bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of Doulas in Improving Maternal Health and Health Equity Among Medicaid Enrollees, 2014‒2023
Authors: Falconi April M. , Ramirez Leah , Cobb Rebecca , Levin Carrie , Nguyen Michelle , Inglis Tiffany 
Published: October 2024

Objectives. To assess the relationship between doula utilization and health outcomes of females enrolled in Medicaid-affiliated plans in the United States. Methods. In this retrospective, observational cohort study, we used Medicaid claims data from a national health insurer to compare health outcomes between females who used and who did not use a doula (2014–2023). We conducted propensity score matching using a 1:1 case‒control match, without replacement, and fit logistic regressions to analyze the relative risks for maternal health outcomes. Results. The study population included 722 matched pairs with and without a doula. Results indicate females with doulas had a 47% lower risk of cesarean delivery and a 29% lower risk of preterm birth, and were 46% more likely to attend a postpartum checkup (all differences P < .05). Conclusions. Doula care is associated with improved health outcomes among Medicaid enrollees. Public Health Implications. Doulas have garnered increasing interest from policymakers as a strategy to address increasing trends in maternal morbidity and persistent health disparities. This study provides evidence from Medicaid enrollees across the United States that doula care can improve maternal health. ( Am J Public Health. 2024;114(11):1275–1285. https://doi.org/10.2105/AJPH.2024.307805 )
Validation of Examination Maneuvers for Adolescent Idiopathic Scoliosis in the Telehealth Setting
Authors: Farid Alexander R. , Hresko M. Timothy , Ghessese Semhal , Linden Gabriel S. , Wong Stephanie , Hedequist Daniel , Birch Craig , Cook Danielle , Flowers Kelsey Mikayla , Hogue Grant D. 
Published: October 2024

Background:
Telehealth visits (THVs) have made it essential to adopt innovative ways to evaluate patients virtually. This study validates a novel THV approach that uses educational videos and an instructional datasheet, enabling parents to use smartphones to measure their child’s scoliosis at home or in telehealth settings.

Methods:
We identified a prospective cohort of patients with adolescent idiopathic scoliosis (AIS) scheduled for follow-up care from March to July 2021. The angle of trunk rotation (ATR) was first measured at home by patients’ guardians using instructional video guidance and a smartphone application with internal accelerometer software. The second measurement was made during a THV examination performed by caregivers with supervision by trained associates via a telehealth appointment. Lastly, the clinician measured the child’s ATR during an in-person clinic visit. Intraclass correlation coefficients (ICCs) and interrater reliability were compared between in-person clinic measurements and (1) at-home and (2) THV measurements. Shoulder, lower back, and pelvic asymmetry were observed and quantified at home and virtually, and then were compared with in-person clinic evaluations using kappa values. Surveys were used to evaluate the experience of the patient/caregiver with the at-home and telehealth assessment tools.

Results:
Seventy-three patients were included (mean age, 14.1 years; 25% male). There was excellent agreement in the ATR measurements between THVs and in-person visits (ICC = 0.88; 95% confidence interval [CI] = 0.83 to 0.92). ATR agreement between at-home and in-person visits was also excellent, but slightly diminished (ICC = 0.76; 95% CI = 0.64 to 0.83). Agreement between THV and in-person measurements was significantly higher compared with that between at-home and in-person measurements (p = 0.04). There was poor agreement in lower back asymmetry between THV and in-person assessments (kappa = 0.37; 95% CI = 0.14 to 0.60); however, there was no significant agreement between at-home and in-person assessments (kappa = 0.06; 95% CI = −0.17 to 0.29). Patient/caregiver satisfaction surveys (n = 70) reported a median score of 4 (“good”) for comfort with use of the technology, and a score of 3 (“neutral”) for equivalence of THV and in-person evaluation.

Conclusions:
There was a high level of agreement between telehealth and in-person spine measurements, suggesting that THVs may be reliably used to evaluate AIS, thus improving access to specialized care.

Level of Evidence:
Diagnostic Level II. See Instructions for Authors for a complete description of levels of evidence.
Does intervention with clindamycin and a live biotherapeutic drug containing Lactobacillus crispatus impact the reproductive outcome of IVF patients with abnormal vaginal microbiota: a randomised double-blind, placebo-controlled multicentre trial
Authors: Haahr Thor , Freiesleben Nina , Jensen Mette , Elbaek Helle , Alsbjerg Birgit , Laursen Rita , Praetorius Lisbeth , Nielsen Henriette , Pinborg Anja , Hartvig Vibeke , Pedersen Thomas , Skafte-Holm Axel , Jensen Jørgen , Humaidan Peter 
Published: October 2024

Abstract

The aim of the present randomised, double-blind, placebo-controlled trial was to investigate whether antibiotics and live lactobacilli would improve clinical pregnancy rates in IVF patients with abnormal vaginal microbiota (AVM) defined by high quantitative PCR loads of Fannyhessea vaginae and Gardnerella spp. IVF patients were randomised prior to embryo transfer into three parallel groups 1:1:1. Group one (CLLA) received clindamycin 300 mg ×2 daily for 7 days followed by vaginal Lactobacillus crispatus until the day of pregnancy scan, using the investigational drug LACTIN-V. Group two (CLPL) received clindamycin and placebo LACTIN-V, and finally, group three (PLPL) received an identical placebo of both drugs. A total of 1533 patients were screened, and 338 patients were randomised. The clinical pregnancy rate per embryo transfer was 42% (95%CI 32-52%), 46% (95%CI 36-56%) and 45% (95%CI 35-56%) in the CLLA, CLPL, PLPL groups respectively. Thus, treatment of AVM does not improve reproductive outcome.
The EudraCT (European Union Drug Regulating Authorities Clinical Trials Database) clinical trial identifier is 2016-002385-31; first registration day 2016-07-11.
Monofocal intraocular lenses with enhanced intermediate function provide more satisfaction in phaco-vitrectomy for the epiretinal membrane and cataracts
Authors: Ota Junya , Matsunaga Masaaki , Haga Fuminori , Suzumura Ayana , Yamada Kazuhisa , Shimizu Hideyuki , Kachi Shu , Ota Ichiro , Miyake Goichiro , Mokuno Kumiko , Inooka Daiki , Iwata Emi , Akahori Tomohiko , Nishiguchi Koji M , Kaneko Hiroki 
Published: October 2024

Abstract

A newly developed monofocal intraocular lens (IOL), known as Eyhance, features a continuously increasing refractive power from the periphery to the center of the lens, aiming to enhance intermediate vision. Our multicenter prospective, nonrandomized, comparative study in Japan aimed to compare the outcomes of phaco-vitrectomy for epiretinal membrane (ERM) and cataracts using Eyhance (DIB00V) versus a conventional monofocal intraocular lens (DCB00V). Sixty-two eyes implanted with Tecnis-1 and 79 eyes with Eyhance were analyzed. While there was no significant improvement in distance-corrected intermediate visual acuity with Eyhance (0.35 in logMAR) compared to DCB00V (0.39 in logMAR,p = 0.200), Rasch analysis of patient-reported outcomes using the Japanese modified Catquest-9SF Questionnaire revealed that Eyhance scored higher in patient general satisfaction (p = 0.0269). Subgroup analysis revealed a trend toward better postoperative distance-corrected intermediate visual acuity in patients with a certain degree of postoperative myopia. In conclusion, Eyhance may not provide superior immediate vision in phaco-vitrectomy for ERM compared to the conventional monofocal IOL, but it is not inferior. Furthermore, Eyhance could enhance postoperative satisfaction in patients with ERM and cataracts.
Role of Diet in Development of the Risk of Depression Among Geriatric Population: A Multicentric Cross-sectional Study in West Bengal
Authors: Talukdar Arunanshu , Chakraborty Arup , Talukdar Payel , Mukherjee Anindya , Chatterjee Ananya , Maity Suman , Banerjee Ankush , Roychoudhury Bhaskar , Mondal Partha , Das Himadri , Ghosh Sudip 
Published: October 2024

Abstract

Purpose
The scarcity of literature reviews from India to assess the prevalence of psychiatric distresses along with drastic spreading of Non-communicable diseases (NCDs) among frailty geriatric Indian population and the potential beneficial roles of dietary management helps to encourage for finding importance the purpose of this study.
Methods
Observational cross sectional study with analytic design was applied among the geriatric population (n = 400) to conduct this research. From the entire population, 300 were collected from community of three different Medical Colleges and Hospitals’ field practice area and another 100 were from hospital settings from Medical College and Hospital, Kolkata of West Bengal.
Results
In the socio-demographic scenario, majority were Hindu (78.5%), male (63.3%).The study participants were dispersed over several locations: 50.0% lived in hospital contexts, 21.5% lived in urban settings, and 28.3% lived in rural regions. With regard to NCDs, hypertension (p value *0.001), another cardiac outcome (p value *0.001) and diabetes mellitus (p value *0.004) were notably present in this population. In consideration with dietary pattern, the study findings indicate while depressive scores were significantly linked to vitamin C (chi square1.042,p value 0.001*),iron(chi square 0.942,p value < 0.001*) and calcium (chi square 1.184,p value 0.004*)intake.
Conclusion
Less intake of Vitamin C, iron and calcium are significantly associated with the development of depression among the geriatric population of West Bengal.
The Predictive Value of Trendelenburg Position and Neck Ultrasound for Fluid Responsiveness in Prone ARDS Patients with VV-ECMO
Authors: Zhao Junjie , Sun Yong , Tang Jing , Guo Kai , Zhuge Jiancheng , Fang Honglong 
Published: October 2024

Abstract

Background
In clinical practice, fluid administration is widely used to treat hypotension in patients undergoing veno-venous extracorporeal membrane oxygenation (VV-ECMO). However, volume expansion (VE) may aggravate acute respiratory distress syndrome (ARDS) and increase patient mortality, predicting fluid responsiveness is of great significance in the treatment of hypotension in patients undergoing VV-ECMO.
Methods
This prospective single-center study was conducted in a medical intensive care unit and included 51 VV-ECMO patients with ARDS in the prone position who required volume expansion due to hypotension. Stroke volume index variation (△SVI), carotid artery corrected flow time (FTc), and artery peak velocity variation (ΔVpeak) were taken before and during the Trendelenburg position or Volume expason is given. Fluid responsiveness was defined as a volume expansion-induced increase in ΔSVI of ≥ 15%.
Results
33 patients (64.7%) were identified as fluid responders. The area under the receiver operating characteristic curve (ROC) for FTc and ΔVpeak induced by the Trendelenburg position to predict fluid responsiveness were 0.866 (95% confidence interval [CI] 0.755–0.977) and 0.833 (95% CI 0.716–0.949), respectively. The sensitivity at the optimal threshold of 331.5 ms for FTc was 84.85% (95% CI 69.1–93.4%), with a specificity of 83.33% (95% CI 60.8–94.2%). For ΔVpeak, the sensitivity at the optimal threshold of 10.1% was 81.82% (95% CI 65.9–91.4%), with a specificity of 77.78% (95% CI 54.9–91.0%). The grey zone for FTc and ΔVpeak included 29% and 45% of patients, respectively.
Conclusions
Changes in FTc and ΔVpeak, monitored through neck ultrasound and induced by the Trendelenburg position, are reliable indicators for predicting fluid responsiveness in VV-ECMO patients with ARDS in the prone position. Furthermore, FTc demonstrates superior predictive value compared to ΔVpeak.
Classification of iPSC-Derived Cultures Using Convolutional Neural Networks to Identify Single Differentiated Neurons for Isolation or Measurement
Authors: Patel Purva , Ali Lina K. Mohammed , Kaushik Uma , Wright Mallory , Green Kaylee , Waligorski Jason E. , Kremitzki Colin L. , Bachman Graham W. , Elia Serena N. , Buchser William J. 
Published: October 2024

Abstract

Understanding neurodegenerative disease pathology requires a close examination of neurons and their processes. However, image-based single-cell analyses of neurons often require laborious and time-consuming manual classification tasks. Here, we present a machine learning (ML) approach leveraging convolutional neural network (CNN) classifiers capable of accurately identifying various classes of neuronal images, including single neurons. We developed the Single Neuron Identification Model 20-Class (SNIM20) which was trained on a dataset of induced pluripotent stem cell (iPSC)-derived motor neurons, containing over 12,000 images from 20 distinct classes. SNIM20 is built in TensorFlow and trained on images of neurons differentiated from iPSC cultures that were stained for nuclei and microtubules. This classifier demonstrated high predictive accuracy (AUC = 0.99) for distinguishing single neurons. Additionally, the 2-stage training framework can be used more broadly for cellular classification tasks. A variation was successfully trained on images of a human osteosarcoma cell line (U2OS) for single-cell classification (AUC = 0.99). While this framework was primarily designed for single-cell microraft-based identification and capture, it also works with cells in standard plate formats. We additionally explore the impact of fluorescent channels and brightfield images, class groupings, and transfer learning on the quality of the classification. This framework can both assist in high throughput neuronal or cellular identification and be used to train a custom classifier for the user’s specific needs.
99mTc-mercaptoacetyltriglycine renal scintigraphy can prevent unnecessary urinary drainage in patients with malignant ureteral obstruction
Authors: Ohtsu Akira , Arai Seiji , Onose-Kato Mai , Tsuji Yusuke , Sawada Tatsuhiro , Fujizuka Yuji , Nomura Masashi , Sekine Yoshitaka , Koike Hidekazu , Matsui Hiroshi , Higuchi Tetsuya , Suzuki Kazuhiro 
Published: October 2024

Abstract

Objective: Urinary drainage (ureteral stenting, percutaneous nephrostomy) is a standard treatment for malignant ureteral obstruction (MUO), but its exact indications have yet to be determined. 99mTc-mercaptoacetyltriglycine (MAG3) renal scintigraphy evaluates urinary obstruction using radioisotopes and may help to determine whether there is an indication for urinary drainage in patients with MUO. In this study, we investigated the ability of MAG3 scintigraphy to avoid unnecessary urinary drainage by following up patients who did not undergo urinary drainage after evaluation of residual renal function using this imaging modality.
Methods: Fifty patients who received MAG3 scintigraphy for MUO between April 2020 and January 2022 were included. These patients were classified according to the excretion pattern seen on MAG3 scintigraphy and followed up for renal function, development of pyelonephritis, and low back pain after 1, 2, 3, and 6 months.
Results: Fifteen patients received conservative treatment after evaluation by MAG3 scintigraphy. The median patient age was 72 years, and the median creatinine level was 0.79 mg/dl. Hydronephrosis was present on the left side in seven cases, the right side in seven cases, and on both sides in one case. The MAG3 pattern on the affected side was non-function in seven cases, delayed voiding in seven cases, and obstruction in one case. Three patients died as a consequence of their primary malignancy during follow-up. There were no instances of decreased renal function or development of pyelonephritis on conservative treatment. However, one patient underwent ureteral stenting for low back pain on the side contralateral to the nonfunctional kidney.
Conclusion: Fourteen of 15 patients with MUO who were treated conservatively after MAG3 scintigraphy did not experience troublesome renal events during up to 6 months of follow-up. MAG3 scintigraphy may be a valuable tool for preventing unnecessary urinary drainage. We would recommend conservative treatment for patients with a non-functional pattern.
Redeployment and Changes in Working Patterns of Healthcare Workers during COVID-19 in the UK: A Qualitative Study
Authors: Lal Zainab Zuzer , Gogoi Mayuri , Qureshi Irtiza , Al-Oraibi Amani , Chaloner Jonathan , Papineni Padmasayee , Lagrata Susie , Nellums Laura B , Martin Christopher A. , Woolf Katherine , Pareek Manish 
Published: October 2024

Abstract

Background
Redeployment was critical in addressing the increased demands of COVID-19 on the healthcare system. Previous research indicates that ethnic minority healthcare workers (HCWs), those on visas, and in junior roles, were more likely to be redeployed to COVID-19 duties compared to White UK-born HCWs. There is limited evidence on how redeployment was practically organized, preparedness of HCWs and the NHS for rapid changes, and the decision-making processes involved. This paper discusses HCWs’ redeployment experiences, their alignment with NHS policy for deploying staff safely, and potential links to staff attrition.
Methods
As part of the United Kingdom Research study into Ethnicity And COVID-19 outcomes among Healthcare workers, we conducted a qualitative sub-study, between December 2020 and July 2021, consisting of interviews and focus groups with 164 HCWs from different ethnicities, genders, job roles, migration statuses, and UK regions. Sessions were conducted online or by telephone, recorded, transcribed and analysed with participants’ consent. We utilised the breadth-and-depth approach, initially identifying transcripts mentioning redeployment or changes in work patterns, followed by an in-depth thematic analysis.
Results
Of the 164 HCWs, 22 (13.4%) reported redeployment to a new role, while 42 (26.8%) reported changes in their working patterns. Redeployment experiences varied based on HCWs’ workplaces, skillsets, input into decisions, and perceived risks. Four themes were identified: 1. redeployment and the changing nature of work, 2. pandemic (un)preparedness, 3. redeployment decision-making, and 4. risk assessments in the context of redeployment. Our data revealed the practical realities of redeployment, including discrepancies between the NHS policy and actual practices, particularly early deployment without adequate training and supervision. The lack of planning and preparedness had an operational and emotional impact on HCWs, affecting their morale. Lastly, some HCWs felt disempowered and undervalued due to a lack of agency in redeployment decisions
Conclusion
This study highlights HCWs’ redeployment experiences during COVID-19, the conditions under which it occurred, and its impacts. The findings, although rooted in the pandemic, remain relevant for addressing staffing challenges in the healthcare workforce. We recommend future redeployment strategies prioritise HCWs' training and supervision, ensure strategic planning with clear communication and support for all staff, foster a sense of value among HCWs, and integrate an intersectional equity lens into workforce planning to improve staff retention and morale.
Application of driving-pressure-oriented mechanical ventilation in elderly patients undergoing posterior lumbar fusion surgery：A Pilot Feasibility Study
Authors: Gong Hongyan , Qu Liangchao , Cheng Liqin , Long Dingde , Liu Mei , Jiang Yao , Ouyang Ru 
Published: October 2024

Abstract

Background
Elderly patients undergoing posterior lumbar fusion surgery under general anesthesia are at increased risk of postoperative pulmonary complications (PPCs) due to decreased respiratory physiology. Driving pressure in mechanical ventilation is highly associated with occurrence of PPCs. Therefore, driving pressure-oriented ventilation strategy has attracted great attention. To explore the effects of driving pressure-oriented mechanical ventilation on occurrence rate of PPCs in elderly patients undergoing posterior lumbar interbody fusion, We conducted a pilot study in advance to confirm its safety and feasibility.
Methods
The pilot study was prepared to enroll 160 patients for eligibility assessment. Initially, elderly patients undergoing posterior lumbar interbody fusion were randomly divided into two groups: Group P and group C. Treatment of patients in Group P involved the use of driving pressure-oriented mechanical ventilation while conventional lung protective ventilation strategy was used for patients in Group C. Then, the perioperative ventilation and haemodynamic and blood oxygenation were determined.
Results
The minimum driving pressures for Groups C and P were 8.79 ± 1.44 and 7.47 ± 1.17 cm H2O, respectively (p < 0.05). Partial pressure for oxygen and oxygenation index for Group P at 20 min before the end of the surgery were significantly higher than those of Group C(p < 0.05).The incidences of postextubation hypoxemia for Groups C and P were 11.7% and 9.9%, respectively (p > 0.05).
Conclusions
Driving pressure-oriented mechanical ventilation improved intraoperative arterial oxygenation in elderly patients undergoing posterior lumbar fusion, but the incidence of postextubation hypoxemia was not affected.
Trial registration:
This pilot study is registered at www.medresman.org (ChiCTR2100054078), and the date of first registration was 08/12/2021 .
Terminal ileal intubation is not recommended in routine colonoscopy: data from a large-scale retrospective study
Authors: Shu Shunqing , Zhang Chen , Liu Liu , Shan Jing , Xiang Tong , Shu Tao , Sun Xiaobin 
Published: October 2024

Abstract

Background
Terminal ileal intubation (TII) demonstrates a complete colonoscopy, but whether it should be performed in routine colonoscopies remains uncertain. We aimed to explore the diagnostic yield of TII in routine colonoscopy and investigate the association of TII and the detection of lesion.
Methods
We conducted a retrospective study included patients who underwent colonoscopy with cecal intubation at our endoscopic center between November 1 2022 and July 31 2023. Macroscopic and histologic findings of terminal ileum were recorded. We used propensity score matching to adjust for differences between groups and further analyzed the difference of polyp detection rate (PDR), adenoma detection rate (ADR), sessile serrated lesion detection rate (SSDR) and right-sided lesion detection rate between patients underwent TII or not.
Results
There were 13372 patients with cecal intubation colonoscopy, including 7599 (56.8%) with TII and 5773 (43.2%) without TII. Abnormal endoscopic findings were observed in 150 of 7599 unselected individuals and only 7 of these cases were regarded as pathologically significant. Likewise, abnormal endoscopic findings were found in 20 of 1494 asymptomatic individuals with 19 nonspecific ileitis determined by histopathology. After PSM, there were no significant differences in PDR (51.5% vs 50.8%, P = 0.506), ADR (31.3% vs 30.0%, P = 0.156), SSDR (1.7% vs 1.8%, P = 0.613) and right-sided lesion detection rate (16.5% vs 16.5%, P = 1.000) between the two groups.
Conclusion
TII was not proposed in routine colonoscopy, owing to the limited diagnostic value and lack of superiority on lesion detection.