International Journal of Women's Health最新文献

{"title":"Unlocking Success: The Optimal Gonadotrophin Starting Point for Luteal-Phase Stimulation in IVF Patients with Normal Responses.","authors":"Xinyu Nie, Qi Wang, Mengmeng Xu, Rulin Dai, Bo Pang, Cong Hu","doi":"10.2147/IJWH.S540342","DOIUrl":"10.2147/IJWH.S540342","url":null,"abstract":"<p><strong>Purpose: </strong>To analyze and discover the optimal gonadotrophin (Gn) starting point for luteal-phase stimulation (LPS) in in vitro fertilization (IVF) Patients with normal ovarian response (NOR).</p><p><strong>Patients and methods: </strong>A total of 199 IVF or intracytoplasmic sperm injection (ICSI) cycles performed at the Reproductive Center of the First Hospital of Jilin University from January 1, 2021, to December 31, 2023, were recruited in the study. Of these, 121 cycles followed the follicular phase ovarian stimulation (FPS) (119 cases of adding antagonists), while 78 cycles adhered to the LPS protocol. The LPS group was divided into three subgroups based on the timing of Gn initiation: early, mid-, and late LPS. Comparisons were made between the LPS and FPS groups, as well as among the three subgroups, regarding Gn duration, total Gn dose, number of oocytes retrieved, number of embryos, rate of good-quality embryos, blastocyst formation rate, clinical pregnancy rate, cumulative pregnancy rate, live birth rate and cumulative live birth rate.</p><p><strong>Results: </strong>The rate of high-quality embryos in the late luteal phase was significantly higher than that in the early luteal group and slightly higher than that in the mid-luteal group. The clinical pregnancy rate and live birth rate of the late luteal group were slightly higher than those of the early and mid-luteal group, and were not significantly different from those of the FPS group.</p><p><strong>Conclusion: </strong>Initiating Gn stimulation during the late luteal-phase appears to be the optimal timing in NOR patients.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"17 ","pages":"3119-3131"},"PeriodicalIF":2.6,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research Progress and Clinical Implications of Generative Artificial Intelligence in Perinatal Health Care for Advanced Maternal Age Pregnant Women.","authors":"Shasha Tang, Shihong Zhao","doi":"10.2147/IJWH.S542758","DOIUrl":"10.2147/IJWH.S542758","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the current application status, technical characteristics, and challenges of Generative Artificial Intelligence (Generative AI) in perinatal health care for advanced maternal age pregnant women and explore targeted optimization strategies.</p><p><strong>Methods: </strong>A systematic literature review was conducted by searching PubMed, Web of Science, CNKI, and Wanfang Data from January 2020 to April 2025. Studies were included if they focused on Generative AI applications in perinatal care for women aged ≥35 years; 78 eligible studies (42 Chinese, 36 international) were finally included, covering technical applications, clinical validation, and ethical governance. We summarized the applications of Generative AI in risk prediction, personalized management, and remote monitoring, and analyzed issues related to data governance, technical limitations, resource allocation, and ethical supervision.</p><p><strong>Results: </strong>Generative AI improves healthcare efficiency by integrating multiple data sources for model construction, planning dynamic interventions, and facilitating remote monitoring. Specifically, GANs-based models achieve an AUC of 0.80-0.85 in predicting Group B Streptococcus infection, while Transformer models enhance the accuracy of prenatal depression screening by 15-20% compared to traditional methods. However, it faces challenges including data privacy risks (eg, 32% of maternal health institutions lack encrypted data storage), the \"black box\" nature of models (42% of clinicians report low trust in AI decision-making), urban-rural technological gaps (only 18% of county-level hospitals use AI perinatal tools), and ambiguous liability definitions.</p><p><strong>Conclusion: </strong>Generative AI demonstrates significant application potential in perinatal care for advanced maternal age pregnant women. Promoting its implementation through technological innovation (eg, explainable AI), interpretability optimization, resource deployment (eg, lightweight mobile tools), and ethical supervision is crucial to improving maternal and infant health outcomes in China and globally.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"17 ","pages":"3077-3085"},"PeriodicalIF":2.6,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Application of Noninvasive Prenatal Testing in Singleton Pregnancy with and without in vitro Fertilization: A 6-year Observational Study at a Single Tertiary Center.","authors":"Qian Zhang, Yuhong Guo, Bin Liang, Meihuan Chen, Xiaoqing Wu, Na Lin, Hailong Huang, Liangpu Xu","doi":"10.2147/IJWH.S547427","DOIUrl":"10.2147/IJWH.S547427","url":null,"abstract":"<p><strong>Background: </strong>Studies on the use of noninvasive prenatal testing (NIPT) in pregnancies conceived by in vitro fertilization (IVF) remain inadequate. This study aimed to evaluate the performance of NIPT in singleton pregnancies conceived by IVF and to compare it with that in naturally conceived (NC) pregnancies.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 86397 pregnancies (IVF=3723, NC=82674). The performance of NIPT was assessed by calculating the sensitivity, specificity, and positive predictive value (PPV).</p><p><strong>Results: </strong>The failure rate in the IVF group was significantly higher than that in the NC group (0.16% vs 0.04%, <i>p</i> < 0.05). Among the 3717 cases successfully tested in the IVF group, the sensitivities of trisomy (T) 21 and sex chromosome aneuploidy (SCA) were both 100%, with specificities of 99.92% and 99.76%, respectively. The PPVs of T21 and SCA were both 50%. Of the 82630 cases successfully tested in the NC group, all corresponding sensitivities and specificities were greater than 98%. The PPVs of T21, T18, T13, SCA and rare autosomal aneuploidies were 70.86%, 41.67%, 20.51%, 39.90%, and 7.65%, respectively. Furthermore, although the median fetal fractions (FFs) in the IVF group were significantly lower than that in the NC group (11.23% vs 12.05%, <i>p</i> < 0.001), the kinetics of FFs during gestation demonstrated a very similar trend between these two groups.</p><p><strong>Conclusion: </strong>Our findings suggest that NIPT is a valid technique for detecting fetal chromosomal aneuploidies in IVF singleton pregnancies.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"17 ","pages":"3067-3076"},"PeriodicalIF":2.6,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physiotherapy Reduces Pain and Alters Fatty Acid Biomarkers in Women with Chronic Non-Specific Low Back Pain.","authors":"Zhou Zhang, Xin Li, Wen Tang, Hao Xie, Hong-Jiang Wang, Hao-Yu Xie, Chu-Huai Wang","doi":"10.2147/IJWH.S551117","DOIUrl":"10.2147/IJWH.S551117","url":null,"abstract":"<p><strong>Background: </strong>Chronic nonspecific low back pain (cNLBP) represents the most prevalent musculoskeletal disorder encountered in clinical practice, constituting approximately two-thirds of all chronic low back pain cases. Epidemiological studies have identified significant gender differences in the incidence of cNLBP, with women exhibiting a slightly higher prevalence and reporting greater pain severity compared to men. However, the underlying mechanisms contributing to the increased severity of cNLBP in women remain largely unexplored. Our research is the first to explore fatty acid biomarkers in female patients with cNLBP undergoing physiotherapy from the perspectives of metabolomics and lipidomics.</p><p><strong>Methods: </strong>The study comprised 13 healthy female volunteers and 15 women diagnosed with cNLBP. Metabolomic and lipidomic analyses were employed to identify lipid metabolites closely associated with cNLBP in women. Subsequently, the 15 patients with cNLBP underwent manual therapy and exercise therapy, which incorporated both manual therapy and exercise therapy. Each therapy session lasted 50 minutes and was conducted over six sessions, occurring every two days. The Visual Analog Scale (VAS) scores of the patients were evaluated before and after treatment, and serum samples were collected for lipid determination at both pre- and post-treatment intervals.</p><p><strong>Results: </strong>Our metabolomic and lipidomic analyses revealed significantly elevated levels of three fatty acids (FAs): C14:0 FA (<i>P</i>=0.046), C20:0 FA (<i>P</i>=0.000001), and C20:1 FA (<i>P</i>=0.0007)), alongside significantly reduced levels of C20:5 (<i>P</i>=0.021) FA in women with cNLBP compared to healthy female volunteers. Receiver Operating Characteristic (ROC) curve analyses demonstrated that the Area Under the Curve (AUC) for these FAs exceeded 75%, indicating robust diagnostic performance. Notably, C20:0 FA exhibited an AUC greater than 95%, suggesting its potential as the most effective biomarker for diagnosing female patients with cNLBP. Additionally, physiotherapy significantly reduced pain levels in these women and was associated with a substantial decrease in blood FA levels.</p><p><strong>Conclusion: </strong>The study revealed a significant correlation between FA levels and female patients with cNLBP undergoing physiotherapy, thereby providing valuable insights for the development of personalized treatment approaches.</p><p><strong>Trial registration: </strong>(Chinese Clinical Trial Registry (https://www.chictr.org.cn), No.ChiCTR2300076620, 10/13/2023).</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"17 ","pages":"3055-3065"},"PeriodicalIF":2.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145112843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of WEE2 Gene Polymorphism with Fertilization Failure in Women Undergoing Intracytoplasmic Sperm Injection.","authors":"Zahraa Hamid Mohan Al-Gawwam, Rasha Hamzah Abdulhussein, Hala Saad Abed, Wengong Wei, Meiling Cai","doi":"10.2147/IJWH.S545145","DOIUrl":"10.2147/IJWH.S545145","url":null,"abstract":"<p><strong>Background: </strong>Infertility and pregnancy loss are major concerns in reproductive medicine, often linked to genetic factors affecting oocyte maturation. The WEE2 gene, which encodes an oocyte-specific kinase critical for meiosis, plays a vital role in fertilization. Variants in WEE2 have been implicated in oocyte maturation arrest and total fertilisation failure (TFF), particularly in women undergoing assisted reproductive technologies. This study aimed to investigate the association between WEE2 gene polymorphism and fertilization failure in women undergoing intracytoplasmic sperm injection (ICSI).</p><p><strong>Materials and methods: </strong>This prospective comparative study enrolled 137 infertile women undergoing ICSI procedures. Peripheral blood samples were collected from all participants for genetic analysis. Genotyping of the WEE2 gene variant rs1476640 was performed using a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay, which was specifically designed and optimised for this study.</p><p><strong>Results: </strong>WEE2 gene polymorphism (rs1476640) showed a significant association with fertilization outcomes (p < 0.0001). The T allele was protective, while the C allele increased the risk of fertilization failure (OR = 9.06; 95% CI: 3.27-25.14). Significant differences were also observed in infertility duration, oocyte count, and endometrial thickness between pregnant and non-pregnant women (p < 0.05), but not in age or BMI.</p><p><strong>Conclusion: </strong>The WEE2 rs1476640 polymorphism is significantly associated with fertilization failure in ICSI-treated women. Screening for this variant may help identify patients at risk and support personalised infertility treatment strategies.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"17 ","pages":"3045-3053"},"PeriodicalIF":2.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145112920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breast Density Awareness Among Saudi Women: A National Cross-Sectional Survey.","authors":"Areej S Aloufi, Rania M Ali, Deemah M Alqahtani, Mnayer I Bin Gaood, Reem B Althuniyan, Sultana A Alhurishi","doi":"10.2147/IJWH.S525981","DOIUrl":"10.2147/IJWH.S525981","url":null,"abstract":"<p><strong>Background: </strong>Breast density is an important yet often overlooked factor in breast cancer screening. Limited awareness among women can hinder informed decision-making, especially in regions without standardized breast density notification, such as Saudi Arabia.</p><p><strong>Objective: </strong>This study aimed to assess awareness, knowledge, and educational needs related to breast density among women in Saudi Arabia.</p><p><strong>Methods: </strong>A nationwide, cross-sectional survey was conducted using a structured online questionnaire. Saudi women aged 30 years and older were recruited via convenience sampling through social media platforms and targeted mailing lists. The survey collected demographic data and assessed participants' breast density (BD) awareness, knowledge, perceived risk, and preferred information sources. Data analysis included both descriptive and inferential statistical methods.</p><p><strong>Results: </strong>1,021 Saudi women (30-75 years old) participated in this study. Only 11.4% of the sample had heard of breast density, and less than half of those (5%) understood its association with breast cancer risk. Women with higher education and previous mammography experience had significantly higher awareness (OR: 5.00, 95% CI: 2.18-11.45; p<0.001 and 1.81, 95% CI: 1.15-2.86; p=0.010, respectively). A vast majority (80%) expressed interest in being informed about their breast density, and more than half (56.3%) are willing to pay for additional imaging if they had dense breast tissue.</p><p><strong>Conclusion: </strong>Awareness of breast density among women in Saudi Arabia is remarkably low, likely due to the absence of structured education, lack of provider-patient communication, and no national notification policy. Despite this, women express a clear willingness to receive related information. There is a critical need for targeted education on breast density. National health strategies should prioritize breast density awareness and standardized communication in breast cancer screening programs.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"17 ","pages":"3031-3044"},"PeriodicalIF":2.6,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Influencing Coping Strategies of Women with Advanced Gynecological Cancer: A Secondary Analysis.","authors":"Eungil Ko, Yaelim Lee","doi":"10.2147/IJWH.S520526","DOIUrl":"10.2147/IJWH.S520526","url":null,"abstract":"<p><strong>Background: </strong>Women with advanced gynecological cancer experience both physical and emotional suffering. In response to these challenges, they adopt various coping strategies. Identifying the factors that influence these strategies is essential, as certain coping mechanisms have a significant impact on improving their quality of life.</p><p><strong>Purpose: </strong>This study explored the associations between demographic characteristics, clinical characteristics, uncertainty, and coping strategies among women with advanced gynecological cancer based on the Stress Adaptation Model by Stuart.</p><p><strong>Patients and methods: </strong>Secondary data analysis was completed on the survey responses of 143 women with gynecological cancer in stage III or stage IV of an original 165 respondents.</p><p><strong>Results: </strong>The three most used coping strategies were acceptance (M = 6.24, SD = 1.22), positive reframing (M = 6.16, SD = 1.76), and self-distraction (M = 5.98, SD = 1.91), and the least used coping strategy was substance use (M = 2.03, SD = 0.33). Modifiable variables influencing the 14 coping strategies were education and subjective economic level. Non-modifiable variables influencing the 14 coping strategies were age, treatment experience, comorbidity, and lymphedema. The factor associated with all three groups of coping strategies (problem-focused, active emotional, and avoidant emotional) was uncertainty.</p><p><strong>Conclusion: </strong>Women with advanced gynecological cancer utilized different coping strategies depending on their demographic and clinical characteristics as well as their level of uncertainty. Identifying factors associated with coping strategies used by women with advanced gynecological cancer can lead to interventions that assist them in using adaptive coping strategies.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"17 ","pages":"2999-3011"},"PeriodicalIF":2.6,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rationale and Protocol Design for the Adaptation and Implementation of a Patient Navigation Program for Cervical Cancer Screening Across Contexts in Senegal.","authors":"J Andrew Dykens, Ndèye Marème Sougou, Omar Gassama, Ndeye Mbombe Dieng, Caryn E Peterson, Crystal L Patil, Saria Awadalla, Sarah Abboud, Ibrahima Ndiaye, Fatoumata Binetou Diongue, Aliath Salami, Aida Fall, Rey A Flores, Abigail Suleman, Melissa Vargas, Alexis Claire Klima, Adama Faye","doi":"10.2147/IJWH.S515070","DOIUrl":"10.2147/IJWH.S515070","url":null,"abstract":"<p><p>This article presents the rationale and design for the adaptation and implementation of a patient navigation program for cervical cancer screening across contexts in Senegal. A model, based on the NIH NCI Patient Navigator Research Program (PNRP) model, informs the proposed program for adaptation which aims to reduce intrapersonal- (knowledge, communication), interpersonal- (stigma, misinformation), and community-level (women's lack of autonomy in healthcare decision-making) barriers. The specific aims of the study are to: 1) Evaluate the adaptation process of the evidence-based Patient Navigation Model utilizing the Dynamic Adaptation Process (DAP) across rural and urban contexts in Kedougou and Dakar, Senegal; 2) Conduct an effectiveness-implementation hybrid type 1 stepped-wedge randomized pragmatic trial of the adapted patient navigation program across Kedougou and Dakar, Senegal, and 3) Evaluate the implementation outcomes (feasibility, acceptability, fidelity, penetrance, sustainability, and cost) of The Adapted Patient Navigation Program across multiple contexts in the Kedougou and Dakar regions, using mixed methods and guided by the Exploration, Preparation, Implementation, Sustainment (EPIS) Framework. The Adapted Program is integrated into the existing community health system and is being administered by the Heads of Reproductive Health at the Regional-Level and District Levels who act as Patient Navigator Leaders with oversight by the Regional and District Directors of Health. These individuals coordinate the patient navigation field activities that occur at the health post level. The Community Health Workers (Patient Navigators) are essential to engaging individual clients through education, empowerment, and by accompanying them to the clinical setting for screening and follow-up. The study is a mixed-methods study that collects data from three participant samples: (1) system and organizational stakeholders, (2) patient navigator team members, and (3) clients. The study informs the adaptation and implementation of patient navigation programs for cervical cancer screening in Senegal and other low- and middle-income countries.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"17 ","pages":"3013-3029"},"PeriodicalIF":2.6,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of Bacterial Lipopolysaccharide-Related Molecular Subtypes and Development of a Four-Gene Prognostic Risk Model in Cervical Cancer.","authors":"Yuehong Tong, Lili Xu, YiQun Sun, Keke Zhang, Xiaoyan Fu","doi":"10.2147/IJWH.S537092","DOIUrl":"10.2147/IJWH.S537092","url":null,"abstract":"<p><strong>Background: </strong>Cervical cancer (CC) ranks among the top causes of cancer-related illness and death in women worldwide. Bacterial lipopolysaccharide-related genes (LRGs) contribute to tumor progression and immunosuppression. This study aimed to identify CC molecular subtypes based on LRGs and construct a prognostic model to explore patient prognosis and immune features.</p><p><strong>Methods: </strong>Transcriptomic data and corresponding clinical details for CC patients were obtained from publicly accessible resources such as The Cancer Genome Atlas (TCGA) and the Genotype-Tissue Expression (GTEx) project. Molecular subtypes were uncovered by applying non-negative matrix factorization (NMF) to prognostic LRGs. Significant prognostic genes were identified through Cox regression coupled with Shrinkage and Selection Operator (LASSO) analysis to build a risk model, which was then validated using an independent dataset from the Gene Expression Omnibus (GEO). RT-qPCR validated gene expression. Differences in prognosis, tumor microenvironment (TME), immune status, and tumor mutational burden (TMB) were analyzed between risk groups, and drug sensitivity predictions were performed using pRRophetic.</p><p><strong>Results: </strong>The study successfully identified two molecular subtypes. A prognostic model was developed based on four selected genes, with Receiver Operating Characteristic (ROC) curve analysis confirming its robust predictive performance in both the training and independent validation datasets. RT-qPCR analysis provided additional verification of the gene expression profiles. The low-risk cohort displayed a significantly more favorable outcome, along with increased infiltration of immune cells and enhanced immune scores. Furthermore, the signature genes were associated with sensitivity to multiple anticancer drugs, indicating potential therapeutic targets.</p><p><strong>Conclusion: </strong>The risk model based on LRGs effectively predicts survival outcomes and immune characteristics in CC patients, providing a novel theoretical foundation for personalized treatment and immunotherapy strategies.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"17 ","pages":"2979-2998"},"PeriodicalIF":2.6,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Intraoperative Postural Transitions on Internal Carotid Artery Blood Flow During Gynecologic Laparoscopic Surgery.","authors":"Xi Tan, Wenyi Sun, Hao Zhou, Li Zhang, Chaoxuan Dong","doi":"10.2147/IJWH.S540634","DOIUrl":"10.2147/IJWH.S540634","url":null,"abstract":"<p><strong>Objective: </strong>Reduced internal carotid artery (ICA) blood flow can cause cerebral hypoperfusion, increasing the risk of intraoperative or postoperative cerebral ischemia. In laparoscopic surgery, postural changes and pneumoperitoneum may further compromise ICA hemodynamics. This study aims to evaluate the effects of intraoperative postural transitions on ICA blood flow in patients undergoing gynecologic laparoscopic surgery.</p><p><strong>Methods: </strong>A single-center, prospective, non-randomized observational study was performed. Measurements of ICA blood flow, heart rate (HR), and mean arterial pressure (MAP) were obtained at eight intraoperative time points: upon arrival to the operating table while awake (T1), post-induction of anesthesia in the supine position (T2), following pneumoperitoneum in the supine position (T3), immediately after placement in the Trendelenburg position (T4), 10 minutes (T5) and 20 minutes (T6) after Trendelenburg positioning, upon return to the supine position (T7), and at the conclusion of surgery (T8).</p><p><strong>Results: </strong>A total of 79 patients were enrolled in this study. A significant reduction in ICA blood flow was observed at T2 compared to T1 (263.8 ± 11.4 vs 323.5 ± 12.0 mL/min, <i>p</i> < 0.001), with further reduction at T3 (237.2 ± 9.8 vs 323.5 ± 12.0 mL/min [T1], <i>p</i> < 0.001, vs T1). No statistically significant changes were observed from T4 to T6. Upon transitioning from the Trendelenburg position to supine (T7), ICA blood flow further decreased (202.1 ± 7.5 vs 237.2 ± 9.8 mL/min, <i>p =</i> 0.004), accompanied by reductions in HR (60.0 ± 0.7 vs 66.9 ± 1.0 beats/min, <i>p</i> < 0.001) and MAP (82.8 ± 12.4 vs 93.6 ± 13.5 mmHg, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Intraoperative postural transitions during gynecologic laparoscopic surgery are associated with fluctuations in ICA blood flow. The return from the Trendelenburg to the supine position results in a marked decrease in ICA blood flow, HR, and MAP.</p><p><strong>Clinical trial registration: </strong>https://www.chictr.org.cn/showproj.html?proj=178094, Identifier: ChiCTR2200065104, Registered October 27, 2022.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"17 ","pages":"2969-2977"},"PeriodicalIF":2.6,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12439691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}