bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prematurity and congenital malformations differ according to the type of pregestational diabetes
Authors: Ballesteros Monica , Guarque A , Ingles M , Vilanova N , Lopez M , Martin L , Jane M , Puerto L , Martinez M , De la Flor M , Vendrell J , Megia A 
Published: May 2024

Abstract
Background
Diabetes mellitus (DM) is the most common metabolic disorder in pregnancy. Women with Type 2 DM seems to have no better perinatal outcomes than those with Type 1 DM.

Methods
Single-center prospective cohort observational study. Pregnant women with diabetes (141 with Type 1 DM and 124 with Type 2 DM) that were followed in the university hospital between 2009 and 2021 were included in this study. Clinical data and obstetric and perinatal outcomes were collected.

Results
As expected, women with Type 1 DM were younger and had a longer duration of diabetes than women with Type 2 DM. Obesity and chronic hypertension were higher in the group of women with Type 2 DM and their value of HbA1c in the second and third trimesters were lower than in Type 1 DM. No differences in prematurity were found, but more extreme prematurity was observed in Type 2 DM, as well as a higher rate of congenital malformations. The frequency of hypoglycemia and the weight of the newborn was higher in Type 1 DM. The maternal independent factors related to the weight of the newborn were: the glycemic control at the third trimester, the weight gain during pregnancy, and pregestational BMI.

Conclusions
Newborns born to mothers with Type 1 DM were larger and had a higher frequency of hypoglycemia, while congenital malformations and precocious preterm was more associated to Type 2 DM. Metabolic control, weight gain and pregestational weight were important determinants of both obstetric and neonatal complications.
Patient-derived castration-resistant prostate cancer model revealed CTBP2 upregulation mediated by OCT1 and androgen receptor
Authors: Obinata Daisuke , Takayama Kenichi , Lawrence Mitchell G , Funakoshi Daigo , Hara Makoto , Niranjan Birunthi , Teng Linda , Taylor Renea A , Risbridger Gail P , Takahashi Satoru , Inoue Satoshi 
Published: May 2024

Abstract
Background
Prostate cancer is dependent on androgen receptor (AR) signaling, and androgen deprivation therapy (ADT) has proven effective in targeting prostate cancer. However, castration-resistant prostate cancer (CRPC) eventually emerges. AR signaling inhibitors (ARSI) have been also used, but resistance to these agents develops due to genetic AR alterations and epigenetic dysregulation.

Methods
In this study, we investigated the role of OCT1, a member of the OCT family, in an AR-positive CRPC patient-derived xenograft established from a patient with resistance to ARSI and chemotherapy. We conducted a genome-wide analysis chromatin immunoprecipitation followed by sequencing and bioinformatic analyses using public database.

Results
Genome-wide analysis of OCT1 target genes in PDX 201.1 A revealed distinct OCT1 binding sites compared to treatment-naïve cells. Bioinformatic analyses revealed that OCT1-regulated genes were associated with cell migration and immune system regulation. In particular, C-terminal Binding Protein 2 (CTBP2), an OCT1/AR target gene, was correlated with poor prognosis and immunosuppressive effects in the tumor microenvironment. Metascape revealed that CTBP2 knockdown affects genes related to the immune response to bacteria. Furthermore, TISIDB analysis suggested the relationship between CTBP2 expression and immune cell infiltration in prostate cancer, suggesting that it may contribute to immune evasion in CRPC.

Conclusions
Our findings shed light on the genome-wide network of OCT1 and AR in AR-positive CRPC and highlight the potential role of CTBP2 in immune response and tumor progression. Targeting CTBP2 may represent a promising therapeutic approach for aggressive AR-positive CRPC. Further validation will be required to explore novel therapeutic strategies for CRPC management.
Does collagen cross linking have any effect on retinal circulation in patients with keratoconus? An optical coherence tomography angiography (OCTA) study
Authors: Bamdad Shahram , Attar Alireza , Fallahzadeh Milad , Ebrahimi Fatemeh , Faizabadi Sanam , Azimi Ali 
Published: May 2024

Abstract
Background
We aimed to employ Optical Coherence Tomography Angiography (OCTA) to comprehensively assess changes in the optic nerve head (ONH) and macular perfusion before and after the Corneal Collagen Cross-Linking (CCL) procedure in patients with keratoconus.

Methods
A total of 22 keratoconus patient’s candidate for CCL procedures were included based on specific criteria, with meticulous exclusion criteria in place to minimize potential confounders. Participants underwent OCTA assessments of the ONH and macula using the Spectralis OCT (Heidelberg) before CCL, as well as at 1- and 3-months post-CCL. MATLAB software was utilized for image analysis.

Results
The mean age of the participants was 20.09 ± 6.11, including 59% male, and the mean intraocular pressure (IOP) before the surgery was 13.59 ± 2.85 mmHg. Peripapillary Retinal nerve fiber layer (ppRNFL) thickness and overall retinal thickness remained stable post-CCL. However, significant alterations were observed in macular vessel density, emphasizing regional variations in vascular response. For macular large vessel density (LVD), both superficial and deep vascular complex (SVC and DVC) demonstrated significant differences between before surgery and the 3 months post-surgery follow-up (p < 0.001 and p = 0.002, respectively). Optic nerve head markers demonstrated relative stability, except for changes in avascular complex density, which was 49.2 ± 2.2% before the surgery and decrease to 47.6 ± 1.7% three months after the operation (P-value = 0.005).

Conclusion
While CCL appears to maintain the integrity of certain ocular structures, alterations in macular perfusion post-CCL suggest potential effects on retinal blood supply. Long-term monitoring is crucial to understand the implications of these changes, particularly in the context of conditions such as diabetes.
Changes in fractional exhaled nitric oxide, forced expiratory volume in one second, and forced oscillation technique parameters over three years in adults with bronchial asthma managed under Yokohama Seibu Hospital’s coordinated care system
Authors: Tsuburai Takahiro , Tanaka Satoshi , Komase Yuko , Oyama Baku , Muraoka Hiromi , Shinozaki Yusuke , Nishiyama Kazuhiro , Shibuya Junko Ueno , Nishi Yoshihiro , Numata Yu , Hida Naoya , Mineshita Masamichi , Inoue Takeo 
Published: May 2024

Abstract
Background
In western Yokohama, our hospital and primary care clinics manage adults with asthma via a coordinated care system. We investigated the changes in the fractional expired nitric oxide (FeNO), forced expiratory volume in 1 second (FEV1), and forced oscillation technique (FOT) parameters over 3 years in a cohort of patients in our collaborative system.

Methods
From 288 adults with well controlled asthma managed under the Yokohama Seibu Hospital coordinated care system between January 2009 and May 2018, we selected 99 subjects to undergo spirometry, FeNO and FOT testing over 3 years and analyzed the changes in these parameters.

Results
Of the 99 patients enrolled, 17 (17.2%) experienced at least one exacerbation (insufficiently controlled (IC)), whereas, 82 (82.8%) remained in well controlled during the 3-year study period. Of well-controlled patients, 54 patients (54.5%) met the criteria for clinical remission under treatment (CR); the remaining 28 patients did not meet the CR criteria (WC). There were no differences in FeNO, FEV1, or FOT parameters at baseline among the IC, WC, and CR groups. The levels of FEV1 decreased gradually, whereas the levels of FeNO decreased significantly over 3 years. The levels of percent predicted FEV1 (%FEV1) significantly increased. We also observed significant improvement in FOT parameters; reactance at 5 Hz (R5), resonant frequency (Fres), and integral of reactance up to the resonant frequency (AX). The CR group demonstrated significant relationships between the change in FeNO and the change in FEV1 and between the change in FEV1 and the change in FOT parameters. No significant correlations emerged in the IC or WC group.

Conclusion
The decrease in FeNO and increase in %FEV1, we observed in all study participants suggest that the coordinated care system model benefits patients with asthma. Although it is difficult to predict at baseline which patients will experience an exacerbation, monitoring changes in FeNO and FEV1 is useful in managing patients with asthma. Furthermore, monitoring changes in R5, Fres, and AX via forced oscillation technique testing is useful for detecting airflow limitation.
Association between early childhood caries and parental education and the link to the sustainable development goal 4: a scoping review
Authors: Folayan Morenike Oluwatoyin , Coelho Elisa Maria Rosa de Barros , Ayouni Imen , Nguweneza Arthemon , Al-Batayneh Ola Barakat , Daryanavard Hamideh , Duangthip Duangporn , Sun Ivy Guofang , Arheiam Arheiam , Virtanen Jorma I. , Gaffar Balgis , El Tantawi Maha , Schroth Robert J , Feldens Carlos Alberto 
Published: May 2024

Abstract
Background
The goal of the United Nations Sustainable Development Goal (SDG) 4 is to ensure inclusive and equitable quality education and promote lifelong learning opportunities for all. The aim of this scoping review was to map the current evidence on the association between the prevalence of early childhood caries (ECC) and parental education; and to identify possible pathways by which parental education may protect against ECC.

Methods
The two questions that guided this review were: what is the existing evidence on the association between maternal and paternal education and ECC; and what are the pathways by which parental education protects against ECC? The initial search was conducted in January 2023 in PubMed, Web of Science and Scopus. Articles published in English between January 2000 and October 2022 that reported on the association between parental education and ECC were screened, and the extracted data were compiled, summarized, and synthesized. Review papers and non-primary quantitative research papers were excluded from the full-text review. Open coding was applied to develop a conceptual framework.

Results
In total, 49 studies were included: 42 cross-sectional, 3 case-control and 4 cohort studies. The majority (91.8%) reported on the associations between ECC and maternal (n = 33), paternal (n = 3), and parental (n = 9) level of education, and 13 (26.7%) reported on the association between parental education and the severity of ECC. Mothers with more than primary school education (n = 3), post-secondary/college/tertiary education (n = 23), and more than 4–12 years of education (n = 12) had children with lower risk for ECC. Two studies reporting on parental education found an association between maternal but not paternal education and ECC. The review suggests that achieving the SDG 4.1 may reduce the risk of ECC. Possible pathways by which maternal education protects from ECC were feeding practices, oral hygiene practices, and the use of dental services.

Conclusion
The study findings suggests that higher maternal educational level may reduce the risk for the consumption of cariogenic diet, poor oral hygiene practices and poor use of dental services for caries prevention. However, the association between paternal education and ECC was not consistently observed, with significant associations less frequently reported compared to maternal education. Future studies are needed to define the magnitude and modifiers of the impact of maternal education on the risk for ECC.
The Ottawa resident observation form for nurses (O-RON): evaluation of an assessment tool’s psychometric properties in different specialties
Authors: Chiu Hedva , Wood Timothy J. , Garber Adam , Halman Samantha , Rekman Janelle , Gofton Wade , Dudek Nancy 
Published: May 2024

Abstract
Background
Workplace-based assessment (WBA) used in post-graduate medical education relies on physician supervisors’ feedback. However, in a training environment where supervisors are unavailable to assess certain aspects of a resident’s performance, nurses are well-positioned to do so. The Ottawa Resident Observation Form for Nurses (O-RON) was developed to capture nurses’ assessment of trainee performance and results have demonstrated strong evidence for validity in Orthopedic Surgery. However, different clinical settings may impact a tool’s performance. This project studied the use of the O-RON in three different specialties at the University of Ottawa.

Methods
O-RON forms were distributed on Internal Medicine, General Surgery, and Obstetrical wards at the University of Ottawa over nine months. Validity evidence related to quantitative data was collected. Exit interviews with nurse managers were performed and content was thematically analyzed.

Results
179 O-RONs were completed on 30 residents. With four forms per resident, the ORON’s reliability was 0.82. Global judgement response and frequency of concerns was correlated (r = 0.627, P < 0.001).

Conclusions
Consistent with the original study, the findings demonstrated strong evidence for validity. However, the number of forms collected was less than expected. Exit interviews identified factors impacting form completion, which included clinical workloads and interprofessional dynamics.
A hybrid framework for glaucoma detection through federated machine learning and deep learning models
Authors: Aljohani Abeer , Aburasain Rua Y. 
Published: May 2024

Abstract
Background
Glaucoma, the second leading cause of global blindness, demands timely detection due to its asymptomatic progression. This paper introduces an advanced computerized system, integrates Machine Learning (ML), convolutional neural networks (CNNs), and image processing for accurate glaucoma detection using medical imaging data, surpassing prior research efforts.

Method
Developing a hybrid glaucoma detection framework using CNNs (ResNet50, VGG-16) and Random Forest. Models analyze pre-processed retinal images independently, and post-processing rules combine predictions for an overall glaucoma impact assessment.

Result
The hybrid framework achieves a significant 95.41% accuracy, with precision and recall at 99.37% and 88.37%, respectively. The F1 score, balancing precision and recall, reaches a commendable 93.52%. These results highlight the robustness and effectiveness of the hybrid framework in accurate glaucoma diagnosis.

Conclusion
In summary, our research presents an innovative hybrid framework combining CNNs and traditional ML models for glaucoma detection. Using ResNet50, VGG-16, and Random Forest in an ensemble approach yields remarkable accuracy, precision, recall, and F1 score. These results showcase the methodology’s potential to enhance glaucoma diagnosis, emphasizing its promising role in early detection and preventing irreversible vision loss. The integration of ML and DNNs in medical imaging analysis suggests a valuable path for future advancements in ophthalmic healthcare.
A stakeholder analysis to prepare for real-world evaluation of integrating artificial intelligent algorithms into breast screening (PREP-AIR study): a qualitative study using the WHO guide
Authors: Newlands Rumana , Bruhn Hanne , Díaz Magdalena Rzewuska , Lip Gerald , Anderson Lesley A. , Ramsay Craig 
Published: May 2024

Abstract
Background
The national breast screening programme in the United Kingdom is under pressure due to workforce shortages and having been paused during the COVID-19 pandemic. Artificial intelligence has the potential to transform how healthcare is delivered by improving care processes and patient outcomes. Research on the clinical and organisational benefits of artificial intelligence is still at an early stage, and numerous concerns have been raised around its implications, including patient safety, acceptance, and accountability for decisions. Reforming the breast screening programme to include artificial intelligence is a complex endeavour because numerous stakeholders influence it. Therefore, a stakeholder analysis was conducted to identify relevant stakeholders, explore their views on the proposed reform (i.e., integrating artificial intelligence algorithms into the Scottish National Breast Screening Service for breast cancer detection) and develop strategies for managing ‘important’ stakeholders.

Methods
A qualitative study (i.e., focus groups and interviews, March-November 2021) was conducted using the stakeholder analysis guide provided by the World Health Organisation and involving three Scottish health boards: NHS Greater Glasgow & Clyde, NHS Grampian and NHS Lothian. The objectives included: (A) Identify possible stakeholders (B) Explore stakeholders’ perspectives and describe their characteristics (C) Prioritise stakeholders in terms of importance and (D) Develop strategies to manage ‘important’ stakeholders. Seven stakeholder characteristics were assessed: their knowledge of the targeted reform, position, interest, alliances, resources, power and leadership.

Results
Thirty-two participants took part from 14 (out of 17 identified) sub-groups of stakeholders. While they were generally supportive of using artificial intelligence in breast screening programmes, some concerns were raised. Stakeholder knowledge, influence and interests in the reform varied. Key advantages mentioned include service efficiency, quicker results and reduced work pressure. Disadvantages included overdiagnosis or misdiagnosis of cancer, inequalities in detection and the self-learning capacity of the algorithms. Five strategies (with considerations suggested by stakeholders) were developed to maintain and improve the support of ‘important’ stakeholders.

Conclusions
Health services worldwide face similar challenges of workforce issues to provide patient care. The findings of this study will help others to learn from Scottish experiences and provide guidance to conduct similar studies targeting healthcare reform.

Study registration
researchregistry6579, date of registration: 16/02/2021.
Barriers and facilitators of pharmacists’ integration in a multidisciplinary home care team: a qualitative interview study based on the normalization process theory
Authors: Bø Karl-Erik , Halvorsen Kjell H. , Le Anna Yen-Ngoc , Lehnbom Elin C. 
Published: May 2024

Abstract
Background
There is a growing recognition of multidisciplinary practices as the most rational approach to providing better and more efficient healthcare services. Pharmacists are increasingly integrated into primary care teams, but there is no universal approach to implementing pharmacist services across healthcare settings. In Norway, most pharmacists work in pharmacies, with very few employed outside this traditional setting. The home care workforce is primarily made up of nurses, assistant nurses, and healthcare assistants. General practitioners (GPs) are not based in the same location as home care staff. This study utilized the Normalization Process Theory (NPT) to conduct a process evaluation of the integration of pharmacists in a Norwegian home care setting. Our aim was to identify barriers and facilitators to optimal utilization of pharmacist services within a multidisciplinary team.

Methods
Semi-structured interviews (n = 9) were conducted with home care unit leaders, ward managers, registered nurses, and pharmacists in Norway, in November 2022-February 2023. Constructs from the NPT were applied to qualitative data.

Results
Findings from this study pertain to the four constructs of the NPT. Healthcare professionals struggled to conceptualize the pharmacists’ competencies and there were no collectively agreed-upon objectives of the intervention. Consequently, some participants questioned the necessity of pharmacist integration. Further, participants reported conflicting preferences regarding how to best utilize medication-optimizing services in everyday work. A lack of stakeholder empowerment was reported across all participants. Moreover, home care unit leaders and managers reported being uninformed of their roles and responsibilities related to the implementation process. However, the presence of pharmacists and their services were well received in the setting. Moreover, participants reported that pharmacists’ contributions positively impacted the multidisciplinary practice.

Conclusion
Introducing new work methods into clinical practice is a complex task that demands expertise in implementation. Using the NTP model helped pinpoint factors that affect how pharmacists’ skills are utilized in a home care setting. Insights from this study can inform the development of tailored implementation strategies to improve pharmacist integration in a multidisciplinary team.
Knowledge and practice of health workers towards maternal and child health in the Democratic Republic of the Congo: a cross-sectional study
Authors: Ndela Britou , N’siala Adrien , Ngwala Philippe , Kalonji Albert , Minuku Felix , Bokole Harmonie , Kemaina Pascal , Masumbuku Jean-Jacques , Kintaudi Ngoma Miezi , Mandja Bien-Aimé M. 
Published: May 2024

Abstract
Background
The burden of maternal and child mortality is high in the Democratic Republic of the Congo (DRC). While health workers (HWs) with adequate knowledge and practice of maternal and child health (MCH) are crucial to reduce this burden, the skill level of HWs in charge of MCH in the DRC is currently insufficient. This study aimed to assess the knowledge and practice of HWs towards MCH in Kasai and Maniema, two DRC provinces with very high maternal mortality ratios and under-5 mortality rates.

Methods
This cross-sectional study was conducted in 96 health facilities of Kasai and Maniema provinces in 2019. All HWs in charge of MCH were eligible for the study. Data were collected using a structured questionnaire containing 76 questions on knowledge and practice of MCH. Analyses were performed using the Wilcoxon-Mann-Whitney test, Kendall’s correlation test, and a multivariate linear mixed regression model.

Results
Among participating HWs, 42.6% were A2 nurses (lowest qualification), 81.9% had no up-to-date training in MCH, and 48.4% had only 1-5 years of experience in MCH. In the two provinces combined, about half of HWs had poor knowledge (50.6%) and poor practice (53.3%) of MCH. Knowledge and practice scores were higher in Maniema than in Kasai (P < 0.001). Good knowledge and practice scores were significantly associated with high qualification (P = 0.001), continuing up-to-date training in MCH (P = 0.009), and 6 years of experience or more in MCH (P = 0.01).

Conclusion
In Maniema and Kasai provinces, about half of HWs had poor knowledge and poor practice of MCH. The conversion of A1 nurses into midwives as well as the provision of up-to-date training in MCH, supervision, and mentorship could improve the skill level of HWs and could thus reduce the burden of MCH in the DRC.