Darya Smetanina

Background/Objectives: Term and preterm premature ruptures of membranes (PROM and PPROM) are serious pregnancy complications associated with adverse maternal and neonatal outcomes. Although widely studied in the global literature, data on the risk factors and outcomes of PROM and PPROM in the Middle East and North Africa (MENA) region remain limited. This mapping review aimed to identify and assess existing evidence and highlight gaps in knowledge regarding risk factors for PROM, including preterm PROM, and related maternal and neonatal outcomes among women in the region. Methods: We conducted a comprehensive and systematic search of articles published in English and Arabic between January 2000 and June 2025 across Scopus, Embase, Web of Science, and PubMed/Medline. Eligible studies included observational and interventional studies conducted in MENA countries. Data were extracted and synthesised using thematic mapping. Results: Out of 5359 retrieved records, 136 met the inclusion criteria. The main study design was cross-sectional (51 studies), followed by case–control (41), cohort (26), and 15 randomised controlled trials. The geographic distribution of the evidence varied significantly. Research has mainly focused on PROM and its biological risk factors, such as infections and chronic medical conditions. Psychological and environmental factors have been the least reported. Neonatal and gestational outcomes have frequently been addressed, whereas maternal outcomes have received less attention. Conclusions: The findings reveal significant geographic, thematic, and methodological disparities in research throughout the MENA region. The results underscore the need for further studies on the prevention and identification of women at higher risk of PROM.

Background: Breast cancer is one of the leading causes of female mortality, especially if diagnosed in late stages. While mammography is the cornerstone of screening, its diagnostic accuracy is limited by tumor heterogeneity and subjective interpretation. Objective: Herein, we explored the potential of radiomics and machine learning to improve the diagnostic accuracy of mammograms and personalise patient management in breast cancer. Methods: We manually segmented tumours and lymph nodes to analyse mammograms of the open-source INbreast dataset, which comprised multiple cases of benign and malignant breast masses with and without lymphadenopathy. Ra- diomics features (morphological, texture, wavelet) were extracted using PyRadiomics. Stratified sampling ensured balanced class representation. Then, we trained ML classifiers (XGBoost, CatBoost, LightGBM, etc.) to detect malignancy from the extracted radiomical features. Random Forest classifier was used to prognosticate the molecular subtype of the tumour from radiomical findings. Results: Significant radiomic differences were observed between benign and malignant lesions. Combining features of breast mass and lymph node yielded the highest classification accuracy (up to 99%) in detecting malignancy. The Random Forest model achieved 90.8% accuracy in identifying Luminal A molecular subtypes, with first-order and shape-based features contributing most to model perfor- mance. Conclusion: Radiomics-based ML models significantly improve diagnostic accuracy and enable non-invasive prediction of breast cancer subtypes. This approach supports precision oncology by enhancing screening efficiency and informing personalized treatment strategies.

Background and Objectives: Surgical treatment is central to breast cancer management; however, its long-term impact on QoL varies substantially among patients. This study sought to model the dynamic trajectories of postoperative QoL following breast-conserving surgery (BCS), mastectomy with immediate reconstruction (Mx+IR), and mastectomy alone (MA). It also examined how these trajectories varied across different age groups and over time. Materials and Methods: The review and meta-analysis identified 150 peer-reviewed studies reporting QoL outcomes using validated instruments (EORTC QLQ-C30 or BREAST-Q). A total of 123 observations from 45 studies were included for analysis of global QoL. We standardized QoL scores to a 0–100 scale and harmonized postoperative assessments across six time intervals, extending to more than 73 months. Multilevel random-effects models evaluated linear, quadratic, and logarithmic functions. Subgroup analyses and meta-regressions assessed the moderating effects of surgical type and age. Results: BCS showed the steepest QoL gains, followed by Mx+IR, while MA had the lowest scores and slowest recovery. Compared to BCS, MA showed significantly poorer and delayed recovery, and Mx+IR showed a smaller, borderline decrease. All groups displayed modest long-term QoL plateauing. Conclusions: Global QoL after breast cancer surgery follows distinct, time-dependent patterns shaped by surgical approach and age. These findings emphasize the importance of discussing patients’ quality-of-life expectations with them so that survivorship care can be personalized to their needs.

Background: The prevalence of sexual dysfunctions varies from 35.5% to over 80% among postpartum women. Controversy exists regarding the risk factors for female sexual dysfunction (FSD) in the postpartum period. It remains unclear whether breastfeeding types contribute to the development of FSDs differently. Aims: The primary goal of this meta-analysis was to explore the role of baby feeding practices in developing sexual dysfunctions in women. Methods: We conducted a systematic literature search using the biomedical databases Scopus, CINAHL, Embase, the Web of Science, and PubMed/Medline. We looked for peer-reviewed, original studies written in English, Polish, and Arabic and published between January 2000 and June 2023. We included publications that reported scores in sexuality domains assessed with the Female Sexual Dysfunction Index (FSFI) and any sexuality-related issues during postpartum. The FSFI scores were combined in a meta-analysis using the random-effects inverse-variance model. Other findings were synthesized with a narrative review. Results: Eighteen articles met the eligibility criteria for the systematic review and meta-analysis. Sexual dysfunctions were detected in all the women, irrespective of the feeding type. Better overall sexual functioning was reported among women using complementary feeding than among those who breastfed exclusively or used baby bottles: 22.16, 95% CI [21.68; 22.65]; 21.61, 95% CI [20.27; 22.95]; and 20.18, 95% CI: [20.93; 61.30], respectively. Slightly lower scores were reported in all the FSFI subscales in exclusively breastfeeding women compared to those using the complementary method. Conclusions: Breastfeeding females experience difficulties in sexual life during the postpartum period, irrespective of the feeding type. These findings can help in designing preventive measures for tackling postpartum sexual dysfunctions in women.

Background and Objective: Corneal collagen cross‐linking (CXL) is a treatment which arrests keratoconus (KC) progression, but its effectiveness differs radically among patients. Herein, we report preoperative diagnostic findings that reflect CXL outcomes and allow physicians to prognosticate treatment efficiency. Methods: In a medical centre, we retrospectively analysed pre‐ and postoperative data about 107 patients (112 eyes) treated with CXL from January 2018 to December 2022. Exclusion criteria were age below 16 years, a corneal thickness below 400 microns, severe dry eye, other corneal diseases/infections, re‐CXL, pregnancy and missing follow‐up examinations. All the subjects (79 males and 28 females) were followed for a minimum of 4 and a maximum of 40 months. The study dataset was comprised of 796 cases of clinical assessment, pachymetry, visiometry, refractometry and topography examinations. With these data, we modelled maximum anterior keratometry ( K _max ) and curvature power of the flat and steep meridians of the corneal anterior surface ( K ₁ and K ₂ ). Results: Two years after the invasion, corneal curvature coefficients decreased progressively. Then, they remained stable for four months and rose afterwards. In the most accurate K ₁ , K ₂ and K _max models, the proportion of mean absolute error to the range of values was 1.72, 3.66 and 2.37%, respectively. Pronounced corneal thinning, low best‐corrected visual acuity and high K _max levels predict unfavourable outcomes. Conclusions: The high accuracy of the models advocates for a personalised approach to candidate selection for CXL.

Background: The prevalence of sexual dysfunctions varies from 35.5% to over 80% among post-partum women. Controversy exists regarding risk factors for female sexual dysfunction (FSDs) in the postpartum period. It remains unclear whether the breastfeeding types contribute to the development of FSDs differently. Aims: The primary goal of this meta-analysis is to explore the role of baby-feeding practices in developing sexual dysfunctions in women. Methods: We con-ducted a systematic literature search using the biomedical databases Scopus, CINAHL, Embase, Web of Science, and PubMed/Medline. We looked for peer-reviewed original studies written in English, Polish, and Arabic and published from January 2000 to June 2023. We included publica-tions that reported scores in sexuality domains assessed with the Female Sexual Dysfunction Index (FSFI) and any sexuality-related issues during postpartum. FSFI scores were combined in a meta-analysis using the random-effects inverse-variance model. Other findings were synthesized with a narrative review. Results: Nineteen articles met the eligibility criteria for systematic review and meta-analysis. Sexual dysfunctions were detected in all women, irrespective of the feeding type. Better overall sexual functioning was reported among women using complementary feeding than among those who breastfeed exclusively or use baby bottles: 22.16, 95% CI: 21.68 – 22.65, 21.61, 95% CI: 20.27 – 22.95, and 20.18, 95% CI -20.93 – 61.30, respectively. Slight lower scores were reported in all FSFI subscales in exclusively breastfeeding women compared to those using the complementary method. Conclusion: Breastfeeding females experience difficulties in sexual life during the postpartum period, irrespective of the feeding type. The most important aspects of the postpartum period that should be considered in the future are early diagnosis and prevention of sexual dysfunctions in all breastfeeding females.

Background: Quality of life (QoL) may change in female patients with breast cancer over time due to its dynamic construct. Recent studies have provided statistics on the diverse predictors of QoL in breast cancer patients. Still, the literature findings on the prognostication of QoL are scarce. Objectives: With this meta-analysis, we aim to describe the dynamics of overall QoL and its dimensions: mental status, physical functioning, and social interactions. Methods: To reach this aim, we will systematically evaluate the peer-reviewed literature on QoL of women who have undergone either mastectomy or breast-conserving surgery. The proposed study will focus on, but not be limited to, the analysis of BIRS, FACT-B, and EORTC QLQ-C30 questionnaires, which are most commonly used in the assessment of the quality of life of cancer patients. Then, we will extract the following outcome measures: The participants’ age, time since surgery, type of tumor removal procedure (mastectomy or breast-conserving surgery), breast reconstruction technique, mean value, and standard deviation in a QoL score. A random-effects model will then compute the pooled QoL and construct the trend lines for scores received from each diagnostic tool. The findings will be adjusted according to the reconstruction techniques and tumor removal surgery. Finally, we will model the QoL dynamics with a set of predictors identified in the extracted studies. Conclusions: The study findings may serve as a tool for stratifying female patients with breast cancer by the risk of significant reduction in QoL.

The rationale for the current study is the sparsity of data on the combined effect of the environmental and individual risks of obesity and sedentary lifestyle in children of different races/ethnicities from different regions. An effective weight management strategy is hard to design due to insufficient evidence. This work was initiated to study race, ethnicity, and geography as determinants of excessive weight and low physical activity in the pediatric population. To achieve this aim, we systematically review publications on daily length of physical activity of light, moderate, and vigorous intensity, as well as sedentary time and BMI and its dynamics in children of different races/ethnicities and geographies. The extracted data are stratified into six major geographic regions and six races/ethnicities. Then, a random-effects meta-analysis is used to calculate the pooled mean of each outcome measure. A ridge regression is constructed to explore age-related change in BMI. A Kruskal–Wallis H test is applied to compare the pooled duration of physical activity and sedentary time in the subgroups. Finally, we calculate paired correlation coefficients between BMI and physical activity/inactivity for each group. The findings can be further used in public health surveillance to clarify the epidemiology of obesity, to guide priority setting and planning, and to develop and evaluate public health policy and strategy.

Background: Studies have tried to identify predictors of functional markers of keratoconus progression, whereas structural outcomes of collagen cross-linking have not been properly investigated. Objective: find and set up a combination of diagnostic modalities and measurements to reliably reflect CXL efficiency. Material and methods: We retrospectively reviewed the medical histories of 107 KC patients (131 eyes) who underwent CXL in a medical center from January 2018 to December 2022. The dataset included preoperative examinations and follow-up results, which provided a total of 796 observations. The cases of other corneal diseases, repeated CXL, pregnancy, and observations without follow-up examinations were excluded. Results: The study findings revealed a significant drop in the central and corneal thickness during 14.01±9.98 months of observations. Linear and polynomial equations suggested different trends in pachymetry change after CXL. The linear model showed corneal thinning, and according to the polynomials, pachymetry findings return to baseline values two years after CXL. Conclusion: The most reliable prognosis of postoperative corneal thickness is achieved with the models trained on keratometry readings and topography indices. BAD indices are also reliable predictors of the corneal thickness after CXL. A combination of the aforementioned structural parameters and their derivatives can reliably predict CXL efficiency.

Herein, we examined the effects of weather parameters and individual clinicodemographic risk factors on hemorrhagic stroke (HS) incidence, severity on admission, and disability at discharge in a harsh desert climate. In a retrospective design we studied patients admitted to a stroke unit in Arab Emirates in 2016-2019. With a distributed lag nonlinear model we explored immediate and delayed effects of weather on stroke incidence. Supervised machine learning was used to build models predictive of scores in NIHSS and mRS scales. We assessed model performance by calculating ROC AUC, F1 scores, specificity, and sensitivity. HS risk increased after a significant change in any weather parameter. The risk was reduced below baseline after 1-week adjustment to environmental changes. Climate input from the previous 3 days yielded reliable classification models. Humidex was a better predictor of severity than air temperature, whereas body mass index, age, and time of day at stroke onset were the strongest clinical predictors. Weather parameters before admission were stronger predictors of disease severity than individual clinical factors. We addressed limitations of previous studies by analyzing a full set of climate parameters: ambient temperature, relative humidity, humidex, atmospheric pressure, and wind speed. Predictive models may help to optimize patient management and develop preventative strategies.