in all examined organs. The main organs that contribute to chemical biotransformation and clearance (liver, kidneys, and lungs) consistently presented histopathological changes following exposure to the chemical mixture. In conclusion, exposure to very low doses (below the NOAEL) of the tested mixture for 18 months induced histopathological lesions and cytotoxic effects in a dose and tissue-dependent manner.
Weight-gain independent effect of mirtazapine on fasting plasma lipids in healthy men
Authors: Lechner Katharina , Heel Sarah , Uhr Manfred , Dose Tatjana , Holsboer Florian , Lucae Susanne , Schaaf Ludwig , Fulda Stephany , Kloiber Stefan , Hennings Johannes M. 
Published: March 2023

Abstract
Treatment with mirtazapine, a widely prescribed antidepressant, has been linked to weight gain and dyslipidemia. Whether dyslipidemia occurs secondary to increased appetite due to antidepressant treatment, or due to direct pharmacological effects of mirtazapine is unknown. The aim of this analysis is to complement our previously published results of the effect of mirtazapine on metabolism and energy substrate partitioning from a proof-of-concept, open-label clinical study (ClinicalTrials.gov NCT00878540) in 12 healthy males (20–25 years). We report the effect of a seven-day administration of mirtazapine 30 mg per day on weight and lipid metabolism in healthy men under highly standardized conditions with respect to diet, physical activity and day-night-rhythm and under continuous clinical observation. After a 7-day administration of mirtazapine 30 mg, we observed a statistically significant increase in triglyceride levels (mean change + 4.4 mg/dl; 95% CI [– 11.4; 2.6]; p = 0.044) as well as TG/HDL-C ratio (mean change + 0.2; 95% CI [– 0.4; 0.1]; p = 0.019) and a decrease in HDL-cholesterol (mean change – 4.3 mg/dl; 95% CI [2.1; 6.5]; p = 0.004), LDL-cholesterol (mean change – 8.7 mg/dl; 95% CI [3.8; 13.5]; p = 0.008), total cholesterol (mean change – 12.3 mg/dl; 95% CI [5.4; 19.1]; p = 0.005), and non-HDL-C (mean change – 8.0 mg/dl; 95% CI [1.9; 14.0]; p = 0.023). Notably, weight (mean change – 0.6 kg; 95% CI [0.4; 0.8]; p = 0.002) and BMI (mean change – 0.2; 95% CI [0.1; 0.2]; p = 0.002) significantly decreased. No change in waist circumference (mean change – 0.4 cm; 95% CI [– 2.1; 2.9]; p = 0.838) or waist-to-hip-ratio (mean change 0.0; 95% CI [– 0.0; 0.0]; p = 0.814) was observed. This is the first study showing unfavorable changes in lipid metabolism under mirtazapine in healthy individuals despite highly standardized conditions including dietary restriction, and despite the observation of a decrease of weight. Our findings support the hypothesis that mirtazapine has direct pharmacological effects on lipid metabolism. ClinicalTrials.gov: NCT00878540.
Systemic exposure to cisplatin and paclitaxel after intraperitoneal chemotherapy in ovarian cancer
Authors: de Jong Loek A. W. , Lambert Marie , van Erp Nielka P. , de Vries Lukas , Chatelut Etienne , Ottevanger Petronella B. 
Published: March 2023

Abstract
Purpose
To determine the systemic exposure to cisplatin and paclitaxel after adjuvant intraperitoneal administration in patients with advanced ovarian cancer who underwent primary debulking surgery. This could provide an explanation for the high incidence of systemic adverse events associated with this treatment regimen.

Methods
This is a prospective pharmacokinetic study in patients with newly diagnosed advanced ovarian cancer who were treated with intraperitoneal administered cisplatin and paclitaxel. Plasma and peritoneal fluid samples were obtained during the first treatment cycle. The systemic exposure to cisplatin and paclitaxel was determined and compared to previously published exposure data after intravenous administration. An exploratory analysis was performed to investigate the relation between systemic exposure to cisplatin and the occurrence of adverse events.

Results
Pharmacokinetics of ultrafiltered cisplatin were studied in eleven evaluable patients. The geometric mean [range] peak plasma concentration (Cmax) and area under the plasma-concentration time curve (AUC0–24 h) for cisplatin was 2.2 [1.8–2.7] mg/L and 10.1 [9.0–12.6] mg h/L, with a coefficient of variation (CV%) of 14 and 13.0%, respectively. The geometric mean [range] observed plasma concentration of paclitaxel was 0.06 [0.04–0.08] mg/L. No correlation was found between systemic exposure to ultrafiltered cisplatin and adverse events.

Conclusion
Systemic exposure to ultrafiltered cisplatin after intraperitoneal administration is high. In addition to a local effect, this provides a pharmacological explanation for high incidence of adverse events seen after intraperitoneal administration of high-dose cisplatin. The study was registered at ClinicalTrials.gov under registration number NCT02861872.
Microwave ablation versus radiofrequency ablation for patients with primary and secondary hyperparathyroidism: a meta-analysis
Authors: Xu Wei , Li Shihui , Cheng Fang , Gong Lifeng , Tang Weigang , Lu Jingkui , Li Yani , Wang Zhixia 
Published: March 2023

Abstract
Objective
Thermal ablation, including microwave ablation (MWA) and radiofrequency ablation (RFA), has been recommended for the treatment of primary hyperparathyroidism (PHPT) and refractory secondary hyperparathyroidism (SHPT). This meta-analysis was conducted to evaluate the efficacy and safety of MWA and RFA in patients with PHPT and refractory SHPT.

Methods
Databases including PubMed, EMbase, the Cochrane Library, CNKI (China National Knowledge Infrastructure), and Wanfang were searched from inception to December 5, 2022. Eligible studies comparing MWA and RFA for PHPT and refractory SHPT were included. Data were analyzed using Review Manager software, version 5.3.

Results
Five studies were included in the meta-analysis. Two were retrospective cohort studies, and three were RCTs. Overall, 294 patients were included in the MWA group, and 194 patients were included in the RFA group. Compared with RFA for refractory SHPT, MWA had a shorter operation time for a single lesion (P < 0.01) and a higher complete ablation rate for a single lesion ≥ 15 mm (P < 0.01) but did not show a difference in the complete ablation rate for a single lesion < 15 mm (P > 0.05). There were no significant differences between MWA and RFA for refractory SHPT concerning parathyroid hormone (P > 0.05), calcium (P > 0.05), and phosphorus levels (P > 0.05) within 12 months after ablation, except that calcium (P < 0.01) and phosphorus levels (P = 0.02) in the RFA group were lower than those in the MWA group at one month after ablation. There was no significant difference between MWA and RFA concerning the cure rate of PHPT (P > 0.05). There were no significant differences between MWA and RFA for PHPT and refractory SHPT concerning the complications of hoarseness (P > 0.05) and hypocalcaemia (P > 0.05).

Conclusion
MWA had a shorter operation time for single lesions and a higher complete ablation rate for large lesions in patients with refractory SHPT. However, there was no significant difference in efficacy and safety between MWA and RFA in cases of both PHPT and refractory SHPT. Both MWA and RFA are effective treatment methods for PHPT and refractory SHPT.