Publications by authors named "Nicola Tavella"

Objectives: This study examined research-related privacy and confidentiality concerns among adolescent sexual minority males (ASMM) and provides lessons learned to inform recruitment and enrollment strategies for this population.

Methods: Participants were a 2017-2018 internet-based U.S.

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Background: Postpartum hemorrhage (PPH) contributes significantly to maternal morbidity and mortality. The use of cell salvage has been implemented in operating rooms across the world, but only a limited number of institutions have protocols for use of cell salvage during vaginal hemorrhage at the time of vaginal delivery. Observations suggest that blood salvaged from vaginal delivery is comparable to blood salvaged during cesarean delivery.

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Medical students from racially minoritized backgrounds receive negative evaluations more frequently, possibly from implicit bias. To determine if a preference for White applicants over Asian and Black applicants exists among resident and attending reviewers of obstetrics and gynecology (OB/GYN) residency applications. In 2021, we sampled academic OB/GYN physicians from 6 academic institutions to randomly receive questionnaire form A or B, each containing 4 contrived Electronic Residency Application Service profiles stratified by United States Medical Licensing Examination scores; institutions attended; and strength of recommendation letters into top-, mid-, and low-tiers.

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Background: Cell-free fetal DNA (cffDNA) screening is routinely performed in pregnancy. Abnormal fetal fraction has been associated with adverse pregnancy outcomes, including hypertensive disorders of pregnancy, which are associated with severe maternal and neonatal morbidity and mortality.

Objective: This study examined whether abnormal fetal fraction, defined in this study as fetal fraction either <6 or >15 on the basis of restricted-cubic-spline-plot within our study population, was associated with HDP in a retrospective sample, as well as whether fetal fraction improves the prediction of hypertensive disorders of pregnancy (HDP).

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Article Synopsis
  • - The study examines the social characteristics influencing patients' choices between labor after cesarean (TOLAC) and scheduled repeat cesarean delivery (SRCD), aiming to address disparities in delivery methods.
  • - Analyzing data from 1,983 patients, results show that those with high social vulnerability, certain racial/ethnic identities, public insurance, and obesity were more likely to choose TOLAC over SRCD.
  • - The findings highlight that disadvantaged groups may prefer TOLAC, indicating the need for better individualized counseling and shared decision-making regarding delivery options.
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  • The study investigates the relationship between transvaginal cervical length (TVCL) measurements after cerclage placement and the risk of spontaneous preterm birth (sPTB).
  • It analyzes data from 210 patients with singleton pregnancies, focusing on the odds of sPTB in those with TVCL measurements less than 2.5 cm compared to those with measurements 2.5 cm or greater.
  • The results indicate that while a TVCL <2.5 cm does not significantly increase the odds of sPTB, a TVCL <2.0 cm is associated with significantly higher odds of sPTB.
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Aim This study aims to assess the effect of implementing an enhanced prenatal genetic checklist to guide the provider's discussion on both screening and diagnostic options for fetal aneuploidy testing at the initial prenatal visit. Methods A retrospective quality improvement (QI) project was performed at a single, large, urban academic medical center. The implementation of this project was prospective; however, data was examined retrospectively after the QI initiative was implemented for three months.

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  • The study explored health inequities in maternal and neonatal outcomes for patients with placenta accreta spectrum across various racial and ethnic groups.
  • Researchers analyzed data from 408 pregnancies, finding that most diagnoses were made before birth and that the patient demographic largely consisted of non-Hispanic White and non-Hispanic Black individuals.
  • Ultimately, the study concluded that after accounting for various factors like age and income, there were no significant differences in adverse outcomes among the different racial and ethnic groups studied.
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  • This study aimed to determine if factors like BMI, advanced maternal age (AMA), and length of the second stage of labor could enhance predictions of obstetric anal sphincter injury (OASIS) during forceps-assisted vaginal deliveries (FAVD).
  • A total of 979 singleton pregnancies were analyzed, and it was found that 20.4% of patients experienced OASIS, but the inclusion of new predictive factors did not significantly improve prediction accuracy compared to established models.
  • The conclusion suggests that incorporating these factors into decision-making for FAVD does not increase the likelihood of predicting OASIS effectively.
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Background: Choosing whether to pursue a trial of labor after cesarean (TOLAC) or scheduled repeat cesarean delivery (SRCD) requires prenatal assessment of risks and benefits. Providers and patients play a central role in this process. However, the influence of provider-associated characteristics on delivery methods remains unclear.

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Objective: To clinically assess a cell-based noninvasive prenatal genetic test using sequence-based copy number analysis of single trophoblasts from maternal blood.

Methods: Blood was obtained from 401 (243 + 158) individuals (8-22 weeks) and shipped overnight. Red cells were lysed, and nucleated cells stained for cytokeratin (CK) and CD45 and enriched for positive CK staining.

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Objective: To evaluate whether use of both preoperative 2% chlorhexidine gluconate abdominal cloth and 4% chlorhexidine gluconate vaginal scrub is effective in reducing surgical site infections (SSIs) in patients undergoing cesarean delivery after labor.

Study Design: This is a single-center, randomized clinical trial in which patients were randomized 1:1 to receive 2% chlorhexidine gluconate cloth applied to the abdomen in addition to the application of 4% chlorhexidine gluconate vaginal scrub versus standard of care. The primary outcome was rate of SSIs, including endometritis, by 6 weeks postdelivery.

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Objective: Sexual minority men (SMM) of colour are disproportionately impacted by HIV and bacterial STIs (bSTIs). To better understand within-group heterogeneity and differential risk factors by race and ethnicity, we sought to examine rates of undiagnosed HIV and rectal bSTI at the intersection of racial and ethnic identity with other sociodemographic factors.

Methods: We examined data from 8105 SMM conducting home-based self-testing at enrolment in a nationwide cohort study collected from November 2017 to August 2018.

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