bluuebunny/crossref_metadata_2025_split huggingface dataset:
Completion of the Maternal Health Care Continuum—Barriers and Facilitators Among Pregnant Women in Jimma Zone, Southwest Ethiopia: A Prospective Study
Authors: Kitila Sena Belina , Feyissa Garumma Tolu , Wordofa Muluemebet Abera 
Published: November 2023

Background: Continuum of care (CoC) for Maternal Health Care (MHC) is a key strategy aimed at saving lives and promoting the well-being of women and newborns. To achieve the global targets for reducing maternal and newborn mortality, it is preferable to ensure the completion of key care stages (Antenatal, Institutional Delivery, and Postnatal) rather than fragmented care. Therefore, investigating the determinants of CoC completion for MHC is imperative for recommending schemes and designing strategies. Objective: To assess the determinants influencing completion of the maternal healthcare continuum among pregnant women in Jimma Zone, Southwest Ethiopia. Methods and Materials: A community-based prospective study was conducted from July 2020 to June 2021 among 1065 pregnant women from randomly selected woredas in Jimma Zone. The data were collected, entered using Epi-data and analyzed with SPSS software. Binary logistic regression was used to select candidate variables for multivariate analysis. Multivariate analysis was performed to identify associations between the dependent and independent factors. Principal Component Analysis (PCA) was used to determine the socioeconomic index. Results: The overall completion rate was 16.1% (CI, 13.8%–18.5%), with significant dropouts observed between the first and the fourth ANC. Factors associated with the completion of MHC included the women’s residence (AOR: 1.73 95% CI: 1.07, 2.81), educational status of their partners (AOR: 5.60 95% CI: 2.40, 13.08), women’s occupation (AOR: 2.57 95% CI: 1.28, 5.16), knowledge of ANC (AOR: 7.64 95% CI: 4.03, 14.48), knowledge of PNC (AOR: 4.88 95% CI: 3.21, 7.42), service provided during ANC contacts (AOR: 3.39 95% CI: 1.94, 5.93), parity (AOR: 1.86 95% CI: 1.11, 3.12), time of booking for ANC (AOR: 2.10 95% CI: 1.45, 3.03), and nature of care (AOR: 2.03 95% CI: 1.07, 3.82). Additionally, factors such as topography, distance, lack of transportation, facility closeness, and indirect costs were associated with the completion for MHC. Conclusion and Recommendations: The completion rate of CoC for MHC remains low. Factors influencing completion include women’s residence, partners’ educational status, women’s occupation, services provided during ANC, history of PNC use, parity, time of booking for ANC, knowledge of ANC and PNC, and nature of care. To address this, strategies should focus on empowering women economically, improving knowledge of ANC and PNC, enhancing the capacity of health facilities to provide comprehensive ANC services, and making the service delivery more supportive. Further research is recommended to explore the impact of CoC for MHC on birth outcomes.
Hypokalaemia in pregnancy – Prevalence, underlying causes, and an approach to investigation
Authors: He Jinwen , Morton Adam 
Published: November 2023

Objective To investigate the prevalence and aetiology of hypokalaemia in pregnancy. Methods This was a five-year retrospective audit of women who received care at a tertiary hospital, who developed hypokalaemia during pregnancy and within three weeks postpartum. Serum potassium and magnesium levels cause(s) of hospitalization and investigations for hypokalaemia were obtained from hospital records. Results One hundred and ten women developed hypokalaemia during pregnancy and the immediate postpartum period, representing 0.36% of total births. Ninety-one per cent of patients had mild to moderate hypokalaemia (K 2.6–3.1 mmol/L), while 9% had severe hypokalaemia (K < 2.6 mmol/L). The most common associations of hypokalaemia were infection (38%), vomiting (18%), hypertensive disorders (12%) and postpartum haemorrhage (9%). Twenty-four patients did not have a clear underlying aetiology of hypokalaemia, but only five had further investigations. Conclusions There was inadequate investigation and follow-up of hypokalaemia, particularly in women in whom an obvious cause was not apparent.
Regional variation in urinary catheter use in the Netherlands from 2012 to 2021: a population-based cohort
Authors: van Veen Felice E. E. , Scheepe Jeroen R. , Blok Bertil F. M. 
Published: November 2023

Objectives: Our aim was to evaluate trends and regional differences in the use of indwelling and intermittent urinary catheters in the community setting in the Netherlands from 2012 to 2021. Design and methods: For this population-based cohort study, data on catheter use was collected from the Drug and Medical Devices Information System of the National Healthcare Institute of the Netherlands. This database contains information on the Dutch insured population, which was 100% of the total population in 2018. Users were divided into 12 provinces according to the Nomenclature of Territorial Units for Statistics codes. The number of catheter users was adjusted for the total population of the provinces by sex and age, and was expressed by users per 100,000 people. Negative binomial regression (NBR) was used to test for differences in clean intermittent catheter (CIC) and indwelling catheter (IDC) users across Dutch provinces. Results: Between 2012 and 2021, IDC users increased by 44.6% from 41,619 to 60,172, and CIC users increased by 27.3% from 34,204 to 43,528. The greatest increases were mainly observed among IDC users over 85 years old and male CIC users over 65 years old. NBR showed significant differences for IDC and CIC users between the 12 provinces. CIC incidence was higher in Drenthe and Groningen (Northern Netherlands) compared to Zuid-Holland (Southern Netherlands). IDC incidence was higher in seven provinces dispersed throughout the Netherlands compared to Noord-Holland. Conclusion: CIC and IDC users have continued to increase in recent years; this was especially observed among older men. In addition, there were regional differences in the number of CIC and IDC users; CIC was more prominent in the northern region of the Netherlands, and IDC varied between multiple provinces. Practice variation in urinary catheterization may result from patient population differences or healthcare provider preferences and their alignment with guidelines.
Factores socioeconómicos asociados por nivel de inseguridad alimentaria en adultos mexicanos con diabetes mellitus durante la pandemia de la COVID-19
Authors: Pérez-Peralta Liliana , Reynoso-Noverón Nancy , Martínez-Domínguez Jesús , Juárez-Martínez y Liliana 
Published: November 2023

La pandemia de la COVID-19 ha sido uno de los mayores desafíos de salud pública a nivel mundial. Afecta al sistema alimentario, ampliando las desigualdades y compromete el derecho a la alimentación y a un adecuado estado de bienestar y nutrición, especialmente entre los más vulnerables. Objetivos: estimar la prevalencia de la inseguridad alimentaria e identificar los factores socioeconómicos asociados en adultos mexicanos con diabetes mellitus, durante la pandemia de la COVID-19. Métodos: estudio transversal, análisis secundario de los datos de la Encuesta Nacional de Salud y Nutrición 2020 sobre la COVID-19. Se estudió a 1 232 individuos que representan a 9 569 330 adultos con diabetes mellitus. La inseguridad alimentaria se midió utilizando la Escala Latinoamericana y Caribeña de Seguridad Alimentaria adaptada para México. Se realizó un modelo de regresión logístico binario para cada nivel de inseguridad alimentaria. Se calcularon razón de momios e intervalos de confianza al 95 %. Un valor de p < 0.05 fue estadísticamente significativo. Resultados: el 64.8 % presentó inseguridad alimentaria: 40.7 % leve, 14.2 % moderada y 9.9 % severa. Los factores asociados a inseguridad alimentaria leve fueron: nivel socioeconómico muy bajo (RM 2.6), pérdida del empleo de algún miembro del hogar (RM 2.0) y reducción de gastos en alimentación (RM 5.0); para inseguridad moderada la RM fue de 7.7, 3.4 y 18.6 y en severa la RM 7.1, 3.0 y 46.7, respectivamente. Conclusiones: la COVID-19 ha tenido efectos inmediatos en la inseguridad alimentaria de la población de adultos mexicanos con diabetes mellitus. Identificar los factores socioeconómicos asociados es prioritario para llevar a cabo políticas públicas que permitan redirigir los recursos y cubrir necesidades básicas como la alimentación.
Current Lack of Evidence on Treatment Strategies and Clinical Outcomes for Osteochondral Lesions of the Subtalar, Talonavicular, and Calcaneocuboid Joints: A Systematic Review
Authors: Shimozono Yoshiharu , Rammelt Stefan , Takao Masato 
Published: November 2023

ObjectiveIn contrast to osteochondral lesion (OCL) of the ankle, OCLs in other joints of the foot, such as subtalar joint, talonavicular joint, calcaneocuboid joint, and the midfoot, are rare conditions, but they can also lead to significant morbidity. The objective of this systematic review was to summarize the clinical evidence for the treatment of OCLs of the subtalar, talonavicular, calcaneocuboid, and the other midfoot joints.DesignA systematic search of the MEDLINE, EMBASE, and Cochrane Library databases was performed in January 2021 based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines by 2 independent reviewers. Included studies were evaluated with regard to LOE (level of evidence) and QOE (quality of evidence). Variable reporting outcome data, clinical outcomes, and complications were evaluated.ResultsSeventeen studies with 21 patients were included, all of which were case reports (level 5) without any case series reporting greater than 3 patients. There were 5 patients with OCL in the subtalar joint, 15 patients in the talonavicular joint, and 1 patient in the calcaneocuboid joint. Thirteen case reports (4 subtalar joint, 8 talonavicular joint, and 1 calcaneocuboid joint) reported surgical treatment. Surgical procedures mainly included debridement, bone marrow stimulation, fixation, and bone grafting, through open or arthroscopy, all of which resulted in successful outcomes. Four case reports (1 subtalar joint, 3 talonavicular joint) reported successful conservative treatment. Other 13 case reports reported successful surgery after failed conservative treatment. No complications and reoperations were reported.ConclusionsThe current systematic review revealed that there is no available evidence to ascertain clinical outcomes of both conservative and surgical treatments for cartilage lesions in the talonavicular joint, subtalar joint, and the midfoot joints, owing to the extreme paucity of literature. Both nonoperative and operative treatments can be considered, but no treatment strategies have been established.
Alterations in Magnitude and Shape of Thoracic Kyphosis Following Surgical Correction for Adult Spinal Deformity
Authors: Lafage Renaud , Song Junho , Diebo Bassel , Daniels Alan H. , Passias Peter G. , Ames Christopher P. , Bess Shay , Eastlack Robert , Gupta Munish C. , Hostin Richard , Kebaish Khaled , Kim Han Jo , Klineberg Eric , Mundis Gregory M. , Smith Justin S. , Shaffrey Christopher , Schwab Frank , Lafage Virginie , Burton Douglas ,   International Spine Study Group
Published: November 2023

Study Design Retrospective review of prospective multicenter data. Objectives This study aimed to investigate the shape of TK before and after fusion in ASD patients treated with long fusion. Methods ASD patients undergoing posterior spinal fusions including at least T5 to L1 without prior fusion extending to the thoracic spine were included. Patients were categorized based on the preoperative T1-T12 kyphosis into: Hypo-TK (if < 30°), Normal-TK, and Hyper-TK (if > 70°). Regional kyphosis at T10-L1 (Distal), T5-T10 (Middle), and T1-T5 (Proximal) and their relative contributions to total kyphosis were compared between groups, and the pre-to postoperative changes were investigated using paired t test. Results In total, 329 patients were included in this analysis (mean age: 57 ± 16 years, 79.6% female). Preoperative T1-T12 TK for the entire cohort was 40.9 ± 2° (32% Hypo-TK, 11% Hyper-TK, 57% Normal-TK). The Hypo-TK group had the smallest distal TK (5.9 vs 17.1 & 26.0), and middle TK (8.0 vs 25.3 & 45.4), but the percentage of contribution to total kyphosis was not significantly different (Distal: 24.1% vs 34.1% vs 32.8%; Middle: 46.6% vs 53.9% vs 56.8%, all P > .1). Postoperatively, T1-12 TK increased significantly (40.9 ± 2.0° vs 57.8 ± 17.6°). Each group had a decrease in distal kyphosis (Hypo-TK 2.6 ± 10.4°; Normal-TK 8.9 ± 11.5°; Hyper-TK 14.9 ± 12°, all P < .05). The middle kyphosis significantly decreased for Hyper-TK (11.8 ± 12.4) and increased for both Normal-TK and Hypo-TK (3.8 ± 11° and 14.2 ± 11°). Proximal TK increased significantly for all groups by 14-18°. Deterioration from Normal-TK to Hyper-TK postoperatively was associated with lower rate of patient satisfaction (59.6% vs 77.3%, P = .032). Conclusions Posterior spinal fusion for ASD alters the magnitude and shape of thoracic kyphosis. While 60% of patients had a normal TK at baseline, 30% of those patients developed iatrogenic hyperkyphosis postoperatively. Patients with baseline hypokyphosis were more likely to be corrected to normal TK than hyperkyphotic patients. Future research should investigate TK restoration in ASD and its impact on clinical outcomes and complications.
Practical steps of intervention design for teenage students’ musculoskeletal health: An intervention mapping approach
Authors: NeJhaddadgar Nazila , Pirmoradi Alireza , Montazeri Nafiseh , Nazari Babak , Rastgoo Leila 
Published: November 2023

Background: According to the studies conducted, teen pregnancy and its related health issues are among the most significant issues. The purpose of the study was to develop a musculoskeletal health intervention training programme using an intervention mapping approach (IMA) for teenagers aged 12–14 years old. Methods: The present study is a study protocol where IMA has been used as a planning framework for developing a musculoskeletal health intervention training programme. Six steps of the intervention mapping process have been completed in the study. As the first step, needs assessment has been performed through systematic review and qualitative evaluation. In the second step, a matrix of change objectives was designed. Later on, after designing the programme and planning its implementation, the programme evaluation plan was developed. Results: IMA guided us in designing and implementing a control-oriented training programme with the participation of the participants, along with the definition of outcomes, performance goals, and determinants, theoretical methods, practical applications, an intervention programme, implementation, and step-by-step assessment. Conclusion: Intervention mapping is a participation-based approach to designing and implementing promotion programmes.
Diagnostic separation of conventional ⩾50% carotid stenosis and near-occlusion with phase-contrast MRI
Authors: Holmgren Madelene , Henze Alexander , Wåhlin Anders , Eklund Anders , Fox Allan J , Johansson Elias 
Published: November 2023

Introduction: The aim of this study was to assess sensitivity, specificity and interrater reliability of phase-contrast MRI (PC-MRI) for diagnosing carotid near-occlusion. Patients and methods: Prospective cross-sectional study conducted between 2018 and 2021. We included participants with suspected 50%–100% carotid stenosis on at least one side, all were examined with CT angiography (CTA) and PC-MRI and both ICAs were analyzed. Degree of stenosis on CTA was the reference test. PC-MRI-based blood flow rates in extracranial ICA and intracranial cerebral arteries were assessed. ICA-cerebral blood flow (CBF) ratio was defined as ICA divided by sum of both ICAs and Basilar artery. Results: We included 136 participants. The ICAs were 102 < 50% stenosis, 88 conventional ⩾50% stenosis (31 with ⩾70%), 49 near-occlusion, 12 occlusions, 20 unclear cause of small distal ICA on CTA and one excluded. For separation of near-occlusion and conventional stenoses, ICA flow rate and ICA-CBF ratio had the highest area under the curve (AUC; 0.98–0.99) for near-occlusion. ICA-CBF ratio ⩽0.225 was 90% (45/49) sensitive and 99% (188/190) specific for near-occlusion. Inter-rater reliability for this threshold was excellent (kappa 0.98). Specificity was 94% (29/31) for cases with ⩾70% stenosis. PC-MRI had modest performance for separating <50% and conventional ⩾50% stenosis (highest AUC 0.74), and eight (16%) of near-occlusions were not distinguishable from occlusion (no visible flow). Conclusion: ICA-CBF ratio ⩽0.225 on PC-MRI is an accurate and reliable method to separate conventional ⩾50% stenosis and near-occlusion that is feasible for routine use. PC-MRI should be considered further as a potential standard method for near-occlusion detection, to be used side-by-side with established modalities as PC-MRI cannot separate other degrees of stenosis.
Evidence of fluid-induced myrmekite formation after alkali-feldspar megacrysts: an example from a meta-porphyritic granitoid in Makrohar, Madhya Pradesh, India
Authors: Chakrabarty Arimita , Karmakar Shreya , Dutta Upama , Sanyal Sanjoy , Sengupta Pulak 
Published: November 2023

AbstractA meta-porphyritic granitoid in the Makrohar Granulite Belt, Central India contains extensive myrmekite. This work evaluates the controls of fluid in relation to deformation and the formation of myrmekite all along the periphery of an alkali-feldspar megacryst. Two different myrmekite morphologies are present: (1) vermicular intergrowth of plagioclase (An38–39) and quartz (Myr1); and (2) polygonal aggregates of coarse plagioclase (An45–46) and quartz (Myr2). Petrographic features suggest that myrmekite Myr1 nucleates on alkali-feldspar and plagioclase porphyroclasts and the myrmekite front moved into the alkali feldspar by replacing it; and that myrmekite Myr2 and the secondary biotite which replaces plagioclase porphyroclasts and garnet form together. Deformation had a decisive role in forming the polygonal aggregates of Myr2, however field and microtextural features do not support any significant control of deformation during the formation of Myr1. Reaction modelling and a mass-balance calculation suggest that Ca and Na are added to, and K is removed from, the alkali feldspar during the myrmekite formation at nearly constant Si and Al. However, the secondary biotite-forming reaction, consumes K and releases Ca. Interpretation of the reaction textures in different isothermal–isobaric sections of μK2O–μCaO in the KCFASH system suggest that CaO and K2O moved in opposite directions for myrmekitisation and along their respective chemical potential gradients created between the sites of formation of myrmekite and secondary biotite. The feedback mechanism which operated between the two reaction sites was controlled by infiltration of brine-rich fluid in the meta-granitoid during a regional hydration event (550–600oC and 5–6 kbar). Volume reduction of ~10% during the formation Myr1 and Myr2 drew the brine-rich fluid towards the alkali feldspar and thus facilitated the process of myrmekite formation. Variation in the morphology of quartz in the myrmekite is attributed to the cooling of the complex.
Using an electronic diary and wristband accelerometer to detect exacerbations and activity levels in COPD: a feasibility study
Authors: Finney Lydia J. , Avey Stefan , Wiseman Dexter , Rowe Anthony , Loza Matthew J. , Branigan Patrick , Stevenson Christopher S. , Baribaud Frédéric , Wedzicha Jadwiga A. , Pandis Ioannis , Donaldson Gavin C. 
Published: November 2023

BackgroundEarly and accurate identification of acute exacerbations of COPD may lead to earlier treatment and prevent hospital admission. Electronic diaries have been developed for symptom monitoring and accelerometers to monitor activity. However, it is unclear whether this technology is usable in the COPD population. This study aimed to assess the feasibility of an electronic diary (eDiary) for symptom reporting using the MoreCare app and activity monitoring with the Garmin Vivofit 2 in COPD.MethodsParticipants were recruited from the London COPD Cohort. Participants were provided a Garmin Vivofit 2 activity monitor and an android tablet with the MoreCare app for a period of 3 months.Results25 COPD patients were recruited (mean±sdage 70.8±7.1 years, forced expiratory volume in 1 s (FEV1) 49.8±14.8% predicted). Age, gender, disease severity and exacerbation frequency had no impact on eDiary compliance. There was a moderate positive correlation between median daily very active minutes and FEV1% pred (ρ=0.62, p=0.005). Daily step counts decreased during the initial 7 days of exacerbation and recovery compared to a pre-exacerbation baseline. A decision-tree model identified change in sputum colour, change in step count, severity of cold, exacerbation history and use of rescue medication as the most important predictors of acute exacerbations of COPD in this cohort.ConclusionsSymptom and activity monitoring using digital technology is feasible in COPD. Further large-scale digital health studies are needed to assess whether eDiaries can be used to identify patients at risk of exacerbation and guide early intervention.
Addressing lung cancer screening eligibility in Spain using 2013 and 2021 US Preventive Service Task Force criteria: cross-sectional study
Authors: Candal-Pedreira Cristina , Ruano-Ravina Alberto , Calvo de Juan Virginia , Cobo Manuel , Trigo José Manuel , Carcereny Enric , Cucurull Marc , López Castro Rafael , Solís García Eduardo , Sánchez-Gastaldo Amparo , Massutí Bartomeu , Rodríguez-Abreu Delvys , Estival Anna , Guirado Risueño María , Pamiés Ramón María , García Campelo Rosario , Alonso-Jáudenes Guillermo , Camps Carlos , del Barco Morillo Edel , González Ojea Clara , Dómine Manuel , Sanchez-Hernandez Alfredo , Bosch-Barrera Joaquím , Sala González María Ángeles , Provencio Mariano 
Published: November 2023

ObjectivesThe aim of the study was to ascertain the percentage of Spanish lung cancer cases that would fulfil the lung cancer screening inclusion criteria recommended by the United States Preventive Service Task Force (USPSTF) in 2013 and 2021.MethodsA cross-sectional study was carried out. All lung cancer cases registered in the Thoracic Tumor Registry with data on date of birth, date of diagnosis, smoking habit, number of pack-years and time elapsed since smoking cessation were included.ResultsThe study included 15 006 patients diagnosed with lung cancer in Spain between 2016 and 2022. Eligibility to participate in screening increased from 53.7% to 63.5% (an increase of 9.8%) according to the 2013 and 2021 recommendations, respectively. The percentage of eligible men rose by 9.2 percentage points with the 2021versus2013 recommendations, whereas this rise was 11.5 percentage points in women. Under the 2021 recommendations, 36.6% of women and 5.3% of men would not have fulfilled the screening inclusion criteria due to being never-smokers; 14.9% of women and 11.0% of men would not have fulfilled the age criterion; and 27.0% of ex-smokers among women compared to 35.6% among men would not have been eligible due to >15 years having elapsed since smoking cessation.ConclusionsIn Spain, over one-third of lung cancer cases could not be detected through screening, by virtue of not meeting the most recent inclusion criteria stated by the USPSTF. The degree of fulfilment in a potential nationwide screening programme should be analysed, with the aim of establishing inclusion criteria in line with each country's context.