bluuebunny/crossref_metadata_2025_split huggingface dataset:
Birth Defects and Adverse Pregnancy Outcomes in Hospital-based Birth Surveillance in Eswatini
Authors: Gill Michelle M. , Khumalo Philisiwe Ntombenhle , Hoffman Heather J. , Chouraya Caspian , Kunene Mthokozisi , Dlamini Futhi , Tukei Vincent , Scheuerle Angela E. , Nhlabatsi Bonisile , Mofenson Lynne 
Published: February 2025

Background:
The Botswana Tsepamo study identified an initial neural tube defect (NTD) safety signal with dolutegravir antiretroviral therapy (ART) exposure at conception. We conducted similar surveillance in 5 hospitals in Eswatini from September 2021 to September 2023 to evaluate the prevalence of birth defects and adverse pregnancy outcomes by maternal HIV status and ART regimen/timing.

Methods:
Routine pregnancy history and HIV/ART status were collected from clinic records. Women of live or stillborn infants with birth defects consented for interviews and photographs of defects. A medical geneticist reviewed blinded interview data and photographs.

Results:
Of 45,836 women with live-born or stillborn infants, 13,577 (29.6%) were living with HIV; 11,581 (86.0%) were receiving ART at conception (84.1% dolutegravir). Overall, birth defects were confirmed in 387 (0.8%) women. Comparing women with and without HIV, there were no significant differences in major defects (0.48% vs. 0.38%) or NTD (0.10% vs. 0.08%). In women with HIV, there were no significant differences between those on dolutegravir versus non-dolutegravir at conception for major defects (0.53% vs. 0.49%) or NTD (0.08% vs. 0.22%). Stillbirths were significantly higher in women with HIV than those without (2.6% vs. 1.9%, P < 0.001), as was low birthweight and preterm delivery (11.8% vs. 10.4%, P < 0.001; 12.5% vs. 10.7%, P < 0.001, respectively). There were no significant differences in outcomes by ART regimen.

Conclusions:
While these data from sub-Saharan Africa further strengthen the lack of a NTD safety signal in women with HIV on ART, there remained elevated adverse birth outcomes despite treatment compared to women without HIV.
Chronic Disease and Future Perceptions of Financial Control
Authors: Davis Victoria H. , Zhang Guanghao , Patel Minal R. 
Published: February 2025

Objective:
Rising health care costs and chronic disease prevalence have increased concerns about health-related financial burden. This study examined how baseline chronic disease burden was associated with subsequent perceptions of financial control ∼9 years later.

Methods:
Data came from the Midlife in the United States (MIDUS) cohort, with MIDUS 1 and 2 used as baseline predictors for future perceived financial control outcomes at MIDUS 3. Adjusted mixed effect models examined the relationship between baseline chronic disease burden on 4 variables representing future perceptions of financial control.

Results:
A total of 3297 participants [mean (SD) age: 54 (11.36) y] were included. Greater chronic disease burden and medication use at baseline were associated with a higher likelihood of inadequate resources [adjusted odds ratio (AOR) = 1.22; 95% CI: 1.07–1.38; P = 0.001 and AOR = 1.29; 95% CI: 1.13–1.46; P = 0.001, respectively]. Having more chronic conditions predicted reduced feelings of financial control (AOR=0.85; 95% CI, 0.78-0.93; P<0.001) and a more pessimistic financial outlook (AOR = 0.87; 95% CI: 0.79–0.97; P < 0.01). Higher baseline cholesterol levels showed mixed associations: better perception of current finances (AOR = 1.36; 95% CI: 1.22–1.51; P=0.001) but reduced sense of financial control (AOR = 0.86; 95% CI: 0.78–0.95; P < 0.001) and more negative financial outlook (AOR = 0.69; 95% CI: 0.62–0.77; P < 0.001). No baseline factors predicted bill payment capability.

Conclusion:
The findings suggest a need for additional strategies to reduce the financial burden of chronic diseases.
Intolerance of Uncertainty and Its Association With Cancer-Related Symptoms
Authors: Yang Yesol , Lin Yufen , Kim Bohyun , Gorka Stephanie M. , Von Ah Diane 
Published: February 2025

Background
Cancer-related symptoms have negative impacts on the health outcomes of adults with cancer. Thus, it is critical to identify who might be at risk. Intolerance of uncertainty (IU) could be the major contributor for cancer-related symptoms; however, this relationship is understudied in the context of cancer.

Objective
The purpose of this scoping review was to map the literature that has investigated IU and its link to cancer-related symptoms.

Methods
This scoping review used the framework proposed by Arksey and O’Malley and PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). A comprehensive search was conducted using 5 databases. English-language primary research published focusing on IU and cancer-related symptoms was included in this review.

Results
Of 12 articles included in this review, 11 studies found a positive relationship of IU with affective symptoms, including anxiety, depression, stress, fear, worry, and distress. Additionally, one study showed that higher IU was associated with greater cognitive impairment and that association was mediated by anxiety.

Conclusion
Findings from this scoping review support the positive association between IU and cancer-related symptoms. This review further suggests that IU could be a potential risk factor for cancer-related affective and cognitive symptoms.

Implication for Practice
The incidence of affective and cognitive symptoms in cancer survivors is high. Given that IU is associated with these symptoms, IU-focused treatments may be beneficial in this group.
The Impact of National Orthopaedic Fracture Registries: A Systematic Review
Authors: Jozefowski Nicolas , Eikani Carlo , Lingampalli Nithya , Lawler Patrick , Barrett Athena , Hoyt Aaron , Pickles Andrew , Huggins Elizabeth , Agel Julie , Seymour Rachel , Nguyen Mai , Marmor Meir , Levack Ashley E. ,   the OTA Classification and Outcomes Committee
Published: February 2025

Abstract

Purpose:
Large-scale registry data efforts are common in orthopaedic surgery; however, there is wide variation between registries and little known about registry impact. The purpose of this study was to assess the publication or “scholarly” impact of current national trauma/fracture registries.

Methods:
A search was executed to identify potential national and international trauma/fracture registries and create a comprehensive list of registries. Thirty-four relevant national registries were identified. Searches were executed to identify any published articles published by or affiliated with the selected registries. Over 13,000 abstracts were screened by at least 2 reviewers. The full text of 650 articles were screened by at least 2 reviewers, and data were extracted from 383 articles. Citations were excluded if they were reviews and meta-analyses; referencing non–trauma-specific, insurance, institutional, or state-wide databases; describing facial, spine, or rib trauma; reporting nonregistry data; and did not report on fracture patients. Data were collected at the article level and registry level.

Results:
The median number of articles per registry was 3.5 (range: 1–66) with a median impact factor of 3.2 (range per registry: 1.4–11.0). The National Hip Fracture Database (United Kingdom) had the highest publication rate per year of any registry (3.9). Twenty-four percent of registries had a publication rate of greater than 1 article per year, whereas only 8.8% had a publication rate over 2 per year. Only 8 registries had 10 or more publications in total. The National Trauma Data Bank (United States) had the highest number of fracture-specific publications overall (66) and an average citation rate of 29 per publication. The National Hip Fracture Database had the second highest number of article (62) with an average citation per article of 23.6.

Conclusion:
With the exception of a few registries, most national trauma/fracture registries have low yearly publication and citation rates. Researchers must consider the utility of resources needed to sustain registry efforts in the context of the impact of registry data. Future studies will seek to identify salient features of the highest impact registries.
Case study on the applicability of the international classification of functioning, disability, and health in a patient with mitochondrial myopathy treated in the rehabilitation service
Authors: Taranu Mihaela , Borda Daniel , Rivadeneira Jorge , Laxe Sara 
Published: February 2025

Background:
Mitochondrial myopathies are rare neuromuscular diseases characterized by heterogeneous symptoms and severity. They affect multiple organs, including the brain, peripheral nervous system, muscles, kidneys, and liver.

Objective:
To illustrate how the application of the International Classification of Functioning, Disability, and Health (ICF) can help in managing a patient with mitochondrial myopathy in a rehabilitation setting.

Methods:
We present the case of a 26-year-old male diagnosed with a neuromuscular disease at age 12, exhibiting bilateral eyelid ptosis, dysphonia, dysphagia, and motor disorders. The patient underwent a thorough physical evaluation and various scales. The ICF model was employed to document and quantify deficits using a standardized template and numerical qualifiers.

Results:
Priority treatment areas included reeducation of postural and gait patterns, improving aerobic capacity through physical therapy, and managing pain via myofascial infiltration. Post-treatment, significant improvements were observed, although persistent challenges in participation domains, such as mobility in urban environments and employment, remained.

Conclusions:
This case study highlights the utility of the ICF framework in structuring rehabilitation plans, setting clear objectives, and evaluating outcomes for patients with rare diseases like mitochondrial myopathy. The ICF facilitates standardized assessment and comparison across different pathologies, promoting an integrative biopsychosocial model in rehabilitation.
FDG PET/CT in 2 Cases of Primary Urothelial Carcinoma of the Prostate
Authors: Man Xiaojun , Song Xiandong , Dong Aisheng 
Published: February 2025

Abstract
Primary prostatic urothelial carcinoma is a very rare aggressive tumor with poor prognosis. We describe FDG PET/CT findings in 2 patients with primary prostatic urothelial carcinoma. In 1 patient, FDG PET/CT showed intense activity of the prostate tumor with extraprostatic invasion. In the other patient, FDG PET/CT showed heterogeneous intense activity of the primary tumor and multiple hypermetabolic metastases in the regional lymph nodes, bone, and lung. Both patients had normal serum total prostate-specific antigen levels. These cases highlight the usefulness of FDG PET/CT in detecting and staging of primary prostatic urothelial carcinoma due to high FDG avidity.
Impact of a Quantitative Early Activity Program on Gastrointestinal Function Following Laparoscopic Pancreaticoduodenectomy: A Single-Center Retrospective Analysis
Authors: Zhang Ling , Zhang Fan , Xiao Chen-Jie , Shu Yue-Fen , Li Zheng , Wang Jun , Tang Wen-Jie 
Published: February 2025

Objective:
The objective of this study is to assess the impact of a quantitative early activity program, integrated into the Enhanced Recovery After Surgery (ERAS) protocol on gastrointestinal function in patients undergoing laparoscopic pancreatoduodenectomy (LPD).

Methods:
Perioperative data from 203 patients who underwent LPD at the Department of Comprehensive Treatment of Pancreatic Cancer, Fudan University Shanghai Cancer Center, between January 2021 and December 2022 were analyzed retrospectively. The patients were categorized into 2 groups based on their nursing plans. Group A received the standard perioperative ERAS nursing plan, while group B followed the ERAS plan supplemented with a quantitative early activity program. We assessed postoperative outcomes including bowel sound recovery time, time to first anal exhaust, time to first mobilization, activity compliance 1-week postsurgery, and incidence of postoperative breakthrough pain.

Result:
We compared several postoperative metrics between group A and group B. Specifically, the time to bowel sound recovery was 62.39±17.89 hours in group A versus 56.45±22.85 hours in group B. The time to first anal exhaust was 78.88±71.99 hours in group A compared with 63.62±24.73 hours in group B. The time to first mobilization was 56.98±18.66 hours in group A versus 49.85±20.48 hours in group B. In addition, activity compliance 1-week postsurgery and the incidence of postoperative breakthrough pain (1.55±2.01 times in group A vs. 0.94±1.16 times in group B) were also compared. All these differences were statistically significant (P<0.05). Conversely, the incidence of postoperative complications and the length of hospital stay (11.20±5.69 d in group A vs. 12.47±6.67 d in group B) did not reveal any significant differences (P>0.05).

Conclusion:
The quantitative early activity program for LPD, based on the ERAS protocol, enhances the adherence to postoperative activity and decreases the incidence of breakthrough pain, thereby facilitating gastrointestinal function recovery in patients. This approach merits clinical adoption.
Promoting international acceptance of clinical studies about traditional Chinese medicine interventions
Authors: Li Ling , Luo Xiaochao , Liu Jiali , Yao Minghong , Liu Yanmei , Ma Yu , Huang Luqi , Sun Xin 
Published: February 2025

Abstract
Promoting the international acceptance of clinical studies about traditional Chinese medicine (TCM) interventions is a key strategy for internationalization of TCM. However, the complexities of TCM interventions—in terms of the theories, practice patterns, and components—pose challenges to the design and implementation of clinical studies that are well accepted by the international community. This article summarized the current status of clinical studies about TCM interventions that were published in international journals, explored underlying barriers hindering the international acceptance, and discussed potential strategies for future development.
The effect of the proportion of low-titer O whole blood for resuscitation in pediatric trauma patients on 6-, 12- and 24-hour survival
Authors: Petersen Ethan M. , Fisher Andrew D. , April Michael D. , Yazer Mark H. , Braverman Maxwell A. , Borgman Matthew A. , Schauer Steven G. 
Published: February 2025

INTRODUCTION
Hemorrhage is a leading cause of death in pediatric patients. Accumulating data suggest that low-titer group O whole blood (LTOWB) improves clinical outcomes in the pediatric population. We examined what ratio of LTOWB to total blood product conferred a survival benefit in transfused pediatric trauma patients.

METHODS
We retrospectively examined a cohort of injured subjects younger than 18 years from the Trauma Quality Improvement Program database who received any quantity of LTOWB and no documented prehospital cardiac arrest. We created a variable representing the volume of transfused LTOWB divided by the total volume of all transfused blood products administered within the first 4 hours of admission, that is, the proportion of LTOWB transfused. We analyzed increasing proportions of transfused LTOWB to determine whether there was an inflection point conferring increased survival.

RESULTS
From 2020 to 2022, 1,122 subjects were included in the analysis. The median (interquartile range) age was 16 (14–17) years. Firearms were the most common mechanism at 47% followed by collisions at 44%. The median composite injury severity score was 25 (16–34). Survival was 91% at 6 hours, 89% at 12 hours, and 88% at 24 hours. We noted an inflection point with improved survival at an LTOWB proportion of ≥30% of total volume of blood products received. The odds of survival at 6, 12, and 24 hours for those receiving ≥30% LTOWB was 1.85 (1.02–3.38), 2.09 (1.20–3.36), and 1.80 (1.06–3.08), and 3.55 (1.66–7.58), 3.71 (1.89–7.27), and 2.69 (1.44–5.02) when excluding those who died within 1 hour, respectively.

CONCLUSION
Among LTOWB recipients, we found that a strategy of using LTOWB comprising at least 30% of the total transfusion volume within the first 4 hours was associated with improved survival at 6, 12, and 24 hours.

LEVEL OF EVIDENCE
Therapeutic/Care Management; Level III.
Improvement in Quality of Seizures in Electroconvulsive Therapy With Zotepine
Authors: Matsuoka Teruyuki , Ayani Nobutaka , Yamano Sumihiro 
Published: February 2025

Abstract
Regular symmetric high-amplitude seizure waves, postictal suppression, constant seizure duration, and sympathetic nervous system excitation are used to evaluate the efficacy of electroconvulsive therapy (ECT) for seizures. Seizure quality is rated from 0 to 3 (higher scores indicate better quality) using seizure quality categories (SQC). We report a case in which zotepine (ZTP) improved seizure quality. A woman in her 50s developed schizophrenia in 1993. In December 2021, her delusions, anxiety, and agitation worsened, and she was admitted to our hospital. ECT was started in November 2022 but discontinued after 10 sessions because of the patient's refusal. However, her agitation became more noticeable, and she was placed in isolation in December 2022. ECT was resumed in March 2023 and accompanied by risperidone (RIS) 4 mg, with SQC scores of 1–2 points for sessions 1–8. A gradual change from RIS to ZTP began at session 9, and RIS was discontinued by session 17. The SQC was 2 points with ZTP dose of 150 mg. The SQC improved to 3 points during sessions 21–23 after ZTP dose was increased to 300 mg. The electroencephalogram showed improvement, especially in regular symmetric high-amplitude seizure waves and postictal suppression during sessions 21–23. ECT was terminated in September 2023 (after 27 sessions in total) when the patient was mentally ready to be released from isolation. This case indicates that ZTP may improve the quality of ECT-induced seizures.
Presentation and Types of Childhood Cancer at the Muhimbili National Hospital (MNH), 2023
Authors: Ali Salih Arga Malaz Adam , Laiti Rehema H. , Abd El Raheem Ghada Omer Hamad , Hammor Yasar 
Published: February 2025

ABSTRACTBACKGROUNDIn sub-Saharan Africa in Tanzania, with an incidence of 1.4/100,000 cases. A lot of cancer cases in Tanzania are not diagnosed until later because there aren’t many healthcare institutions offering cancer-related care and treatment. Cancer that manifests in its late stages not only reduces survival chances but also places a heavy load on the healthcare system. a lower-middle-income nation, has numerous barriers to receiving treatment for children’s malignancies. The research aims to study the clinical presentation and types of childhood cancer at the Muhimbili National Hospital.METHODSA hospital-based cross-sectional survey and convenience sample technique were used to assess the presentation and association factors of childhood cancer. Descriptive statistics and statistical analysis to assess associations among variables were performed through chi2 and one-way ANOVA. A p-value of <0.05 was considered significant.RESULTS141 patients were assessed; the most common types of cancer were Blastoma and Leukaemia between 1 and 5 years. The Sukuma tribe had the highest percentage of patients. Most of the patients came from Dar es Salaam. The majority of patients presented with masses and abdominal distention. There was a statistically significant difference between family history and the type of cancer, between the stage of disease and response to treatment, and between the ages across types of cancer. There is no statistical difference or association between the type of cancer and the history of chronic illness or exposure.CONCLUSIONChildhood cancer has high mortality and morbidity in Tanzania. Most of the patients die before 5 years old, and patients come to the hospital with a late-stage disease with serious symptoms. Other patients didn’t complete treatment, which may be due to financial problems or a low level of education among carers.
Tremor asymmetry and the development of bilateral phase-specific deep brain stimulation for postural tremor
Authors: He Shenghong , Deli Alceste , West Timothy O , Plazas Fernando R , Pogosyan Alek , Wiest Christoph , Wehmeyer Laura , Baig Fahd , Morgante Francesca , Andrade Pablo , Hart Michael G , FitzGerald James J. , Visser-Vandewalle Veerle , Pereira Erlick A , Green Alexander L , Tan Huiling , Cagnan Hayriye 
Published: February 2025

AbstractBackgroundTremor phase-locked deep brain stimulation (DBS) has been shown to modulate symptom severity in patients with postural tremor, including essential (ET) and dystonic tremor (DT). This, provides a potential alternative therapy that targets the underlying pathological oscillations with less energy delivered to the brain than existing systems. Previous phase-locked DBS studies focused on evaluating the effect of unilateral stimulation on the tremor-dominant hand. Considering that postural tremor usually presents bilaterally, it remains unknown how tremor asymmetry interacts with stimulation in the context of bilateral phase-locked DBS, which was investigated in the current study.MethodsArchival limb acceleration from nine ET patients with postural tremor was analysed to explore potential asymmetries in tremor amplitude, frequency, and instability across the two upper limbs, and the relationship between these asymmetries and continuous high-frequency DBS (cDBS). Then, as a proof of concept, bilateral phase-locked DBS was tested in one ET and one DT patient with postural tremor and chronically implanted DBS devices.ResultsOur results confirmed that postural tremor is asymmetric; larger tremor power being associated with smaller amplitude and frequency stability in one hand compared to the other. These asymmetries were significantly reduced during cDBS. The effects of cDBS on aforementioned characteristics were greater on the tremor with larger amplitude. Accordingly, the effects of bilateral phasic DBS were also asymmetric.ConclusionsThis study creates a better understanding of tremor asymmetry and its relationship with DBS and provides important insights for the development of patient specific approaches for tremor.