bluuebunny/crossref_metadata_2025_split huggingface dataset:
Novel Anti-Ovarian Epithelial Adenocarcinoma Agent: HM-10/10 HDL-Mimetic Peptide—Pharmacokinetic and Pharmacodynamic Characterization [ID: 1377510]
Authors: Wells Brittney , Doe Emily , Farias-Eisner Robin , Taylor Mitchell 
Published: May 2023

INTRODUCTION:
Epithelial adenocarcinoma of the ovary (EOC) is the second most common cancer affecting the female reproductive system and is associated with the fifth highest rate of cancer-related deaths in women. With many women presenting in late stages, the estimated chance of survival for 2, 5, and 10 years were 65%, 44%, and 36%, respectively. In recent literature, the role of HDL-associated apolipoproteins has been shown to be effective in the treatment of proinflammatory diseases, including cancer. Previously we developed a novel 20-amino acid mimetic peptide, HM-10/10, which was able to inhibit tumor development and growth in EOC models in vitro and in vivo. These findings prompted our decision to further our research by performing characterization to advance HM-10/10 as our apolipoprotein mimetic peptide candidate of choice for use as a novel therapeutic agent against EOC. The aim of this study was to report the pharmacokinetic (PK) and pharmacodynamic (PD) properties of HM-10/10 relative to its stability in vitro.

METHODS:
To evaluate PK/PD, multiple procedures were performed in vitro.

RESULTS:
The results demonstrated PK/PD good stability in plasma and the gastric environment. However, under conditions modeling the small intestine, HM-10/10 demonstrated significant degradation, likely because of the diverse array of peptidases encountered therein.

CONCLUSION:
These data highlight the PK/PD of HM-10/10 and demonstrate its potential as an effective therapeutic for treating EOC. The preferred route of delivery of HM-10/10 is oral, and toward that end, HM-10/10 demonstrated remarkable stability over a broad physiologic pH range; however, its stability was significantly degraded by conditions simulating the small intestine.
Comparison of Obstetric Outcomes Between Unassisted Pregnancies and Non-IVF Fertility Treatment Pregnancies in Infertile Patients [ID: 1365555]
Authors: Qin Jennifer , Adeleye Amanda , Cedars Marcelle , Huang David , Rinaudo Paolo , Zablotska Lydia 
Published: May 2023

INTRODUCTION:
Prior studies suggest that pregnancies conceived with non-IVF fertility treatment (NIFT) have an increased risk of adverse obstetric outcomes compared to unassisted pregnancies. However, recent population-based studies suggest that infertility independently contributes to elevated perinatal risks. It is unclear whether underlying infertility or NIFT itself contributes to obstetric risks. To understand the effects of NIFT on pregnancy, we compare obstetric outcomes between NIFT and unassisted pregnancies in infertile patients.

METHODS:
The Developmental Epidemiological Study of Children Born Through Reproductive Technology (DESCRT) recruited an IRB-approved prospective cohort of women with infertility who delivered between 2018 and 2022 (funded under R01-HD084380). We compared maternal serum analyte levels and obstetric outcomes between infertile patients who conceived spontaneously and those who utilized NIFT (ovulation induction, superovulation, and/or intrauterine insemination). Serum analytes were compared using the Mann-Whitney test. Obstetric outcomes regarding placental insufficiency were reviewed by two ob-gyns and compared using χ2 tests.

RESULTS:
We analyzed 101 unassisted pregnancies and 141 NIFT pregnancies. There were no significant differences in mean maternal age (36.6 and 35.6, P=.08). There were no significant differences in maternal serum analytes or in adverse obstetric outcomes, including hypertensive disorders of pregnancy (P=.35), fetal growth restriction (P=.12), abnormal placentation (P=.79), spontaneous preterm birth (P=.97), and gestational diabetes (P=.30).

CONCLUSION:
Among infertile patients, there were no significant differences in maternal serum analytes or adverse obstetric outcomes between unassisted and NIFT pregnancies. This suggests that the previously demonstrated risk of adverse pregnancy outcomes associated with NIFT could be attributed to underlying infertility rather than the utilization of NIFT.
A Randomized Controlled Trial to Assess the Effectiveness of a Specially Formulated Food Supplement and Pelvic Floor Muscle Training in Women With Stress-Predominant Urinary Incontinence [ID: 1372768]
Authors: Takacs Peter , Koroknai Erzsebet , Kozma Bence , Krasznai Zoard , Pakozdy Krisztina 
Published: May 2023

INTRODUCTION:
The objective of this study was to assess the effectiveness of a creatine-leucine-based food supplement and standardized pelvic floor muscle training (PFMT) in women with stress-predominant urinary incontinence (SUI).

METHODS:
Women with SUI were randomized to receive daily oral supplementation for 6 weeks with either a supplement or placebo. Both groups were instructed to perform daily PFMT at an intensity of at least 75% of one repetition maximum of 45 pelvic floor muscle contractions per day. The primary outcome was the Urogenital Distress Inventory Short Form (UDI-6) score. Secondary outcomes were the Incontinence Impact Questionnaire (IIQ-7) score, Biomechanical Integrity (BI) score measured by Vaginal Tactile Imager. To have a power of 80% and a significance level of 5%, a sample size of 32 was needed. The trial was IRB approved.

RESULTS:
Within-group analysis showed that UDI-6 and IIQ-7 scores improved significantly from baseline to 6 weeks in the treatment group but not in the control group (UDI-6 score [mean±SD], 45±21 versus 29±21, P=.02; 43±18 versus 33±26, P=.22) (IIQ-7 score [mean±SD], 50±30 versus 30±21, P=.01; 48±23 versus 40±28, P=.36). Out of the 52 examined VTI parameters, significantly more parameters improved in the treatment group compared to the control group (11/52 versus 3/52, P=.04). BI-score, on average, improved significantly in the treatment and control group as well (SD unit, mean, from −1.06 to −0.58, P=.001; from −0.66 to −0.42, P=.04).

CONCLUSION:
Women with SUI receiving a specially formulated supplement in addition to daily PFMT for 6 weeks had improved urinary symptoms (significant decrease in UDI-6 and IIQ-7 scores) and better BI score compared to baseline.
Predicting Miscarriage and Stillbirth Using Weighted Ensemble Machine Learning [ID: 1338167]
Authors: Lokhande Anagha , Gimovsky Alexis , Sarkar Indra 
Published: May 2023

INTRODUCTION:
Prediction of miscarriage and stillbirth remains a clinical challenge. Prior efforts to use machine learning tools have not used an ensemble weighted machine learning approach, called “super learner,” which offers the opportunity to improve prediction performance by aggregating the outputs of constituent machine learning models and preferentially weighting the highest-performing models.

METHODS:
Data were obtained from hospital-wide electronic health records from a large academic institution. The sample comprised 13,337 patients who delivered between 2008 and 2019, 6,932 of whom experienced a miscarriage or stillbirth. Phecodes for ICD-9-CM and ICD-10-CM were used to define miscarriage and stillbirth and create comorbidity categories. The constituent models of the super learner were XGBoost, random forest, a regularized generalized linear model (both lasso and ridge regressions), and a support vector machine. The objective of this study was to develop a super learner algorithm to predict miscarriage and stillbirth.

RESULTS:
The super learner model predicted miscarriage and stillbirth classification with an area under the receiver operating characteristic curve of 0.94 and an accuracy of 92%. It used two models: random forest, weighted at 73%, and SVM, weighted at 27%. The most highly weighted predictors were amniotic cavity abnormalities, pelvic soft tissue abnormalities, and preeclampsia.

CONCLUSION:
A super learner performs comparably to other models in the literature. External validation is warranted. The promising results suggest that a super learner model can be used as a clinical decision support tool, supplementing clinical judgement in predicting miscarriage and stillbirth.
Mobile Assessments to Improve Screening and Novel Patient Engagement to Diagnose and Manage Maternal Mental Health (MIND) Study Midpoint Analysis: Compliance Rate of Antenatal Screening [ID: 1363058]
Authors: Lucas Kathryn , Hoeppner Catherine , Marko Kathryn , Sebastian Anish , Sheth Sheetal , Tung Bonnie 
Published: May 2023

INTRODUCTION:
One in five to seven birthing people are affected by perinatal mood disorders. While screening for gestational diabetes is well defined, the efficacy of standardized assessment of mood disorders is less understood. Between 2018 and 2020, screening at an academic center was highly variable, demonstrating need for improvement. Remote surveillance using novel integrated technology was used to improve patient participation in routine antenatal screening.

METHODS:
A prospective observational cohort of 81 patients from two clinical sites in the Babyscripts (BRx) Maternal Mental Health Module received digital Edinburgh Postnatal Depression Scale (EPDS) screening at 12 and 28 weeks of gestation. The control group consisted of 81 randomly selected patients who received in-person standardized screening from 2018 to 2020. In a midpoint analysis, EPDS completion was assessed at weeks 12 and 28 in the intervention group and compared to the control group using χ2 analysis. The study was reviewed and exempted by the George Washington University IRB.

RESULTS:
The BRx treatment group totaled 45 patients enrolled prior to week 14 and 74 patients enrolled prior to week 30. At week 14, 38% of BRx patients (17/45) had completed an EPDS survey, compared with 10% of patients in the control group (8/81). At week 30, 36% of BRx patients (27/74) had completed an EPDS survey, compared with 21% of control (17/81). Improved EPDS response rates of the BRx cohort were statistically significant at both assessments (P<.01 and P=.03).

CONCLUSION:
Remote mood screening resulted in significantly higher rates of adherence in the first and second trimesters as compared to standard methods. In the next phase of analysis, we plan to assess adherence of screening through 12 months postpartum. Future analysis is planned to determine noninferiority as compared to in-office methods among a larger cohort. We hypothesize that novel telehealth mood screenings will help to sustain engagement with providers and reduce time to intervention.
The Effect of Trimester of COVID-19 Infection on Pregnancy Outcomes After Recovery [ID: 1365996]
Authors: Seif Karl , Desai Andrea , Mangione Mary , Tadbiri Hooman , Turan Shifa , Wolfe Alexa 
Published: May 2023

INTRODUCTION:
Many physiological, immune, and respiratory adaptations occur during pregnancy. Data have emerged that COVID-19 infection affects placental function, raising concerns about obstetric morbidity. It is not currently known how timing of COVID-19 infection affects pregnancy. We hypothesize that maternal and neonatal outcomes are different if COVID-19 infection occurs in different trimesters of pregnancy.

METHODS:
This IRB-approved retrospective cohort study was conducted at a single center from March 2020 to June 2022. Pregnant patients with a positive COVID-19 infection more than 10 days before delivery (COVID-recovered) were identified and grouped by trimester of infection. Demographics and maternal infection, obstetric, and neonatal outcomes were collected. Wilcoxon rank-sum and Fisher’s exact tests were used to compare continuous and categorical data, respectively. To account for multiple comparisons, a significant P value was set at .01.

RESULTS:
Two hundred ninety-eight COVID-recovered pregnant patients were identified. Of those, 48 (16%) were infected in the first trimester, 123 (41%) in the second trimester, and 127 (43%) in the third trimester. There were no significant demographic differences between the study groups. Vaccination status was similar. Hospital admission rate and the need for oxygen therapy while infected were significantly higher in patients with second- or third-trimester infection (18% and 20% versus 2% and 13% and 14% versus 0%, respectively). Rates of preterm birth (PTB) less than 37 weeks (33% versus 19% and 12%, P=.006) and extreme PTB (19% versus 5%, P<.001) were higher in the first-trimester infection group. Infants born to mothers infected in the second trimester had more neonatal sepsis workups (22% versus 12% and 7%, P=.008). Other maternal, obstetric, and neonatal outcomes were similar between groups.

CONCLUSION:
First-trimester COVID-recovered patients were more likely to have preterm birth despite having lower rates of hospital admission and oxygen supplementation while infected than patients who recovered from a second- or third-trimester infection.
Cervical Length Surveillance in Patients With a History of Early Versus Late Preterm Birth [ID: 1378074]
Authors: Alzamora Maria , Anders Jacqueline , Chornock Rebecca , Kumnick Allison , Mokhtari Neggin 
Published: May 2023

INTRODUCTION:
The American College of Obstetricians and Gynecologists recommends patients with a history of a preterm birth (PTB) be monitored with serial cervical length (CL) measurements for short cervix. We sought to evaluate the utility of serial CL surveillance in patients based on gestational age at the time of their prior PTB.

METHODS:
This was a multi-institutional retrospective study of pregnant patients with a history of spontaneous PTB between 23 weeks 0 days and 36 weeks 6 days that underwent a transvaginal CL between January 2017 and December 2021. Multiple gestation pregnancies were excluded. Data were compared between patients with a history of late PTB (>34 weeks) and patients with a history of early PTB (<34 weeks) using χ2 tests, t tests, and ANOVA analyses, as appropriate (α=0.05). Institutional review board approval was obtained for the study.

RESULTS:
Of 321 patients with a history of spontaneous PTB, 106 (33%) had a late PTB and 215 (67%) had an early PTB. Patients with a prior late PTB were less likely to be on 17-OHP (42.5% versus 54.5%, P=.04) and have a cerclage placed (4% versus 19.5%, P=.0002) compared to patients with an early PTB. Patients with a prior late PTB had their first CL performed at later gestations (18 weeks 0 days versus 17 weeks 2 days, P=.016) and fewer CL measurements (3.2 versus 3.5, P=.034). There was no difference in the gestational age that the shortest CL was detected (21 weeks 0 days versus 21 weeks 0 days, P=.98).

CONCLUSION:
In patients with either a history of early or late spontaneous PTB, universal CL surveillance at the time of the anatomy (18–20 weeks) may be sufficient to identify patients for intervention.
Role of Environmental Discrimination on Birth Weight: A Systematic Examination in a Sample of Black, Latina, and White Women in the Phoenix Metropolitan Area [ID: 1341491]
Authors: Mickelson Kristin , Chambers Claudia , Doehrman Pooja , Kaneris Marianna , Stewart Chelsea , Sullivan Shea 
Published: May 2023

INTRODUCTION:
Health inequities begin before birth, with Black women being more likely to have low-birth-weight babies than White and Latina women. The purpose of this study is to examine the relationship of discrimination (environmental, vicarious, and daily) on birth weight in Black, Latina, and White women.

METHODS:
This study utilized medical records and face-to-face interviews to examine the role of discrimination on birth weight (controlling for gestational age and assigned sex). Data analysis involved multiple linear regression. The spatial relationship between environmental discrimination and mean birth weights from neighborhoods in Phoenix was examined using heat maps that layer environmental discrimination onto geographic locations. Institutional review board approval was obtained from St. Joseph Medical Center.

RESULTS:
In this sample of 329 patients, Black women reported the lowest birth weight (M 3,268.25, SE 65.61), with Latina (M 3,313.99, SE 33.91) and White (M 3,327.98, SE 39.23) women reporting similar birth weights. Only environmental discrimination emerged as a significant predictor of baby’s birth weight (b=−67.57, SE 25.99, P=.01), such that greater perceived environmental discrimination was related to lower birth weight. Environmental discrimination was compared to geographic areas in the Phoenix metropolitan area using zip code data and a comparison of these regions showed statistically significant differences in experiences of environmental discrimination based on geographic location (P=.010).

CONCLUSION:
Women experiencing high rates of environmental discrimination had lower birth weight babies. These experiences were localized to geographic areas within the Phoenix metropolitan area. These findings may help better target resources to specific centers to overcome the issues that influence how people experience their environment.
Experiences of Discrimination and Treatment Outcomes Among Pregnant and Postpartum People With Opioid Use Disorder [ID: 1376917]
Authors: Xu Joyce , DeFranco Emily , Murnan Aaron , Nidey Nichole , Terplan Mishka , Wilder Christine 
Published: May 2023

INTRODUCTION:
Experiences of discrimination among pregnant and postpartum people with opioid use disorder (OUD) are common and likely affect utilization of medication for OUD (MOUD), which is associated with reduced risk of overdose and death. We aimed to examine experiences of discrimination by prenatal care (PNC) and substance use disorder (SUD) treatment settings and estimate its effect on the risk of various MOUD utilization outcomes.

METHODS:
Patient-stakeholders co-designed survey questions to measure self-reported outcomes related to MOUD treatment utilization, return to substance use, and overdose. First, we examined the proportion of participants who endorsed items on a modified Healthcare Discrimination Scale and summed the total scores. Next, we quantified the effect of discrimination experienced by health care setting on postpartum MOUD utilization, return to use, and overdose using log-binomial models to calculate relative risk (RR) and 95% CIs.

RESULTS:
Among the 100 participants enrolled in the study, 57 reported experiencing discrimination, 56 within PNC and 33 within SUD treatment settings. Discrimination within PNC (RR 2.6, CI 1.06–6.40) and SUD treatment (RR 3.26, CI 1.59–6.70) were associated with increased risk of not using MOUD as prescribed. Discrimination within SUD treatment settings correlated with an increased risk of MOUD discontinuation (RR 2.56, CI 1.19–5.54) and return to use (RR 2.36, CI 1.18–4.73).

CONCLUSION:
Experiences of discrimination were common, especially within prenatal care settings, and discrimination was associated with poor MOUD treatment outcomes and risk of return to use. Interventions to address discrimination within health care settings can improve outcomes for pregnant and postpartum people with OUD.
Increased Risk of Preterm Birth in a Native American Population Concurrent With the COVID-19 Pandemic [ID: 1377321]
Authors: Baranco Nicholas , Mastrogiannis Alexander , Mastrogiannis Dimitrios , Thompson Brian 
Published: May 2023

INTRODUCTION:
The objective of this study was to evaluate changes in obstetric outcomes in a Native American population compared with other racial groups.

METHODS:
An electronic birth certificate based system was used to obtain data for all singleton births in the Central New York region from January 2012 to June 2022 after IRB exemption. Race was self-identified and categorized as White, Black, Native American, or other. We compared delivery before or after January 2020. The primary outcome was premature birth. Secondary outcomes included prenatal care adequacy, fetal growth restriction, neonatal outcome, diabetes, hypertension, and obesity. Analysis was preformed using χ2 and logistic regression including body mass index (BMI), smoking, hypertension, and diabetes.

RESULTS:
Out of 178,420 singleton births, 2,647 (1.4%) identified as Native American, 143,743 (77.7%) as White, and 15,476 (8.4%) as Black. Compared to patients before 2020, no racial group had a higher rate of inadequate or late prenatal care, and all groups had increased obesity (BMI >30) and decreased smoking. Preterm birth increased in the Native American population before 37, 34, and 28 weeks of gestation: adjusted odds ratio (95% CI) 1.42 (1.02–1.99), 1.81 (1.02–3.22), and 3.68 (1.39–9.77). No other population had increased preterm birth before 34 or 28 weeks of gestation.

CONCLUSION:
There was a significant increase in all categories of preterm birth in the Native American population during the COVID-19 pandemic without a differential increase in known risk factors compared to other racial groups. This highlights the need for more research on the causes of adverse outcomes in Native American populations.
Geospatial Analysis of Access to Evidence-Based Early Pregnancy Loss Management in New Mexico [ID: 1377363]
Authors: Krashin Jamie , Black Patricia , Brannen Eric , Gard Charlotte , Lin Yan , Schreiber Courtney 
Published: May 2023

INTRODUCTION:
Little is known about availability of evidence-based early pregnancy loss (EPL) treatment in emergency departments (EDs), where patients often first seek care. We evaluated geographic access to mifepristone/misoprostol and uterine aspiration in New Mexican hospitals.

METHODS:
We used an enhanced two-step floating catchment area method to model accessibility from census block groups’ population-weighted centroids to hospitals. Our primary outcome was access to mifepristone/misoprostol and uterine aspiration in EDs; our secondary outcome was access to in-hospital aspiration, both outcomes defined as less than a 60-minute commute. We surveyed all EDs in New Mexico and used public databases to compute census block groups’ demographic, transportation, rurality, and area deprivation data. We used logistic regression to evaluate the associations between access and race and ethnicity, area deprivation, and rural location. The University of New Mexico IRB approved this study.

RESULTS:
Thirty-five (83%) of 42 hospitals responded. Two (6%) provided in-ED treatment, and 24 (69%) in-hospital aspiration. Half of reproductive-aged women had access to in-ED treatment, and 90% to in-hospital aspiration. Census block groups with higher quartile proportions of American Indian/Native Alaskan reproductive-aged women had higher adjusted odds ratios of accessing in-ED treatment (2.5–7.3, P<.05). Rural areas and higher area deprivation quartiles had lower in-ED access adjusted odds ratios (0.03–0.07 [P<.05] and 0.3–0.4 [P<.05], respectively) compared with urban and lower area deprivation quartiles. In-hospital aspiration results were similar to in-ED treatment results across all categories.

CONCLUSION:
By prioritizing rural areas and areas with higher socioeconomic deprivation, EPL treatment implementation efforts can improve equitable care access and equity for patients.