A blended learning approach for capacity strengthening to improve the quality of integrated HIV, TB, and malaria services during antenatal and postnatal care in LMICs: a feasibility study.

Background: The blended learning (BL) approach to training health care professionals is increasingly adopted in many countries because of high costs and disruption to service delivery in the light of severe human resource shortage in low resource settings. The Covid-19 pandemic increased the urgency to identify alternatives to traditional face-to-face (f2f) education approach. A four-day f2f antenatal care (ANC) and postnatal care (PNC) continuous professional development course (CPD) was repackaged into a 3-part BL course; (1) self-directed learning (16 h) (2) facilitated virtual sessions (2.

Sexual dimorphism in lung transcriptomic adaptations in fetal alcohol spectrum disorders.

Current fetal alcohol spectrum disorders (FASD) studies primarily focus on alcohol's actions on the fetal brain although respiratory infections are a leading cause of morbidity/mortality in newborns. The limited studies examining the pulmonary adaptations in FASD demonstrate decreased surfactant protein A and alveolar macrophage phagocytosis, impaired differentiation, and increased risk of Group B streptococcal pneumonia with no study examining sexual dimorphism in adaptations. We hypothesized that developmental alcohol exposure in pregnancy will lead to sexually dimorphic fetal lung morphological and immune adaptations.

CASP5 associated with PANoptosis promotes tumorigenesis and progression of clear cell renal cell carcinoma.

Clear cell renal cell carcinoma (ccRCC) is a globally severe cancer with an unfavorable prognosis. PANoptosis, a form of cell death regulated by PANoptosomes, plays a role in numerous cancer types. However, the specific roles of genes associated with PANoptosis in the development and advancement of ccRCC remain unclear.

HCV and HBV genotypes: vital in the progression of HCV/ HBV co-infection.

Background: Viral hepatitis is the major contributor to liver cirrhosis and hepatocellular carcinoma (HCC). Studies indicated that the co-infection of hepatitis C and hepatitis B virus also prompts liver damage progression. Therefore, in the present study, the prevalence of HCV-HBV co-infection and the impact of HCV-HBV co-infection on the progression of liver damage was evaluated amongst the HCV-infected patients in Pakistan.

Unexpected placenta accreta spectrum in an unscarred uterus causing catastrophic post-partum hemorrhage: a case report and review of the literature.

Background: Placenta accreta spectrum (PAS) disorder is a fatal condition responsible for obstetric haemorrhage, which contributes to increased feto-maternal morbidity and mortality. The main contributing factor is a scarred uterus, often from a previous cesarean delivery, myomectomy, or uterine instrumentation. The occurrence of PAS in an unscarred uterus is extremely rare, with only anecdotal cases reported so far in the literature.

Intraovarian platelet-rich plasma injection significantly improves blastocyst yield and quality in IVF patients.

This study evaluated the effectiveness of intraovarian platelet-rich plasma (PRP) injection in improving ovarian response and embryo quality in IVF patients with poor embryo quality in previous controlled ovarian hyperstimulation (COH) cycles. 74 patients participated, with 30 in the control group and 44 in the PRP group. PRP was injected during the follicular phase for the PRP group.

Prognostic significance of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio in uterine carcinosarcoma.

Introduction: Uterine carcinosarcoma (UCS) and uterine sarcomas (US) are rare but aggressive cancer with poor prognoses. The prognostic value of systemic inflammatory response (SIR) indicators, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR), in predicting outcomes of UCS and US remains unclear. This study investigated the prognostic significance of SIR indicators for UCS and US.

The Diverse Roles of Long Non-Coding RNA HOTTIP in Breast and Gynecological Cancer Progression.

Long non-coding RNAs (lncRNAs) play vital roles in the development and progression of various tumors through multiple mechanisms. Among these, HOTTIP (HOXA transcript at the distal tip) stands out as an intriguing candidate with diverse functions in several malignancies, including breast cancer and gynecologic cancers such as ovarian, cervical, and endometrial cancers, which are significant global health concerns. HOTTIP interacts with key signaling pathways associated with these cancers, including Wnt/β-catenin, PI3K/AKT, and MEK/ERK pathways, enhancing their activation and downstream effects.

Predictive Value and Potential of Targeting Complement Factor C3 in Patients with Renal Injury in Preeclampsia.

Aim: The activation of the complement system is accompanied by the occurrence and development of preeclampsia, as well as kidney diseases. Here, the role of complement C3 [C3] in renal injury in preeclampsia was explored, and its potential application as an early diagnostic biomarker or drug target to ameliorate kidney injury induced by preeclampsia was preliminarily evaluated.

Method: A total of 48 subjects were included in the present study, and the complement C3 levels and renal function were analyzed.

Videolaryngoscopy in paediatrics: in search of the clinical evidence.

Despite the numerous recent trials, systematic reviews and meta-analyses have not conclusively shown superiority of videolaryngoscopy over other techniques for tracheal intubation of children. Clinical trials have shown significant differences using various outcome measures, but the overall clinical evidence remains weak. An international group of experts is currently working on developing good clinical research practice guidelines for paediatric airway management research, with the ultimate aim of identifying a core set of outcomes to be applied to develop future robust and comparable trials.

Intrauterine metformin exposure and adiposity outcomes in children: a systematic review and meta-analysis.

Objective: The study aims to assess the effect of intrauterine metformin exposure on offspring adiposity measures in childhood.

Design: Systematic review and meta-analysis.

Data Sources: Medline, Embase and Cochrane Central were searched from inception to 4 October 2024.

Contraception Update: A Focus on Safety and Efficacy.

This clinical update serves as a brief summary of recently published and potentially practice changing journal articles. We review recent publications related to contraceptive safety and efficacy. The article discusses updated medical eligibility recommendations, effectiveness of progestin-only pills (including the newly approved over-the-counter pill), safety of estrogen containing contraceptives in those with migraine, topiramate interactions with hormonal contraception, and the use of nonsteroidal antiinflammatory drugs (NSAIDs) with oral emergency contraception to improve efficacy.

Effect of phenylephrine infusion on postpartum blood loss after cesarean delivery: A Placebo-controlled, randomized clinical trial.

Background: Preclinical studies have documented the role of alpha-adrenergic agonists in myometrial contraction. Phenylephrine is frequently used to prevent and treat post-spinal hypotension during cesarean delivery. We hypothesized phenylephrine would reduce postpartum blood loss due to alpha-1 receptor-mediated uterine and vascular smooth muscle contraction.

The association between maternal depression and anxiety symptoms during pregnancy and child sleep patterns at age 3 years.

Background: Childhood sleep problems are common and impact physical and emotional health. Prior work suggests that prenatal maternal depression and anxiety associate with disturbed child sleep in infancy. The current study evaluated whether these same associations extend to children at 3 years of age, and if so, whether the timing of symptoms in pregnancy is relevant.

Thromboprophylaxis in patients with locally advanced cervical cancer treated with chemoradiation and brachytherapy.

Objective: To determine the incidence of clinical and subclinical venous thromboembolic events (VTE) in patients with locally advanced cervical cancer (LACC) treated with high-dose thromboprophylaxis during definitive chemoradiation and brachytherapy.

Methods: A prospective observational study was undertaken from August 2021 to December 2023 in patients with primary LACC treated with definitive chemoradiation in two Dutch tertiary hospitals. Patients received high-dose thromboprophylaxis during chemoradiation and brachytherapy.

Priority Setting Partnership on Placental Pathology: Consensus recommendations for placental research.

Introduction: The placenta supports the metabolic and respiratory requirements of the fetus. Placental disorders, caused by various pathophysiological mechanisms, may result in adverse pregnancy and neonatal outcomes. Knowledge gaps remain in the understanding, reporting and interpretation of placental pathology relating to clinical conditions.

The trustworthiness of registered randomised control trials on hysteroscopy.

Introduction: The objective of this study was to assess the publication status of RCTs studying hysteroscopy registered on clinical trial registries, and the trustworthiness of these studies.

Material And Methods: We systematically searched 23 clinical trial registries and MEDLine for studies on hysteroscopy registered between March 2012 and 25 March 2022. Published RCTs were assessed for trustworthiness using the Trustworthiness in RAndomised Controlled Trials (TRACT) checklist.

Early detection of carcinoma: correlating quantifiable tumor biomarkers with high-resolution microscopy (HRME) findings.

Introduction: Cancer ranks as the second most prevalent cause of death worldwide, responsible for approximately 9.6 million deaths annually. Approximately one out of every six deaths is caused by cancer.

Signaling via retinoic acid receptors mediates decidual angiogenesis in mice and human stromal cell decidualization.

At the maternal-fetal interface, tightly regulated levels of retinoic acid (RA), the physiologically active metabolite of vitamin A, are required for embryo implantation and pregnancy success. Herein, we utilize mouse models, primary human cells, and pharmacological tools to demonstrate how depletion of RA signaling via RA receptor (RAR) disrupts implantation and progression of early pregnancy. To inhibit RAR signaling during early pregnancy, BMS493, an inverse pan-RAR agonist that prevents RA-induced differentiation, was administered to pregnant mice during the peri-implantation period.

Body Composition in Adults Born at Very Low Birthweight-A Sibling Study.

Background: Individuals born preterm at very low birthweight (VLBW, < 1500 g) tend to attain a smaller adult body size compared with term-born peers but less is known regarding specific body composition characteristics.

Objectives: We aimed to assess whether adults born at VLBW have less beneficial body composition characteristics, potentially mediating the association between VLBW birth and cardiometabolic disease. Sibling controls were used to account for the potential influence of shared genetic and/or lifestyle factors.

Early-Life Exposures and Odds of Adenomyosis: A Population-Based Case-Control Study.

Background: Adenomyosis can confer life-altering symptoms such as pelvic pain. Yet, the epidemiologic study of this uterine condition lags other gynaecologic conditions. This includes the investigation of intrauterine exposures that could disrupt foetal development and contribute to the presence of adenomyosis in adulthood.

Validation and Recalibration of a Model for Predicting Surgical-Site Infection After Pelvic Organ Prolapse Surgery.

Introduction And Hypothesis: The objective was to externally validate and recalibrate a previously developed model for predicting postoperative surgical-site infection (SSI) after pelvic organ prolapse (POP) surgery.

Methods: This study utilized a previously validated model for predicting post-POP surgery SSI within 90 days of surgery using a Medicare population. For this study, the model was externally validated and recalibrated using the Premier Healthcare Database (PHD) and the National Surgical Quality Improvement Project (NSQIP) database.

New Rat Model Mimicking Sacrocolpopexy for POP Treatment and Biomaterials Testing via Unilateral Presacral Suspension.

Introduction And Hypothesis: Pelvic organ prolapse (POP) impacts women's health and quality of life. Post-surgery complications can be severe. This study uses rat models to replicate sacrocolpopexy and test materials for pelvic support, verifying the 4-week postoperative mortality rate, the mechanical properties of the mesh tissue, and the collagen content.