Abortion and unintended pregnancy in Pakistan: new evidence for 2023 and trends over the past decade.

Background: Despite induced abortion being highly legally restricted in Pakistan, studies in 2002 and 2012 showed that many women rely on abortion when faced with an unintended pregnancy. Following the 2012 study, concerted efforts were made to improve contraceptive services and to strengthen postabortion care. The availability and use of misoprostol also expanded in the past decade.

Exploring the Influence of PCBs Exposure on Neonatal Birth Outcomes and Neurobehavioral Development after 20 years of prohibition.

Despite polychlorinated biphenyls (PCBs) have been banned in Taiwan for two decades, epidemiological studies indicated that prenatal PCBs exposure may still affect newborns and their birth outcomes. The study aimed to investigate the association between PCB concentrations in umbilical cord blood and infants' birth outcomes and neurodevelopment. We recruited 100 pairs of mothers and infants, residing in Changhua and Yunlin countries in Taiwan from 2014-2016.

Associations between Advanced Paternal Age and Adverse Reproductive Outcomes in the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (nuMoM2b).

Objective:  The association between paternal age and adverse pregnancy outcomes (APOs) has not been well studied. We sought to determine whether advanced paternal age (APA) is associated with adverse maternal or neonatal outcomes.

Study Design:  Secondary analysis of 8,863 pregnancies from the Nulliparous Pregnancy Outcomes Study Monitoring Mothers-to-Be (nuMoM2b) prospective cohort in which both maternal and paternal age at conception were known.

International Society for Pediatric and Adolescent Diabetes Clinical Practice Consensus Guidelines 2024: Insulin and Adjunctive Treatments in Children and Adolescents with Diabetes.

The International Society for Pediatric and Adolescent Diabetes (ISPAD) guidelines represent a rich repository that serves as the only comprehensive set of clinical recommendations for children, adolescents, and young adults living with diabetes worldwide. This chapter builds on the 2022 ISPAD guidelines, and updates recommendations on the principles of intensive insulin regimens, including more intensive forms of multiple daily injections with new-generation faster-acting and ultra-long-acting insulins; a summary of adjunctive medications used alongside insulin treatment that includes details on pramlintide, metformin, glucagon-like peptide-1 (GLP-1) receptor agonists (GLP-1RA) and sodium-glucose cotransporter inhibitors; and key considerations with regard to access to insulin and affordability to ensure that all persons with diabetes who need insulin can obtain it without financial hardship.

Immune mechanisms in multiple sclerosis: CD3 levels on CD28+ CD4+ T cells link antibody responses to human herpesvirus 6.

Compelling evidence suggests a significant association between antibody-mediated immune responses and multiple sclerosis (MS). However, the exact causal relationships between these immune responses and MS remain unclear. In this study, we conducted a comprehensive examination of the link between antibody-mediated immune responses and MS via Mendelian randomization (MR) analysis to identify specific infectious pathogens potentially involved in the onset and progression of MS.

Effect of postpartum oral furosemide use on postpartum readmissions and blood pressure trends.

Background: Oral furosemide postpartum improves the time to hypertension resolution in randomized control trials. Further investigation is needed to determine the impact of furosemide in routine clinical practice.

Objective: Real world study to assess impact of furosemide on rates of postpartum hypertension and readmissions for patients with hypertensive disorders of pregnancy.

Management of hypertension in the early postpartum: A randomized controlled trial.

Objectives: To evaluate blood pressure control during the immediate postpartum period in hypertensive women who had used methyldopa during pregnancy, comparing continuation of that drug with switching it for captopril.

Study Design: A single-blind, randomized clinical trial involving 172 postpartum women with hypertension who had previously used methyldopa during pregnancy at a minimum dose of 750 mg/day for at least one week prior to delivery. The subtypes of hypertension included were gestational hypertension, chronic hypertension, preeclampsia, superimposed preeclampsia, HELLP syndrome and eclampsia.

The Research Agenda for Perinatal Innovation and Digital Health Project: Human-Centered Approach to Multipartner Research Agenda Codevelopment.

Background: Digital health innovations provide an opportunity to improve access to care, information, and quality of care during the perinatal period, a critical period of health for mothers and infants. However, research to develop perinatal digital health solutions needs to be informed by actual patient and health system needs in order to optimize implementation, adoption, and sustainability.

Objective: Our aim was to co-design a research agenda with defined research priorities that reflected health system realities and patient needs.

Comprehensive analysis of ceRNA Networks in UCEC: Prognostic and therapeutic implications.

Endometrial cancer (UCEC) is the most prevalent gynecological malignancy in high-income countries, and its incidence is rising globally. Although early-stage UCEC can be treated with surgery, advanced cases have a poor prognosis, highlighting the need for effective molecular biomarkers to improve diagnosis and prognosis. In this study, we analyzed mRNA and miRNA sequencing data from UCEC tissues and adjacent non-cancerous tissues from the TCGA database.

Breast and cervical cancer screening among women at reproductive age in Cambodia: A secondary analysis of Cambodia Demographic and Health Survey 2022.

Breast and cervical cancers are the most prevalent diagnosed in women worldwide, significantly contributing to maternal morbidity and mortality. We examined socio-demographic and behavioral factors associated with breast and cervical cancer screening among Cambodian women aged 15-49 years old. We analyzed women's data from the 2022 Cambodia Demographic and Health Survey (CDHS).

The assessment of routine health information system performance towards improvement of quality of reproductive, maternal, newborn, child and adolescent health services in Ondo and Ekiti States, Nigeria.

Background: Nigeria's reproductive, maternal, newborn, child, and adolescent health indicators have remained unsatisfactory in the face of poor-quality healthcare services. Nigeria initiated the reproductive, maternal, newborn, child, and adolescent, elderly + nutrition (RMNCAEH+N) quality of care (QoC) agenda to address the challenge. The health management information system (HMIS) is integral to the agenda but there is sparse evidence on its performance so far.

Pre-exposure Prophylaxis (PrEP) Awareness and Engagement Among MSM at High Risk of HIV Infection in China: A Multi-City Cross-Sectional Survey.

This study aimed to explore the awareness, willingness, and engagement with pre-exposure prophylaxis (PrEP) among high-risk Chinese men who have sex with men (MSM) and to investigate the factors influencing its use. A cross-sectional survey of 1800 HIV-negative MSM was conducted in Chengdu, Suzhou, and Wuhan between June 2022 and February 2023 through in-person and online recruitment methods. Univariate and multivariate logistic regression analyses were used to identify predictors of PrEP use.

A High-Throughput Integrated Nontargeted Metabolomics and Lipidomics Workflow Using Microelution Enhanced Matrix Removal-Lipid for Comparative Analysis of Human Maternal and Umbilical Cord Blood Metabolomes.

Sample pretreatment for mass spectrometry (MS)-based metabolomics and lipidomics is normally conducted independently with two sample aliquots and separate matrix cleanup procedures, making the two-step process sample-intensive and time-consuming. Herein, we introduce a high-throughput pretreatment workflow for integrated nontargeted metabolomics and lipidomics leveraging the enhanced matrix removal (EMR)-lipid microelution 96-well plates. The EMR-lipid technique was innovatively employed to effectively separate and isolate non-lipid small metabolites and lipids in sequence using significantly reduced sample amounts and organic solvents.

Maternal and Infant Outcomes in a Subset of Patients with Sickle Cell Disease in South Carolina.

Objectives: Sickle cell disease (SCD), which disproportionately affects minorities, increases complications during pregnancy. Severe maternal mortality is increased in women with SCD, including morbidity related to the disease and other nondisease-related complications. It also can have devastating complications for fetuses, with increases in premature birth and low birth weight.

Examining priorities and investments made through the Global Financing Facility for maternal and newborn health: a sub-analysis on quality.

Improving quality of care could avert most of the 4.5 million maternal and neonatal deaths and stillbirths that occur each year. The Global Financing Facility (GFF) aims to catalyse the national scale-up of maternal and newborn health (MNH) interventions through focused investments.

Re-evaluating large for gestational age: differential effects on perinatal outcomes in term and premature births.

Objective: Pregnancies with large-for-gestational-age (LGA) fetuses are associated with increased risks of various adverse perinatal outcomes. While existing research primarily focuses on term neonates, less is known about preterm neonates. This study aims to explore the risks of adverse maternal and neonatal perinatal outcomes associated with LGA in term neonates and neonates with different degrees of prematurity, compared to appropriate-for-gestational-age (AGA) neonates.

Determinants of epilepsy among outpatients in public health institutions of Dawo district, South West Shoa Zone, Oromia, Ethiopia, 2023: an institutional-based unmatched case-control study.

Background: Globally, in ~50% of epilepsy cases, the underlying cause remains unknown, despite the fact that various disease pathways may contribute to the condition. Nearly 80% of people with epilepsy live in low- and middle-income countries and the risk of premature death in people with epilepsy is up to three times higher than that for the general population. Identifying the determinants of epilepsy is important for applying evidence-based interventions to achieve a better outcome.

Early life adverse environmental, nutrition and infection factors are associated with lower developmental scores in Pakistani children at 5 years: a cohort study.

Background: The effects of multiple early adverse psychosocial and biological factors on child development at preschool age in deprived settings are not fully understood.

Methods: The 'Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development' (MAL-ED) project followed children from eight countries, recording sociodemographic, nutritional, illness, enteroinfection biomarkers and scores for quality of home environment (Home Observation for Measurement of the Environment (HOME)), development (Bayley) and maternal depression during the first year of life. In the Pakistan cohort, we investigated associations of these early factors with Z-scores (derived from the eight participating countries) of three developmental outcomes at 5 years: Executive Functions (Z-EF), the Wechsler Preschool and Primary Scale for Intelligence (Z-WPPSI) and the externalising behaviours component of the Strength and Difficulties test (Z-externalising behaviours).

Enhancing Perinatal Safety with the Advancement of Obstetric Anesthesia in Japan.

Japan is one of the most developed countries in the world, and perinatal care is safe, with low maternal and neonatal mortality rates. However, as birthrate declines, advanced maternal age and the number of cesarean deliveries increases, efforts must be made to maintain safety in the future. The characteristic of the delivery facilities is "many small clinics," and half of all facilities have fewer than 500 deliveries per year.

Effectiveness of a technical support program with women's self-help groups in catalyzing health and nutrition behaviors in Bihar-a multicomponent analysis.

Introduction: Bihar Rural Livelihoods Promotion Society launched the JEEViKA program in 2007 to improve livelihoods through the Self-Help Group (SHG) platform. Women's SHGs have shown members' health improvements by promoting awareness, practices and access to services. This study investigates whether Health & Nutrition (HN) interventions delivered by JEEViKA Technical Support Program (JTSP) via SHG platforms could improve maternal and newborn health and nutritional behaviors in rural Bihar.

The mechanism underlying metastasis in triple-negative breast cancer: focusing on the interplay between ferroptosis, epithelial-mesenchymal transition, and non-coding RNAs.

Triple-negative breast cancer (TNBC) is a type of breast cancer with lack the expression of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2). It is the most aggressive breast cancer and the most difficult to treat due to its poor response to treatments and extremely invasive characteristics. The typical treatment for TNBC frequently results in relapse because of the lack of particular treatment choices.

Angelica sinensis polysaccharide as potential protectants against recurrent spontaneous abortion: focus on autophagy regulation.

Introduction: Recurrent spontaneous abortion (RSA) represents a significant clinical challenge, with its underlying mechanisms yet to be fully elucidated. Despite advances in understanding, the precise pathophysiology driving RSA remains unclear. Angelica sinensis, a traditional herbal remedy, is frequently used as an adjunctive treatment for miscarriage.

Psychological impacts of maternal migration on left-behind children: a cross-cultural review.

In the pursuit of a brighter future for their children, many female migrant workers leave their home countries to seek employment abroad, often as caregivers for families in wealthier nations. This decision necessitates prolonged separation from their own children, depriving them of the opportunity to witness and participate in crucial stages of their children's development. The absence of these mothers, combined with inconsistent caregiving in their stead, significantly increases the vulnerability of left-behind children to mental health challenges, such as depression, anxiety, and difficulties in forming emotional bonds with others.

Per- and Polyfluoroalkyl Substances and Twin Growth Discordance: New Insights from a Twin Birth Cohort Study.

Prenatal exposure to per- and polyfluoroalkyl substances (PFASs) has been linked to adverse fetal growth and development. However, most evidence was generated based on the singleton pregnancy studies, whereas potential impact on twin fetuses remains largely unknown. This study aimed to explore the associations of prenatal PFAS exposure with the growth and developmental differences within twin pairs by investigating 162 twin newborns and their mothers and determining 19 PFASs in maternal serum during the first, second, and third trimesters and cord serum of twins.