Women's Health Commons^™

Standardization And Quality Control Of The Introduction Of A Noninvasive Cardiac Output Monitor For Pregnancy Measurements In A Low- And Middle-Income Country, Helen Perry

Centre of Excellence in Women and Child Health

Introduction :There is increasing awareness of the role of the maternal cardiovascular system in complicated pregnancies. Despite the high disease burden, noninvasive cardiac output monitors have not been used extensively in low- and middle-income countries. The aim of this study was to evaluate the quality control of the use of the ultrasonic cardiac output monitor (USCOM) 1A® in a LMIC.

Material and Methods This was a quality assessment study of the introduction of the USCOM 1A® to measure maternal hemodynamic indices. Inter-observer agreement was assessed across all four study sites by intraclass correlation coefficient. Quality control was assessed using pre-defined …

"Health Gatekeepers": The Influence Of Women On Health Practices In Rural, Central Appalachia, Reese Lycan

Senior Theses

Women have historically assumed leadership roles in familial and community health promotion, intervention, and facilitation. While the role of women in family health is globally understood and the historical importance of female leadership has been documented, there remains a gap in knowledge regarding the role of women as “health gatekeepers”. Furthermore, when considering the Appalachian region, there are limited studies regarding women’s place in leadership as far as health is concerned. Therefore, this study employs a hermeneutic phenomenological framework to explore the lived experiences of women in relation to their family and community’s health in rural, Central Appalachia- a region …

Role Of Race And Ethnicity In The Development, Diagnosis, And Treatment Of Gestational Diabetes Mellitus, Gabrielle D. Shupard

Senior Theses

Gestational diabetes mellitus (GDM) is the most common metabolic disorder of pregnancy, and rates of this disease have been steadily increasing over the past ten years. GDM disproportionately impacts racial and ethnic minorities at higher rates than their Caucasian counterparts. In this study, the PRECEDE model framework was employed during a literature review to gain a greater understanding of the complex risk factors contributing to differences in the development, diagnosis, and treatment of GDM among these population subgroups. The second part of this study concentrated on reviewing the extent to which current literature evaluates the role of race and ethnicity …

Cell-Free Dna Results Indicating Mosaic Monosomy X Of Likely Maternal Origin: Impact On Genetic Counseling Practices And Patient Experiences, Audrey Mcbride, Ashley Cannon, Siddharth Prakash, Aaron W Roberts, Angela Seasely, Anna C E Hurst, Laura Hendon

Faculty, Staff and Student Publications

Objective: To investigate the current genetic counseling practices involving a cfDNA result indicating mosaic monosomy X of likely maternal origin, and to better understand the perspectives of patients who have received this result.

Method: A total of 60 prenatal genetic counselors completed surveys about their experiences with this result, cfDNA consenting practices, and management practices. In addition, qualitative interviews were conducted with 5 patients to gain insight into their experiences with result disclosure and follow-up care.

Results: 95% of genetic counselors reported feeling prepared to counsel on these results. However, responses to current practices varied. Of the genetic counselors surveyed, …

Women’S Health Considerations In Traumatic Brain Injury, Sindhoori Nalla

Department of Rehabilitation Medicine Faculty Papers

Purpose of Review: Biological sex differences are an important factor to consider when treating TBI, as there can be a disproportionate manifestation of symptoms and recovery process when comparing females to males. Historically, these differences have not been well studied, and there is still much to be understood as to why these differences exist. Recent Findings: A number of factors are thought to contribute to disparities with women who have a TBI, including lack of well-designed research studies focused on women, hormonal fluctuations at the time of and as a result of a TBI, psychosocial comorbidities, and societal norms/expectations. While …

Uterine Pgrmc2 Deficiency Attenuates Endometrial Hyperplasia And Cancer And Prolongs Lifespan In A Pten Loss-Of-Function-Induced Cancer Model, Nicole C Kelp, Cindy A Pru, Sandeep Paudel, John P Lydon, J Julie Kim, John J Peluso, James K Pru

Faculty, Staff and Students Publications

The expression of members of the progesterone receptor membrane component (PGRMC) family, particularly PGRMC1, is elevated in diverse types of cancers, particularly those of the female reproductive system. While xenograft tumor studies using human transformed cell lines in immunocompromised mice have suggested that PGRMC1 enhances tumor growth and chemoresistance, the exact role of members of the PGRMC family in cancer development in vivo remains unclear. In this study, we examined the effect of deleting Pgrmc2 on the development of endometrial hyperplasia and cancer using a murine phosphatase and tensin homologue (Pten) conditional loss-of-function model. We previously established that …

Mothers’ Characteristics And Children's Diarrhea Between 2010-2020 In Rwanda, Amans Ntakarutimana Dr., Patrick A. Tschida Dr.

Journal of Social, Behavioral, and Health Sciences

Mothers’ characteristics influence children’s health and development. We conducted a cross-sectional study to assess the influence of mothers’ education level, employment status, and exposure to domestic violence on diarrhea among children under 5 years old using secondary data from 2010, 2015, and 2020 Rwanda Demographic Health Surveys. We used stratified descriptive statistics, pairwise comparisons, and logistic regression designs to assess (a) the prevalence of mothers per education level, employment status, and exposure to domestic violence; (b) their variation over time; and (c) their influence on diarrhea among children under 5 years old between 2010 and 2020 in Rwanda. According to …

The Diagnostic Role Of Pharmacological Provocation Testing In Cardiac Electrophysiology: A Clinical Consensus Statement Of The European Heart Rhythm Association And The European Association Of Percutaneous Cardiovascular Interventions (Eapci) Of The Esc, The Esc Working Group On Cardiovascular Pharmacotherapy, The Association Of European Paediatric And Congenital Cardiology (Aepc), The Paediatric & Congenital Electrophysiology Society (Paces), The Heart Rhythm Society (Hrs), The Asia Pacific Heart Rhythm Society (Aphrs), And The Latin American Heart Rhythm Society (Lahrs), Elijah R Behr, Bo Gregers Winkel, Bode Ensam, Alberto Alfie, Elena Arbelo, Colin Berry, Marina Cerrone, Giulio Conte, Lia Crotti, Cecilia M Gonzalez Corcia, Juan Carlos Kaski, Koonlawee Nademanee, Pieter G Postema, Silvia Priori, Vincent Probst, Georgia Sarquella-Brugada, Eric Schulze-Bahr, Rafik Tadros, Arthur Wilde, Jacob Tfelt-Hansen, Christian Wolpert, Alejandro Cuesta, Peter Damman, Dobromir Dobrev, Fabrizio Drago, Kristina Haugaa, Andrew Krahn, Ulrich Krause, Pier D Lambiase, Carlo Napolitano, Katja E Odening, Wataru Shimizu, Christian Veltmann

Faculty, Staff and Students Publications

The pharmacological provocation test is a pivotal tool in cardiac electrophysiology for the diagnosis of potential causes of sudden cardiac death, sudden cardiac arrest (SCA), arrhythmias, symptoms, or ECG abnormalities. The 2022 European Society of Cardiology Guidelines for the Treatment of Ventricular Arrhythmias and Prevention of Sudden Cardiac Death offered guidance on provocation testing but did not describe the indications and requirements in depth. This clinical consensus statement, led by the European Heart Rhythm Association and approved by major international stakeholders, aims to advise the general cardiologist and the arrhythmia expert who to test and when, where, and how to …

Breast Cancer Diagnoses Are Increasing Among Racial And Ethnic Minority Women In The U.S., Esther Oshaji

Population Health Research Brief Series

Breast cancer is the second most common cancer and a leading cause of cancer deaths among women in the United States. This data slice uses data from the Surveillance, Epidemiology and End Results Program (SEER) Incidence Database to examine trends in breast cancer incidence rates among women by race and ethnicity in the U.S. from 2000 to 2021. The author finds that, while incidence rates remain highest among non-Hispanic White women, the largest increases in diagnoses have been among American Indian/Alaska Native Asian/Pacific Islander women.

The Feasibility And Safety Of Robot-Assisted Vaginal Natural Orifice Transluminal Endoscopic Surgery (Ra-Vnotes) For Gynecologic Disease: 298-Case Series, Qiannan Yang, Daniel Y Lovell, Yingchun Ma, Chunhua Zhang, Xiaoming Guan

Faculty, Staff and Students Publications

Objectives: To explore the feasibility and surgical outcomes of robot-assisted vaginal natural orifice transluminal endoscopic surgery (RA-vNOTES) for women suffering from gynecologic disease.

Methods: We performed an observational study reporting and analyzing the perioperative outcomes of 298 patients with gynecologic disease who underwent RA-vNOTES in a single institution from June 2019 to August 2024.

Results: A total of 298 patients with a median age of 41 years and median body mass index of 29 kg/m2 underwent RA-vNOTES. The primary indications for surgery were endometriosis (43.62%), chronic pelvic pain (11.07%), abnormal uterine bleeding (20.81%), and uterine leiomyomata (14.77%). A total of …

Health Equity & Parental Leave: Addressing Gaps In Maternal Health Policy, Destiny L. Smith

Public Health Capstone Projects

Objective: This capstone project at Duquesne University will address health equity by focusing on employer-provided maternal and parental leave policies in the United States among underserved groups. It aims to address the gaps in these policies and analyze how disparities in leave policies across different industries can impact maternal and infant health outcomes.

Priority Population Served: This study will primarily target underserved employees who had to take some type of leave policy while working for an intended employer.

Methods: This project will engage in data analysis of the 2024 BIRTH survey results that the Pittsburgh Business Group on …

Trauma In Pregnancy: A Statistical Retrospective Analysis Of Leading Causes And Demographic Insights, Andrea Argenal, Sonya Bhatia, Sowmya Duddu, Julia Paz, Sriya Gullapalli, Kelsey Baker, Bharathi Gadad

Research Symposium

Background: Trauma during pregnancy is a significant contributor to maternal and fetal morbidity and mortality. Understanding the leading causes of trauma can guide interventions to improve outcomes of injuries for pregnant women. This study aimed to analyze the distribution of trauma causes in a cohort of pregnant women treated in Texas Emergency Department over the year 2021.

Methods: A retrospective statistical analysis was conducted on a sample of 96 pregnant women who experienced trauma. Data was collected from the Texas Emergency Department for patients admitted to the hospital during 2021 and categorized by the cause of injury; some of these …

From Crisis To Action: Investigation, Research, And Response In The Rio Grande Valley Following The Anencephaly Cluster Of 1990-1991, Jonathan Hebert, Miguel Lopez, Padmanabhan Rengasamy

MEDI 9331 Scholarly Activities Clinical Years

The 1990-1991 birth defect cluster of anencephaly in the Rio Grande Valley has had lasting effects on Texas public health and birth defect prevention nationwide. The purpose of this study is to clearly illuminate public health efforts to investigate, identify, and combat the rise of anencephaly and other neural tube defects (NTDs) in the Rio Grande Valley and other border counties following the 1990-1991 cluster, as well as to report the findings of each branch of environmental, infectious, and genetic investigation into the possible causes of the disaster. Information was gathered via a literature review and from other sources including …

Risk Factors And Public Health Interventions Associated With Adolescent Pregnancy Prevention Among Females Aged 10–19 Years In Kenya: A Scoping Review Protocol, Kimbley Asaso Omwodo, Abdu Mohiddin, Danielle Denwood, Augustine N. Gitonga

Centre of Excellence in Women and Child Health

Background ; Adolescent pregnancy is associated with multifaceted challenges that impact countries’ health, education and economic stability. Despite ongoing interventions, in developing countries such as Kenya, adolescent pregnancy rates continue to be high. There is a need for more synthesised evidence on regional-specific risk factors to support tailored prevention strategies.

Objective; This scoping review aims to explore what is known about the risk factors and intervention strategies focused on adolescent pregnancy prevention in Kenya.

Methods and analysis; Using the Arksey and O’Malley framework combined with a three-step search strategy as recommended by the Joanna Briggs Institute, relevant articles will be …

Assessing Healthcare Insurance Policies In Mississippi: An Evaluation Of Public And Private Options, Latarsha H. Michael, Brieah D. Hudson

The Journal of the Research Association of Minority Professors

Medicaid is the main payer for maternity care in the U.S., covering nearly half of all births. Federal law provides postpartum coverage for 60 days, but gaps exist, especially in non-expansion states. The American Rescue Plan Act of 2021 allows states to extend Medicaid postpartum coverage to 12 months. Mississippi, where Medicaid covers 65% of births, faces severe maternal and infant health challenges. Despite its surplus, extending postpartum care to 12 months could cost $7 million annually. This study examines private and public health insurance coverage for perinatal care in Mississippi. This involves analyzing how different insurance policies address the …

Pharmacodynamics Of Aspirin Through Gestation: Predictors Of Aspirin Response And Association With Pregnancy Outcome, A Prospective Cohort Study, Rupsa C. Boelig, Emily Foecke Munden, Tingting Zhan, Steven E. Mckenzie, Walter K. Kraft

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

Low-dose aspirin is recommended for prevention of hypertensive disorders of pregnancy (HDP) and preterm birth (PTB) in high-risk pregnancies. There is limited data on factors impacting aspirin response in pregnancy. We aimed to evaluate predictors of aspirin response and association with pregnancy outcome with a prospective study of high-risk pregnancies taking 81 mg aspirin daily. Aspirin response was evaluated with Platelet Function Assay-100 (PFA-100) epinephrine closure time at baseline (< 16 weeks' gestation), follow-up 1 (2-4 weeks after aspirin initiation), and follow-up 2 (28-32 weeks gestation). Multivariable regression was used to identify factors associated with PFA-100 at each visit, and results presented with beta coefficient (B) and confidence interval. The median difference (MD) in PFA-100 in those with and without HDP or PTB was compared. Results included 108 who completed follow-up 1 and 96 who completed both visits with > 75% adherence. PFA-100 was increased from baseline at follow-ups 1 and 2 (MD 37 (27-49); MD 26 (15.5-38.5) respectively). At follow-up 1, obesity (B = -30 (-53 to -7) seconds), …

Contraceptive Hormone Influences On The Role Of Primary Reinforcement And Reinforcer-Enhancement In Nicotine Self-Administration, Kathleen Robin Mcnealy

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Hormonal contraceptives contain a synthetic estrogen (e.g., ethinyl estradiol/EE) and/or a synthetic progestin (e.g., levonorgestrel/LEVO) and can exacerbate nicotine intake. However, whether altered intake reflects changes in nicotine reinforcement or enhancement by nicotine of co-occurring reinforcers is unknown. This reinforcer-enhancement effect is evidenced in rats when nicotine self-administration is increased by the presence of a visual stimulus (VS) reinforcer. This dissertation examined the effects of EE and LEVO on nicotine reinforcement and reinforcer-enhancement in ovary-intact female Sprague-Dawley rats. Rats were implanted with a jugular catheter and assigned to receive daily injections of EE (Vehicle, 0.125 [Low], or 0.18 [High] μg/day; …

Bevacizumab Beyond Progression: Impact Of Subsequent Bevacizumab Re-Treatment In Patients With Ovarian, Fallopian Tube, And Peritoneal Cancer After Progression, Amma Asare, Rebecca Ann Previs, Daniel Spinosa, Bryan Fellman, Amelia L Scott, Isabelle Mulder, May Mahmoud, Ahmed Enbaya, Jean Hansen Siedel, Lauren Cobb, Pamela T Soliman, Anil K Sood, Robert L Coleman, Angeles Alvarez Secord, Shannon N Westin

Faculty, Staff and Student Publications

Background: This study evaluated whether patients with epithelial ovarian, fallopian tube, and primary peritoneal carcinoma (OC) who are immediately re-treated with bevacizumab derive benefit after disease progression on a bevacizumab-containing regimen.

Methods: This multi-institutional, retrospective study compared patients with high grade non-mucinous epithelial OC who received bevacizumab followed directly by another bevacizumab-containing treatment regimen to patients who received bevacizumab followed by a regimen that did not contain bevacizumab (or received no further treatment). Progression-free survival (PFS) and overall survival (OS) were estimated using Kaplan Meier product-limit estimator and modeled via Cox proportional hazards regression.

Results: Among 226 patients with OC …

Zika Virus Ns1 Drives Tunneling Nanotube Formation For Mitochondrial Transfer And Stealth Transmission In Trophoblasts, Rafael T Michita, Long B Tran, Steven J Bark, Deepak Kumar, Shay A Toner, Joyce Jose, Indira U Mysorekar, Anoop Narayanan

Faculty, Staff and Students Publications

Zika virus (ZIKV) is unique among orthoflaviviruses in its vertical transmission capacity in humans, yet the underlying mechanisms remain incompletely understood. Here, we show that ZIKV induces tunneling nanotubes (TNTs) in placental trophoblasts which facilitate transfer of viral particles, proteins, mitochondria, and RNA to neighboring uninfected cells. TNT formation is driven exclusively via ZIKV non-structural protein 1 (NS1). Specifically, the N-terminal 1-50 amino acids of membrane-bound ZIKV NS1 are necessary for triggering TNT formation in host cells. Trophoblasts infected with TNT-deficient ZIKV

Cervical Cancer Screening And Hpv Vaccine Intentions: An Egyptian Population Assessment Through University Channels, Rita Hany Ebeid

Theses and Dissertations

Background: Cervical cancer remains a significant global health burden, disproportionately affecting low- and middle-income countries. While HPV vaccination and cervical cancer screening programs have shown promise in reducing incidence and mortality, access to these interventions remains limited in Egypt. The purpose of this study was to analyze female and male beliefs, knowledge of, and perceptions related to cervical cancer screening and HPV vaccination, and how these factors influence women and men’s intentions to respectively undergo or promote these behaviors in Egypt. This study also aimed to develop recommendations for more effective cervical cancer prevention measures that promote greater uptake among …

Disparities In Pap Smear Rates Among Diverse California Populations: A Data-Driven Analysis, Julie Paik, Thrisha Reddy, Giovanna Park, Angela Nguyen, Sherli Koshy-Chenthittayil

Annual Research Symposium

No abstract provided.

Menstrual Poverty In Egypt: Padding The Way To Period Equity, Sara Hesham Nasr

Theses and Dissertations

With approximately 800 million women menstruating daily worldwide, a significant portion of this demographic experiences barriers to accessing sanitary products. In Egypt, despite having around third of the population in reproductive age and menstruating monthly, an economic turmoil in 2017 opted the government to label menstrual products as luxury items and the prices have increased since then.

The current study aimed to investigate menstrual poverty in Egypt, focusing on the economic and social challenges faced by women during menstruation. Key objectives include assessing the financial challenges related to menstruation, exploring existing policies aimed at alleviating these challenges, and proposing evidence-based …

Current Concepts In Prenatal Dental Care: A Narrative Review, Adam Lawlor

Annual Research Symposium

No abstract provided.

Dysbiosis Of The Oral Microbiome And Pathophysiology Of Pregnancy Complications, Jiselle Cornejo, Claudia M. Tellez Freitas

Annual Research Symposium

No abstract provided.

Prevalence And Correlates Of Depressive And Anxiety Symptoms Among Pregnant Women From An Urban Informal Settlement In Nairobi, Kenya: A Community-Based Cross-Sectional Study, Stephen Mulupi, Amina Abubakar, Moses Nyongesa, Vibian Angweny, Margaret Kabue, Paul Mwangi, Rachel Odhiambo, Joyce Marangu, Eunice Njoroge, Mercy Mokaya, Emmanuel Obulemire, Eunice Ombech, Kofi Marfo

Institute for Human Development, East Africa

Purpose: Previous research, largely from the Global North, reports high rates of common mental health disorders among women in the antenatal period, but there is paucity of such data in contexts like Kenya. This study investigated the prevalence and correlates of depressive and anxiety symptoms among pregnant women in an urban informal settlement in Kenya’s capital – Nairobi.

Method: An analysis of baseline cross-sectional data from a pilot cluster randomized trial of an integrated early childhood development programme. Participants were pregnant women in their third pregnancy trimester (N = 249), residing in an urban informal settlement in Nairobi County. Mental …

Implementation Of In Utero Laparotomy-Assisted Fetoscopic Spina Bifida Repair In Two Centers In Latin America: Rationale For This Approach In This Region, Jezid Miranda, Miguel A Parra-Saavedra, William O Contreras-Lopez, Cristóbal Abello, Guido Parra, Juan Hernandez, Amanda Barrero, Isabela Leones, Adriana Nieto-Sanjuanero, Gerardo Sepúlveda-Gonzalez, Magdalena Sanz-Cortes

Faculty, Staff and Students Publications

Background: Spina bifida (SB) is a severe congenital malformation that affects approximately 150,000 infants annually, predominantly in low- and middle-income countries, leading to significant morbidity and lifelong disabilities. In Latin America, the birth prevalence of SB is notably high, often exacerbated by limited healthcare resources and poor access to advanced medical care. The implementation of laparotomy-assisted fetoscopic in-utero SB repair programs in Latin America targets reducing prematurity rates and enabling vaginal births while preserving the benefits of decreased need for hydrocephalus treatment and improved mobility in children.

Objective: This study evaluated the safety, efficacy, and outcomes of laparotomy-assisted fetoscopic in-utero …

Procalcitonin-Guided Duration Of Antibiotic Treatment In Children Hospitalised With Confirmed Or Suspected Bacterial Infection In The Uk (Batch): A Pragmatic, Multicentre, Open-Label, Two-Arm, Individually Randomised, Controlled Trial, Cherry-Ann Waldron, Philip Pallmann, Simon Schoenbuchner, Debbie Harris, Lucy Brookes-Howell, Céu Mateus, Jolanta Bernatoniene, Katrina Cathie, Saul N. Faust, Helen Nabwera

Centre of Excellence in Women and Child Health

Background Procalcitonin is a rapid response biomarker specific for bacterial infection, which is not routinely used in the UK National Health Service. We aimed to assess whether using a procalcitonin-guided algorithm would safely reduce the duration of antibiotic therapy compared with usual care, in which C-reactive protein is the commonly used biomarker.

Methods The BATCH trial was a pragmatic, multicentre, open-label, parallel, two-arm, individually randomised, controlled trial conducted in 15 hospitals in England and Wales. Children aged 72 h to 18 years who were admitted to hospital and were being treated with intravenous antibiotics for suspected or confirmed bacterial infection …

Atypical Presentation Of Non-Small Cell Lung Carcinoma With Metastasis To Breast Tissue, Tylar P. Seckman, Diane Krutzler-Berry, Mohamed Ashal, Waqas Mahmud, Krista L. Denning, Logan M. Lawrence

Marshall Journal of Medicine

Malignant neoplasms of the lung commonly metastasize to lymph nodes, bone, brain, and liver via hematogenous and lymphatic routes. Much less commonly, metastasis occurs in the breast. Secondary metastatic disease of the breast is very rare, with a reported incidence ranging from 0.4-1.3%­­—with primary lung cancer being one of the most anomalous sources. This case details non-small cell lung cancer metastasis to the breast with proven primary contralateral lung origination. This atypical finding prompts medical professionals to consider these malignant cells' immunologic, histologic, and pathologic makeup to understand further and treat the neoplasm.

Efektivitas Kartu Permainan Dan Kombinasi Video Animasi -Kartu Permainan Dan Terhadap Kepatuhan Minum Tablet Tambah Darah, Ardi Bastian, Agustin Widyowati, Riza Yuliawati, Kristin Ernawati, Dian Mustikawati

Perilaku dan Promosi Kesehatan : Indonesian Journal of Health Promotion and Behavior

Background: Screening results at the Baron Health Center, Nganjuk Regency showed that the prevalence of anemia in adolescent girls reached 60.89%. Although counseling and provision of iron tablets to increase hemoglobin levels have been carried out, adolescent girls' adherence to iron tablet is still low.

Objective: The study aims to see the differences in two educational methods to improve adolescent girls' compliance in consuming iron tablet

Method: A total of 201 adolescent girls were divided into 2 different groups. The first group was given education in the form of game cards, while the second group was given combination education cards …

Impaired Driving Among Rural Appalachian Women In The Year Following Incarceration, J. Matthew Webster, Megan F. Dickson, Shawn M. Jamison, Michele Staton

Journal of Appalachian Health

Introduction: Despite the known risks associated with substance use following incarceration, no studies have examined substance-impaired driving as a post-incarceration health risk behavior in rural Appalachia.

Purpose: The present study examined differences by impaired driving following incarceration and identified predictors of impaired driving in sample of rural Appalachian women with a history of drug use and risky sex.

Methods: Women (N=340) from three rural Appalachian jails completed a baseline interview in jail and follow-up interviews at six and 12 months post-release. Interview questions included demographic characteristics and information on substance use risk, mental health, criminal legal system involvement, and impaired …