bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk Factors for Neonatal Clavicular Fractures
Authors: Kadar Assaf , Yaniv Noga , Rutenberg Tal Frenkel , Turjeman Adi , Shemesh Shai , Sidon Eliezer , Cohen Matan J. 
Published: September 2024

Background:
Neonatal clavicular fractures represent the most common fracture during delivery. We aimed to define risk factors associated with these fractures in a large population-based database.

Methods:
Data were extracted from Clalit Health Services’ electronic health records from 2000 to 2020. Newborns with clavicular fractures were compared with a healthy control group. The following parameters were compared—for the newborns: sex, birth weight, birth height, and head circumference; for the delivery process: assisted delivery, cesarean section, use of epidural, birth week, and number of fetuses; and for the mother: age at delivery, socioeconomic status, height, weight, and body mass index (BMI).

Results:
We found a rate of 0.28% for neonatal clavicular fractures (5015 clavicular fractures/1 755 660 deliveries). Male gender and heavier birth weight were found to be significantly associated with clavicular fractures (P < .001). Increased risk was also associated with lower socioeconomic status, baseline weight, and maternal BMI (P < .001 for all). Assisted delivery increased the risk of clavicular fracture (OR = 2.274; 95% CI, 1.661-3.115; P < .0001), while cesarean section and use of epidural were found to be protective (OR = 0.149; 95% CI, 0.086-0.26; P < .0001; and OR = 0.687; 95% CI, 0.0531-0.89; P < .004, respectively).

Conclusions:
This study provides insight into the risk factors associated with neonatal clavicular fractures on the largest group of patients reported to date.
An Internet-Based Developmental Home Care Support Program Improved Maternal Psychological Symptoms and Infant Growth
Authors: Zhang Jun , Chen Bowen , Yang Xinyi , Cao Mi , Mahoney Ashley Darcy , Zhu Luyang , Yu Nancy Xiaonan 
Published: September 2024

Objective: To examine the effects of an internet-based Developmental Home Care Support program (DHCSP) to reduce maternal psychological symptoms and improve preterm infants’ physical growth outcomes. Methods: A randomized controlled trial was conducted. The mother-infant dyads (n
m = 34, n
p = 40) were randomly assigned to either the DHCSP intervention group or the control group. Data were collected at discharge (T0), 1-month corrected age (T1), and 2-month follow-up (T2), including mothers’ postpartum depressive and posttraumatic stress disorder (PTSD) symptoms and mother-proxy infants’ body length, weight, and head circumference. Results: There were no significant differences in sociodemographic characteristics between the 2 groups at T0, except for mothers’ age and monthly household income (both P = .01). Mothers in the DHCSP group reported significantly higher decreases in depression symptoms (β = −2.24; 95% confidence interval [CI], −4.31 to −0.16, P = .03), and their preterm infants showed significantly more increases in body length (β = 2.09; 95% CI, 0.30-3.87, P = .02) than the control participants at T2. The 2 groups did not show significant differences in mothers’ PTSD symptoms or infants’ body weight and head circumference. Conclusion: The internet-based DHCSP intervention was effective in improving mothers’ depressive symptoms and infants’ body length.
Comparison of State–Trait Anxiety and Fear of Childbirth According to Attachment Styles of Pregnant Women
Authors: Yıldırım Yusuf Ezel , Çetinay Aydın Pınar , İnan Ünlü Alevhan , Karaca İbrahim , Ekin Murat 
Published: September 2024

Aims/Background:
Fear of childbirth (FoC) and its extreme form, tokophobia, is a clinical condition that can lead to many negative consequences, and its importance is increasingly understood. This article aims to assess the severity of FoC and anxiety levels according to different attachment styles and to investigate the relationships between these factors.

Design/Methods:
A cross-sectional study was conducted in a state hospital in the largest city in Turkey. Three hundred pregnant women attending the Antenatal Outpatient Clinic were included. A sociodemographic questionnaire, Wijma Delivery Expectancy/Experience Questionnaire—version-A (W-DEQ), Spielberger State–Trait Anxiety Inventory and Adult Attachment Style Scale were administered.

Results:
8.1% of participants had tokophobia (W-DEQ sum score ≥85). FoC was significantly higher in pregnant women who had a history of pregnancy loss and past psychiatric history. For multiparous women, adverse birth outcomes were also associated with higher FoC. State and trait anxiety were positively correlated with FoC levels. Regarding the attachment patterns, pregnant women with avoidant attachment styles presented with higher levels of FoC than those with secure attachment styles. In logistic regression analysis, higher anxiety levels, adverse birth outcomes, and insecure attachment styles were found to predict severe and clinical FoC.

Conclusion:
FoC has a considerable effect on pregnant women, albeit at different clinical levels. Adverse birth outcomes, high anxiety levels, and insecure attachment styles were associated with higher FoC. Therefore, antenatal patients with adverse birth outcomes and higher anxiety levels, which are risk factors for FoC, should be carefully evaluated in terms of tokophobia and referred to mental health professionals when necessary.
Supporting Fathers in the Neonatal Intensive Care Unit
Authors: Hull William , Rodriguez Alejandra , Talarico Nathan , Bordelon Curry 
Published: September 2024

Purpose:
This scoping review explores the critical yet often overlooked role of fathers in the neonatal intensive care unit (NICU) environment, particularly during the emotionally tumultuous period following the birth of a critically ill infant.

Background:
The birth of an infant significantly disrupts family dynamics and may impact the role of each parent. Fathers in the NICU are frequently overlooked, leading to feelings of isolation and stress. Fathers often face confusion, stress, and a sense of exclusion, which are compounded by the trauma of having a critically ill infant.

Discussion:
Using the Preferred Reporting Item for Systematic Reviews and Meta‐analysis model, the authors identified 18 articles that provide guidance on potential solutions to supporting an inclusive NICU environment for families, including fathers. The articles also consider the need for staff and provider training for a sustainable and inclusive NICU environment. Outcomes from the scoping review highlight the need for inclusive support for fathers, emphasizing that their involvement is crucial for the well-being of the infant and the family.

Implications for practice:
Creating a welcoming NICU environment, training staff to address fathers’ needs, and providing flexible policies can improve paternal engagement. Effective communication and support systems, including peer-led groups, are vital.

Precis Statement:
Inclusive practices, better communication, and tailored support for fathers in the NICU can enhance paternal involvement and engagement.
Pregnancy outcomes in Greek women with inflammatory bowel disease: a longitudinal national retrospective study
Authors: Papathanasiou Evgenia , Kokkotis Georgios , Axiaris Georgios , Bellou Georgia , Chalakatevaki Konstantina , Christidou Angeliki , Christodoulou Dimitrios K. , Foteinogiannopoulou Kalliopi , Gatopoulou Anthia , Giouleme Olga , Gkoumas Konstantinos , Κalogirou Maria , Karatzas Pantelis , Κarmiris Konstantinos , Κatsanos Konstantinos , Κourikou Anastasia , Κoutroubakis Ioannis E. , Liatsos Christos , Mantzaris Gerassimos J. , Μathou Nicoletta , Michalopoulos George , Μantaka Aikaterini , Nikolaou Penelope , Oikonomou Michael , Papatheodoridis George , Polymeros Dimitrios , Skouloudis Epameinondas , Soufleris Konstantinos , Stergiou Evdoxia , Theodoulou Aggelos , Theodoropoulou Angeliki , Theoxaris Georgios , Tsafaraki Styliani , Tsiolakidou Georgia , Tsironi Eftychia , Tzouvala Maria , Viazis Nikos , Michopoulos Spyridon , Bamias Giorgos , Zampeli Evanthia 
Published: September 2024

Background
Inflammatory bowel disease (IBD) commonly affects patients of reproductive age. The effect of disease activity on the outcome of pregnancy and its impact on neonatal health are areas of intense research.

Methods
Α national retrospective study of pregnancies in women with IBD between 2010 and 2020 was carried out in 22 IBD reference centers in Greece.

Results In total
223 pregnancies in 175 IBD patients [122 Crohn’s disease (CD)] were included. Mean age at diagnosis was 26 years (12–44) with a mean duration of 7.4 (0–23). Pregnancy as a result of IVF occurred in 15 cases (6.7%). At the beginning of gestation, 165 patients (74%) were under treatment: 48 (29%) with anti-tumor necrosis factor alpha agents, 43 (26%) with azathioprine, 101 (61%) with 5-aminosalicylates, and 12 (7%) with steroids. Forty-nine cases (22%) of IBD flares were recorded: Two-thirds (n = 30) were in clinical remission at the onset of pregnancy, whereas treatment with corticosteroids was required in 22 (45%). Patients with ulcerative colitis were at greater risk for flare compared to those with CD (P < 0.001). All but two pregnancies (99.1%) resulted in an uncomplicated delivery. In 147 cases (67.1%), c-section was performed. Two late fetal deaths (0.9%) were reported, both in patients with persistently active disease. After delivery, 75 patients (34%) presented with a disease flare, associated with active disease at the beginning of pregnancy (P < 0.001).

Conclusion
The majority of Greek patients with IBD have a favorable pregnancy outcome. Active inflammation during gestation and a diagnosis of ulcerative colitis are negatively associated with pregnancy outcomes.
Pancreatic Cancer Risk in Prediabetes
Authors: Jain Akhil , Keesari Praneeth Reddy , Pulakurthi Yashwitha Sai , Katamreddy Rewanth , Dhar Meekoo , Desai Rupak 
Published: September 2024

Objectives
Pancreatic cancer and prediabetes pose significant public health challenges. Given the lack of strong evidence we performed a meta-analysis to assess the risk of pancreatic cancer in prediabetes.

Materials and Methods
We performed a thorough search of the major databases over the last 10 years to identify relevant articles. The pooled odds ratio (OR) and hazard ratio (HR) were combined to calculate the effect size (ES).

Results
We analyzed 5 studies including 5,425,111 prediabetic individuals and 16,096,467 normoglycemic population across 5 countries with a median follow-up of 8.5 years. We identified a noteworthy association between prediabetes and pancreatic cancer, reporting an unadjusted ES of 1.36 (95% confidence interval [CI] 1.05–1.77, P = 0.02) and an adjusted ES of 1.40 (1.23–1.59, P < 0.01). Subgroup analyses by age revealed variations in risk, with studies involving participants aged 60 and above exhibiting a higher ES (ES 1.83, 95% CI 1.28–2.62, P < 0.01). Geographical differences were also observed, with Japanese studies reporting a higher risk (ES 1.89, 95% CI 1.15–3.10, P < 0.01) compared with those from the United States (ES 1.32, 95% CI 1.13–1.53, P < 0.01).

Conclusions
We identified 40% higher risk of pancreatic cancer in patients with prediabetes than those with normal blood glucose necessitating urgent attention for further research and policy change.
Challenges of using data analytics in health services
Authors: Khalil Hanan 
Published: September 2024

Purpose of review
This review will discuss the challenges associated with using data analytics in health services.

Recent findings
The integration of data analytics in health services holds promise for transforming healthcare delivery, enhancing patient outcomes, and optimizing operational efficiency. However, this Undertaking is associated with challenges that include ethical, legal, financial, and organizational domains. Ethical concerns arise from biases in algorithms and the imperative for transparency in decision-making processes. Legal complexities include navigating stringent regulations to safeguard patient privacy and data security. Financial implications involve the substantial costs of infrastructure development, resource allocation, and ongoing maintenance required for effective data analytics implementation. Moreover, resistance to change among healthcare professionals poses a significant barrier, driven by concerns over unfamiliarity with data-driven methodologies.

Summary
Addressing these challenges requires adopting best practices and innovative solutions. Establishing robust data governance frameworks and adherence to ethical guidelines are crucial steps to ensure fairness, accountability, and transparency in data analytics practices. Technological advancements, including cloud computing and advanced analytics platforms, offer scalable solutions to enhance data integration and interoperability across healthcare systems. Leadership support, comprehensive training programs, and effective communication strategies are essential for overcoming resistance to change and fostering a data-driven culture within healthcare organizations.
HPV Infection and Prevention in Patients With Immune-Mediated Inflammatory Diseases
Authors: Goulenok Tiphaine , Sacré Karim 
Published: September 2024

Background/Historical Perspective
Human papillomavirus (HPV) infections are a significant public health concern as they cause various cancers, including those of the cervix, vulva, vagina, anus, penis, and oropharynx, in both women and men.

Summary Integrating the Current Published Literature
Individuals with immune-mediated inflammatory diseases, particularly systemic lupus erythematosus, have an increased risk of developing persistent HPV infection and subsequent precancerous lesions due to their immunosuppression.

Major Conclusions
Vaccination and screening for precancerous lesions are 2 central management strategies that must be implemented in patients with immune-mediated inflammatory diseases. Although HPV vaccination has been proven to be safe and effective in these patients, coverage remains low and should be encouraged. Screening for cervical cancer should be more widely implemented in this population, as recommended in guidelines for other immunosuppressed patients.

Future Research Directions
Catch-up vaccination, vaginal self-sampling screening for HPV detection, and therapeutic vaccination are new options that should be considered.
Reproductive Health in Scleroderma, Vasculitis, and Sjögren Syndrome
Authors: Crisafulli Francesca , Lazzaroni Maria Grazia , Nalli Cecilia , Orabona Rossana , Franceschini Franco , Tincani Angela 
Published: September 2024

Abstract
Women with systemic chronic inflammatory disease, such as those with scleroderma, systemic vasculitis, and Sjögren syndrome, need preconception evaluation by a multidisciplinary team. Counseling and pregnancy management should be tailored to patients' needs, considering specific disease features, organ involvement, treatment options, and risk factors to minimize risks of maternal-fetal complications during pregnancy.
Additionally, considerations regarding fertility, assisted reproductive techniques, and contraception also need to be addressed for these women.
In this narrative review, we integrate the current published literature with our expert opinion to address the issues faced by patients with the aforementioned inflammatory conditions.
Oral Testosterone Therapy in Hypogonadal Men: A Comprehensive Systematic Review and Meta-Analysis of Safety, Efficacy, and Secondary Health Outcomes
Authors: Borges Julian Y.V. 
Published: September 2024

AbstractObjectiveTo conduct a systematic review and meta-analysis to evaluate the safety and efficacy of oral testosterone therapy in hypogonadal men. The primary outcome is the assessment of safety, focusing on cardiovascular risks, liver toxicity, and prostate safety. Secondary outcomes include evaluations of bone mass, cardiovascular benefits, cognitive function, and potential reductions in mortality.MethodsA systematic search was conducted using databases such as PubMed, Embase, and Cochrane Library, identifying peer-reviewed studies published until August 2024. The search included randomized controlled trials (RCTs), cohort studies, and large clinical trials. The studies involved a total of 3,183 hypogonadal men. Data were extracted and analyzed to assess primary and secondary outcomes. Statistical methods for meta-analysis included fixed-effects and random-effects models to calculate pooled estimates and assess heterogeneity.ResultsThe analysis included 21 studies, encompassing a total of 3,183 hypogonadal men. Oral testosterone therapy demonstrated a safety profile comparable to other testosterone replacement therapies (TRT). No significant increase in liver toxicity was observed, supported by studies showing no liver damage after long-term oral testosterone undecanoate (TU) administration. Cardiovascular safety results were mixed; some studies noted minor increases in systolic blood pressure, but there was no consistent evidence of a significant increase in major cardiovascular events compared to other TRT forms. The prostate safety profile was consistent with existing TRT modalities, with only minor increases in prostate-specific antigen (PSA) levels noted.Secondary outcomes were generally favorable: bone density improved, fat mass was reduced, and there were indications of cognitive benefits, although these findings varied across studies. However, the evidence for mortality reduction was inconclusive, with no strong data supporting a significant effect of oral testosterone on reducing mortality.ConclusionOral testosterone therapy appears to be a safe and effective treatment for hypogonadal men, with a risk profile comparable to other TRT forms. It offers potential benefits in bone health and cognitive function but requires careful monitoring of cardiovascular health and prostate safety during treatment. The findings suggest that oral testosterone therapy can be a valuable option for hypogonadal men, though long-term studies are needed to better understand its full range of effects, particularly concerning mortality and cardiovascular outcomes.
Stepwise Isolation of Diverse Metabolic Cell Populations Using Sorting by Interfacial Tension (SIFT)
Authors: Shulman Matthew , Mathew Thomas , Trivedi Aria , Gholizadeh Azam , Colcord Charlotte , Wiley Ryan , Allen Kiron S. , Thangam Lakshmi , Voss Kelsey , Abbyad Paul 
Published: September 2024

ABSTRACTWe present here a passive and label-free droplet microfluidic platform to sort cells stepwise by lactate and proton secretion from glycolysis. A technology developed in our lab, Sorting by Interfacial Tension (SIFT), sorts droplets containing single cells into two populations based on pH by using interfacial tension. Cellular glycolysis lowers the pH of droplets through proton secretion, enabling passive selection based on interfacial tension and hence single-cell glycolysis. The SIFT technique is expanded here by exploiting the dynamic droplet acidification from surfactant adsorption that leads to a concurrent increase in interfacial tension. This allows multiple microfabricated rails at different downstream positions to isolate cells with distinct glycolytic levels. The device is used to correlate sorted cells with three levels of glycolysis with a conventional surface marker for T-cell activation. As glycolysis is associated with both disease and cell state, this technology facilitates the sorting and analysis of crucial cell subpopulations for applications in oncology, immunology and immunotherapy.
The Neural Underpinnings of Aphantasia: A Case Study of Identical Twins
Authors: Megla Emma , Prasad Deepasri , Bainbridge Wilma A. 
Published: September 2024

SummaryAphantasia is a condition characterized by reduced voluntary mental imagery. As this lack of mental imagery disrupts visual memory, understanding the nature of this condition can provide important insight into memory, perception, and imagery. Here, we leveraged the power of case studies to better characterize this condition by running a pair of identical twins, one with aphantasia and one without, through mental imagery tasks in an fMRI scanner. We identified objective, neural measures of aphantasia, finding less visual information in their memories which may be due to lower connectivity between frontoparietal and occipitotemporal lobes of the brain. However, despite this difference, we surprisingly found more visual information in the aphantasic twin’s memory than anticipated, suggesting that aphantasia is a spectrum rather than a discrete condition.
Breast cancer spheroids prefer activated macrophages as an accomplice: An in vitro study
Authors: Teli Abhishek , Iyer Ranjani , Shanbhag Karthik , Gawarguru Rahul , Gayan Sukanya , Shaikh Sumaiya , Tamhankar Anup , Kamat Siddhesh S. , Dey Tuli 
Published: September 2024

AbstractCancer, a heterogeneous disease in nature, often requires help from diverse pro-tumor or tumor-associated- cells, which are recruited and persevered within the stroma. Pro-tumor stromal cells provide the essential support needed for tumor growth, metastasis, and development of drug resistance in due time. Tumor-associated macrophages, one of such cells, are essential to tumor microenvironment and tumor survival. In recent years, TAMs have been identified as potential drug targets and therapeutic agents, which encourages the in-depth characterization of their crosstalk with the tumors. The current study has successfully developed a cost-effective in vitro platform for Chemokine Assisted Recruitment of Macrophages to spheroids mimicking the physiology of TAM recruitment. Firstly, monocytic cell line (U937) were converted into activated naive macrophages (M0) and pro-and anti-inflammatory (M1 and M2) subtypes. Monocytes, M0, M1, and M2 macrophages are characterized extensively. Secondly, the naive and polarized macrophages were subjected to chemokine-dependent recruitment into monotypic and heterotypic breast cancer spheroids. The nature of the recruitment is further investigated by assessing the profile of chemokines and chemokine receptors. Recruited macrophages are also observed to manipulate spheroid behavior in many ways. The recruited macrophages also exhibit an increased level of Siglec-1 (CD169), one of the potential TAM markers. The current platform’s potential for application can be extended to understand the recruitment process of other immune/stromal cells to solid tumors. It could be a potential addition to the arrays of in vitro platforms developed to screen the efficiency of cell-based immunotherapeutics in the future.
Diversity and abundance of ring nucleases in type III CRISPR-Cas loci
Authors: Hoikkala Ville , Chi Haotian , Grüschow Sabine , Graham Shirley , White Malcolm F. 
Published: September 2024

SummaryMost type III CRISPR-Cas systems facilitate immune responses against invading mobile genetic elements such as phages by generating cyclic oligoadenylates (cOAs). Downstream effectors activated by cOAs are typically non-specific proteins that induce damage to essential cellular components, thereby preventing phage epidemics. Due to these toxic effects, it is crucial that the production and concentration of cOAs remain under tight regulatory control during infection-free periods or when deactivating the immune response after clearing an infection. Type III CRISPR loci often encode enzymes known as ring nucleases (RNs) that bind and degrade specific cOAs, while some effectors are auto-deactivating. Despite the discovery of several classes of RNs, a comprehensive bioinformatic analysis of type III CRISPR-Cas loci in this context is lacking. Here, we examined 38,742 prokaryotic genomes to provide a global overview of type III CRISPR loci, focussing on the known and predicted RNs. The candidate RNs Csx16 and Csx20 are confirmed as active enzymes, joining Crn1-3. Distributions and patterns of co-occurrence of RNs and associated effectors are explored, allowing the conclusion that a sizeable majority of type III CRISPR systems regulate cOA levels by degrading the signalling molecules, which has implications for cell fate following viral infection.