bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of female circumcision on maternal and neonatal outcomes after childbirth: a cohort study
Authors: Rabiepour Soheila , Ahmadi Zeynab 
Published: January 2023

Abstract
Background
Circumcision has many side effects and complications on women’s lives and affects their physical, mental, and social health. The present study aimed to investigate the effect of female circumcision on maternal and neonatal outcomes.

Methods
Methods: A prospective cohort study was performed with 320 pregnant women by convenience sampling (160 individuals were circumcised and 160 were uncircumcised). Circumcision and its level were confirmed using observation. The data relating to demographic, midwifery history, medical history, maternal and neonatal outcomes were compiled using a questionnaire. All Statistical analyses were conducted by SPSS ver. 16.0. P-values less than 0.05 were considered significant.

Results
The mean age of circumcised women was significantly higher vs. Uncircumcised women (28.92±6.2 vs. 25.42±4.8; P < 0.001). Circumcision was significantly higher in rural compared to urban areas (51.9% vs.18.1%). The level of female education, his parents, spouse, and husband’s employment status were significantly associated with circumcision (P < 0.001). 94.4% of uncircumcised nulliparous women and 86.9% of circumcised women experienced Intended Pregnancy (P=0.02). Eighty- five percent of women were circumcision type I. The higher mean duration of the second stage of labor, Second and Third degree of tear, and need for oxytocin in induction were significantly higher among circumcised women (P = 0.03, 0.003, 0.002, respectively).
The existence one stage of labor, Second and Third degree of tear, and the need for oxytocin in induction were significantly higher among circumcised women (P = 0.03, 0.003, 0.002, respectively).

Conclusion
These findings underscore that Circumcision a prevalent predictor of poor neonatal outcomes and delivery processes, therefore this circumcised women needs intensive care during delivery.
Development of the short form Iranian women childbirth experience questionnaire: a confirmatory factor analysis approach item reduction
Authors: Shahhosseini Zohreh , Nikbakht Roya , Motaghi Zahra , Hosseini Tabaghdehi Monirolsadate 
Published: January 2023

Abstract
Introduction
Considering that childbirth experience has short- and long-term effects on women’s lives, it is necessary to examine their delivery experiences. This study aimed to prepare the short form of a 52-item Iranian women’s childbirth experience questionnaire with seven factors: professional support, preparation, control, positive perception, baby, family support, and fear.

Methods
This methodological research was conducted on women aged 15 to 49 years (n = 770) with uncomplicated vaginal delivery. The short form of the Iranian women’s childbirth experience questionnaire was prepared in four stages. The first stage was exploratory factor analysis, conducted on 250 samples, the second stage was confirmatory factor analysis which was performed on 260 samples, independent of the first stage, to report goodness and fit indices, and the third stage employed items from modification indices, expected parameter change, and standardized residual covariance, leading to the short form of Iranian women childbirth experience questionnaire. Finally, confirmatory factor analysis was run on 260 samples, independent of the previous two stages, to confirm the short form and compare it with the original questionnaire for psychometric analysis.

Results
In the exploratory factor analysis stage, nine items with a factor load of less than 0.4 were removed, and the number of domains was reduced to five. The second stage showed that the questionnaire had a goodness of fit index. However, the third stage resulted in removing 11 overlapping items and making a short questionnaire with 33 items. Finally, the confirmatory factor analysis in the last stage showed appropriate goodness of fit for the short form of the Iranian women’s childbirth experiences questionnaire (𝛘2/df = 2.352, CFI = 0.881, PCFI = 0.750, RMSEA = 0.072, SRMR = 0.0862).

Conclusion
The short form of the Iranian women’s childbirth experiences questionnaire enjoyed from an appropriate psychometric evaluation. It is recommended when applying the original questionnaire is not feasible due to lack of time.
Risk factors associated with low bone mineral density in children with idiopathic scoliosis: a scoping review
Authors: Yang Yuqi , Chen Zhengquan , Huang Zefan , Tao Jing , Li Xin , Zhou Xuan , Du Qing 
Published: January 2023

AbstractBackgroundChildren with idiopathic scoliosis (IS) have a high risk of osteoporosis and IS with low bone mineral density (BMD) are susceptible to curve progression. This review aims to explore the risk factors of low BMD in children with IS.MethodsStudies were retrieved from 5 databases that were published up to January 2022. Search terms are keywords in titles or abstracts, including subject headings related to “Scoliosis”, “Bone Mineral Density”, and “Risk Factors”. Observational studies on risk factors of low BMD in children with IS were enrolled in this review. The number of studies, sample size, outcome measures, research type, endocrine, and lifestyle-related factors, gene/signal pathway, and other contents were extracted for qualitative analysis.ResultsA total of 56 studies were included in this scoping review. Thirty studies involved genetic factors that may affect BMD, including the Vitamin-D receptor gene, RANK/RANKL signal pathway, the function of mesenchymal stem cells, Runx2, Interleukin-6 (IL-6), and miR-145/β-catenin pathway. Eight studies mentioned the influence of endocrine factors on BMD, and the results showed that serum levels of IL-6, leptin and its metabolites, and ghrelin in children with IS were different from the age-matched controls. In addition, there were 18 articles on lifestyle-related factors related to low BMD in children with IS, consisting of physical activity, calcium intake, Vitamin D level, and body composition.ConclusionsGenetic, endocrine, and lifestyle-related factors might relate to low BMD and even osteoporosis in IS. To prevent osteoporosis, the effectiveness of regular screening for low BMD risk factors in children with IS needs to be investigated. Additionally, clear risk factors suggest strategies for bone intervention. Future studies should consider the effectiveness of calcium and vitamin D supplements and physical activity in BMD improvement.
Education to keep the abdomen relaxed versus contracted during pilates in patients with chronic low back pain: study protocol for a randomised controlled trial
Authors: Lunkes Luciana Crepaldi , Dias Neto Milton Apolinário , Barra Lavínia Fernandes , de Castro Lívia Resende , Ferreira Arthur Sá , Meziat-Filho Ney 
Published: January 2023

AbstractBackgroundLow back pain is a very common symptom frequently characterized as a biopsychosocial problem. This study aims to investigate the effectiveness of education to keep the abdomen relaxed versus contracted during Pilates exercises in patients with primary chronic low back pain.MethodsTwo-group randomised controlled trial with allocation of parallel groups and intention-to-treat-analysis. This study will be conducted in Lavras, MG, Brazil. A total of 152 participants will be randomised into two groups that will be treated with Pilates exercises for 12 weeks (twice a week for 60 minutes). Recruitment began in May 2022. The control group will receive guidance on the specific activation of the center of strength (the powerhouse), while the experimental group will receive guidance to perform the exercises in a relaxed and smooth way. Primary outcomes will be pain intensity (Numeric Pain Rating Scale) and disability (Rolland-Morris Questionnaire) 12 weeks post randomisation. Secondary outcomes will be global improvement (Perception of Global Effect Scale) and specific functionality (Patient-specific Functional Scale). The outcomes will be analyzed using repeated-measure linear mixed models. The assessors were not considered blinded because the participants were not blinded, and outcomes were self-reported.DiscussionThe findings of this study will help in clinical decision-making concerning the need to demand abdominal contraction during the exercises, understanding if it’s a fundamental component for the effectiveness of the Pilates method for this population.Trial registrationThis trial was prospectively registered in the Clinical Trials (NCT05336500) in April 2022.
Circulating exosomal microRNAs as potential prognostic biomarkers in gastrointestinal cancers: a systematic review and meta-analysis
Authors: Gheytanchi Elmira , Tajik Fatemeh , Razmi Mahdieh , Babashah Sadegh , Cho William Chi Shing , Tanha Kiarash , Sahlolbei Maryam , Ghods Roya , Madjd Zahra 
Published: January 2023

Abstract
Background
Recent reports suggested that circulating exosomal microRNAs (exomiRs) may serve as non-invasive prediction biomarkers in gastrointestinal (GI) cancers, yet their clinicopathological and prognostic values need to be more clarified. Hence, the present meta-analysis was aimed to quantitatively assess the evidence regarding the association between circulating exomiRs and prognosis in GI cancer patients.

Methods
A comprehensive search was carried out in prominent literature databases, including PubMed, ISI Web of Science, Scopus, and Embase. Odds ratios (ORs) or hazard ratios (HRs) with 95% confidence intervals (CIs) were gathered to evaluate the strength of the association. The quality assessment was investigated through the Newcastle-Ottawa Scale (NOS) and publication bias via Eggers’ test and funnel plots.

Results
A total of 47 studies, comprising of 4881 patients, were considered eligible for this meta-analysis. Both up-regulated and down-regulated circulating exomiRs are significantly associated with differentiation (HR = 1.353, P = 0.015; HR = 1.504, P = 0.016), TNM stage (HR = 2.058, P < 0.001; HR = 2.745, P < 0.001), lymph node metastasis (HR = 1.527, P = 0.004; HR = 2.009, P = 0.002), distant metastasis (HR = 2.006, P < 0.001; HR = 2.799, P = 0.002), worse overall survival (OS) (HR = 2.053, P < 0.001; HR = 1.789, P = 0.001) and poorer disease/relapse/progression-free survival (DFS/RFS/PFS) (HR = 2.086, P < 0.001; HR = 1.607, P = 0.001) in GI cancer patients, respectively. In addition, subgroup analyses based on seven subcategories indicated the robustness of the association. The majority of findings were lack of publication bias except for the association between up-regulated exomiRs and OS or DFS/RFS/PFS and for the down-regulated exomiRs and TNM stage.

Conclusion
This study supports that up- and down-regulated circulating exomiRs are associated with poorer survival outcomes and could be served as potential prognostic biomarkers in GI cancers. Given the limitations of the current findings, such as significant heterogeneity, more investigations are needed to fully clarify the exomiRs prognostic role.
Primary hepatic myopericytoma coexisting with multiple cystic hepatic lesions: a case report
Authors: Yuan Jing , Li Jie , Dong Zhouhuan , Xu Wei , Wang Zhanbo 
Published: January 2023

Abstract
Background
Hepatic myopericytoma (MPC) is an extremely rare pathological entity in the liver. Conversely, cystic hepatic lesions are a group of heterogeneous lesions encountered commonly in daily practice. Here, we report a unique case of the coexistence of primary hepatic MPC and multiple cystic hepatic lesions along with our perceptions on its diagnosis and treatment.

Case presentation
A 56-year-old female patient was found to have a left liver mass during a routine physical examination. Computer tomography (CT) and magnetic resonance imaging (MRI) confirmed the existence of a left hepatic neoplasm along with multiple hepatic cysts but could not exclude the possible malignant nature of the neoplasm. Computer tomography (CT) also identified an enlarged mediastinal lymph node with a maximum diameter of 4.3 cm, which further underwent core needle biopsy under CT guidance. A histopathological examination was performed to rule out malignancy. Afterwards, the patient underwent left hemihepatectomy to resect a solid tumor of 5.5 cm × 5 cm × 4.7 cm with multiple cystic lesions which were histopathologically examined to establish the diagnosis of myopericytoma with hepatic cysts. Postoperatively, the patient recovered from the surgery quickly without significant adverse events and was not found to have a reoccurrence of the primary pathological entity.

Conclusions
This is the first reported case of a patient with the co-existence of primary hepatic myopericytoma and multiple cystic hepatic lesions undergoing surgical treatment with eventual recovery.
Implementing the WHO Labour Care Guide to reduce the use of Caesarean section in four hospitals in India: protocol and statistical analysis plan for a pragmatic, stepped-wedge, cluster-randomized pilot trial
Authors: Vogel Joshua P. , Pingray Veronica , Althabe Fernando , Gibbons Luz , Berrueta Mabel , Pujar Yeshita , Somannavar Manjunath , Vernekar Sunil S. , Ciganda Alvaro , Rodriguez Rocio , Welling Saraswati A. , Revankar Amit , Bendigeri Savitri , Kumar Jayashree Ashok , Patil Shruti Bhavi , Karinagannanavar Aravind , Anteen Raveendra R. , Pavithra M. R. , Shetty Shukla , Latha B. , Megha H. M. , Gaddi Suman S. , Chikkagowdra Shaila , Raghavendra Bellara , Armari Elizabeth , Scott Nick , Eddy Katherine , Homer Caroline S. E. , Goudar Shivaprasad S. 
Published: January 2023

abstract
Background
The World Health Organization (WHO) Labour Care Guide (LCG) is a paper-based labour monitoring tool designed to facilitate the implementation of WHO’s latest guidelines for effective, respectful care during labour and childbirth. Implementing the LCG into routine intrapartum care requires a strategy that improves healthcare provider practices during labour and childbirth. Such a strategy might optimize the use of Caesarean section (CS), along with potential benefits on the use of other obstetric interventions, maternal and perinatal health outcomes, and women’s experience of care. However, the effects of a strategy to implement the LCG have not been evaluated in a randomised trial. This study aims to: (1) develop and optimise a strategy for implementing the LCG (formative phase); and (2) To evaluate the implementation of the LCG strategy compared with usual care (trial phase).

Methods
In the formative phase, we will co-design the LCG strategy with key stakeholders informed by facility assessments and provider surveys, which will be field tested in one hospital. The LCG strategy includes a LCG training program, ongoing supportive supervision from senior clinical staff, and audit and feedback using the Robson Classification. We will then conduct a stepped-wedge, cluster-randomized pilot trial in four public hospitals in India, to evaluate the effect of the LCG strategy intervention compared to usual care (simplified WHO partograph). The primary outcome is the CS rate in nulliparous women with singleton, term, cephalic pregnancies in spontaneous labour (Robson Group 1). Secondary outcomes include clinical and process of care outcomes, as well as women’s experience of care outcomes. We will also conduct a process evaluation during the trial, using standardized facility assessments, in-depth interviews and surveys with providers, audits of completed LCGs, labour ward observations and document reviews. An economic evaluation will consider implementation costs and cost-effectiveness.

Discussion
Findings of this trial will guide clinicians, administrators and policymakers on how to effectively implement the LCG, and what (if any) effects the LCG strategy has on process of care, health and experience outcomes. The trial findings will inform the rollout of LCG internationally.
Trial registration: CTRI/2021/01/030695 (Protocol version 1.4, 25 April 2022).
The relationship between the radiation dose of pelvic-bone marrow and lymphocytic toxicity in concurrent chemoradiotherapy for cervical cancer
Authors: Zhang Bao-Zhong , Li Yang , Xu Li-Ming , Chai Yan-Lan , Qu Chao , Cao Yuan-Jie , Wang Jing , Hou Hai-Ling , Zhang Jiaqi 
Published: January 2023

Abstract
Objective
The purpose of this study is to verify the correlation between medium and low radiation doses of the pelvic-bone marrow and the incidence of lymphocytic toxicity during concurrent chemoradiotherapy for cervical cancer.

Materials and methods
This research included 117 cervical cancer patients, who received concurrent chemoradiotherapy. Radiotherapy included external-beam radiation therapy and brachytherapy. The dosimetry parameters include the Volume receiving 5 Gy (V5), 10 Gy (V10), 20 Gy (V20), 30 Gy (V30), 40 Gy (V40), 50 Gy (V50), and the mean dose (D mean) of the bone marrow. Lymphocytic toxicity was calculated from lowest lymphocytic count after two cycles of concurrent chemotherapy.

Results
During concurrent chemoradiotherapy, the incidence of lymphocytic toxicity is 94.88%. The incidence of grade 3–4 toxicity is 68.38%. Multivariate analysis findings show that the dosimetry parameters V5, V10, V20, and V30 are significantly correlated with lymphocytic toxicity. The patients are divided into small-volume subgroups and large-volume subgroups based on the cutoff values. The relative risk of both grade 1–4 and grade 3–4 lymphocytic toxicity is significantly lower in the small-volume subgroups than in the large-volume subgroups (P < 0.05). Kaplan–Meier analysis shows that the incidence of both grade 1–4 and grade 3–4 lymphocytic toxicity of the small-volume subgroups is significantly lower than that of the large-volume subgroups (P < 0.05).

Conclusion
There is a significant correlation between a medium and low dose of pelvic-bone-marrow radiation and incidence of lymphocytic toxicity. Reducing the volume of medium and low radiation doses could effectively reduce incidence of lymphocytic toxicity.
The neuroprotective and neural circuit mechanisms of acupoint stimulation for cognitive impairment
Authors: Zhang Zichen , Chen Liuyi , Guo Yi , Li Dan , Zhang Jingyu , Liu Ling , Fan Wen , Guo Tao , Qin Siru , Zhao Yadan , Xu Zhifang , Chen Zelin 
Published: January 2023

AbstractCognitive impairment is a prevalent neurological disorder that burdens families and the healthcare system. Current conventional therapies for cognitive impairment, such as cholinesterase inhibitors and N-methyl-d-aspartate receptor antagonists, are unable to completely stop or reverse the progression of the disease. Also, these medicines may cause serious problems with the digestive system, cardiovascular system, and sleep. Clinically, stimulation of acupoints has the potential to ameliorate the common symptoms of a variety of cognitive disorders, such as memory deficit, language dysfunction, executive dysfunction, reduced ability to live independently, etc. There are common acupoint stimulation mechanisms for treating various types of cognitive impairment, but few systematic analyses of the underlying mechanisms in this domain have been performed. This study comprehensively reviewed the basic research from the last 20 years and found that acupoint stimulation can effectively improve the spatial learning and memory of animals. The common mechanism may be that acupoint stimulation protects hippocampal neurons by preventing apoptosis and scavenging toxic proteins. Additionally, acupoint stimulation has antioxidant and anti-inflammatory effects, promoting neural regeneration, regulating synaptic plasticity, and normalizing neural circuits by restoring brain functional activity and connectivity. Acupoint stimulation also inhibits the production of amyloid β-peptide and the phosphorylation of Tau protein, suggesting that it may protect neurons by promoting correct protein folding and regulating the degradation of toxic proteins via the autophagy-lysosomal pathway. However, the benefits of acupoint stimulation still need to be further explored in more high-quality studies in the future.
Modulating and monitoring the functionality of corticostriatal circuits using an electrostimulable microfluidic device
Authors: Han Sukmin , Bang Seokyoung , Kim Hong Nam , Choi Nakwon , Kim Sung Hyun 
Published: January 2023

AbstractThe central nervous system is organized into different neural circuits, each with particular functions and properties. Studying neural circuits is essential to understanding brain function and neuronal diseases. Microfluidic systems are widely used for reconstructing and studying neural circuits but still need improvement to allow modulation and monitoring of the physiological properties of circuits. In this study, we constructed an improved microfluidic device that supports the electrical modulation of neural circuits and proper reassembly. We demonstrated that our microfluidic device provides a platform for electrically modulating and monitoring the physiological function of neural circuits with genetic indicators for synaptic functionality in corticostriatal (CStr) circuits. In particular, our microfluidic device measures activity-driven Ca2+ dynamics using Ca2+ indicators (synaptophysin-GCaMP6f and Fluo5F-AM), as well as activity-driven synaptic transmission and retrieval using vGlut-pHluorin. Overall, our findings indicate that the improved microfluidic platform described here is an invaluable tool for studying the physiological properties of specific neural circuits.
Ovarian seromucinous carcinoma: an independent epithelial ovarian cancer?
Authors: Hu Yi , Fu Kun , Liu Huining , He Qiongqiong , Qiu Xiaoqin , Yang Wenqing , Zhang Yu 
Published: January 2023

Abstract
Background
2020 World Health Organization Classification of Female Genital Tumors removed ovarian seromucinous carcinoma as a distinct entity and recategorized it as ovarian endometrioid carcinoma with mucinous differentiation according to its pathological features. The aim of this study was to find whether ovarian seromucinous carcinoma truly represented a distinct category of ovarian tumors or an analogue of ovarian endometrioid carcinoma.

Methods
Twelve patients diagnosed with ovarian seromucinous carcinoma and received surgery at the Xiangya Hospital from January 2010 to December 2019 were included in this study. Clinicopathological features such as clinical symptoms, serological indicators, surgical information, postoperative findings, chemotherapy sensitivity, follow-up information, HE staining and IHC staining images and other clinicopathologic features were collected. Using t-test and Kaplan Meier to perform statistical analysis. Pathological review was conducted using the 2014 World Health Organization criteria. All pathological diagnoses were reviewed by two experienced pathologists.

Results
The age of 12 patients diagnosed with ovarian seromucinous carcinoma ranged from 23 to 68 years, with a median age of 46.8 years. Serum level of CA125 was elevated in 10 patients, and CA125/CEA ratio was less than 25 in 6 patients. Eleven patients underwent radical ovarian cancer surgery, and one patient underwent fertility preservation surgery. The progression free survival and overall survival of ovarian seromucinous carcinoma is 46.8 months and 50.2 months. Kaplan-Meier survival curve showed that the prognosis of ovarian seromucinous carcinoma and ovarian endometrioid carcinoma was significantly different (P = 0.03). The prognosis of ovarian seromucinous carcinoma and ovarian mucinous carcinoma was similar.

Conclusion
Although ovarian seromucinous carcinoma and ovarian endometrioid carcinoma are similar in pathologic morphology, their clinical features and prognosis are significantly different. The signs, serum biomarker and prognosis of the ovarian seromucinous carcinoma are similar with ovarian mucinous carcinoma. Therefore, ovarian seromucinous carcinoma is not suitable to be directly classified as ovarian endometrioid carcinoma.