bluuebunny/crossref_metadata_2025_split huggingface dataset:
Unravelling the current shortfalls, challenges, and opportunities in traumatic brain injury
Authors: Theadom A. , Andelic N. , Chavda V. , Pedersen M. 
Published: December 2023

AbstractThe brain is the control centre of the human body. Injury to the brain can have diverse and disabling effects. Yet there remain important unanswered questions for clinicians, those affected and their families. This special collection aims to advance understanding of how we can better diagnose, treat and support those affected by brain injury across the severity spectrum.
Reduction in spontaneous and iatrogenic preterm births in twin pregnancies during COVID-19 lockdown in Melbourne, Australia: a multicenter cohort study
Authors: Manno Juliana M. , Marzan Melvin B. , Rolnik Daniel L. , Potenza Stephanie , Pritchard Natasha , Said Joanne M. , Palmer Kirsten R. , Whitehead Clare L. , Sheehan Penelope M. , Ford Jolyon , Mol Ben W. , Walker Susan P. , Hui Lisa 
Published: December 2023

Abstract
Background
Melbourne, Australia, recorded one of the longest and most stringent pandemic lockdowns in 2020, which was associated with an increase in preterm stillbirths among singleton pregnancies. Twin pregnancies may be particularly susceptible to the impacts of pandemic disruptions to maternity care due to their higher background risk of adverse perinatal outcomes.

Methods
Multicenter retrospective cohort study of all twin pregnancies birthing in public maternity hospitals in Melbourne. Multivariable log-binomial regression models were used to compare perinatal outcomes between a pre-pandemic group to women in whom weeks 20+0 to 40+0 of gestation occurred entirely during one of two lockdown-exposure periods: exposure 1 from 22 March 2020 to 21 March 2021 and exposure 2 from 22 March 2021 to 27 March 2022.

Results
Total preterm births < 37 weeks were significantly lower in exposure 1 compared with the pre-pandemic period (63.1% vs 68.3%; adjusted risk ratio 0.92 95% CI 0.87–0.98, p = 0.01). This was mainly driven by fewer spontaneous preterm births (18.9% vs 20.3%; adjusted risk ratio 0.95 95% CI 0.90–0.99, p = 0.04). There were also lower rates of preterm birth < 34 weeks (19.9% vs 23.0%, adjusted risk ratio 0.93 95% CI 0.89–0.98 p = 0.01) and total iatrogenic births for fetal compromise (13.4% vs 20.4%; adjusted risk ratio 0.94 95% CI 0.89–0.98, p = 0.01). There were fewer special care nursery admissions (38.5% vs 43.4%; adjusted risk ratio 0.91 95% CI 0.87–0.95, p < 0.001) but no significant changes in stillbirth (1.5% vs 1.6%; adjusted risk ratio 1.00 95% CI 0.99–1.01, p = 0.82). Compared with the pre-pandemic period, there were more preterm births < 28 weeks and neonatal intensive care unit admissions in exposure 2.

Conclusions
Melbourne’s first lockdown-exposure period was associated with lower preterm births in twins without significant differences in adverse newborn outcomes. Our findings provide insights into the influences on preterm birth and the optimal timing of delivery for twins.
Development of birth weight estimation model for Ethiopian population from sonographic evaluation
Authors: Seman Nejat Mohammed , Adem Hamdia Murad , Disasa Fanta Assefa , Simegn Gizeaddis Lamesgin 
Published: December 2023

Abstract
Background
Fetal birth weight (FBW) estimation involves predicting the weight of a fetus prior to delivery. This prediction serves as a crucial input for ensuring effective, accurate, and appropriate obstetric planning, management, and decision-making. Typically, there are two methods used to estimate FBW: the clinical method (which involves measuring fundal height and performing abdominal palpation) or sonographic evaluation. The accuracy of clinical method estimation relies heavily on the experience of the clinician. Sonographic evaluation involves utilizing various mathematical models to estimate FBW, primarily relying on fetal biometry. However, these models often demonstrate estimation errors that exceed acceptable levels, which can result in inadequate labor and delivery management planning. One source of this estimation error is sociodemographic variations between population groups in different countries. Additionally, inter- and intra-observer variability during fetal biometry measurement also contributes to errors in FBW estimation.

Methods
In this research, a novel mathematical model was proposed through multiple regression analysis to predict FBW with an accepted level of estimation error. To develop the model, population data consisting of fetal biometry, fetal ultrasound images, obstetric variables, and maternal sociodemographic factors (age, marital status, ethnicity, educational status, occupational status, income, etc.) of the mother were collected. Two approaches were used to develop the mathematical model. The first method was based on fetal biometry data measured by a physician and the second used fetal biometry data measured using an image processing algorithm. The image processing algorithm comprises preprocessing, segmentation, feature extraction, and fetal biometry measurement.

Results
The model developed using the two approaches were tested to assess their performance in estimating FBW, and they achieved mean percentage errors of 7.53% and 5.89%, respectively. Based on these results, the second model was chosen as the final model.

Conclusion
The findings indicate that the developed model can estimate FBW with an acceptable level of error for the Ethiopian population. Furthermore, this model outperforms existing models for FBW estimation. The proposed approach has the potential to reduce infant and maternal mortality rates by providing accurate fetal birth weight estimates for informed obstetric planning.
Co-design of a question prompt list about pregnancy and childbearing for women with polycystic kidney disease: an exploratory sequential mixed-methods study
Authors: Holton Sara , Nelson Craig , Rasmussen Bodil , Levidiotis Vicki 
Published: December 2023

Abstract
Background
Although women with polycystic kidney disease (PKD) generally have healthy pregnancies and babies, pregnancy is associated with a greater risk of maternal complications and requires planning and management of their condition. Given these possible complications, routine communication about childbearing between women with PKD and their treating team is important. A question prompt list (QPL), a structured list of questions used by patients during consultations with healthcare providers, may be beneficial in assisting women with PKD to discuss their childbearing concerns with, and seek related information from, their treating team. The aims of this study were to co‐design a QPL about pregnancy and childbearing for women with PKD, and evaluate its comprehensibility, salience, and acceptability.

Methods
An exploratory sequential mixed‐methods study of women of reproductive age with PKD living in Australia, using an experience‐based co‐design approach with two phases. Women were recruited from a metropolitan public health service and via social media and invited to complete an anonymous online survey about the development of the PKD QPL (phase one) and participate in an online discussion group about its refinement (phase two).

Results
Sixteen women completed the development survey and seven participated in the evaluation discussion group. Participants reported that women with PKD would value and use a QPL to prompt discussions with and seek further information about pregnancy and childbearing from their healthcare providers. Women identified four main topics for the QPL: ‘thinking about having a baby’, ‘pregnancy’, ‘my medications’ and ‘after my baby is born’. Within each section a series of questions was developed. Based on the findings, a QPL about pregnancy and childbearing for women with PKD was co-designed.

Conclusions
Women with PKD often find it difficult to access information and have discussions with their health care providers about pregnancy and childbearing. The PKD QPL co-designed in this study was perceived to be an acceptable tool which will, from the perspectives of participants, assist women with PKD to access information more easily about pregnancy, childbearing and PKD; ask more targeted questions of their treating team; and make informed childbearing decisions.
Accessing health information during the COVID-19 pandemic: the experience of NHS maternity service users
Authors: Ambihaipahan Rushvini , Chisnall Georgia , Vindrola-Padros Cecilia , Irvine Lucy 
Published: December 2023

Abstract
Background
The COVID-19 pandemic caused various disruptions to NHS maternity services in England. Changes were made to antenatal and postnatal care and the way that information was shared with maternity service users during these times. Fewer face-to-face appointments, increased virtual appointments and changes in guidance about the suitability of the COVID-19 vaccine without appropriate information sharing and evidence caused concern.

Methods
This study took a blended inductive-deductive approach to secondary data analysis using a population subset of 16 from a wider study that sought to understand the impact of COVID-19 on maternity services in England. Participants of this study were aged 28–44 and gave birth using NHS maternity services in England. The data were collected and coded using Rapid Analysis Procedure sheets, which generated key themes, which are used here to structure the results.

Results
Four main themes were generated from the analysis: 1) service restrictions to antenatal and postnatal appointments 2) access to information and changes to antenatal and postnatal care 3) inconsistencies in the implementation of government and NHS policy and 4) limited information about COVID-19 vaccine provided by NHS trusts and hesitancy in vaccine acceptance.

Conclusion
Participants experienced poor communication that affected their understanding of maternity service changes and there was limited general and maternal health information provided. Vaccine information was also inadequate, and participants expressed a desire for clearer guidance. The UK Government, Royal College of Obstetricians and Gynaecologists, and NHS must collaborate with maternity service users to ensure that there are evidence-based guidelines and policies that can be understood and standardised across all NHS maternity trusts.
Effects of an animated educational video on knowledge of cell-free DNA screening among Thai pregnant women: a randomized control trial
Authors: Nintao Nutta , Manonai Jittima , Wattanayingcharoenchai Rujira , Bumrungphuet Sommart , Hansahiranwadee Wirada , Dulyaphat Wirada , Somchit Werapath , Wattanasirichaigoon Duangrurdee , Prakobpanich Maneerat , Tangshewinsirikul Chayada 
Published: December 2023

Abstract
Background
In developing countries, pregnant women have insufficient knowledge about cell-free DNA screening. Reports from developed countries have found that various tools in prenatal genetic counseling can improve the knowledge of pregnant women who undergo cell-free DNA screening. Data are limited from developing countries where women have different baseline socio-educational backgrounds. The objective of this study was to compare the effects of an animated educational video combined with traditional counseling versus traditional counseling alone in changing pregnant women’s knowledge of cell-free DNA screening.

Methods
This study was a randomized control trial at an antenatal clinic. Eligible subjects who were Thai pregnant women, were randomized to either view or not view the 4-minute animated educational video explaining cell-free DNA screening. Both groups received traditional counseling. The women were asked to complete a Thai questionnaire assessing knowledge of the screening before and after intervention. The questionnaire consisted of three sections: demographic data of the research participants and their existing awareness about cell-free DNA testing; performance and limitations of cell-free DNA screening; and participants’ attitudes toward the positive screening. Primary outcome was the change in knowledge scores. Secondary outcomes were attitudes toward positive screening test, levels of satisfaction with counseling, and screening acceptance rates.

Results
Data from 83 women in the video group and 82 in the non-video group were analyzed. The knowledge score (range 0–18) change after counseling was significantly higher in the video group than the non-video group (+ 7.1 ± 3.3 vs + 4.2 ± 2.5; p = 0.03). There were no significant differences in attitudes toward positive screening test (p = 0.83), levels of satisfaction (p = 0.24), or screening acceptance rates (p = 0.15) between the groups.

Conclusions
Adding the video to traditional counseling was better than traditional counseling alone in improving pregnant women’s knowledge about cell-free DNA screening.

Trial registration
The study was retrospectively registered with the Thai Clinical Trials Registry (TCTR20210917001, 17/09/2021).
Exploring the geospatial epidemiology of breast cancer in Iran: identifying significant risk factors and spatial patterns for evidence-based prevention strategies
Authors: Soleimani Mohsen , Ayyoubzadeh Seyed Mohammad , Jalilvand Ahmad , Ghazisaeedi Marjan 
Published: December 2023

AbstractBackgroundBreast Cancer (BC) is a formidable global health challenge, and Iran is no exception, with BC accounting for a significant proportion of women’s malignancies. To gain deeper insights into the epidemiological characteristics of BC in Iran, this study employs advanced geospatial techniques and feature selection methods to identify significant risk factors and spatial patterns associated with BC incidence.MethodsUsing rigorous statistical methods, geospatial data from Iran, including cancer-related, sociodemographic, healthcare infrastructure, environmental, and air quality data at the provincial level, were meticulously analyzed. Age-standardized incidence rates (ASR) are calculated, and different regression models are used to identify significant variables associated with BC incidence. Spatial analysis techniques, including global and local Moran's index, geographically weighted regression, and Emerging hotspot analysis, were utilized to examine geospatial patterns, identify clustering and hotspots, and assess spatiotemporal distribution of BC incidence.ResultsThe findings reveal that BC predominantly affects women (98.03%), with higher incidence rates among those aged 50 to 79. Isfahan (ASR = 26.1) and Yazd (ASR = 25.7) exhibit the highest rates. Significant predictors of BC incidence, such as marriage, tertiary education attainment rate, physician-to-population ratio, and PM2.5 air pollution, are identified through regression models.ConclusionThe study's results provide valuable information for the development of evidence-based prevention strategies to reduce the burden of BC in Iran. The findings underscore the importance of early detection, health education campaigns, and targeted interventions in high-risk clusters and adjacent regions. The geospatial insights generated by this study have implications for policy-makers, researchers, and public health practitioners, facilitating the formulation of effective BC prevention strategies tailored to the unique epidemiological patterns in Iran.
Impact of respiratory care training and family support using telemedicine on tracheostomized children admitted with respiratory infection after discharge
Authors: Tovichien Prakarn , Khaowsibsam Nuntiya , Choursamran Bararee , Charoensittisup Pawinee , Palamit Apinya , Udomittipong Kanokporn 
Published: December 2023

Abstract
Objective
Children with tracheostomies usually require a long hospital stay, high healthcare costs and caregiver burden. With the help of telemedicine, this study attempted to determine how home respiratory care training and family support affected admission days, admission costs, ICU admission rates, and caregivers’ confidence.

Methods
We enrolled children with tracheostomies who were admitted between 2020 and 2022 with respiratory infections. Before discharge, we evaluated the knowledge and skills of the caregivers and gave them practice in home respiratory care while providing them with structured feedback using a checklist, a peer-to-peer mentor assignment, a virtual home visit, teleeducation, and teleconsultation via a mobile application. We compared the admission days, admission costs, and ICU admission rates one year following the program with the historical control one year earlier.

Results
Forty-eight children with tracheostomies were enrolled. Thirteen percent of those had a 1-year readmission. The median [IQR] number of admission days decreased from 55 [15–140] to 6 [4–17] days (p value < 0.001). The median [IQR] admission costs decreased from 300,759 [97,032 – 1,132,323] to 33,367 [17,898—164,951] baht (p value < 0.001). The ICU admission rates decreased from 43.8% to 2.1% (p value < 0.001). Immediately after the program, caregivers’ confidence increased from 47.9% to 85.5% (p value < 0.001).

Conclusions
This respiratory care training and telehealth program decreased admission days, admission costs, and ICU admission rates for children with tracheostomies admitted with respiratory infections. The confidence of caregivers was also increased immediately after the program.
Can peripheral psychophysiological markers predict response to exposure-based cognitive behavioral therapy in youth with severely impairing irritability? A study protocol
Authors: Grasser Lana Ruvolo , Erjo Trinity , Goodwin Matthew S. , Naim Reut , German Ramaris E. , White Jamell , Cullins Lisa , Tseng Wan-Ling , Stoddard Joel , Brotman Melissa A. 
Published: December 2023

Abstract
Background
Irritability, an increased proneness to anger, is a primary reason youth present for psychiatric care. While initial evidence supports the efficacy of exposure-based cognitive behavioral therapy (CBT) for youth with clinically impairing irritability, treatment mechanisms remain unclear. Here, we propose to measure peripheral psychophysiological indicators of arousal—heart rate (HR)/electrodermal activity (EDA)—and regulation—heart rate variability (HRV)—during exposures to anger-inducing stimuli as potential predictors of treatment efficacy. The objective of this study is to evaluate whether in-situ biosensing data provides peripheral physiological indicators of in-session response to exposures.

Methods
Blood volume pulse (BVP; from which HR and HRV canl be derived) and EDA will be collected ambulatorily using the Empatica EmbracePlus from 40 youth (all genders; ages 8-17) undergoing six in-person exposure treatment sessions, as part of a multiple-baseline trial of exposure-based CBT for clinically impairing irritability. Clinical ratings of irritability will be conducted at baseline, weekly throughout treatment, and at 3-month and 6-month follow-ups via the Clinical Global Impressions Scale (CGI) and the Affective Reactivity Index (ARI; clinician-, parent-, and child-report). Multilevel modeling will be used to assess within- and between-person changes in physiological arousal and regulation throughout exposure-based CBT and to determine whether individual differences are predictive of treatment response.

Discussion
This study protocol leverages a wearable biosensor (Empatica) to continuously record HR/HRV (derived from BVP) and EDA during in-person exposure sessions for youth with clinically impairing irritability. Here, the goal is to identify changes in physiological arousal (EDA, HR) and regulation (HRV) over the course of treatment in tandem with changes in clinical symptoms.

Trial registration
The participants in this study come from an overarching clinical trial (trial registration numbers: NCT02531893 first registered on 8/25/2015; last updated on 8/25/2023). The research project and all related materials were submitted and approved by the appropriate Institutional Review Board of the National Institute of Mental Health (NIMH).
Physical activity of children and adolescents who use a wheelchair: a systematic review
Authors: Seemüller Selina , Beck Franziska , Reimers Anne Kerstin 
Published: December 2023

AbstractPhysical activity has numerous health benefits for people with physical disabilities. Nevertheless, activity levels are often below recommended levels. To promote physical activity among children and adolescents who use a wheelchair as their primary source of mobility, this systematic review explores the physical activity patterns of this group. A systematic search of PubMed, Sports Medicine & Education Index, Web of Science, and SPORTDiscus was performed, included articles were synthesized in terms of duration, intensity, and settings in which physical activity occurred, as well as the physical activity measurement methods. Nine articles were included. The mean overall physical activity level across the included studies was 98 minutes per day (range: 78–115 minutes per day). Two articles analysed the duration of physical activity at different intensities (very light physical activity, light physical activity (LPA), moderate to vigorous physical activity (MVPA) and intensities near to maximum). Within the included articles, both subjective and objective measurement methods were used. Due to the small number of articles, combined with small sample sizes, there is not enough evidence to answer the research questions sufficiently. Nevertheless, the review provides an overview of actual research and clearly shows that the physical activity values are insufficiently researched. There is a need for further research on the scope, types and settings of physical activity in the target group.
An integrated newborn care kit (iNCK) to save newborn lives and improve health outcomes in Gilgit Baltistan (GB), Pakistan: study protocol for a cluster randomized controlled trial
Authors: Fadaleh Sarah M. Abu , Pell Lisa G. , Yasin Muhammad , Farrar Daniel S. , Khan Sher Hafiz , Tanner Zachary , Paracha Shariq , Madhani Falak , Bassani Diego G. , Ahmed Imran , Soofi Sajid B. , Taljaard Monica , Spitzer Rachel F. , Bhutta Zulfiqar A. , Morris Shaun K. 
Published: December 2023

Abstract
Background
Ongoing high neonatal mortality rates (NMRs) represent a global challenge. In 2021, of the 5 million deaths reported worldwide for children under five years of age, 47% were newborns. Pakistan has one of the five highest national NMRs in the world, with an estimated 39 neonatal deaths per 1,000 live births. Reducing newborn deaths requires sustainable, evidence-based, and cost-effective interventions that can be integrated within existing community healthcare infrastructure across regions with high NMR.

Methods
This pragmatic, community-based, parallel-arm, open-label, cluster randomized controlled trial aims to estimate the effect of Lady Health Workers (LHWs) providing an integrated newborn care kit (iNCK) with educational instructions to pregnant women in their third trimester, compared to the local standard of care in Gilgit-Baltistan, Pakistan, on neonatal mortality and other newborn and maternal health outcomes. The iNCK contains a clean birth kit, 4% chlorhexidine topical gel, sunflower oil emollient, a ThermoSpot™ temperature monitoring sticker, a fleece blanket, a click-to-heat reusable warmer, three 200 μg misoprostol tablets, and a pictorial instruction guide and diary. LHWs are also provided with a handheld scale to weigh the newborn. The primary study outcome is neonatal mortality, defined as a newborn death in the first 28 days of life.

Discussion
This study will generate policy-relevant knowledge on the effectiveness of integrating evidence-based maternal and newborn interventions and delivering them directly to pregnant women via existing community health infrastructure, for reducing neonatal mortality and morbidity, in a remote, mountainous area with a high NMR.

Trial registration
NCT04798833, March 15, 2021.