Moe Takenoshita

All Publications

• A Multicenter Assessment of Postpartum Recovery Using the STanford Obstetric Recovery Checklist. Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC Takenoshita, M., Guo, N., Carvalho, B., Leonard, S. A., Panelli, D. M., Farber, M. K., Toledo, P., Higgins, N., Sultan, P. 2026: 103233

  Abstract

  Outpatient postpartum recovery remains poorly understood. We aimed to characterize postpartum recovery and compare recovery by delivery mode and parity using with the newly validated STanford Obstetric Recovery checKlist (STORK).Following institutional review board approval, English-speaking adults were recruited from three U.S. academic centers. Demographic and clinical data were collected. Participants completed STORK (47 items covering physical, mental/emotional health, motherhood experience/social support, sleep/fatigue domains), at two, six and 12 weeks postpartum. Chi-square, one-way ANOVA, and Kruskal-Wallis tests were used to compare categorical and continuous variables.A total of 498 participants were included (Asian 15%, Black 8%, White 51%), mean age 33±5years. Median gestational age was 39 weeks (IQR 2), and 46% were primiparous. Spontaneous/induced vaginal delivery (SVD), scheduled cesarean delivery (CD), non-scheduled CD, and operative vaginal delivery (OVD) represented 52%, 27%, 18% and 3% of participants, respectively. Total STORK, physical health, and sleep/fatigue scores improved from inpatient postpartum period to week 12 postpartum (P<0·001) for all delivery modes, with a 22% increase in median total scores. Mental health and motherhood experience scores improved until week six (P<0·001). Physical recovery scores differed significantly between delivery modes, with best scores after SVD and lowest after OVD up to week two. Overall recovery was better in multiparous compared to primiparous patients up to six weeks postpartum, though differences resolved by week 12.Postpartum recovery continues through 12 weeks and varies by delivery mode and parity. Future studies are needed to determine clinically meaningful differences to inform thresholds for targeted interventions.

  View details for DOI 10.1016/j.jogc.2026.103233

  View details for PubMedID 41638483

• Addressing Gender Inequality in Sports: Mechanisms and Strategies for Preventing Soft Tissue Injury in Elite Female Athletes. British journal of hospital medicine (London, England : 2005) Powling, A. S., Lisacek-Kiosoglous, A. B., Takenoshita, M., Fontalis, A., Haddad, F. S. 2025; 86 (12): 1-23

  Abstract

  As female participation in sports, traditionally dominated by males continues to grow, a notable trend has emerged: female athletes are disproportionately affected by soft tissue injuries, with anterior cruciate ligament (ACL) injury having an incidence rate up to 9 times more frequently than in their male counterparts. The burden of soft tissue injuries in female athletes such as hamstring injury, ankle sprain, and ACL injury is exacerbated by the underrepresentation of elite female athletes in sports medicine, and therefore suboptimal prevention and rehabilitative methods. This manuscript delves into the anatomical, hormonal, and training-related factors that contribute to this disparity. It examines common injury patterns including knee, ankle, and hamstring injuries, elucidating the pathophysiological mechanisms involved. The severe impact of these injuries can jeopardise the careers of elite sportswomen and prompt the need for a paradigm shift in sports medicine. This paper provides a current overview of injury management and discusses essential changes in prevention and rehabilitation strategies to improve outcomes for female athletes. By examining the existing body of knowledge, this review focuses on proposing future interventions and prevention strategies that are tailored to the unique needs of female athletes.

  View details for DOI 10.12968/hmed.2024.1060

  View details for PubMedID 41443216

• Factors associated with higher inpatient opioid consumption after primary total knee arthroplasty: a retrospective tertiary centre analysis. The Knee Takenoshita, M., Fontalis, A., Lisacek-Kiosoglous, A. B., Oliver, T., Robinson, A., Wignadasan, W., Haddad, F. S. 2025

  Abstract

  PURPOSE: To characterize inpatient postoperative opiate consumption(OC) and identify risk factors associated with high OC among total knee arthroplasty(TKA) patients.METHODS: In this retrospective single centre cohort study, 1,550 TKAs from May 2019 to July 2023 were analysed using electronic healthcare records. Clinical data was collected, including anaesthesia type, post anaesthesia care unit(PACU) admissions, implant fixation, operative duration, peri-operative haemoglobin levels, surgical technique, as well as OC(oral morphine milliequivalents, MME) during inpatient stay. The correlation between OC 24h post operatively and total inpatient OC, as well as average daily inpatient OC, were assessed with Spearman's Rank-Order correlation coefficient. Multivariate logistic regression identified predictors of high opioid use, defined as the top quartile of total inpatient opioid consumption.RESULTS: The cohort included 1,077 females (69.5%) and 473 males (30.5%), with robotic TKA performed in 786 cases (50.7%). Median OC MME for 0-24h post op, 24-48h post op and 48-72h post op was 42mg (IQR 21.0-70.1), 29mg (12.0-45.0), 12mg (0.0-30.0) respectively. Median total inpatient OC for the cohort was 96.0mg MME (IQR=49.0-165). Opiate use decreased by 71.4% from day 1 to day 3 post operatively. Strong positive correlations were found between early OC (24-48h post op) and total inpatient OC (rs(1548)=0.717, p<0.001). On average, 86.5% of total inpatient opiates were consumed in the first 72h post operatively. Higher opioid use was significantly associated with earlier admission year, younger age, increased body mass index(BMI), PACU admission, ASA 3 or 4 and general anaesthesia.CONCLUSIONS: Daily opiate use fell rapidly by the third postoperative day, whilst high OC within the first 24-48h was associated with higher opiate use overall. Younger age, higher BMI and general anaesthesia were associated with higher opiate use. These insights can help tailor pain management strategies for patients at higher risk of opioid reliance during their inpatient stay.

  View details for DOI 10.1016/j.knee.2025.11.005

  View details for PubMedID 41309352

• Proposed domains of postpartum sleep: a concept elicitation study using qualitative interviews. Sleep advances : a journal of the Sleep Research Society Bekemeyer, Z., Takenoshita, M., Michel, G., Martinez, E., Callihan, P., Tang, X., Ciechanowicz, S., Manber, R., Lyell, D., Panelli, D., Morris, A., Elkhateb, R., Mhyre, J., Cella, D., Shaunfield, S., Sultan, P. 2025; 6 (4): zpaf068

  Abstract

  Sleep as a construct in the postpartum period and its perceived importance to postpartum patients remain largely under explored. The aim of this concept elicitation study was to develop a conceptual framework for postpartum sleep based on the key themes (domains and subdomains) identified. Secondary aims were to determine the frequency of discussion of individual domains/subdomains among participants and provide exemplar patient quotes for the most frequently discussed subdomains.This study received Institutional Review Board approval from Stanford Lucile Packard Children's Hospital and the University of Arkansas for Medical Sciences. Semi-structured interviews were conducted with patients, partners and multidisciplinary experts until thematic saturation was achieved. All interviews were audio recorded and professionally transcribed and de-identified. Thematic codes (domains and subdomains of postpartum sleep) were derived from review of interview transcripts. Iterative thematic analysis of transcripts with constant comparison across cases was conducted systematically by ≥2 analysts. All transcripts were coded in Nvivo software and qualitatively analyzed to report frequency of domain/subdomain discussion and to identify exemplar patient quotes for individual subdomains.Interviews were conducted with 42 patients, 13 multidisciplinary experts, and 6 partners over a total of 20 h. Median interval between delivery and interview for the recruited postpartum women was 8 weeks (interquartile range 6-10 weeks, range 3-52 weeks). Analysis of all 61 participant interviews resulted in derivation of 10 domains (psychological, pharmacological, non-pharmacological, sleep interference, medical factors, feeding of neonate, sleep disruption, social factors, societal and cultural factors, and infant related factors) and 85 subdomains related to the construct of postpartum sleep. The three most frequently discussed domains were sleep disruption, non-pharmacological interventions to improve sleep, and medical factors related to sleep. The top 10 most frequently discussed subdomains were breast feeding/feeding, maternal awakenings, social support, childbirth experience, infant sleep routine, day time sleep, infant care (bottles, milk, diapers), sleep arrangements, chronotype, and nighttime sleep.This study provides a conceptual framework based on 10 domains and 85 subdomains, which can be used to comprehensively describe and study the complex construct of postpartum sleep. These findings can be used to counsel patients regarding postpartum sleep experiences, facilitate patient discussion in the postnatal period when assessing postpartum sleep experiences, guide development of new measures, and assess content validity of existing sleep measures.

  View details for DOI 10.1093/sleepadvances/zpaf068

  View details for PubMedID 41425943

  View details for PubMedCentralID PMC12713739

• Prophylactic antibiotics in hand trauma surgery: a network meta-analysis. The British journal of surgery Yusuf, S., Zhang, C., Takenoshita, M., Wade, R. G., Wormald, J. C. 2025; 112 (9)

  Abstract

  Surgical site infections (SSI) complicate at least 5% of hand trauma operations; however, the efficacy of prophylactic antibiotics remains unclear. Unlike previous meta-analyses, this network meta-analysis (NMA) provides a definitive summary of all currently available data across multiple antibiotic classes, allowing indirect comparisons to provide a robust understanding of relative antibiotic effectiveness.A systematic literature search was performed across EMBASE, MEDLINE, CINAHL, and CENTRAL, supplemented by Google Scholar and clinical trial registries. Prospective comparative studies comparing antibiotics versus placebo/no antibiotics in patients undergoing surgery for hand and wrist trauma were included. Data on SSI rates were extracted and analysed using network meta-analysis with frequentist random-effects models.Some 4499 articles were screened, with 13 randomized controlled trials (RCT) and 2 non-randomized studies involving 3898 participants included in the analysis. The pooled SSI prevalence was 3.6%. Our NMA indicated that prophylactic antibiotics did not significantly reduce SSI risk compared to placebo: the highest-ranking treatment (mixed antibiotic regimen) demonstrating a relative risk of 0.29 (95% c.i. 0.04, 2.13). Subgroup analyses revealed no significant differences based on injury type or location of surgery.There was insufficient evidence to support routine prophylactic antibiotic use in hand trauma surgery. Low event rates, wide confidence intervals, and moderate-to-high risk of bias in most included studies limit the certainty of this conclusion: the evidence remains inconclusive. Future high-quality RCTs are warranted to evaluate the benefit of antibiotic prophylaxis in hand trauma surgery.

  View details for DOI 10.1093/bjs/znaf191

  View details for PubMedID 41020332

• Association between body composition and mortality in patients requiring extracorporeal membrane oxygenation support. Clinical radiology Takenoshita, M., Weir McCall, J. R., Barker, A. P., Suresh, S., Celik, H., Vuylsteke, A. 2024; 79 (4): 272-278

  Abstract

  To ascertain the association between body composition, including muscle mass and adiposity, and patient mortality in those requiring extracorporeal membrane oxygenation (ECMO) for acute respiratory failure.A retrospective study was undertaken of all patients with acute respiratory failure requiring veno-venous (VV) ECMO between January 2015 and December 2019. Automated image segmentation software was used to quantify the cross-sectional area and average radiodensity (in Hounsfield units) of different muscle and fat compartments at the L3 level of whole-body computed tomography (CT) images taken within 48 h of initiation of ECMO support. The primary endpoint was 30-day post-ECMO initiation all-cause mortality. Logistic regression was used to analyse the correlation between CT measurements, co-morbidities, and 30-day survival.The study included 189 patients (age = 43.8 ± 14.6, sex = 42.3% female). There was no significant association between 30-day survival status and cross-sectional area of muscle or fat. Muscle attenuation (psoas, long spine, and abdominal muscles respectively) at the L3 level were significantly lower in those who died within 30 days of ECMO cannulation (p<0.05). On multivariable analysis including age, sex, and pre-existing respiratory comorbidities, psoas muscle attenuation was an independent predictor of survival at 30 days (OR 0.97; 95% CI 0.94 to 1.00; p=0.047).Reduced psoas muscle attenuation is associated with poorer survival outcomes at 30 days post-ECMO cannulation in patients who received VV ECMO support for respiratory failure. Cross-sectional areas of muscle and fat compartments did not correlate with survival outcomes at 30 days even when corrected for height and sex.

  View details for DOI 10.1016/j.crad.2023.12.011

  View details for PubMedID 38278741

• O02 Antibiotic prescribing practices in primary healthcare in sub-Saharan Africa: a systematic review and our experience on the use of telemedicine in Zambia Takenoshita, M., Hettle, D., Quattrocchi, G. OXFORD UNIV PRESS. 2022

  View details for DOI 10.1093/jacamr/dlac003.001

  View details for Web of Science ID 000768372600018