bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utilization of non-pneumatic anti-shock garment for treating obstetric hemorrhage and associated factors among obstetric care providers in Ethiopia: A systematic review and meta-analysis
Authors: Addisu Dagne , Gebeyehu Natnael Atnafu , Belachew Yismaw Yimam , Mekie Maru 
Published: November 2023

Background
The non-pneumatic anti-shock garment (NASG) is a life-saving device that can help to avoid delays and prevent further complications in the case of obstetric hemorrhage. Although there are many fragmented primary studies on the NASG utilization in Ethiopia, the pooled utilization rate is unknown. In addition, a disagreement was observed among those studies while reporting the associated factors. Therefore, this study was intended to determine the pooled level of NASG utilization and its associated factors among obstetric care providers in Ethiopia.

Methods
A total of 51 studies were retrieved from PubMed, Google Scholar, the African Journal of Online, direct open-access journals, and Ethiopian universities’ institutional repositories. This study was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. The quality of studies was evaluated using the modified Newcastle-Ottawa quality assessment tool. The data were extracted by two authors independently using Microsoft Excel and analyzed by Stata version 11. A random-effects model was applied to calculate the pooled level of NASG utilization and its associated factors. The PROSPERO registration number for the review is CRD42023414043.

Result
A total of 8 studies comprising 2,575 study participants were involved in this meta-analysis. The pooled utilization rate of NASG was found to be 39.56%. Having NASG training (pooled odds ratio (OR) = 3.99, 95%CI = 2.35, 6.77), good knowledge about NASG (OR = 2.92, 95%CI = 2.04, 4.17), a positive attitude towards NASG (OR = 3.17, 95%CI = 2.10, 4.79), and having ≥ 2 NASGs in the health facility (OR = 10.59, 95%CI = 6.59, 17.01) were significantly associated with NASG utilization.

Conclusion
Utilization of NASG for the treatment of obstetric hemorrhage was low in Ethiopia. To increase its utilization, Ministry of Health should improve the accessibility of NASG at each health facility and increase the Health professionals’ knowledge and attitude through in-service and pre-service training.
Explainable AI-based Alzheimer’s prediction and management using multimodal data
Authors: Jahan Sobhana , Abu Taher Kazi , Kaiser M. Shamim , Mahmud Mufti , Rahman Md. Sazzadur , Hosen A. S. M. Sanwar , Ra In-Ho 
Published: November 2023

Background
According to the World Health Organization (WHO), dementia is the seventh leading reason of death among all illnesses and one of the leading causes of disability among the world’s elderly people. Day by day the number of Alzheimer’s patients is rising. Considering the increasing rate and the dangers, Alzheimer’s disease should be diagnosed carefully. Machine learning is a potential technique for Alzheimer’s diagnosis but general users do not trust machine learning models due to the black-box nature. Even, some of those models do not provide the best performance because of using only neuroimaging data.

Objective
To solve these issues, this paper proposes a novel explainable Alzheimer’s disease prediction model using a multimodal dataset. This approach performs a data-level fusion using clinical data, MRI segmentation data, and psychological data. However, currently, there is very little understanding of multimodal five-class classification of Alzheimer’s disease.

Method
For predicting five class classifications, 9 most popular Machine Learning models are used. These models are Random Forest (RF), Logistic Regression (LR), Decision Tree (DT), Multi-Layer Perceptron (MLP), K-Nearest Neighbor (KNN), Gradient Boosting (GB), Adaptive Boosting (AdaB), Support Vector Machine (SVM), and Naive Bayes (NB). Among these models RF has scored the highest value. Besides for explainability, SHapley Additive exPlanation (SHAP) is used in this research work.

Results and conclusions
The performance evaluation demonstrates that the RF classifier has a 10-fold cross-validation accuracy of 98.81% for predicting Alzheimer’s disease, cognitively normal, non-Alzheimer’s dementia, uncertain dementia, and others. In addition, the study utilized Explainable Artificial Intelligence based on the SHAP model and analyzed the causes of prediction. To the best of our knowledge, we are the first to present this multimodal (Clinical, Psychological, and MRI segmentation data) five-class classification of Alzheimer’s disease using Open Access Series of Imaging Studies (OASIS-3) dataset. Besides, a novel Alzheimer’s patient management architecture is also proposed in this work.
Experiences of gender-diverse youth during the COVID-19 pandemic in Canada: A longitudinal qualitative study
Authors: Everest Louis , Henderson Jo , Dixon Mahalia , Relihan Jacqueline , Hawke Lisa D. 
Published: November 2023

Background
Recent studies have suggested that the COVID-19 pandemic has increased existing health challenges experienced by transgender (trans) and non-binary people. Additionally, COVID-19 has also negatively impacted youth mental health. However, the impact of the COVID-19 pandemic with respect to the intersection of youth and trans and non-binary populations is currently not well established. The present longitudinal qualitative study aimed to examine the evolving challenges experienced by trans and non-binary youth during the COVID-19 pandemic.

Methods
Gender-diverse youth, defined as participants who did not identify as cisgender in April 2020, were invited to participate from among the participant pool of a COVID-19 cohort study in Canada. Qualitative interviews were conducted in August 2020, January 2021, and August 2021, during the first year and a half of the COVID-19 pandemic. Qualitative themes were identified based on reflexive thematic analysis and plot-line narrative inquiry.

Results
Ten participants aged 18 to 28 were included in the present analysis, yielding 29 transcripts. We identified themes of (1) losses of connection to gender-diverse communities, (2) changes in gender identity, affirmation, and self-reflection, (3) a dual burden of trans and non-binary specific health and service access challenges as well as COVID-19 pandemic related health challenges, and (4) virtually rebuilding gender-diverse communities during the COVID-19 pandemic.

Conclusions
Gender-diverse youth may experience unique challenges during the COVID-19 pandemic. The losses with gender-diverse communities may further isolate queer people from access to healthcare, housing, and employment. Public health policy targeted at gender-diverse youth may consider addressing “upstream” disparities in healthcare and housing in order to support the rebuilding of queer and gender-diverse communities by gender-diverse people.
Effects of beta-blocker withdrawal in patients with heart failure with preserved ejection fraction: A protocol for systematic review and meta-analysis
Authors: Fukuta Hidekatsu , Goto Toshihiko , Kamiya Takeshi 
Published: November 2023

Background
The primary chronic symptom of patients with heart failure with preserved ejection fraction (HFpEF) is severe exercise intolerance. The inability to adequately increase heart rate during exercise (chronotropic incompetence) is commonly present in HFpEF patients and contributes importantly to exercise intolerance in these patients. Since HFpEF patients often have cardiac comorbidities such as hypertension, coronary artery disease, and atrial fibrillation, beta-blockers are frequently prescribed for the treatment of these comorbidities. However, there is a concern that beta-blockers may worsen chronotropic incompetence by slowing heart rate in HFpEF patients and may further exacerbate their symptoms. There are several studies on the effects of beta-blocker withdrawal in HFpEF patients. We aim to perform the systematic review and meta-analysis of studies on the effects of beta-blocker withdrawal in HFpEF patients.

Methods
This meta-analysis will include randomized controlled trials and prospective cohort studies on the effect of beta-blocker withdrawal in HFpEF patients. Information of studies will be collected from PubMed, Web of Science, and Scopus. The primary outcome will be peak oxygen uptake (peak VO2). The secondary outcome will be 6-minute walk distance. Other outcomes of interest will be health-related quality of life, plasma BNP levels, and cardiac structure and function.

Discussion
This systematic review and meta-analysis will evaluate whether beta-blocker withdrawal is beneficial for HFpEF patients, providing evidence regarding beta-blocker withdrawal in these patients.

Trial registration
Systematic review registration: INPLASY202370066.
Indications, types, and diagnostic implications of prenatal genetic testing in Sub-Saharan Africa: A descriptive study
Authors: Sium Abraham Fessehaye , Shimels Tariku , Abdosh Abdulfetah Abdulkadir , Diress Tesfaye , Tsegaye Tigist , Yifrashewa Tizibt , Terefework Zewdu , Gudu Wondimu 
Published: November 2023

Objective
To describe indications, test types, and results of prenatal diagnostic genetic amniocentesis among Ethiopian pregnant women.

Methods
This study was a descriptive study on prenatal diagnostic genetic testing among Ethiopian pregnant women with certain indications and it was conducted at St. Paul’s Hospital Millennium Medical College (Addis Ababa, Ethiopia) from January 2017 to April 2023. Data on sociodemographic characteristics, genetic testing indications, types, and results were collected electronically. Data were analysed using SPSS version 23.

Results
A total of 159 cases were analysed. The commonest indication for genetic testing among the study subjects was major fetal structural anomalies identified on specialized prenatal anatomic scanning of the index pregnancy detected in 71(44.7%) cases. Down syndrome and Edward syndrome were the commonest genetic aberrations detected accounting for 6.3% (10/159) and 4.4% (7/159), respectively. Among the rare genetic aberration detected were Di-George syndrome (0.6%) and Duchenne muscular dystrophy (0.6%).

Conclusion
Findings of our study underscore the importance of diagnostic prenatal testing in a Sub-Saharan Africa setting, as common (trisomy 21&18) and rare genetic defects were identified using this important prenatal diagnostic testing. Considering the implications of detecting chromosomal abnormalities for future counselling and care, carrier state in parents for some chromosomal anomalies, and planning post-natal management of some abnormalities that are associated with aneuploidies (notably cardiac anomalies), initiation of diagnostic prenatal genetic testing service at tertiary public health facilities should be acted up on.
Association of probiotic ingestion with serum sex steroid hormones among pre- and postmenopausal women from the NHANES, 2013–2016
Authors: Zou Siying , Yang Xu , Li Nihong , Wang Hong , Gui Junhao , Li Junjun 
Published: November 2023

Background
Sex hormone-related diseases, encompassing a wide range of conditions from reproductive disorders to certain cancers, pose significant health challenges worldwide. Recent scientific investigations have highlighted the intricate interplay between the gut microbiome and sex hormone regulation, indicating the potential for microbiota-targeted interventions in the management of such diseases. Although individual studies have elucidated the influence of the gut microbiome on sex hormones, a comprehensive cross-sectional examination of the population-wide prevalence of probiotic intake and its correlation with sex hormones is still lacking.

Objectives
This study aimed to evaluate the association of probiotic ingestion with sex hormones in pre- and post-menopausal women.

Methods
We conducted an observational cohort study comprising a nationally representative sample of adults who participated in the National Health and Nutrition Examination Survey between 2013 and 2016. Probiotic ingestion was considered when a subject reported yogurt or probiotic supplement consumption during the 24-h dietary recall or during the Dietary Supplement Use 30-Day questionnaire. A survey-weighted generalized linear model was used to analyze the association between probiotic intake and female/male sex hormones. To reduce selection bias, we used propensity score matching (PSM).

Results
This study included 2,699 women, with 537 of them consuming yogurt and/or dietary supplements containing probiotics, while the remaining 2,162 women did not consume any probiotics. The findings indicated that there were associations between probiotic intake and sex hormone levels in premenopausal and postmenopausal women. For premenopausal women, probiotic intake was positively associated with estradiol (E2) levels. On the contrary, in postmenopausal women, probiotic intake was inversely associated with total testosterone (TT) levels.

Conclusions
This study indicated that probiotic consumption was associated with higher E2 level in premenopausal women and lower TT level in postmenopausal women. Probiotic intake might be a sensible strategy for preventing sex hormone-related diseases.
Anethole attenuates motor dysfunctions, striatal neuronal activity deficiency and blood brain barrier permeability by decreasing striatal α-synuclein and oxidative stress in rotenone-induced Parkinson’s disease of male rats
Authors: Moradi Vastegani Sadegh , Khoshnam Seyed Esmaeil , Ghafouri Samireh , Bakhtiari Nima , Farbood Yaghoob , Sarkaki Alireza 
Published: November 2023

Introduction
Anethole is the main compound of the essential oil of anise and several other plants, which has antioxidant, anti-inflammatory, and neuroprotective properties. Oxidative stress is considered as an important factor in the pathogenesis of PD. In the present study, we aimed to investigate the effects of anethole against rotenone-induced PD.

Methods
Male Wistar rats were randomly divided into six groups. Control group received DMSO + sunflower oil, model group received rotenone (2 mg/kg, s.c, daily for 35 days), positive control group received L-Dopa, and test groups received anethole (62.5, 125, and 250 mg/kg, i.g, daily for 35 days) 1 hour before each rotenone injection. Body weight changes, rotarod test, stride length test, and extracellular single unit recording were performed after treatment. After behavioral test, Brain water content and blood brain barrier (BBB) permeability were evaluated, and the levels of malondialdehyde (MDA), superoxide dismutases (SOD), alpha-synuclein and MAO-B were measured in the striatum.

Results
Chronic administration of rotenone induced body weight loss and caused significant dysfunction in locomotor activity, neuronl firing rate, and BBB. Rotenone also decreased SOD activity, increased MDA level, and elevated the expression of alpha-synuclein and MAO-B in the striatum. However, treatment with anethole attenuated body weight loss, motor function, neuronal activity, and BBB function. Furthermore, Anethole treatment attenuated oxidative stress and decreased the expression of alpha-synuclein and MAO-B compared to the rotenone group.

Conclusion
Our results show that through its antioxidant properties, aethole can improve the cellular, molecular and behavioral characteristics of rotenone-induced Parkinson’s disease.
The accessibility and quality of health services for diabetes mellitus and chronic respiratory disease patients during Covid-19 in Northern Jordan: A mixed method study
Authors: Al-Bataineh Raya , Al-Hammouri Mohammed , Al-Jaraideh Wafa’a 
Published: November 2023

BackgroundThe catastrophe caused by the Coronavirus disease has affected all services worldwide. A range of policies were introduced to slow the virus spread, which in turn, affected the accessibility and quality of healthcare services. This was a problematic and concerning for patients with chronic diseases, such as patients with diabetes mellitus (DM) and chronic respiratory diseases (CRD), due to their sustained need for ongoing health care. The aims of the study were: 1) assessing the level of both accessibility and quality of healthcare services during the Covid-19 pandemic from the DM and CRD patients’ perspectives, 2) assessing the association between the patients’ socio-demographics and their perspectives on health services accessibility and quality, and 3) exploring the perspectives of DM and CRD patients on barriers and facilitators of health services accessibility and quality during the era of COVID -19.MethodDesign. A sequential explanatory mixed-method was used in this study. In the quantitative part, a self -administered questionnaire was used to collect data from 300 patients with DM and/or CRD. In the qualitative part, focus group approach was used to collect data from 25 patients.Setting. Public, private and teaching hospitals were involved.Analysis. SPSS Version 25 was used to analyze the quantitative data. Thematic analysis was used to analyze the qualitative data.ResultsThe quantitative findings indicated that almost 99% of the participating patients perceived barriers, ranging from low to high, to accessing health services during COVID-19. Additionally, more than half of the sample perceived low to moderate level of quality of health services. Four themes and nine subthemes related to barriers and facilitators were identified in the qualitative part of the study.ConclusionThe study revealed that both quality and accessibility of healthcare services for DM and CRD patients were impacted during the era of COVID -19. The findings lay the ground for developing future health programs and establishing or revising policies with the goal of improving healthcare services quality and accessibility for the target population.
A new chapter of healthy indoor air: antiviral air treatments
Authors: Glas Irina , David Shannon C 
Published: November 2023

Aerosol transmission remains a major challenge for the control of respiratory viruses. To date, prevention strategies include masks, vaccinations, physical distancing, travel restrictions, and lockdowns. Such measures are effective but come with heavy societal burdens and rely on public compliance. Additionally, most are simply not suitable as long‐term measures. Other strategies evolve around the concept of improved indoor air quality and involve ventilation, relative humidity (RH) control, and air filtration. Unfortunately, natural ventilation increases exposure to airborne pollutants and vector‐borne diseases, and incurs substantial energy losses in colder months. Mechanical ventilation concepts, including regular air changes and filtration, are effective but costly, and often require expensive engineering solutions and widespread renovations. Alternative options to reduce the spread of emerging and seasonal infections are sorely needed. In this issue of EMBO Molecular Medicine, Styles et al (2023) describe the use of propylene glycol (PG) to inactivate infectious bioaerosols and virus‐containing droplets deposited on surfaces.
Lawfare y populismo punitivo: las dos caras en América Latina
Authors: Sáenz-Solís Jesús 
Published: November 2023

Los sistemas de justicia en América Latina han sufrido una serie de transformaciones en los años recientes. Esto ha implicado un mayor protagonismo de los jueces y juezas en decisiones con alto impacto dentro del sistema político. En este contexto, se ha generado el auge de dos fenómenos: el lawfare y el populismo punitivo.
El lawfare representa la aplicación de medios judiciales de manera arbitraria para la eliminación y anulación de los adversarios políticos. Este fenómeno en América Latina ha tenido principalmente, impacto en los sectores de corte progresistas, los cuales han sido censurados por impulsar una serie de reformas que modifican la estructura social y económica regional.
Por otra parte, el populismo punitivo es una corriente que plantea el uso de las herramientas judiciales en el sistema penitenciario promoviendo las políticas de “mano dura” con el fin de obtener un rédito político. Estas han generado principalmente, un debilitamiento de las garantías procesales en el nivel regional y la criminalización de los sectores en mayor condición de vulnerabilidad.
Ante esto se plantea que ambos fenómenos tienen profundas raíces culturales y políticas, y que forman parte de un solo continuo articulado al que se propone llamar como el momento punitivista. Este concepto pretende evidenciar la relación entre las problemáticas planteadas y como se han profundizado las condiciones de exclusión y represión mediante los sistemas judiciales orientado a dos sectores: a los más pobres y a quienes los defiendan.
Nursing guidelines for caregivers of children with congenital heart disease after discharge: Integrative Review
Authors: Alves Machado Amazonas Bruna , Guerreiro Vieira da Silva Denise Maria , De Souza Ribeiro Maria de Nazaré 
Published: November 2023

Objective. To identify the nursing guidelines for caregivers of children with congenital heart disease (CHD) after hospital discharge.
Methods. This is an integrative literature review of articles published between 2016 and 2022. In order to select the studies, the controlled descriptors “Nursing Care”, “Nursing”, “Heart Defects, Congenital”, “Caregivers” and “Child” were used in four scientific databases – LILACS, SCIELO, PUBMED and BDENF.
Results. The current integrative literature review analyzed 11 articles from the original sample. The main nursing care issues are those related to nutrition, oral health, leisure and physical activity, care with medication and the surgical wound, as well as the need to offer support to these children’s families. The authors emphasize that nurses are present at various moments in a child’s life, including at birth, but the approach to CHD is scarce in their basic training as nurses, as well as in their professional practice, and there is a shortage of continuing education proposals for the care of children with CHD.
Conclusion. The study showed that nursing guidelines are focused on basic care and family support for these children. Lastly, this study highlighted the important role of nurses in terms of consolidating guidelines on the care needs of these children.
“I didn't know anything, but I learned over time”: The process of nurses attaining autonomy in Intensive Care Units
Authors: Naranjo Nestor , Florez Inna , Gómez Edna 
Published: November 2023

Objective. Understand the social processes experienced by nursing professionals and the meanings underlying autonomy in adult Intensive Care Units in the city of Cartagena (Colombia).
Methods. A qualitative study with a grounded theory approach was conducted. Fifteen semi-structured interviews were carried out with nursing professionals, and the analysis was based on the coding technique proposed by Strauss & Corbin.
Results. Of the respondents, fourteen were female and one was male, with ages ranging from 23 to 57 years. Experience in intensive care units ranged from 1 to 28 years, and none had postgraduate studies. After thematic analysis, the central category was obtained from four categories: adaptation process, applicability of autonomy exercise, building autonomous competence, and limitations to the exercise of autonomy.
Conclusion. Nursing professionals achieve their autonomy through a social process, based on different stages of learning when facing the environment of the units. It is grounded in decision-making and the power to act freely. However, barriers continue to hinder it, including limitations imposed by institutions, protocol-based interventions, social status, and individual differences among professionals