bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating the relationship between hepatitis B viral activity and gestational diabetes mellitus: A prospective cohort study
Authors: Whyler Naomi , Pyle Anwyn , Krishnaswamy Sushena , Said Joanne M , Giles Michelle L 
Published: July 2024

Background: Hepatitis B infection has been associated with the development of gestational diabetes but the underlying mechanism is not known. Objective: To examine associations between viral activity, gestational diabetes mellitus (GDM), and insulin resistance in pregnant people with chronic hepatitis B infection (HBV). Design: Prospective cohort study across three tertiary maternity centres in Melbourne, Australia, between May 2021 and April 2023. Methods: Participants were followed prospectively through pregnancy to evaluate subsequent GDM diagnosis. Demographics, pregnancy outcomes, and markers of viral activity were compared between those with GDM versus those without. Logistic regression analysis was performed pre- and post-adjustment for known confounders. Sub-group analysis of participants from South East Asia (SEA) was performed. Outcome measures included GDM diagnosis, insulin resistance (Homeostatic Model Assessment Insulin Resistance score (HOMA-IR) score), HBV activity as measured by liver function tests, HBV viral load, hepatitis B e antigen, and quantitative hepatitis B surface antigen (quantHBsAg). Results: A total of 113 women were recruited. One third (38/112, 33.9%) developed GDM, mostly diagnosed on isolated postprandial hyperglycaemia (25/38, 65.8%). Over half were born in SEA (66/113, 58.4%). Mean quantHBsAg was significantly lower in those with GDM ( p = 0.044). No other associations were identified between GDM or HOMA-IR and markers of hepatic activity on multivariate logistic regression analysis and on sub-group analysis of those born in SEA. Conclusions: QuantHBsAg was significantly lower in those with GDM; otherwise, no association between GDM and measures of HBV viral activity was found. QuantHBsAg may be useful as an early pregnancy marker for GDM risk and warrants further research.
Breaking the period product insecurity cycle: An observational study of outcomes experienced by recipients of free period products in the United States
Authors: Massengale Kelley EC , Bowman Kelsey M , Comer Lynn H , Van Ness Susan 
Published: July 2024

Background: The United States is increasingly recognizing period product insecurity, insufficient access to menstrual products and limited private spaces for managing menstruation due to financial constraints, as an issue impacting the well-being and dignity of Americans. One strategy to address period product insecurity has been distributing free period products via period supply banks. The outcomes of period product distribution outside the school setting are absent from the literature. Objectives: This study, a formative evaluation of the free period product distribution efforts of the Alliance for Period Supplies, aims to identify (1) characteristics of individuals receiving products from period supply banks and their experiences of period product insecurity and (2) health and social outcomes experienced by recipients of free period products. Design: Survey data collection occurred at two points: baseline and one-year follow-up. All study participants provided verbal consent. Methods: Between Fall 2018 and Spring 2020, 1863 baseline and 80 follow-up surveys were administered. Participants received free period products for themselves and/or a household member from one of 20 participating Alliance for Period Supplies period supply banks directly or from one of their 64 partner agencies. Results: At baseline, 72.4% of participants had to choose between buying period products and another basic need. One year after accessing a period supply bank, 36.3% of participants reported this experience ( p = 0.018). Participants reported at baseline, on average, 7.8 days in the past year of avoiding seeing others, canceling appointments, or skipping work or school because they did not have access to period products. At follow-up, this was reduced to 1.2 days, on average, t(68) = 2.214, p < 0.05. Conclusion: Period supply banks play an essential role in facilitating access to period products and the resulting benefits. Our study highlights the need for sustainable, well-funded policies and interventions to address period product insecurity effectively in society.
Effectiveness of a postpartum vascular risk reduction clinic on behavioral change and long-term cardiovascular outcomes in women who had preeclampsia: a case-control study
Authors: Pihelgas Allison , Sevick Laura , Pelinska Gabriela , Sia Winnie W 
Published: July 2024

Objectives We aimed to evaluate the effectiveness of our vascular risk reduction clinic for women who had preeclampsia, in improving patients’ cardiovascular outcomes, self-reported healthy behaviors, and knowledge about their long-term cardiovascular health. Study Design Retrospective case-control study where 470 surveys were mailed: half were patients seen in Postpartum Preeclampsia Clinic 2010–2019, and controls were patients who did not attend a scheduled clinic appointment or were seen in Obstetric Medicine clinic postpartum for preeclampsia. Primary outcome was a lack of postpartum weight gain. Secondary outcomes included new vascular diseases, smoking, exercise, and physician follow-up. Results Ninety-four (43.3%) of clinic attendees returned survey and 30.3% of controls. Fewer clinic attendees gained weight postpartum, and attendees had fewer hypertension and followed up more with family physicians. Most attendees found the clinic helpful. Conclusions Postpartum Preeclampsia Clinic was effective in affecting some vascular outcomes and in improving knowledge and follow-up behaviors.
Megaesophagus in an 8-month-old cat secondary to a laryngomucocele
Authors: Theron Marie-Laure 
Published: July 2024

Case summaryAn 8-month-old spayed female cat presented with a 7-week history of progressive dyspnoea, dysphagia and regurgitation. Plain radiography revealed megaoesophagus with a large, rounded, soft tissue opacity laryngeal mass. Endoscopic examination revealed a fluid-filled lesion, which was lanced and drained completely. As a result of recurrence of the mass and infection 2 days later, the mass was surgically excised. The mass was diagnosed as a laryngomucocele based on clinical and histopathological findings. Clinical signs resolved immediately after removal of the mass, the megaoesophagus resolved a couple of days postoperatively and no relapse was noted over the following 3 years.Relevance and novel informationTo the author’s knowledge, this is the first case of laryngomucocele described in a cat. This cause should be included in the differential diagnosis of respiratory obstruction and acquired megaoesophagus in cats. This report demonstrates that megaoesophagus resulting from a respiratory obstruction resolves spontaneously after removal of the obstruction; therefore, respiratory tract assessment should be recommended in cats with signs of megaoesophagus because the prognosis could be good compared with other causes of megaoesophagus.
Improving safety claims in digital health interventions using the digital health assessment method
Authors: Harrison Stuart , Maple Carsten , Epiphaniou Gregory , Arvanitis Theodoros N 
Published: July 2024

Objective Establish a relationship between digital health intervention (DHI) and health system challenges (HSCs), as defined by the World Health Organization; within the context of hazard identification (HazID), leading to safety claims. To improve the justification of safety of DHIs and provide a standardised approach to hazard assessment through common terminology, ontology and simplification of safety claims. Articulation of results, to provide guidance for health strategy and regulatory/standards-based compliance. Methods We categorise and analyse hazards using a qualitative HazID study. This method utilises a synergy between simplicity of DHI intended use and the interaction from a multidisciplinary team (technologists and health informaticians) in the hazard analysis of the subject under assessment as an influencing factor. Although there are other methodologies available for hazard assessment. We examine the hazards identified and associated failures to articulate the improvements in the quality of safety claims. Results Applying the method provides the hazard assessment and helps generate the assurance case. Justification of safety is made and elicits confidence in safety claim. Controls to hazards contribute to meeting the HSC. Conclusions This method of hazard assessment, analysis and the use of ontologies (DHI & HSC) improves the justification of safety claim and evidence articulation.
Streamlining the Journey of Research Into Clinical Practice: Making Your Patients and Practice Flourish Understanding and Setting Treatment Expectations for Patients With Metastatic Spine Tumors
Authors: Reynolds Jeremy J. , Charest-Morin Raphaële , Versteeg Annemarie L. , Galgano Michael , Lubelski Daniel , Newman W. Christopher , Patel Shalin S. , Sullivan Patricia L. Z. , Dea Nicolas , Gasbarrini Alessandro , Lazary Aron , Rhines Laurence D. , Sahgal Arjun , Verlaan Jorrit-Jan , Fisher Charles G. , Laufer Ilya 
Published: July 2024

Study Design Literature review with clinical recommendation. Objective A concise curation of the latest spine literature exploring the relationship between expectations and satisfaction for patients with metastatic spinal disease (MSD). Deliver recommendations to practicing clinicians regarding interpretation and utilisation of this evidence. Methods The latest spine literature in the topic of factors affecting the expectations of patients with MSD was reviewed and clinical recommendations were formulated. Recommendations are graded as strong or Conditional. Results 5 articles were selected. Article 1: risk factors for the development of dissatisfaction from a cohort of 362 MSD patients. Strong recommendation to incorporate risk factor assessment when considering treatment. Article 2: systematic review assessing the relationship between pre-operative patient expectations and subsequent satisfaction in allied disciplines. Conditional recommendation to optimize patient expectation to positively modify patient satisfaction. Article 3: qualitative study of how clinicians, from different specialties, counsel patients with MSD pre-treatment. Strong recommendation to use a multidisciplinary approach. Article 4 qualitative study of how MSD patients experience their pre-treatment counselling and how that affected their appreciation of treatment success. Conditional recommendation to furnish patients with tailored, expected outcomes in the context of systemic progression. Article 5 Design and validation of a pre-treatment questionnaire specific to MSD. A conditional recommendation to incorporate this questionnaire in clinical and research MSD practice. Conclusion Patients with MSD are approaching end of life care and high levels of treatment satisfaction are crucial at this juncture. The role of expectation management and comprehensive counselling is critical.
Sustaining a Workforce: Reflections on Work from Home and Community Care Nurses Transitioning out of the COVID-19 Pandemic
Authors: Nizzer Sonia , Baliga Simran , McKay Sandra M. , Holness D. Linn , King Emily C. 
Published: July 2024

Introduction The COVID-19 pandemic has had an unprecedented impact on nurses’ well-being and desire to practice; however, the experience of Canadian home and community care nurses remains less well understood. As the health human resources crisis in this sector persists, understanding these nurses’ experiences may be vital in creating more effective retention strategies. Objective The aim of this study was to explore how the COVID-19 pandemic shaped the working experiences, motivations, and attitudes of home and community care nurses in the Greater Toronto Area. Methods Using an exploratory, descriptive, qualitative approach, 16 home and community care nurses participated in semistructured interviews. Data were analyzed using collaborative thematic analysis. Participants shared their reflections on work by detailing their experiences prepandemic, during crisis, transitioning out of crisis, and regarding pandemic recovery. Results During the COVID-19 pandemic inadequate staffing resources during and beyond the crisis period disrupted many desirable facets of work for home and community care nurses such as stable, balanced, and flexible work conditions, and exacerbated the unfavorable aspects such as isolation and inconsistent support. Many nurses were reevaluating their careers: for some, this meant stronger professional attachment and for others, it meant intentions to leave. Improved sector preparedness, wages, and workplace support were identified as strategies to sustain this workforce beyond the pandemic. Conclusion Home care organizations must consider ways to address the root cause of concerns expressed by nurses who wish to practice in a supportive environment that is sufficiently staffed and sensitive to workload expectations.
Serum 25-Hydroxyvitamin D Concentrations in Patients with Type 2 Diabetes Mellitus in Eastern Sudan: A Case–Control Study
Authors: Hassan Ahmed A. , Omar Saeed M. , Abdelbagi Omer , Adam Ishag 
Published: July 2024

Introduction Diabetes mellitus (DM) is one of the world's major public health problems. There are few published data on 25-hydroxyvitamin D (25[OH]D) concentrations and DM, and these studies showed different results. Objectives The current study aimed to compare 25[OH]D concentrations between patients with type 2 DM (T2DM) and healthy controls in eastern Sudan. Methods A case–control study of two groups matched for age and gender (88 in each group) was conducted in eastern Sudan from March to May 2022. The cases were patients with T2DM, and the controls were healthy participants. Sociodemographic data were collected, and serum 25(OH)D levels were assessed. A univariate analysis was performed. Results Of the total 176, 82 (47%) were males, and 94 (53%) were females; the median (interquartile range [IQR]) of age, body mass index (BMI), and 25(OH)D concentration were 55 (50–61) years, 27 (23–31) kg/m2, and 13 (10–19) ng/mL, respectively. Of the 176, 137 (78%) were vitamin D deficiency cases. Compared with the controls, age, gender, educational level, marital status, or BMI were not different in the circumstances. Moreover, the median (IQR) for serum 25(OH)D concentrations showed no difference between patients with T2DM and the healthy controls (12 [10–18] ng/mL vs. 13 [10–20] ng/mL). The prevalence of vitamin D deficiency (25(OH)D level < 20 ng/mL) was not different between patients with T2DM and the healthy controls (66/88 [75%] vs. 71/88 [81%]). There was no association in the serum 25(OH)D levels between diabetic and nondiabetic participants (OR = 1.01, 95% CI 0.97–1.06) or in vitamin D deficiency between diabetic and nondiabetic participants (OR = 0.72, 95% CI 0.35–1.47). Conclusion There was no significant difference in 25(OH)D levels between diabetic and nondiabetic participants in this study. Further studies investigating the mechanisms of association between 25(OH)D levels and DM are needed.
Effect of Aromatherapy on Perceived Mental Health Parameters for Academic Department Workers Working From Home During the COVID-19 Pandemic: A Pilot Study
Authors: Cutshall Susanne M. , Mallory Molly J. , Noehl Shelley M. , Soderlind Jennifer N. , Fischer Karen M. , Nanda Sanjeev , Bauer Brent A. , Wahner-Roedler Dietlind L. 
Published: July 2024

Background Before the COVID-19 pandemic began, medical staff and academic department workers reported increasing levels of stress and burnout because of strain on the health care system. The COVID-19 pandemic exacerbated this strain and introduced several novel stressors, which included transitioning to remote work. Safe and scalable strategies are needed to help health care workers cope with these stressors. Aromatherapy may help address this need. Objectives To assess the effect of 2 aromatherapy interventions (essential oil blends termed STILL and FOCUS) on perceived mental/psychological health parameters for academic department workers working from home during the COVID-19 pandemic. Methods Participants were advised to use STILL for 5 days (Monday through Friday). After a 2-day washout period (Saturday and Sunday), participants were instructed to use FOCUS for 5 days (Monday through Friday). Participants completed a visual analog scale survey evaluating restlessness, fatigue, anxiety, stress, happiness, energy, relaxation, calmness, and well-being before and after each of the 2 intervention periods. Results Twenty academic department remote workers participated in the study. Mental/psychological health surveys were completed by 6 participants before and after using STILL and by 10 before and after using FOCUS. Five participants answered all survey questions before and after both interventions. Although mean (SD) perceived stress scores improved after both the STILL (4.3 [2.3] vs 1.8 [1.7], P = .03) and FOCUS (2.9 [2.3] vs 1.5 [1.4], P = .02) interventions, this improvement was not statistically significant after Bonferroni correction (adjusted α = .006). Most participants (73.3%) reported that participating in the study was worthwhile, and 81.3% indicated that they would recommend aromatherapy to others. Conclusions The STILL and FOCUS aromatherapy interventions did not significantly improve mental/psychological health parameters for remote academic department workers, although perceived stress was marginally improved and participants reported a perceived benefit from using aromatherapy.
A Pharmacy-Based Observational Study of Digest-8 Dietary Supplement in a Consumer Healthcare Context
Authors: Brodsky Marc , Hartnett Josette , Houston Kaly , Rose Suzanne J. 
Published: July 2024

Background Functional gastrointestinal disorders (FGIDs), a frequent cause of gastrointestinal (GI) symptomology, impact 40%–69% of the United States population. People who suffer from FGIDs often self-manage their symptoms using consumer healthcare products such as dietary supplements. Objective To investigate use of Digest-8 dietary supplement by people who purchased the product from pharmacies for their FGID symptoms. Methods This pharmacy-based observational study included a convenience sample recruited by flyers at 2 pharmacies upon purchase of Digest-8 dietary supplement to assess symptoms, satisfaction, tolerability, and side-effects through 7 weekly voluntary surveys completed by consenting participants. Results Twenty-two participants completed an initial survey and a collective total of 59 follow-up surveys. Analysis of follow-up surveys compared to baseline provided pilot data on symptom improvement, satisfaction, tolerability, and low side effect profile. Conclusion Preliminary findings of the study warrant a follow-up prospective randomized clinical trial to address the study limitations.
The MINUTES bundle for the initial 30 min management of undifferentiated circulatory shock: an expert opinion
Authors: Hasanin Ahmed , Sanfilippo Filippo , Dünser Martin W , Ahmed Hassan M , Zieleskiewicz Laurent , Myatra Sheila Nainan , Mostafa Maha 
Published: July 2024

AbstractAcute circulatory shock is a life-threatening emergency requiring an efficient and timely management plan, which varies according to shock etiology and pathophysiology. Specific guidelines have been developed for each type of shock; however, there is a need for a clear timeline to promptly implement initial life-saving interventions during the early phase of shock recognition and management. A simple, easily memorable bundle of interventions could facilitate standardized management with clear targets and specified timeline. The authors propose the “MINUTES” acronym which summarizes essential interventions which should be performed within the first 30 min following shock recognition. All the interventions in the MINUTES bundle are suitable for any patient with undifferentiated shock. In addition to the acronym, we suggest a timeline for each step, balancing the feasibility and urgency of each intervention. The MINUTES acronym includes seven sequential steps which should be performed in the first 30 min following shock recognition: Maintain “ABCs”, INfuse vasopressors and/or fluids (to support hemodynamic/perfusion) and INvestigate with simple blood tests, Ultrasound to detect the type of shock, Treat the underlying Etiology, and Stabilize organ perfusion.
Genomic diversity in Paenibacillus polymyxa: unveiling distinct species groups and functional variability
Authors: Wallner Adrian , Antonielli Livio , Mesguida Ouiza , Rey Patrice , Compant Stéphane 
Published: July 2024

Abstract
Background
Paenibacillus polymyxa is a bacterial species of high interest, as suggested by the increased number of publications on its functions in the past years. Accordingly, the number of described strains and sequenced genomes is also on the rise. While functional diversity of P. polymyxa has been suggested before, the available genomic data is now sufficient for robust comparative genomics analyses.

Results
Using 157 genomes, we found significant disparities among strains currently affiliated to P. polymyxa. Multiple taxonomic groups were identified with conserved predicted functions putatively impacting their respective ecology. As strains of this species have been reported to exhibit considerable potential in agriculture, medicine, and bioremediation, it is preferable to clarify their taxonomic organization to facilitate reliable and durable approval as active ingredients.

Conclusions
Strains currently affiliated to P. polymyxa can be separated into two major species groups with differential potential in nitrogen fixation, plant interaction, secondary metabolism, and antimicrobial resistance, as inferred from genomic data.
Potentially pathogenic culturable bacteria in hemodialysis waters
Authors: Ghafari Shokouh , Alavi Seyed Mohammad , Khaghani Soheila 
Published: July 2024

Abstract
Background
Hemodialysis patients are at risk of acquiring healthcare-related infections due to using non-sterile water to prepare hemodialysis fluid. Therefore, microbiological control and monitoring of used water are of crucial importance.

Materials and methods
In this work, we identified bacterial populations occupying a hemodialysis water distribution system for almost a 6-month period in Ahvaz city, southwest of Iran. A total of 18 samples from three points were collected. We found high colony counts of bacteria on R2A agar. 31 bacteria with different morphological and biochemical characteristics were identified by molecular-genetic methods based on 16 S rRNA gene sequencing. Endotoxin concentrations were measured, using Endosafe® Rapid LAL Single-Test Vials.

Results
A diverse bacterial community was identified, containing predominantly Gram-negative bacilli. The most frequently isolated genus was Sphingomonas. Five species including M. fortuitum, M. lentiflavum, M.szulgai, M. barrassiae, and M. gordonae was identified .Despite the presence of Gram-negative bacteria the endotoxin analysis of all samples revealed that their endotoxin values were below the detection limit.

Conclusion
The members of Sphingomonas genus along with Bosea and mycobacteria could be regarded as pioneers in surface colonization and biofilm creation. These bacteria with others like Pelomonas, Bradyrhizobium, staphylococcus, and Microbacterium may represent a potential health risk to patients under hemodialysis treatment.