bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychometric properties of the maternal breastfeeding evaluation scale: a confirmatory factor analysis
Authors: Escribano Silvia , Herrero-Oliver Raquel , Oliver-Roig Antonio , Richart-Martínez Miguel 
Published: July 2024

Abstract
Background
It has been suggested that maternal satisfaction should be included as an additional and appropriate outcome indicator in relation to the breastfeeding process. The aim of this study was to analyze the psychometric properties of various existing versions of the Maternal Breastfeeding Evaluation Scale in a Spanish sample.

Methods
This was a longitudinal observational study, evaluated at three different time points: in the hospital after delivery, and then at five and 12 months after delivery in a Spanish sample. A total of 690 mother participated in this study.

Results
Confirmatory factor analysis results indicated an improved fit of the data to the original model (CFI = 0.984; TLI = 0.982; RMSEA = 0.079). All dimensions of the Maternal Breastfeeding Evaluation Scale are positively associated with breastfeeding rates and negatively associated with perceived difficulty in continuing to breastfeed after returning to work at five months postpartum. Moreover, the scale can predict breastfeeding behavior at 12 months postpartum.

Conclusions
The results of this study indicate that the structure of the original version of the Maternal Breastfeeding Evaluation Scale mean it is a is valid and reliable tool for assessing maternal perceptions of the breastfeeding experience in Spain. This research enhances our understanding of maternal satisfaction with the breastfeeding experience and its potential implications for supporting breastfeeding practices. It is an opportunity for the academic, healthcare, and policy sectors to develop more effective interventions to improve breastfeeding rates and ensure a positive experience for mothers.
Investigating the effects of artificial intelligence on the personalization of breast cancer management: a systematic study
Authors: Sohrabei Solmaz , Moghaddasi Hamid , Hosseini Azamossadat , Ehsanzadeh Seyed Jafar 
Published: July 2024

Abstract
Background
Providing appropriate specialized treatment to the right patient at the right time is considered necessary in cancer management. Targeted therapy tailored to the genetic changes of each breast cancer patient is a desirable feature of precision oncology, which can not only reduce disease progression but also potentially increase patient survival. The use of artificial intelligence alongside precision oncology can help physicians by identifying and selecting more effective treatment factors for patients.

Method
A systematic review was conducted using the PubMed, Embase, Scopus, and Web of Science databases in September 2023. We performed the search strategy with keywords, namely: Breast Cancer, Artificial intelligence, and precision Oncology along with their synonyms in the article titles. Descriptive, qualitative, review, and non-English studies were excluded. The quality assessment of the articles and evaluation of bias were determined based on the SJR journal and JBI indices, as well as the PRISMA2020 guideline.

Results
Forty-six studies were selected that focused on personalized breast cancer management using artificial intelligence models. Seventeen studies using various deep learning methods achieved a satisfactory outcome in predicting treatment response and prognosis, contributing to personalized breast cancer management. Two studies utilizing neural networks and clustering provided acceptable indicators for predicting patient survival and categorizing breast tumors. One study employed transfer learning to predict treatment response. Twenty-six studies utilizing machine-learning methods demonstrated that these techniques can improve breast cancer classification, screening, diagnosis, and prognosis. The most frequent modeling techniques used were NB, SVM, RF, XGBoost, and Reinforcement Learning. The average area under the curve (AUC) for the models was 0.91. Moreover, the average values for accuracy, sensitivity, specificity, and precision were reported to be in the range of 90-96% for the models.

Conclusion
Artificial intelligence has proven to be effective in assisting physicians and researchers in managing breast cancer treatment by uncovering hidden patterns in complex omics and genetic data. Intelligent processing of omics data through protein and gene pattern classification and the utilization of deep neural patterns has the potential to significantly transform the field of complex disease management.
Whole-body hypothermia in mild neonatal encephalopathy: protocol for a multicentre phase III randomised controlled trial
Authors: Garegrat Reema , Montaldo Paolo , Burgod Constance , Pant Stuti , Mazlan Munirah , Palanisami Balamurugan , Chakkarapani Ela , Woolfall Kerry , Johnson Samantha , Grant Patricia Ellen , Land Sarah , Mahmoud Mariam , Brady Tony , Cornelius Victoria , Adams Eleri , Dorling Jon , Aladangadi Narendra , Fleming Paul , Pressler Ronit , Shennan Andrew , Petrou Stavros , Soe Aung , Basset Paul , Shankaran Seetha , Thayyil Sudhin 
Published: July 2024

Abstract
Background
Mild hypoxic ischemic encephalopathy is associated with sub optimal cognition and learning difficulties at school age. Although whole-body hypothermia reduces death and disability after moderate or severe encephalopathy in high-income countries, the safety and efficacy of hypothermia in mild encephalopathy is not known. The cooling in mild encephalopathy (COMET) trial will examine if whole-body hypothermia improves cognitive development of neonates with mild encephalopathy.

Methods
The COMET trial is a phase III multicentre open label two-arm randomised controlled trial with masked outcome assessments. A total of 426 neonates with mild encephalopathy will be recruited from 50 to 60 NHS hospitals over 2 ½ years following parental consent. The neonates will be randomised to 72 h of whole-body hypothermia (33.5 ± 0.5 C) or normothermia (37.0 ± 0.5 C) within six hours or age. Prior to the recruitment front line clinical staff will be trained and certified on expanded modified Sarnat staging for encephalopathy. The neurological assessment of all screened and recruited cases will be video recorded and centrally assessed for quality assurance. If recruitment occurs at a non-cooling centre, neonates in both arms will be transferred to a cooling centre for continued care, after randomisation. All neonates will have continuous amplitude integrated electroencephalography (aEEG) at least for the first 48 h to monitor for seizures. Predefined safety outcomes will be documented, and data collected to assess resource utilization of health care. A central team masked to trial group allocation will assess neurodevelopmental outcomes at 2 years of age. The primary outcome is mean difference in composite cognitive scores on Bayley scales of Infant and Toddler development 4th Edition.

Discussion
The COMET trial will establish the safety and efficacy of whole-body hypothermia for mild hypoxic ischaemic encephalopathy and inform national and international guidelines in high income countries. It will also provide an economic assessment of whole-body hypothermia therapy for mild encephalopathy in the NHS on cost-effectiveness grounds.

Trial registration number
NCT05889507 June 5, 2023.
Time to recovery and its predictors among under-five children admitted with severe pneumonia in East Wallaga Zone public hospitals, western Ethiopia, 2023; a retrospective cohort study
Authors: Dinka Imana Raga , Seyoum Dejene , Debelo Sidise , Fikadu Gudetu , Regasa Misganu Teshoma , Abdena Hunde Fayera , Jiren Roba Tolessa , Ayana Worku Garuma 
Published: July 2024

Abstract
Background
Globally, pneumonia is one of the leading causes of morbidity and mortality as well as hospitalization burden for under-five children. Despite significant initiatives implemented to reduce morbidity and mortality from pneumonia in under-five children, little is known regarding the time to recovery and its predictors among under-five children admitted with severe pneumonia in Ethiopia. Hence, this study intended to estimate the median time to recovery and its predictors among under-five children admitted with severe pneumonia in East Wallaga zone public hospitals, western Ethiopia; 2023.

Methods
An institution-based retrospective cohort study was conducted among 383 under-five children who were admitted with severe pneumonia in East Wallaga zone public hospitals from January 2017 to December 2022. A systematic sampling method was used to select eligible medical records. EpiData Version 4.6 was used to enter the data and analyzed using STATA Version 17.0. Cox-proportional hazard assumption test and model fitness were checked. Variables with P-value ˂ 0.25 at bivariable Cox regression analysis were selected for the multivariable Cox proportional model. A multivariable Cox regression model with 95% CI and Adjusted Hazard Ratio (AHR) was used to identify a significant predictor of time to recovery from severe pneumonia at a P-value < 0.05.

Results
At the end of the follow-up, 356 observations were developed an event (recovered) with the median time to recovery of 4 days with IQR of 3–5 days. The overall incidence rate of recovery was 22.26 per 100 (95% CI: 20.07–24.70) person-days observations. Being rural residency (AHR: 0.75, 95% CI: 0.60–0.93), late presenters for seeking care (AHR = 0.70, 95% CI: 0.53–0.93), presence of danger sign at admission (AHR = 1.46, 95% CI: 1.15–1.83), and presence of comorbidity (AHR = 1.63, 95% CI, 1.31–2.04) were found to have a statistically significant association with prolonged recovery time.

Conclusion
The median time to recovery from severe pneumonia was long, and factors such as Residence, co-morbidity, presence of danger signs, and duration prior to seeking care were statistically significant predictors of recovery time from severe pneumonia. Hence, due attention has to be given to increasing the community’s health-seeking behavior to visit health facility early and especial attention should be given for children with danger signs and comorbidity.
Physical inactivity and its associated factors among pre-retirement government healthcare workers in Kuala Lumpur, Malaysia
Authors: Dapari Rahmat , Wahab Mohamad Rabani Abdul , Zamzuri Mohd ‘Ammar Ihsan Ahmad , Hassan Mohd Rohaizat , Dom Nazri Che , Rahim Syed Sharizman Syed Abdul 
Published: July 2024

Abstract
Introduction
The rising worldwide concern of Non-Communicable Diseases (NCD) is alarming as it is associated with 80% of annual global mortality. NCD threat is rising due to, among others, the increasing ageing population, thus putting the efforts to promote health ageing at the forefront of many countries’ health agenda. Physical activity has been recognised as one of the significant factors in the pursuit of healthy ageing. Nevertheless, approximately one third of individuals in Malaysia are physically inactive. The aim of this study is to determine the prevalence of physical inactivity and its associated factors among pre-retirement government healthcare workers.

Methods
This cross-sectional study was conducted from May to June 2023 among pre-retirement government healthcare workers in Kuala Lumpur, Malaysia. The sample size required was 233 and proportionate random sampling was used to recruit potential respondents who answered self-administered online questionnaires. Global Physical Activity Questionnaire (GPAQ) was used to measure the level of physical activity and data analysis was performed using SPSS version 29.

Results
A total of 214 complete responses were received from the 233 questionnaires distributed, giving a response rate of 91.8%. The prevalence of physical inactivity among pre-retirement healthcare workers was 39.7% as compare only 29.9% in general population. Significant predictors for physical inactivity included higher education levels (SPM, STPM, or certificate holders) (AOR = 13.4, 95% CI: 2.47–72.65), non-Malay ethinicity (AOR = 4.7, 95% CI: 1.23–18.38), personal barriers (AOR = 1.6, 95% CI:1.35–1.79), social barriers (AOR = 1.21, 95% CI: 1.06–1.39), and physical environment barriers (AOR = 1.468, 95% CI: 1.221–1.765).

Conclusion
This study shows a worrying prevalence of physical inactivity among pre-retirement healthcare workers that is even higher than the general population in Malaysia. The findings highlight the importance of focusing the preventive strategies among non-Malay workers and those with lower education levels. It is also vital to address all the physical, social, and environmental barriers towards physical inactivity. By prioritising these factors, employers and stakeholders will be able to establish better workplace health promotion and address the issue of physical inactivity more efficiently.
“It’s what we perceive as different”: an interpretative phenomenological analysis of Nigerian women’s characterization of their health during the COVID-19 pandemic
Authors: Ndu Mary , Teachman Gail , Martin Janet , Nouvet Elysee 
Published: July 2024

Abstract
Background
Health has historically been adversely affected by social, economic, and political pandemics. In parallel with the spread of diseases, so do the risks of comorbidity and death associated with their consequences. As a result of the current pandemic, shifting resources and services in resource-poor settings without adequate preparation has intensified negative consequences, which global service interruptions have exacerbated. Pregnant women are especially vulnerable during infectious disease outbreaks, and the current pandemic has significantly impacted them.

Methods
This study used an interpretive phenomenological analysis study with a feminist lens to investigate how women obtained healthcare in Ebonyi, Ogun, and Sokoto states Nigeria during the COVID-19 pandemic. We specifically investigated whether the epidemic influenced women’s decisions to seek or avoid healthcare and whether their experiences differed from those outside of it.

Results
We identified three superordinate themes: (1) the adoption of new personal health behaviour in response to the pandemic; (2) the pandemic as a temporal equalizer for marginalized individuals; (3) the impacts of the COVID-19 pandemic on maternal health care. In Nigeria, pregnant women were affected in a variety of ways by the COVID-19 epidemic. Women, particularly those socially identified as disabled, had to cross norms of disadvantage and discrimination to seek healthcare because of the pandemic’s impact on prescribed healthcare practices, the healthcare system, and the everyday landscapes defined by norms of disadvantage and discrimination.

Conclusion
It is clear from the current pandemic that stakeholders must begin to strategize and develop plans to limit the effects of future pandemics on maternal healthcare, particularly for low-income women.
Construction and application of an ICU nursing electronic medical record quality control system in a Chinese tertiary hospital: a prospective controlled trial
Authors: Zhang Shuai , Quan Yin Yin , Chen Juanhong 
Published: July 2024

Abstract
Background
ICU nurses provide critical care and meticulously document electronic medical records (EMRs), tracking vital signs, interventions, and medication hourly. Despite China’s ICUs effectively integrating real-time monitor and ventilator data into EMRs, challenges persist. Patient movements can introduce inaccuracies, and the demands of critical care may lead nurses to miss assessments like pain and nutrition. Traditional manual EMR verification is inefficient and error-prone, highlighting the urgent need for standardized, technology-aided EMR practices in ICU nursing.

Objective
This study aimed to describe the development and evaluation of an electronic medical records quality control system implemented in a Chinese tertiary care ICU setting, where current practices impact the accuracy of electronic medical records.

Methods
A prospective controlled trial was conducted with 600 ICU patients in Zhejiang Province from January to December 2023. An automated EMR quality control system was implemented in July 2023, facilitating real-time data collection and quality control for vital signs, medication management, and nursing evaluations.

Results
After implementing the ICU nursing electronic medical record quality control system, the prevalence of false data on vital signs decreased from 9 to 1.33%. Additionally, the incidence of incomplete medication administration dropped from 3.33 to 1.67%, and the rate of missing evaluations of assessment items in EMRs was reduced from 8 to 1.33%. Besides, the average time spent on quality control of the electronic medical records was 62 (48,76) seconds per record, which was significantly lower than the 264 (195.5,337.5) seconds using the traditional method. The nurses’ satisfaction with the nursing electronic medical record quality control was (105.73 ± 9.31).

Conclusions
The ICU nursing electronic medical record quality control system has led to substantial improvements in the quality and reliability of EMRs. The reduction in false data on vital signs, instances of incomplete medication administration, and missing evaluations of assessment items demonstrates the system’s positive impact on nursing documentation practices. These improvements not only enhance the accuracy of patient records but also contribute to better patient care and safety within the ICU setting.
Foetal gluten immunogenic peptides during pregnancy: a new determinant on the coeliac exposome
Authors: Moreno María de Lourdes , González-Rovira María , Martínez-Pancorbo Cristina , Martín-Cameán María , Nájar-Moyano Ana María , Romero Mercedes , de la Hoz Esther , López-Beltrán Cristina , Mellado Encarnación , Bartha José Luis , Brodin Petter , Rodríguez-Herrera Alfonso , Sainz-Bueno José Antonio , Sousa Carolina 
Published: July 2024

Abstract
Background
The increasing incidence of coeliac disease is leading to a growing interest in active search for associated factors, even the intrauterine and early life. The exposome approach to disease encompasses a life course perspective from conception onwards has recently been highlighted. Knowledge of early exposure to gluten immunogenic peptides (GIP) in utero could challenge the chronology of early prenatal tolerance or inflammation, rather than after the infant’s solid diet after birth.

Methods
We developed an accurate and specific immunoassay to detect GIP in amniotic fluid (AF) and studied their accumulates, excretion dynamics and foetal exposure resulting from AF swallowing. One hundred twenty-five pregnant women with different gluten diets and gestational ages were recruited.

Results
GIP were detectable in AF from at least the 16th gestational week in gluten-consuming women. Although no significant differences in GIP levels were observed during gestation, amniotic GIP late pregnancy was not altered by maternal fasting, suggesting closed-loop entailing foetal swallowing of GIP-containing AF and subsequent excretion via the foetal kidneys.

Conclusions
The study shows evidence, for the first time, of the foetal exposure to gluten immunogenic peptides and establishes a positive correlation with maternal gluten intake. The results obtained point to a novel physiological concept as they describe a plausible closed-loop circuit entailing foetal swallowing of GIP contained in AF and its subsequent excretion through the foetal kidneys. The study adds important new information to understanding the coeliac exposome.
Pseudonectria keratitis—emerging pathogenic fungi in the eye
Authors: Zhu Yongze , Nan Peng , Zhu Zhongliang , Ji Youqi , Zhuo Bingqian , Xu Wei , Ge Yumei 
Published: July 2024

Abstract
Background
Infectious keratitis, a significant contributor to blindness, with fungal keratitis accounting for nearly half of cases, poses a formidable diagnostic and therapeutic challenge due to its delayed clinical presentation, prolonged culture times, and the limited availability of effective antifungal medications. Furthermore, infections caused by rare fungal strains warrant equal attention in the management of this condition.

Case presentation
A case of fungal keratitis was presented, where corneal scraping material culture yielded pink colonies. Lactophenol cotton blue staining revealed distinctive spore formation consistent with the Fusarium species. Further analysis using Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) identified the causative agent as Fusarium proliferatum. However, definitive diagnosis of Pseudonectria foliicola infection was confirmed through ITS sequencing. The patient’s recovery was achieved with a combination therapy of voriconazole eye drops and itraconazole systemic treatment.

Conclusion
Pseudonectria foliicola is a plant pathogenic bacterium that has never been reported in human infections before. Therefore, ophthalmologists should consider Pseudonectria foliicola as a possible cause of fungal keratitis, as early identification and timely treatment can help improve vision in most eyes.
Projecting the economic burden of type 1 and type 2 diabetes mellitus in Germany from 2010 until 2040
Authors: Voeltz Dina , Vetterer Maximilian , Seidel-Jacobs Esther , Brinks Ralph , Tönnies Thaddäus , Hoyer Annika 
Published: July 2024

Abstract
Background
The aim is to estimate age- and sex-specific direct medical costs related to diagnosed type 1 and type 2 diabetes in Germany between 2010 and 2040.

Methods
Based on nationwide representative epidemiological routine data from 2010 from the statutory health insurance in Germany (almost 80% of the population’s insurance) we projected age- and sex-specific healthcare expenses for type 1 and 2 diabetes considering future demographic, disease-specific and cost trends. We combine per capita healthcare cost data (obtained from aggregated claims data from an almost 7% random sample of all German people with statutory health insurance) together with the demographic structure of the German population (obtained from the Federal Statictical Office), diabetes prevalence, incidence and mortality. Direct per capita costs, total annual costs, cost ratios for people with versus without diabetes and attributable costs were estimated. The source code for running the analysis is publicly available in the open-access repository Zenodo.

Results
In 2010, total healthcare costs amounted to more than €1 billion for type 1 and €28 billion for type 2 diabetes. Depending on the scenario, total annual expenses were projected to rise remarkably until 2040 compared to 2010, by 1–281% for type 1 (€1 to €4 billion) and by 8–364% for type 2 diabetes (€30 to €131 billion). In a relatively probable scenario total costs amount to about €2 and €79 billion for type 1 and type 2 diabetes in 2040, respectively. Depending on annual cost growth (1% p.a. as realistic scenario vs. 5% p.a. as very extreme setting), we estimated annual per capita costs of €6,581 to €12,057 for type 1 and €5,245 to €8,999 for type 2 diabetes in 2040.

Conclusions
Diabetes imposes a large economic burden on Germany which is projected to increase substantially until 2040. Temporal trends in the incidence and cost growth are main drivers of this increase. This highlight the need for urgent action to prepare for the potential development and mitigate its consequences.