bluuebunny/crossref_metadata_2025_split huggingface dataset:
Providers’ perspective on vaginal birth after cesarean birth: a qualitative systematic review
Authors: Kanjanakaew Antita , Jiramanee Atchareya , Srimoragot Manassawee 
Published: November 2024

Abstract
Background
Vaginal Birth after Cesarean Birth (VBAC) is a birth mode recommended for reducing repeat cesarean which potentially contributes to adverse outcomes. However, VBAC is not normally practiced in some countries. Providers are an important part of the decision-making process on modes of birth among pregnant individuals. Providers’ perspective on VBAC can influence whether they support or avoid conducting VBAC. This review aimed to explore providers’ perspective on VBAC.

Methods
The comprehensive search was conducted from six databases including PubMed, MEDLINE, Scopus, Cochrane Library, EMBASE, and Google scholar. The studies published in English between 2013 and 2023 were review. The Medical Subject Heading terms for VBAC and perspective were used to search. The eligible studies were selected by the PRISMA flow chart. The initial search yielded 558 articles. After excluding duplicates, articles not retrieved for full-text, and not meeting inclusion and exclusion criteria, eight articles were recruited. Quality appraisal of the studies was performed by the tool of the Joanna Briggs Institute. The meta-aggregation approach was applied to synthesize the findings.

Results
Eight qualitative articles were included in this review, and six themes were developed including (1) different recognition of VBAC, (2) differences of willingness level of conducting Trial of Labor after Cesarean (TOLAC) (the approach attempting to have VBAC), (3) skills and resources needed when performing TOLAC, (4) protocol for recruiting candidacy and TOLAC management, (5) final decision making on VBAC, and (6) onset and duration of providing TOLAC information.

Conclusion
Providers play an important role in influencing individuals’ decision on modes of birth. Providers’ positive recognition and willingness of conducting TOLAC potentially impact successful VBAC rate. However, the lawsuit caused by adverse outcomes from TOLAC/VBAC is a main reason for choosing repeat cesarean.

Trial registration
PROSPERO registration number of this systematic review: CRD42023427662.
Prevalence and factors associated with cerebral malaria among children aged 6 to 59 months with severe malaria in Western Uganda: a hospital-based cross-sectional study
Authors: Mseza Banga , Kumbowi Patrick Kumbakulu , Nduwimana Martin , Banga Desire , Busha Emmanuel Tibasima , Egesa Walufu Ivan , Odong Richard Justin , Ndeezi Grace 
Published: November 2024

Abstract
Introduction
Cerebral malaria, caused by Plasmodium falciparum, represents the most severe neurologic complication of malaria. Its association with high morbidity and mortality rates, especially among young children, underscores its clinical significance. In sub-Saharan Africa, including Uganda, cerebral malaria remains a major health challenge, contributing significantly to the high child mortality rate. Despite advances in malaria control, the burden of cerebral malaria among children under five is substantial, reflecting the need for targeted interventions and improved management strategies. This study aimed to determine the prevalence of cerebral malaria and identify associated factors among children admitted with severe malaria at a tertiary hospital in western Uganda.

Methods
This was a cross-sectional, descriptive, and analytical study involving children aged 6 to 59 months admitted with severe malaria. The study was conducted from January to March 2023 at Fort Portal Regional Referral Hospital. Severe and cerebral malaria were defined as per the WHO criteria. Sociodemographic, clinical, and laboratory data were collected and analyzed using IBM SPSS version 27. Logistic regression analysis was used to evaluate the factors associated with cerebral malaria. A p-value < 0.05 indicated statistical significance.

Results
A total of 250 children were recruited (mean age 33.1 ± 17.3 months). The prevalence of cerebral malaria was 12.8% (95% CI: 8.9–17.6). Cerebral malaria was independently associated with male sex (aOR: 3.05, 95% CI: 1.20–7.77, p = 0.02), abnormal bleeding (aOR: 13.22, 95% CI: 11.54–15.16, p = 0.001), history of convulsions (aOR 12.20, 95% CI: 10.7–21.69, p = 0.010), acute kidney injury (aOR: 4.50, 95% CI: 1.30–15.53, p = 0.02), and hyponatremia (aOR: 3.47, 95% CI: 1.34–8.96, p = 0.010).

Conclusions and recommendations
The prevalence of cerebral malaria was high among children with severe malaria. Factors associated with cerebral malaria included male gender, history of convulsions, abnormal bleeding, acute kidney injury, and hyponatremia. Targeted interventions and early management are essential to improve clinical outcomes.
CILP-2 expression in the intervertebral discs of patients with lumbar radiculopathy
Authors: Kõiv K. , Aunapuu M. , Torga T. , Rätsep T. , Bakhoff K. , Arend A. 
Published: November 2024

Abstract
Background
Intervertebral disc (IVD) degeneration (IVDD) is one of the main causes of low back pain. One of the most important features of IVDD is the loss of extracellular matrix (ECM) with its structural components. Cartilage intermediate layer proteins (CILPs), minor glycoproteins residing in ECM, have been found to be increased in IVD as degeneration and aging progresses. The aim of the present study was to evaluate the expression of CILP-2 in the IVD of patients with lumbar radiculopathy.

Methods
The IVD samples were collected from 25 patients during spinal surgery (interlaminectomy, herniated disc removal). The control IVD samples were obtained from nine patients who underwent lateral corpectomies in the thoracic region. CILP-2 expression was detected by immunohistochemistry. The patients were divided into two groups – aged under or over 50 years. A standardized clinical examination with assessment of radicular signs and deficits was performed. Subjective disability and pain were assessed using the visual analogue scale and Oswestry Disability Index (ODI). The pre-operative MRI was graded for the degree of IVD degeneration by Pfirrmann grading system. IVD samples obtained during operations were subjected to the standardized histopathological analysis applying modified Boos classification. The data were analysed by t-test, Mann-Whitney U-test, and Spearman correlation test.

Results
Both histopathology scores and Pfirrmann grades did not differ between patients’ groups. Also, no correlations were found between histopathology and Pfirrmann grades, neither were any differences seen when correlating both grades to ODI, back pain or leg pain scores. CILP-2 staining was noted in all studied samples, notably strong staining was seen around large cell clusters. However, no differences in CILP-2 staining were seen between the age groups of patients. No correlations were found between CILP-2 staining and Pfirrmann grades. Grading of CILP-2 immunostaining in nine control patient samples resulted in significantly lower values. The difference is statistically significant (P = 0.002) compared to CILP-2 staining scores of all 25 patients’ samples.

Conclusion
In this study, we detected increased CILP-2 expression in the human IVD as compared to the control group patients. CILP-2 can be a possible IVDD marker; however, as knowledge about the role of CILP-2 is limited, further studies are required.
Identifying barriers and opportunities to facilitate the uptake of whole genome sequencing in paediatric haematology and oncology practice
Authors: Bishop Michelle , Vedi Aditi , Bowdin Sarah , Armstrong Ruth , Bartram Jack , Bentley David , Ross Mark , Hook C. Elizabeth , Yin Chung Brian Hon , Moss Parker , Rowitch David H. , Tarpey Patrick , Behjati Sam , Murray Matthew J. 
Published: November 2024

Abstract
Background
The clinical utility of whole genome sequencing (WGS) in paediatric cancer has been demonstrated in recent years. WGS has been routinely available in the National Health Service (NHS) England for all children with cancer in England since 2021, but its uptake has been variable geographically. To explore the underlying barriers to routine use of WGS in this population across England and more widely in the United Kingdom (UK) and the Republic of Ireland (ROI), a one-day workshop was held in Cambridge, United Kingdom in October 2022.

Methods
Following a series of talks, delegates participated in open, round-table discussions to outline local and broader challenges limiting routine WGS for diagnostic work-up for children with cancer in their Principal Treatment Centres (PTCs) and Genomic Laboratory Hubs (GLHs). Within smaller groups, delegates answered structured questions regarding clinical capability, education and training needs, and workforce competence and requirements. Data was recorded, centrally collated, and analysed following the event using thematic analysis.

Results
Sixty participants attended the workshop with broad representation from the 20 PTCs across the UK and ROI and the seven GLHs in England. All healthcare professionals involved in the WGS pathway were represented, including paediatric oncologists, clinical geneticists, clinical scientists, and histopathologists. The main themes highlighted by the group in ensuring equitable access to WGS identified were: lack of knowledge equity between NHS trusts, with a perception of WGS being for research only; and perception of lack of financial support for the clinical process surrounding WGS, including lack of time to take informed consent from patients. The latter also included limited trained staff available for data interpretation, affecting the turnaround time for reporting. Finally, the need for an integrated digital pathway to order, track, and return data to clinicians was highlighted.

Conclusion
At the workshop, the general motivation for including WGS in the diagnostic work up for children with cancer was high throughout the UK, however a perceived lack of resources and education opportunities limit the widespread use of this commissioned assay. This workshop has led to some recommendations to increase access to WGS in this population in England and more widely in the devolved national of the UK and the ROI.
Iron deficiency in dogs suffering from atopic dermatitis
Authors: Ramos Carolina Frizzo , Doulidis Pavlos G. , Polakova Nina , Burgener Iwan A. , Jensen-Jarolim Erika , Cimarelli Giulia , Panakova Lucia , Roth-Walter Franziska 
Published: November 2024

Abstract
Background
Iron-deficiency is associated with increased morbidity and mortality in non-communicable diseases. However, iron parameters are rarely assessed in dogs. Here, we aimed to assess and correlate iron parameters in dogs suffering from Canine Atopic Dermatitis (CAD) compared to non-atopic, healthy dogs.

Results
For this retrospective study, blood values and sera of 34 dogs with confirmed CAD were compared with 94 healthy non-atopic dogs. In our cohort, dogs with CAD had significantly lower mean corpuscular volume (MCV, ) mean corpuscular hemoglobin (MCH) but higher white blood cell counts due to increased levels of circulating neutrophils and monocytes. CAD patients also had elevated total protein and c-reactive protein (CRP), but lower albumin levels compared to our healthy control dogs, indicated low-grade inflammation in the CAD cohort. Spearman correlations associated negatively clinical symptom (CADESI-4/PVAS) with MCV; ceruloplasmin and hepcidin, but positively with serum iron. Only in the CAD-cohort, MCV, CRP and albumin-levels negatively affected serum iron-levels and were positively associated with ceruloplasmin. Linear regression analysis revealed that serum iron-levels in CAD subjects, were positively dependent on hematocrit (packed cell volume, PCV) and albumin, and negatively dependent with white blood cells and neutrophils numbers. In contrast, in the healthy cohort, hepcidin was the sole factor associated with serum iron.

Conclusions
A decreased iron status was associated with a higher symptom burden. Iron homeostasis differed markedly in healthy and atopic dermatitis dogs. CAD patients had depleted iron-stores and presented themselves with subclinical inflammation.
Reducing the harms of cannabis use in youth post-legalization: insights from Ontario youth, parents, and service providers
Authors: Kourgiantakis Toula , Hamilton Angie , Tait Christine , Tekirdag Kosar A. Kumsal , Lau Carrie K. Y. , McNeil Sandra , Lee Eunjung , Craig Shelley , Goldstein Abby L. 
Published: November 2024

Abstract
Background
Canada has one of the highest prevalence of cannabis use globally, particularly among young adults aged 20–24 (50%) and youth aged 16–19 (37%). In 2018, Canada legalized recreational cannabis with the aim of protecting youth by restricting their access and raising public awareness of health risks. However, there has been limited qualitative research on the perceptions of harms associated with youth cannabis use since legalization, which is crucial for developing effective harm reduction strategies. This qualitative study examined perceptions of cannabis use among youth from the perspectives of youth, parents, and service providers. We explored how participants described the perceived risks or harms associated with youth cannabis use, as well as how they described their own and others’ approaches to reducing cannabis-related risks and harms.

Methods
This qualitative study used a community-based participatory research approach in partnership with Families for Addiction Recovery (FAR), a national charity founded by parents of youth and young adults with addiction issues. Virtual semi-structured interviews were conducted, and the data were analyzed using thematic analysis.

Results
The study included 88 participants from three key groups (n = 31 youth, n = 26 parents, n = 31 service providers). Two main themes emerged regarding perceived risks or harms associated with cannabis use: (1) concerns about cannabis-related risks and harms, including addiction, brain development, impact on family, and various adverse effects on areas such as motivation, concentration, finances, employment, education, physical and mental health; and (2) minimization of risks and harms, featuring conflicting messages, normalization, and perceptions of cannabis being less harmful than other substances. Additionally, two themes related to harm reduction approaches were identified: (1) implementation of harm reduction, and (2) challenges in implementing a harm reduction approach. Specific challenges for each participant group were noted, along with structural barriers such as unavailable and inaccessible services, easy access to cannabis, inadequate public education, and insufficient information on lower-risk cannabis use guidelines.

Conclusions
Youth cannabis use is a significant public health concern that requires a multi-pronged approach. Developing youth-centered harm reduction strategies that recognize the developmental needs and vulnerabilities of youth, as well as the important role of families, is imperative.
Hand-washing at critical times and associated factors among mothers of children under-five in Ethiopia: a systematic review and meta-analysis
Authors: Sisay Gizaw , Eshete Negasa , Genetu Kassa 
Published: November 2024

AbstractGood hand-washing practice is the most important preventive measure to reduce the spread of communicable disease to under-five children. Prior studies on good handwashing practice at critical times among mothers of children under-five age in Ethiopia were extremely varied. Therefore, this meta-analysis aimed to assess the overall proportion of good handwashing practice at critical times and identify the associated factors in Ethiopia. A comprehensive search of relevant studies was performed using distinct databases. Data were extracted using Microsoft Excel spreadsheet, and exported to Stata-MPv-17 for analysis. A random-effect model was used to estimate the overall proportion of good hand-washing practice at critical times. A random or fixed effects model was used to compute the pooled AORs with their 95% Cis, which were presented on a forest plot. $${I}^{2}$$

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2

test statistics was used for assessing heterogeneity among the included studies. The funnel plot and Egger's test were used to assess the publication bias. Ten studies were included in this systematic review and meta-analysis. The overall pooled proportion of good hand-washing practice at critical times among mothers of children under-five age in Ethiopia was 43.18% (95% CI = 31.05, 55.31). Insufficient water (AOR = 0.33, 95% CI: 0.13, 0.52), good knowledge (AOR = 1.35, 95% CI = 1.09, 1.61), desirable attitude (AOR = 4.34, 95% CI = 1.84, 6.84) and higher educational level (AOR = 0.17, 95% CI = 0.08, 0.25) were significantly associated with good practice of hand-washing at critical times. The national level of good practice of hand-washing at critical times was low. Hence, to promote good practice of hand-washing, it is essential to increase the accessibility of water and provide hygiene health education and training programs to improve knowledge and desirable attitudes of mothers.
Population dynamics of sympatric Phortica spp. and first record of stable presence of Phortica oldenbergi in a Thelazia callipaeda-endemic area of Italy
Authors: Bernardini Ilaria , Poggi Cristiana , Porretta Daniele , Máca Jan , Perugini Eleonora , Manzi Sara , Gabrielli Simona , Pichler Verena , Latrofa Maria Stefania , Fourie Josephus , Lia Riccardo Paolo , Beugnet Frédéric , Otranto Domenico , Pombi Marco 
Published: November 2024

Abstract
Background
Five species of the Phortica genus (Diptera: Drosophilidae) are known in Europe and the Middle East. Among these, Phortica variegata and Phortica okadai are better known for their role as vectors of the zoonotic eyeworm Thelazia callipaeda. Other species, such as Phortica semivirgo and Phortica oldenbergi, have been studied less. Given the paucity of data about these Phortica spp. vectors, we explored the population dynamics and ecology of Phortica spp. in an area highly endemic for T. callipeada (Manziana, Rome, Central Italy).

Methods
Phortica spp. flies were collected over a 3-year period (2018–2020) during their active season (April–October) with a sweep net while hovering around fermenting fruits or a human operator acting as baits. Collected flies were morphologically identified and tested for a T. callipeada infection and for the presence of Wolbachia, by polymerase chain reaction (PCR). Population dynamics of species collected was associated to environmental drivers through generalized additive models.

Results
Of the 5564 flies collected, 90.8% were P. variegata, 9.1% were P. oldenbergi, 0.05% were P. semivirgo, and one specimen was P. okadai. Only P. variegata scored molecularly infected with T. callipeada throughout the 3-year sampling period (1.8%). Phortica oldenbergi, observed consistently during the entire sampling period, exhibited a marked preference for fruit traps, contrasting with the lachryphagous activity of P. variegata. Analysis of environmental drivers of P. oldenbergi and P. variegata population dynamics indicated temperature, wind speed, and pressure as significant factors. In addition, Wolbachia pipientis endosymbiont was detected in P. oldenbergi and P. okadai.

Conclusions
For the first time, this study analysed several ecological aspects of Phortica species coexisting in a T. callipeada endemic area, highlighting different behaviors in the same environment and their vectorial role. Notably, this is also the first report of the presence of P. oldenbergi in Italy and P. okadai in Europe, underscoring the importance of extensive sampling for detecting potential vectors and alien species with direct implications for vector-borne disease epidemiology.

Graphical Abstract
Dietary supplementation with N-acetyl-L-cysteine ameliorates hyperactivated ERK signaling in the endometrium that is linked to poor pregnancy outcomes following ovarian stimulation in pigs
Authors: Cheng Linghua , Shi Zhicheng , Yue Yuan , Wang Yue , Qin Yusheng , Zhao Wei , Hu Yupei , Li Qin , Guo Min , An Lei , Wang Shumin , Tian Jianhui 
Published: November 2024

Abstract
Background
Exogenous gonadotropin-controlled ovarian stimulation is the critical step in animal reproductive management, such as pig, sheep, bovine and other species. It helps synchronize ovulation or stimulate multiple ovulations. However, a number of evidence indicated an unexpected decrease in pregnancy outcomes following ovarian stimulation. This study aimed to explore the underlying mechanism of the pregnancy defect and develop a practical rescue strategy.

Results
Compared with those in the control group, gilts that underwent ovarian stimulation showed a decrease in pregnancy rate, farrowing rate, and total number of piglets born. Stimulated gilts also showed an increase in estradiol (E2) levels. The supraphysiological E2 level was correlated with the decrease in the number of piglets born. Furthermore, we found that high levels of E2 impair uterine receptivity, as shown by the overproliferation of endometrial epithelial cells. In vitro mechanistic studies demonstrated that high levels of E2 hyperactivate FGF-FGFR-ERK signaling cascade in the uterine endometrium, and in turn induces overproliferation of endometrial epithelial cells. Of note, N-acetyl-L-cysteine (NAC) supplementation effectively inhibits ERK hyperphosphorylation and ameliorates endometrial epithelial overproliferation. Importantly, in vivo experiments indicated that dietary NAC supplementation, compared with ovarian stimulation group, improves the uterine receptivity in gilts, and significantly increases the pregnancy rate and total number of piglets born.

Conclusions
Ovarian stimulation-induced supraphysiological levels of E2 impairs uterine receptivity by hyperactivating FGF-FGFR-ERK signaling cascade, thereby reducing pregnancy rate and litter size. Supplementing NAC to a conventional diet for gilts ameliorates hyperactivated ERK signaling and improves uterine receptivity, thus rescuing adverse pregnancy outcomes following ovarian stimulation.

Graphical Abstract
Research needs of higher specialist trainees in psychiatry in Ireland: mixed methods study
Authors: Counihan Eimear , Carey Cornelia , Feeney Anna , Lally Kevin , O'Connor Ciara , Doherty Anne M. 
Published: November 2024

Aims and method
Higher specialist trainees (HSTs) in psychiatry in Ireland were recruited to complete a 21-item online questionnaire anonymously. Questions were designed to establish the research experience of HSTs in various years of training, identify perceived barriers to participation and generate potential strategies to overcome these barriers.

Results
Of 165 HSTs surveyed, 50 (30%) responded. Most respondents (58%) were in the second or third year of HST. Most (72%) were training in general adult psychiatry. Themes that emerged from analysis of the qualitative data were ‘collaborative research culture’, ‘guidance’, ‘choice’ and ‘access to resources’. Participants felt they needed more structured guidance and regular supervision, and expressed a desire for more networking and collaboration.

Clinical implications
The need for a supportive, collaborative research culture within psychiatry was predominant among responses. Structured research programmes and access to resources may facilitate a more positive research culture and should be considered as part of the training curriculum.