bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of Midwives’ Knowledge and Application of the Modified WHO Partograph at Ga South Public Health Facilities, Greater Accra, Ghana
Authors: Asirifi Vivian Hickson , Sutherland Edward Kofi , Afakorzi Stephen Henry 
Published: November 2024

Background The partograph, one of the vital tools available for the midwife, was originally developed from Friedman’s 1954 Cervicograph by Philpott and Castle in 1972. It was later modified and adopted by the WHO as a universal ‘gold standard’ tool for recording and monitoring progress in labour and providing interventions in cases of abnormal labour. The goal of this study was to assess the level of knowledge of midwives and their utilisation of the modified WHO partograph at the Ga South Municipality in the Greater Accra Region of Ghana. Methodology An institution-based quantitative cross-sectional study was conducted within the municipality from February to March 2019. One hundred and ten (110) midwives were recruited using the census approach. Data were collected using a structured self-administered questionnaire. STATA statistical software version 14 was used for descriptive analysis and results were reported in the form of percentages and frequencies using charts and tables. Pearson’s Chi-Square estimation was also performed to test the association between selected variables with a p value <.05 as the threshold for statistical significance. Results Of the 110 participants, 105 (95.5%) of the midwives could properly describe the partograph and 104 (94.5%) understood that it was used as a tool for vital decision-making, while 92 (83.6%) indicated that partograph contributes in reducing maternal and new-born deaths. Almost all participants, 109 (99.09%) knew all the parameters of the partograph and were also aware that plotting the partograph begins at a cervical dilation of 4 cm. Also, while a good number of participants 103 (93.64%) knew that cervical dilation on the partograph is carried out every four hours during the active phase of labour, 110 (100%) indicated that progress of labour is assessed by the degree of cervical dilation and descent of the presenting part. Routine usage of the partograph was recorded among the majority of midwives, 102 (92.7%), to record and monitor the progress of labour in expectant women. Bivariate analysis showed a significant association between the use of the modified WHO partograph and the knowledge of midwives on Ghana Health Service (GHS) policies ( p = .045). There was, however, no positive association determined among age ( p = .66), rank ( p = .77), years of professional experience ( p = 1.00), place of work ( p = .51), work shift and highest qualification ( p = 1.00) as far as knowledge and use of the WHO modified partograph are concerned. Conclusion The findings of the study underscore the desirable level of knowledge and usage of the partograph among study participants. This affirms that the knowledge and usage of the partograph within the facilities in Ga South health facilities hold the prospect of enhancing the safety of expectant mothers.
Association Between Coagulation Fibrinolysis Markers and Severity in Patients with COVID-19
Authors: Iwamoto Takuya , Hatayama Yuki , Yamashita Noriko , Ichikawa Hitomi , Kawamura Koji 
Published: November 2024

IntroductionThrombosis is a major complication of COVID-19. D-dimer (DD) is an important coagulation fibrinolysis marker in COVID-19 and has been extensively studied. However, very little is known about the role of other fibrinolysis markers, plasmin-plasmin inhibitor complex (PIC), and fibrin monomer complex (FMC) in COVID-19. This study investigated and compared the associations of DD, PIC, and FMC with COVID-19 severity.MethodsArchived plasma samples from patients with COVID-19 (n = 50) were assessed for DD, FMC, and PIC levels. We compared the levels between patients with mild (n = 36) and moderate (n = 14) COVID-19 and evaluated their correlation with other COVID-19 severity markers, including lactate dehydrogenase (LD), serum albumin (Alb), C-reactive protein (CRP), and neutrophil-lymphocyte ratio (NLR).ResultsPatients with moderate COVID-19 had significantly higher DD and PIC levels than those with mild disease, while FMC levels were comparable. DD and PIC levels significantly correlated with LD, Alb, and NLR. Additionally, PIC levels significantly correlated with CRP levels. However, FMC levels correlated only with Alb but not with LD, NLR, or CRP.ConclusionsCOVID-19 severity was significantly associated with PIC and DD levels but not with FMC levels. PIC was the variable with the most clearly significant difference between patients with moderate disease and those with mild disease, highlighting its potential as an indicator of coagulation and fibrinolysis imbalance in patients with COVID-19. Further studies with larger sample sizes and more diverse severity groups are required to confirm these findings.
Occurrence of Eosinophilic Granulocytes in the Decidua of Placentas With Perinatal Clinical Findings
Authors: Feist Henning , Schaumann Nora 
Published: November 2024

Introduction: Inflammatory and immunologic homeostasis in the basal plate of the placenta is essential for the fetal development and growth, since the fetus immunologically constitutes a semi-allograft. Bone marrow derived eosinophilic granulocytes are usually not found in the basal plate. Materials and Methods: We retrospectively analyzed the occurrence of eosinophilic granulocytes in the basal plate of singleton placentas and investigated clinical and pathologic-anatomic associations. Results: In 5 singleton placentas (0.3% of all investigated cases from the archive) eosinophilic granulocytes were detectable. All these cases also displayed chronic deciduitis. Two cases had a clinical history of substitution therapy with methadone, in 2 instances the mothers had a history of atopic diseases, and 1 mother had a SARS-CoV-2-infection during pregnancy. Conclusions: The infiltration of eosinophilic granulocytes in the decidua is a rare feature of placentas with perinatal clinical findings. Strikingly, all 5 affected cases also presented with chronic deciduitis. This may hint at a contribution of the eosinophilic infiltrate to a non-infectious pathologic inflammatory process with an increased risk for perinatal complications.
What is inclusion? Children perspective on education at primary schools in rural Afghanistan
Authors: Trani Jean-Francois , Gettinger Kate , Kaplan Ian , Wang Zijing , Rfat Mustafa , Zhu Yiqi , Hashim Rawab , Bakhshi Parul 
Published: November 2024

Inclusive education remains a distant goal in Afghanistan threatened by issues of discrimination based on gender, disability, ethnicity, cultural beliefs and socioeconomic status. To promote more inclusive practices, we conducted 120 participatory workshops in three rounds, including 1187 volunteer children aged 9 to 12 years old from grades three, four and five in 40 primary rural schools of Badakhshan, Ghazni and Takhar provinces of Afghanistan between 2018 and 2021. Children described inclusion as the combination of allowing all children to access school and to effectively learn. Children were able to meaningfully define the state of education while articulating coherently what motivates them, their teachers, and parents and what actions need to be taken to improve the whole school system. In a political context limiting girls’ education, children voiced their need for a school environment that is enriching, supportive and adapted to their needs and expectations to keep motivated and engaged.
Do Metrics of Temporal Glycemic Variability Reveal Abnormal Glucose Rates of Change in Type 1 Diabetes?
Authors: Richardson Robert 
Published: November 2024

Background: We aimed to identify the normal range of glucose rates of change (RoC) observed in health and assess whether existing metrics of temporal glycemic variability (GV-timing), such as mean absolute glucose change (MAG) and continuous overlapping net glycemic action (CONGA), are predictive of abnormally rapid RoC in type 1 diabetes (T1D). Methods: We identified the normal range of RoC over one-hour intervals from continuous glucose monitoring (CGM) data of healthy individuals. Rapidly rising glucose was defined as RoC values above percentiles 99% (level 1, L1) or 99.9% (level 2, L2), and rapidly falling glucose as below 1% (L1) or 0.1% (L2). The percentage of time these thresholds are exceeded in a given individual is referred to as time in fluctuation (TIF). In a separate CGM dataset of 736 T1D individuals, we calculated TIF-L1 and TIF-L2, and compared them against corresponding values of MAG and CONGA. Results: The extremum percentiles of RoC observed in health are 0.1%: −80 mg/dL/h, 1%: −50 mg/dL, 99%: +56 mg/dL/h, and 99.9%: +89 mg/dL/h. The T1D individuals spend significantly more TIF at rates exceeding these thresholds (TIF-L1: median, 16.7% [interquartile range, 12.7-21.5], TIF-L2: 5.0% [3.1-7.8]) than healthy individuals (TIF-L1: 1.4% [0.6-2.8], TIF-L2: 0.0% [0.0-0.2]). Both MAG and CONGA are highly correlated with TIF-L1 and TIF-L2 ( r > .95 in each pairwise comparison). Conclusions: Individuals with T1D spend significant time with glucose RoC exceeding those observed in health. Existing GV-timing metrics are strongly correlated with time with abnormal RoC. Incorporation of a GV-timing metric in clinical practice is recommended.
Using machine learning to assist decision making in the assessment of mental health patients presenting to emergency departments
Authors: Higgins Oliver , Wilson Rhonda L. , Chalup Stephan K. 
Published: November 2024

Objective The objective of this study was to assess the predictability of admissions to a MH inpatient ward using ML models, based on routine data collected during triage in EDs. This research sought to identify the most effective ML model for this purpose while considering the practical implications of model interpretability for clinical use. Methods The study utilised existing data from January 2016 to December 2021. After data pre-processing, an exploratory analysis revealed the non-linear nature of the dataset. Six different ML models were tested: Random Forest, XGBoost, CatBoost, k-Nearest Neighbours (kNN), Explainable Boosting Machine (EBM) using InterpretML, and Support Vector Machine using Support Vector Classification (SVC). The performance of these models was evaluated using various metrics including the Matthews Correlation Coefficient (MCC). Results Among the models evaluated, the CatBoost model achieved the highest MCC score of 0.1952, demonstrating superior balanced accuracy and predictive power, particularly in correctly identifying positive cases. The InterpretML model also performed well, with an MCC score of 0.1914. While CatBoost showed strong predictive capabilities, its complexity poses challenges for clinical interpretation. Conversely, the InterpretML model, though slightly less powerful, offers better transparency and is more practical for clinical use. Conclusion The findings suggest that the CatBoost model is a compelling choice for scenarios prioritising the detection of positive cases. However, the InterpretML model's ease of interpretation makes it more suitable for clinical application. Integrating explanation methods like SHAP with non-linear models could enhance model transparency and foster clinician trust. Further research is recommended to refine non-linear models within decision support systems, explore multi-source data integration, understand clinician attitudes towards ML, and develop real-time data collection systems. This study highlights the potential of ML in predicting MH admissions from ED data while stressing the importance of interpretability, ethical considerations, and ongoing validation for successful clinical implementation.
Artificial intelligence-powered dentistry: Probing the potential, challenges, and ethicality of artificial intelligence in dentistry
Authors: Rahim Abid , Khatoon Rabia , Khan Tahir Ali , Syed Kawish , Khan Ibrahim , Khalid Tamsal , Khalid Balaj 
Published: November 2024

Introduction Healthcare amelioration is exponential to technological advancement. In the recent era of automation, the consolidation of artificial intelligence (AI) in dentistry has rendered transformation in oral healthcare from a hardware-centric approach to a software-centric approach, leading to enhanced efficiency and improved educational and clinical outcomes. Objectives The aim of this narrative overview is to extend the succinct of the major events and innovations that led to the creation of modern-day AI and dentistry and the applicability of the former in dentistry. This article also prompts oral healthcare workers to endeavor a liable and optimal approach for effective incorporation of AI technology into their practice to promote oral health by exploring the potentials, constraints, and ethical considerations of AI in dentistry. Methods A comprehensive approach for searching the white and grey literature was carried out to collect and assess the data on AI, its use in dentistry, and the associated challenges and ethical concerns. Results AI in dentistry is still in its evolving phase with paramount applicabilities relevant to risk prediction, diagnosis, decision-making, prognosis, tailored treatment plans, patient management, and academia as well as the associated challenges and ethical concerns in its implementation. Conclusion The upsurging advancements in AI have resulted in transformations and promising outcomes across all domains of dentistry. In futurity, AI may be capable of executing a multitude of tasks in the domain of oral healthcare, at the level of or surpassing the ability of mankind. However, AI could be of significant benefit to oral health only if it is utilized under responsibility, ethicality and universality.
The use of telehealth technology for lifestyle modification among patients with hypertension in Nigeria and Ghana
Authors: Echieh Chidiebere Peter , Dele-Ojo Bolade Folasade , Ahmad Oseni Tijani Idris , Blankson Paa-Kwesi , Duodu Fiifi , Tayo Bamidele O , Alabi Biodun Sulyman , Sarpong Daniel F , Amoakoh-Coleman Mary , Boima Vincent , Ogedegbe Gbenga 
Published: November 2024

Introduction Sedentary lifestyle and consumption of an unhealthy diet are significantly associated with hypertension in Nigeria and Ghana. Increasing the uptake of physical activity and diet rich in fruits and vegetables has been a challenge in the region. This study aimed at assessing the effect of a mobile health intervention (mhealth) on physical activity, and fruits and vegetables intake in patients with hypertension in Nigeria and Ghana Methods The study was a quasi-experimental study conducted in Mamprobi Hospital (MH) in Ghana, and State University Teaching Hospital (EKSUTH) in Nigeria. One hundred and sixteen consenting adult patients with hypertension were consecutively recruited and given regular reminders on physical activity and intake of fruits and vegetables via mobile app (mnotify®) for six months. All participants were followed up for six months and data collected at Baseline, three months and six months. Analysis was done using Stata 14 software (StataCorp. College Station, TX) assuming an alpha level of 0.05. Ethical approval was obtained from both countries and ethical standards were followed. Results A total of 116 (53 from Ghana and 63 from Nigeria) patients with hypertension participated in the study. Respondents had a mean age of 61.0 ± 9.1 years, and were mostly females (64.7%). There was an increase in the level of physical activity which was significant by the third month ( p < 0.0001) but became insignificant by the 6th month ( p = 0.311). Fruits and vegetables intake also improved at 3 months ( p = 0.054) and significantly at 6 months ( p = 0.002). Conclusion The study found the use of telehealth as an effective tool for the delivery of adjunct therapy for lifestyle modification in the management of hypertension in Nigeria and Ghana. It is therefore recommended that telehealth be incorporated into the management of hypertension and other chronic diseases for better health outcome.
Improving Access and Timeliness of Employee Annual Exams
Authors: Davis Katie E. , Huntsman-Jones Carrie E. , Wixom Lyndsay , Twitchell Joshua Dean , Clifton Jennifer , West Morgan 
Published: November 2024

Background Access to preventive healthcare improves health outcomes and reduces risk of chronic disease. Annual examinations were integrated into an underutilized clinic at the University of Utah to improve access to preventive care. Methods: Nurse practitioners conducted these examinations, which included history, physical examination, age-based screenings, and immunizations. The service was part of a wellness program offering health premium discounts for participants. With employee permission, visit documentation was shared with primary care providers (PCPs) or used to help establish a PCP. Human resources received monthly reports of participating employees identification numbers, validating participation in order to receive premium discount. Results: In 2023, 373 examinations were performed, including 719 preventive services and screenings, with 143 referrals for specialty and primary care. Patient satisfaction remained high throughout implementation. Conclusion/Application to Practice: This initiative effectively increased access to preventive care for employees, demonstrating the feasibility of offering annual examinations in worksite clinics. The program addresses common barriers to preventive care such as long wait times, PCP shortages, and travel time to appointments.
Effects of Conditioned Media From Human Umbilical Cord-Derived Mesenchymal Stem Cells on Tenocytes From Degenerative Rotator Cuff Tears in an Interleukin 1β–Induced Tendinopathic Condition
Authors: Lee Min Ji , Park Kyungtaek , Yeon Lee Seung , Jang Kwi-Hoon , Won Sungho , Hyunchul Jo Chris 
Published: November 2024

Background: Evidence suggests that mesenchymal stem cells (MSCs) are safe for treating different tendinopathies. Synovial fluid is a pooled environment of biomarkers from the inflammatory and degenerative joint cavity. Understanding the effects of synovial fluid on MSCs is important, as it is the first microenvironment that administered MSCs encounter. Several studies have reported that exposure to osteoarthritic synovial fluid–activated MSCs increased the release of soluble factors; however, the paracrine effects of shoulder synovial fluid–stimulated umbilical cord-derived MSCs (SF-UC-MSCs) on tendinopathy have yet to be investigated. Purpose: To assess the effects of the conditioned media from SF-UC-MSCs on tenocytes from degenerative rotator cuff tears in an interleukin-1β (IL-1β)–induced tendinopathic condition. Study Design: Controlled laboratory study. Methods: UC-MSCs were isolated and cultured from healthy, full-term deliveries by cesarean section. Tenocytes were isolated and cultured from patients with degenerative rotator cuff tears. Conditioned media were obtained from UC-MSCs stimulated with synovial fluid. To evaluate the gene expression of proinflammatory and anti-inflammatory cytokines, enzymes and their inhibitors, matrix molecules, and growth factors, the tenocytes were cultured with IL-1β and 50% of the conditioned media from the SF-UC-MSCs; quantitative, real-time, reverse transcriptase polymerase chain reaction was also performed. A prostaglandin E2 (PGE2) assay was performed to investigate the PGE2 level secreted by the tenocytes. Western blotting was performed to examine protein synthesis of collagen type I and III. Cell viability, senescence, and apoptosis assays were also performed. Results: The conditioned media from the SF-UC-MSCs interfered with the inflammatory gene expression on tenocytes induced by IL-1β, but it increased the gene expression of tissue inhibitor of metalloproteinase (TIMP)-1 and TIMP-3. Meanwhile, the conditioned media decreased the PGE2 level on cells induced by IL-1β. It did increase the type I/III ratio of gene expression and protein synthesis, mainly through the induction of type I collagen. Conditioned media of SF-UC-MSCs reversed senescence and apoptosis induced by IL-1β. Conclusion: Study findings indicated that the conditioned media from SF-UC-MSCs had anti-inflammatory effects and cytoprotective effects on IL-1β–treated tenocytes from degenerative rotator cuff tears. Clinical Relevance: UC-MSCs have useful potential for the treatment of tendinopathy in practice.
Hydroxylbastnäsite-(La), an ‘old new’ bastnäsite-group mineral
Authors: Pekov Igor V. , Zubkova Natalia V. , Kasatkin Anatoly V. , Chukanov Nikita V. , Koshlyakova Natalia N. , Ksenofontov Dmitry A. , Škoda Radek , Britvin Sergey N. , Kirillov Anatoly S. , Zaitsev Anatoly N. , Kuznetsov Aleksey M. , Pushcharovsky Dmitry Yu. 
Published: November 2024

Abstract
Hydroxylbastnäsite-(La), the OH- and La-dominant member of the bastnäsite group, in fact known for many years, was studied in detail and has been approved by the IMA–CNMNC as a new mineral species with the ideal, end-member formula La(CO3)(OH). The holotype originates from the Vuoriyarvi (another spelling: Vuorijärvi) alkaline-ultrabasic complex, Northern Karelia, and the cotype from the Mochalin Log REE deposit, Potaniny Mts, South Urals, both in Russia. At Vuoriyarvi, hydroxylbastnäsite-(La) occurs as clusters (up to 1 mm) of light brown, honey-yellow or colourless hexagonal tabular to short-prismatic crystals up to 0.15 mm associated with fluorite and ancylite-(Ce) in cavities of calcite–dolomite carbonatites. At Mochalin Log, hydroxylbastnäsite-(La) forms light brown grains up to 0.2 mm included in massive aggregates of other LREE minerals: bastnäsite-(Ce), bastnäsite-(La), percleveite-(Ce), percleveite-(La), biraite-(Ce), biraite-(La), törnebohmite-(La), ferriperbøeite-(Ce), allanite-(Ce), etc. Dmeas is 4.75(2) and Dcalc is 4.778 g cm–3 (holotype). Hydroxylbastnäsite-(La) is optically uniaxial (+), ω = 1.76(1) and ε = 1.86(1) (holotype). The chemical composition (wt.%, electron microprobe, CO2 and H2O calculated: holotype/cotype) is: CaO 0.23/0.00, SrO 0.07/0.00, La2O3 39.47/39.58, Ce2O3 33.51/31.99, Pr2O3 1.03/1.51, Nd2O3 1.95/2.38, F 0.76/3.33, CO2 20.49/20.34, H2O 3.77/2.58, –O=F 0.32/1.40, total 100.96/100.31. The empirical formulae, calculated based on the sum of metal cations of 1 apfu and one CO3 group pfu, are (La0.52Ce0.44Nd0.02Pr0.01Ca0.01)Σ1.00(CO3)[(OH)0.90F0.09]Σ0.99 (holotype) and (La0.53Ce0.42Nd0.03Pr0.02)Σ1.00(CO3)[(OH)0.62F0.38]Σ1.00 (cotype). Hydroxylbastnäsite-(La) is hexagonal, P6̅, unit-cell parameters (from powder XRD data, holotype/cotype) are: a = 12.537(3)/12.533(1), c = 9.968(2)/9.908(1) Å, V = 1356.8(5)/1347.9(3) Å3 and Z = 18. Strong reflections of the powder XRD pattern [d,Å(I)(hkl)] are (holotype): 4.98(39)(002), 3.616(88)(300), 2.926(100)(302), 2.089(41)(330), 2.052(46)(304) and 1.927(40)(332). The crystal structure of holotype hydroxylbastnäsite-(La) was refined by the Rietveld method, Rwp = 0.0071, Rp = 0.0050, Robs = 0.0466. It is isostructural to hydroxylbastnäsite-(Ce) and synthetic bastnäsite-type hydroxyl-carbonates REE3+(CO3)(OH) (REE = La–Er), but differs from fluorine-dominant bastnäsites which adopt the space group P6̅2c.