bluuebunny/crossref_metadata_2025_split huggingface dataset:
The relationship between body mass index and perceived control over labor
Authors: Whelan Anna R. , Polnaszek Brock E. , Recabo Olivia , Clark Melissa A. , Lewkowitz Adam K. , Ayala Nina K. 
Published: October 2023

Abstract
Background
Individuals with an increased body mass index (BMI) (≥ 30 kg/m2) experience higher rates of perinatal mental health disorders than individuals with BMI < 30. Personal experience of decreased control over labor has been associated with the development postpartum mood and anxiety disorders. However, no studies have investigated the association between BMI and experience of control over labor. This study aimed to assess perceived control over labor and compare patients with BMI ≥ 30 to those with BMI < 30.

Methods
We performed a secondary analysis of a cross-sectional study of postpartum patients who delivered at term (37–41 weeks gestation). Postpartum, participants completed the Labour Agentry Scale (LAS), a validated tool to assess perceived control over labor/birth. Demographic, maternal health history and obstetric/neonatal outcomes were abstracted from the patient chart. Bivariate analyses were performed between those with BMI < 30 and those with BMI ≥ 30 using Fisher’s exact test. Continuous LAS scores were compared between patients with BMI < 30 and BMI ≥ 30 using Wilcoxon rank-sum tests. Higher LAS scores indicate higher perceived control over labor. Multivariable linear regression was then performed to account for confounding factors identified a priori.

Results
There was no difference in LAS between those with BMI ≥ 30 and BMI < 30. When stratified by World Health Organization (WHO) class of BMI, those with BMI ≥ 40 had a significantly lower LAS scores than those with BMI < 30 (147 vs. 163, p = 0.02), however, this finding was no longer significant after controlling for length of labor and cesarean birth.

Conclusion
Only participants with the highest BMI experienced decreased control over labor, and this finding was no longer significant after controlling for mode of delivery and length of labor. Further research into the experience of birthing people with BMI ≥ 30 is critical to understand the increased risk of perinatal mood disorders among this population.
12-year follow-up of the first endothelial keratoplasty without Descemet stripping in a 3-month newborn with Congenital Hereditary Endothelial Dystrophy (CHED)
Authors: Bellucci Carlo , Mora Paolo , Tedesco Salvatore A. , Gandolfi Stefano , Chierego Chiara , Bellucci Roberto 
Published: October 2023

Abstract
Background
Endothelial Keratoplasty (EK) is now considered as the standard treatment for Congenital Hereditary Endothelial Dystrophy (CHED) by many surgeons. We present the 12-year clinical outcome of the youngest operated patient with CHED in which we successfully performed a bilateral EK procedure without removing the recipient endothelium-Descemet complex.

Case presentation
In November 2010 we performed EK without Descemet Stripping in a 3-month female newborn, thinking that the lower manipulation obtained by leaving the recipient endothelium–Descemet complex could be the key factor for the success of our surgery. Such a particular technique was new in newborns. The surgery was a success, but the long-term visual result was not predictable at that time. We followed the patient at 4 months, and then yearly. At the latest visit in October 2022 the visual, cognitive, and motorial developments were normal, with Best-corrected Distance Visual Acuity of 0.4 LogMAR with − 0.75 D sf + 2.75 D cyl @ 105° in the right eye (RE) and 0.4 LogMAR with + 1.50 D sf + 2.50 D cyl @ 60° in the left eye (LE). The endothelial microscope showed an unexpected healthy endothelium, with a cell count of 2383 cells/mm2 in the RE and of 2547 cells/mm2 in the LE from a starting donor count of 2900 cells/mm2. No secondary procedures were performed during the 12-year follow-up.

Conclusion
EK without Descemet stripping has proved to be a successful procedure over time in our newborn. The unexpected healthy endothelium suggests a role of the Descemet membrane in CHED.
Feasibility, acceptability and effectiveness of a culturally informed intervention to decrease stress and promote well-being in reservation-based Native American Head Start teachers
Authors: Wilson Deborah H. , German Danielle , Ricker Adrian , Gourneau Hilary , Hanson Ginger C. , Mayhew Justin , Brockie Teresa N. , Sarche Michelle 
Published: October 2023

Abstract
Background
While benefiting from strong cultural ties to family, land and culture Native Americans residing on reservations experience psychological distress at rates 2.5 times that of the general population. Treatment utilization for psychological health in reservation-based communities is low with access to culturally appropriate care lacking. Evidence suggests that for mental health treatment, Native Americans prefer culturally informed care that respects Native perspectives on health and well-being.

Methods
To decrease stress and promote well-being in tribal Head Start teachers we adapted and implemented a culturally focused intervention within a community-based participatory research framework using mixed methods. Feasibility and acceptability of the adapted 5-session curriculum was tested in a single arm intervention study with a sample of 18 teachers on the Fort Peck Reservation. Participants completed surveys at baseline and upon completion of the intervention. Within session observations and two post-intervention focus groups (n = 8, n = 10) were conducted to elaborate and explain the quantitative results eliciting participant experience of intervention effectiveness and feasibility, acceptably and appropriateness. Implementation outcomes were assessed quantitatively using the Acceptability of Intervention, Intervention Appropriateness, and Feasibility of Intervention measures.

Results
Quantitively, attendance rate overall was 93% with no dropouts. Pretest/posttest surveys were analyzed using t-tests and Hedges g to measure effect size. Contrary to our hypothesis, self-perceived stress showed a small positive effect size, indicating that participants were more stressed post intervention. However, depression decreased, with tribal identity and resilience showing positive effect sizes. Content analysis for the qualitative data collected within session observations and post intervention focus groups revealed how lifetime traumas were affecting participants, providing some explanation for the increase in stress. Teachers reported that the sessions helped their psychological health and well-being, supporting feasibility of future interventions. Acceptability scored highest with a mean (SD) of 4.25 (.84) out of 5, appropriateness 4.18 (.86) and feasibility 4.06 (.96) supporting intervention to be acceptable, appropriate, and feasible.

Conclusion
Utilizing a culturally based intervention to buffer stress and support the well-being of reservation-based teachers showed promise in helping them recognize their cultural strengths, stress, and need for ongoing support. Implementation outcomes show that intervention scale-out is feasible.
Risk factors associated with post-acute sequelae of SARS-CoV-2: an N3C and NIH RECOVER study
Authors: Hill Elaine L. , Mehta Hemalkumar B. , Sharma Suchetha , Mane Klint , Singh Sharad Kumar , Xie Catherine , Cathey Emily , Loomba Johanna , Russell Seth , Spratt Heidi , DeWitt Peter E. , Ammar Nariman , Madlock-Brown Charisse , Brown Donald , McMurry Julie A. , Chute Christopher G. , Haendel Melissa A. , Moffitt Richard , Pfaff Emily R. , Bennett Tellen D. ,   on behalf of the N3C Consortium,   and the RECOVER Consortium
Published: October 2023

Abstract
Background
More than one-third of individuals experience post-acute sequelae of SARS-CoV-2 infection (PASC, which includes long-COVID). The objective is to identify risk factors associated with PASC/long-COVID diagnosis.

Methods
This was a retrospective case–control study including 31 health systems in the United States from the National COVID Cohort Collaborative (N3C). 8,325 individuals with PASC (defined by the presence of the International Classification of Diseases, version 10 code U09.9 or a long-COVID clinic visit) matched to 41,625 controls within the same health system and COVID index date within ± 45 days of the corresponding case's earliest COVID index date. Measurements of risk factors included demographics, comorbidities, treatment and acute characteristics related to COVID-19. Multivariable logistic regression, random forest, and XGBoost were used to determine the associations between risk factors and PASC.

Results
Among 8,325 individuals with PASC, the majority were > 50 years of age (56.6%), female (62.8%), and non-Hispanic White (68.6%). In logistic regression, middle-age categories (40 to 69 years; OR ranging from 2.32 to 2.58), female sex (OR 1.4, 95% CI 1.33–1.48), hospitalization associated with COVID-19 (OR 3.8, 95% CI 3.05–4.73), long (8–30 days, OR 1.69, 95% CI 1.31–2.17) or extended hospital stay (30 + days, OR 3.38, 95% CI 2.45–4.67), receipt of mechanical ventilation (OR 1.44, 95% CI 1.18–1.74), and several comorbidities including depression (OR 1.50, 95% CI 1.40–1.60), chronic lung disease (OR 1.63, 95% CI 1.53–1.74), and obesity (OR 1.23, 95% CI 1.16–1.3) were associated with increased likelihood of PASC diagnosis or care at a long-COVID clinic. Characteristics associated with a lower likelihood of PASC diagnosis or care at a long-COVID clinic included younger age (18 to 29 years), male sex, non-Hispanic Black race, and comorbidities such as substance abuse, cardiomyopathy, psychosis, and dementia. More doctors per capita in the county of residence was associated with an increased likelihood of PASC diagnosis or care at a long-COVID clinic. Our findings were consistent in sensitivity analyses using a variety of analytic techniques and approaches to select controls.

Conclusions
This national study identified important risk factors for PASC diagnosis such as middle age, severe COVID-19 disease, and specific comorbidities. Further clinical and epidemiological research is needed to better understand underlying mechanisms and the potential role of vaccines and therapeutics in altering PASC course.
Long working hours and self-rated health in the national Brazilian working population: gender and employment status differences, 2019
Authors: de Melo Gomides Luciana , Abreu Mery Natali Silva , Assunção Ada Ávila 
Published: October 2023

Abstract
Background
The regulation of working hours is governed by legal standards in formal employment. While the association between long working hours and various health outcomes has been extensively studied, there is limited evidence regarding Brazil. The objective of this study was to investigate the association among working hours, employment status, and self-rated health (SRH), taking into account differences between men and women in a national representative sample of the working population in Brazil.

Methods
A cross-sectional study was conducted among a representative sample of 33,713 workers in Brazil to assess self-rated health (SRH). We examined the associations between working hours and employment status, categorizing working hours as standard (40–44 h per week) or long (> 44 h per week), and employment status as formal or informal. Logistic regression models were employed, adjusting for sociodemographic, occupational characteristics, and health behaviors. Probabilities of negative SRH were calculated for men and women in different exposure profiles. Results were stratified by gender, and 95% confidence intervals (CIs) were applied to the findings.

Results
The prevalence of long working hours was higher among informal workers for both men and women. Adjusted odds ratio (AOR) results revealed that informal employment (AORwomen = 1.53; 95% CI: 1.13–2.07 and AORmen = 1.55; 95% CI: 1.22–1.96) and long working hours (AORwomen = 1.23; 95% CI: 1.06–1.43 and AORmen = 1.14; 95% CI: 1.00-1.30) were independently associated with negative SRH. Significant interactions between long working hours and informal employment were observed. Among individuals with the same exposure profile, women who engaged in long working hours had a higher probability of reporting negative SRH compared to men.

Conclusions
The results of this study are in line with the literature, as differences between men and women in the likelihood of negative self-rated health were observed. The adverse health effects underscore the importance of implementing intersectoral actions to inform the revision of regulations concerning weekly working hours and the expansion of informal employment in low- and middle-income countries.
Documenting the development, adoption and pre-ebola implementation of Liberia’s integrated disease surveillance and response (IDSR) strategy
Authors: Nyenswah Tolbert G. , Skrip Laura , Stone Mardia , Schue Jessica L. , Peters David H. , Brieger William R. 
Published: October 2023

Abstract
Background
In the immediate aftermath of a 14-year civil conflict that disrupted the health system, Liberia adopted the internationally recommended integrated disease surveillance and response (IDSR) strategy in 2004. Despite this, Liberia was among the three West African countries ravaged by the worst Ebola epidemic in history from 2014 to 2016. This paper describes successes, failures, strengths, and weaknesses in the development, adoption, and implementation of IDSR following the civil war and up until the outbreak of Ebola, from 2004 to early 2014.

Methods
We reviewed 112 official Government documents and peer-reviewed articles and conducted 29 in-depth interviews with key informants from December 2021 to March 2022 to gain perspectives on IDSR in the post-conflict and pre-Ebola era in Liberia. We assessed the core and supportive functions of IDSR, such as notification of priority diseases, confirmation, reporting, analysis, investigation, response, feedback, monitoring, staff training, supervision, communication, and financial resources. Data were triangulated and presented via emerging themes and in-depth accounts to describe the context of IDSR introduction and implementation, and the barriers surrounding it.

Results
Despite the adoption of the IDSR framework, Liberia failed to secure the resources—human, logistical, and financial—to support effective implementation over the 10-year period. Documents and interview reports demonstrate numerous challenges prior to Ebola: the surveillance system lacked key components of IDSR including laboratory testing capacity, disease reporting, risk communication, community engagement, and staff supervision systems. Insufficient financial support and an abundance of vertical programs further impeded progress. In-depth accounts by donors and key governmental informants demonstrate that although the system had a role in detecting Ebola in Liberia, it could not respond effectively to control the disease.

Conclusion
Our findings suggest that post-war, Liberia’s health system intended to prioritize epidemic preparedness and response with the adoption of IDSR. However, insufficient investment and systems development meant IDSR was not well implemented, leaving the country vulnerable to the devastating impact of the Ebola epidemic.
Association between relative muscle strength and hypertension in middle-aged and older Chinese adults
Authors: Luo Jin-hua , Zhang Tu-ming , Yang Lin-lin , Cai Yu-ying , Yang Yu 
Published: October 2023

Abstract
Background
The association between muscle defects and hypertension is well-established. However, the absence of pertinent and uncomplicated clinical indicators presents a challenge. Relative muscle strength (RMS) may offer a viable indicator. This study aimed to explore the association between RMS and hypertension.

Methods
A total of 12,720 individuals aged ≥ 45 years from the 2011 wave of the China Health and Retirement Longitudinal Study (CHARLS) were included. Grip strength was recorded and appendicular skeletal muscle mass (ASM) was estimated using a validated mathematical formula. The RMS was calculated as the ratio of grip strength to ASM. Hypertension was determined based on previous diagnosis, history of hypertension medication use, and current blood pressure. Logistic regression models were employed to investigate the relationship between RMS and hypertension.

Results
The prevalence of hypertension was 41.7% (5,307/12,720 patients). RMS was negatively correlated with hypertension with an OR (95% CI) of 0.68 (0.59–0.79) for males, 0.81 (0.73–0.90) for females, and 0.78 (0.72–0.85) for the entire population after adjusting for related covariates including age, education, marital history, smoking history, drinking history, diabetes, hyperlipidemia, and obesity. The trend test showed a linear association among males, females, or the entire population. Stratified analysis showed a consistent negative correlation between RMS and hypertension.

Conclusions
Higher RMS is an independent protective factor against hypertension and efforts to promote RMS may be beneficial for the prevention and management of hypertension.
Development and psychometric properties of Iranian Women’s Quality of Life Instrument (IWQOLI): mixed exploratory study
Authors: Roshan FatemehSadat SeyedNematollah , Alhani Fatemeh , Zareiyan Armin , Kazemnejad Anoshirvan 
Published: October 2023

AbstractBackgroundTo determine the health needs and promote women's health, their quality of life should be investigated. For this purpose, a valid tool is needed, that has credible validity and reliability, and its concepts are clearly defined and culturally appropriate. This study aimed to develop and assess the psychometric properties of “Iranian Women’s Quality of Life Instrument (IWQOLI)”.MethodsThe items of “IWQOLI” were generated from themes extracted (150 items) from a content analysis approach with the participation of 40 women. Face validity of the questionnaire with the participation of 10 women and content validity by 10 experts was approved. To determine the domains of the questionnaire, exploratory factor analysis (principal component extraction method) was performed. Internal consistency and test—retest reliability methods with 14-day intervals (30 women) were used to assess the reliability of WQOLI.ResultsAfter performing the face and content validity, 32 items were deleted. S-CVI/Ave was obtained for the instrument (0.93). The factor structure of the inventory was identified by undertaking a principal component analysis in a sample of 590 women. Five factors were extracted with a total variance account of 56.24% and 28 items dropped at this point. The IWQOLI score was significantly correlated with the SF-36 (r = 0.717,p < 0.001). Reliability was demonstrated with Cronbach’s alpha coefficient of 0.919 for the entire scale (90-item). Consistency of the instrument was established with test–retest reliability with an interval of 2 weeks (intra-cluster correlation = 0.889,P < 0.001).ConclusionsThe Iranian women’s Quality of life Instrument “IWQOLI”, consisting of 90 items representing 5 domains (sense of peace in life, sense of security, health responsibility, pleasant communication, received comprehensive support), demonstrated excellent psychometric properties, so it may be used for measuring women’s QOL in practical research.
Changes of anthropometric indicators of lithuanian first-graders in 2008–2019 according to International Obesity Task Force (IOTF) and World Health Organization (WHO) definitions
Authors: Špečkauskienė Vita , Trišauskė Justina , Grincaitė Monika , Kriaučionienė Vilma , Petrauskienė Aušra 
Published: October 2023

Abstract
Introduction
The monitoring of children’s growth plays a crucial role in assessing their growth patterns and indicating their weight status. Overweight and obesity, determined by cut-offs of body mass index (BMI), are most commonly associated with unhealthy nutrition, non-communicable diseases, and other health disorders. The World Health Organization (WHO) initiated the WHO European Childhood Obesity Surveillance Initiative (COSI) to measure routinely trends in children’s anthropometric changes, which allow intercountry comparisons within the European Region. Lithuania joined the COSI initiative. Our study aims to evaluate and compare underweight, normal and elevated weight (overweight and obesity) changes of Lithuanian first-graders during eleven years period.

Methods
This study was composed according to the COSI study protocol, and it compares the five rounds of anthropometric measurements of Lithuanian first-graders (7-8-year-old) from 2008 to 2019. The main analysed variables were weight and height; calculated BMI, weight-for-age (W/A), height-for-age (H/A) and body mass index-for-age (BMI/A) z-scores. Changes of the indicators were evaluated according to the International Obesity Task Force (IOTF) cut-offs and WHO child growth standards, grouped by 4 estimates: underweight (thinness), normal weight, overweight and obesity. All comparisons were performed between age groups, gender and COSI round year.

Results
The mean values for weight, height, W/A and H/A Z-scores were significantly higher for both age and gender groups when comparing later COSI round years (2016 or 2019) to earlier years (2008–2013, in some cases 2016 is included in this range). Time trends of the WHO growth standards and IOTF cut-offs indicate significant decrease among 7-year-old overweight group for boys and girls. Also, a significant decrease was indicated among boys aged 8 years in the overweight group according to the WHO definitions. The only significant increase in trend were expressed in girl’s group with obesity aged 8 years according to IOTF cut-offs.

Conclusion
The prevalence of overweight and obesity of first-grade children in Lithuania indicates positive changes, that is the proportion of children with elevated body weight decreased, during eleven-year period. However, it is important to continue the monitoring of children’s growth tendencies.