bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring mothers’ experiences of perinatal care in Cyprus: Babies Born Better survey
Authors: Hadjigeorgiou E. , Andreaki M. , Koliandri I. , Spyridou A. , Balaam M. C. , Christoforou A. 
Published: July 2023

Abstract
Introduction
A positive perinatal experience facilitates a smooth transition to motherhood and enhances the development of a strong bond between mother and newborn, contributing to maternal and societal wellbeing. Given the medicalization of childbirth in Cyprus, the examination of mothers’ experiences of perinatal care becomes imperative.

Aim
To investigate mothers’ experiences of care during the perinatal period and to identify factors related to the provision of maternal care that contribute to the interpretation of these experiences.

Methods
The study draws on data from the European survey “Babies Born Better”, an online survey utilizing a mixed-methods approach to explore women’s experiences of maternity care across Europe. The study population were women who had given birth in Cyprus over a 5-year period (2013–2018). Quantitative data were analyzed using SPSS v22, while qualitative data were analyzed through inductive content analysis.

Findings
A total of 360 mothers participated in the study. In rating their overall experience, 24.2% stated that they had a “bad experience”, 11.1% a “good experience”,13.9% a “very good experience”, and 13,3% a “very bad experience”. The top three sub-factors of the overall experience which received positive evaluation were “Relationship with health care professionals” (33.6%), “Birth environment and care” (11.4%), and “Breastfeeding guidance” (10.8%). The qualitative analysis yielded five themes: “Relationship with health care professionals”, “Breastfeeding establishment”, “Childbirth rights”, “Birth environment and services” and “Choice of mode of birth”.

Conclusion
Mothers in Cyprus wish to have respectful maternity care. They need maternity health care professionals to respect their dignity and ask for evidence-based information with shared decision making. Mothers in Cyprus expect to have their childbirth rights safeguarded, to have better support from HCP, and to receive humanized care. The perinatal care provided in Cyprus needs significant improvements based on mothers’ needs and expectations.
Retinal structure and visual pathway function at school age in children born extremely preterm: a population-based study
Authors: Ingvaldsen Sigrid Hegna , Moljord Kyrre , Grøtting Arnstein , Omland Petter Moe , Dammann Olaf , Austeng Dordi , Morken Tora Sund 
Published: July 2023

Abstract
Background
Children born extremely preterm (gestational age < 28 weeks) show reduced visual function even without any cerebral or ophthalmological neonatal diagnosis. In this study, we aimed to assess the retinal structure with optical coherence tomography (OCT) and visual function with pattern-reversal visual evoked potentials (PR-VEPs) in a geographically defined population-based cohort of school-aged children born extremely preterm. Moreover, we aimed to explore the association between measures of retinal structure and visual pathway function in this cohort.

Methods
All children born extremely preterm from 2006–2011 (n = 65) in Central Norway were invited to participate. Thirty-six children (55%) with a median age of 13 years (range = 10–16) were examined with OCT, OCT-angiography (OCT-A), and PR-VEPs. The foveal avascular zone (FAZ) and circularity, central macular vascular density, and flow were measured on OCT-A images. Central retinal thickness, circumpapillary retinal nerve fibre layer (RNFL) and inner plexiform ganglion cell layer (IPGCL) thickness were measured on OCT images. The N70-P100 peak-to-peak amplitude and N70 and P100 latencies were assessed from PR-VEPs.

Results
Participants displayed abnormal retinal structure and P100 latencies (≥ 2 SD) compared to reference populations. Moreover, there was a negative correlation between P100 latency in large checks and RNFL (r = -.54, p = .003) and IPGCL (r = -.41, p = .003) thickness. The FAZ was smaller (p = .003), macular vascular density (p = .006) and flow were higher (p = .004), and RNFL (p = .006) and IPGCL (p = .014) were thinner in participants with ROP (n = 7).

Conclusion
Children born extremely preterm without preterm brain injury sequelae have signs of persistent immaturity of retinal vasculature and neuroretinal layers. Thinner neuroretinal layers are associated with delayed P100 latency, prompting further exploration of the visual pathway development in preterms.
Clinical usefulness of splanchnic oxygenation in predicting necrotizing enterocolitis in extremely preterm infants: a cohort study
Authors: Palleri E. , van der Heide M. , Hulscher J. B.F. , Bartocci M. , Wester T. , Kooi E. M.W. 
Published: July 2023

Abstract
Background
Impaired intestinal microcirculation seems to play an important role in the pathogenesis of necrotizing enterocolitis (NEC). A previous study showed that a SrSO2 < 30% is associated with an increased risk of developing of NEC. We aimed to determine the clinical usefulness of the cut off < 30% for SrSO2 in predicting NEC in extremely preterm neonates.

Methods
This is a combined cohort observational study. We added a second cohort from another university hospital to the previous cohort of extremely preterm infants. SrSO2 was measured for 1–2 h at days 2–6 after birth. To determine clinical usefulness we assessed sensitivity, specificity, positive and negative predictive values for mean SrSO2 < 30. Odds ratio to develop NEC was assessed with generalized linear model analysis, adjusting for center.

Results
We included 86 extremely preterm infants, median gestational age 26.3 weeks (range 23.0-27.9). Seventeen infants developed NEC. A mean SrSO2 < 30% was found in 70.5% of infants who developed NEC compared to 33.3% of those who did not (p = 0.01). Positive and negative predictive values were 0.33 CI (0.24–0.44) and 0.90 CI (0.83–0.96), respectively. The odds of developing NEC were 4.5 (95% CI 1.4–14.3) times higher in infants with SrSO2 < 30% compared to those with SrSO2 ≥ 30%.

Conclusions
A mean SrSO2 cut off ≥ 30% in extremely preterm infants between days 2–6 after birth may be useful in identifying infants who will not develop NEC.
Health service utilisation for acute respiratory infections in infants graduating from the neonatal intensive care unit: a population-based cohort study
Authors: Stevenson Paul G. , Cooper Matthew N. , Billingham Wesley , de Klerk Nicholas , Simpson Shannon J. , Strunk Tobias , Moore Hannah C. 
Published: July 2023

Abstract
Background
Despite advances in neonatal intensive care, babies admitted to Neonatal Intensive Care Units (NICU) suffer from adverse outcomes. We aim to describe the longer-term respiratory infectious morbidity of infants discharged from NICU using state-wide population-based linked data in Western Australia.

Study design
We used probabilistically linked population-based administrative data to analyse respiratory infection morbidity in a cohort of 23,784 infants admitted to the sole tertiary NICU, born 2002–2013 with follow up to 2015. We analysed incidence rates of secondary care episodes (emergency department presentations and hospitalisations) by acute respiratory infection (ARI) diagnosis, age, gestational age and presence of chronic lung disease (CLD). Poisson regression was used to investigate the differences in rates of ARI hospital admission between gestational age groups and those with CLD, after adjusting for age at hospital admission.

Results
From 177,367 child-years at risk (i.e., time that a child could experience an ARI outcome), the overall ARI hospitalisation rate for infants and children aged 0–8 years was 71.4/1000 (95% confidence interval, CI: 70.1, 72.6), with the highest rates in infants aged 0–5 months (242.9/1000). For ARI presentations to emergency departments, equivalent rates were 114/1000 (95% CI: 112.4, 115.5) and 337.6/1000, respectively. Bronchiolitis was the most common diagnosis among both types of secondary care, followed by upper respiratory tract infections. Extremely preterm infants (< 28 weeks gestation at birth) were 6.5 (95% CI: 6.0, 7.0) times more likely and those with CLD were 5.0 (95% CI: 4.7, 5.4) times more likely to be subsequently admitted for ARI than those in NICU who were not preterm or had CLD after adjusting for age at hospital admission.

Conclusions
There is an ongoing burden of ARI in children who graduate from the NICU, especially those born extremely preterm, that persists into early childhood. Early life interventions to prevent respiratory infections in these children and understanding the lifelong impact of early ARI on later lung health are urgent priorities.
Epidemiological characteristics of alcohol-related liver disease in China: a systematic review and meta-analysis
Authors: Tang Zongzhe , Ding Yajie , Zhang Wei , Zhang Ru , Zhang Liuxin , Wang Minxian , Wang Min , Chen Yue , Wang Jie 
Published: July 2023

Abstract
Background
This meta-analysis aimed to explore the epidemiological characteristics of alcohol-related liver disease (ALD) in China.

Methods
Studies published between January 2000 and January 2023 were searched from 3 databases in English and 3 databases in Chinese. DerSimonian-Laird’s random-effects model was adopted to calculate the pooled prevalence.

Results
A total of 21 studies were included. The pooled prevalence of ALD was 4.8% (95% CI, 3.6%-6.2%) in the general population, 9.3% (95% CI, 4.4%-16.0%) in males, and 2.0% (95% CI, 0.0%-6.7%) in females. The prevalence was the highest in western China (5.0% [95% CI, 3.3%-6.9%]) and the lowest in central China (4.4% [95% CI, 4.0%-4.8%]). The prevalence among people with different drinking histories (less than 5 years, 5 to 10 years, and over 10 years) was 0.9% (95% CI, 0.2%-1.9%), 4.6% (95% CI, 3.0%-6.5%), and 9.9% (95% CI, 6.5%-14.0%), respectively. The prevalence in 1999–2004 was 4.7% (95% CI, 3.0%-6.7%) and then changed from 4.3% (95% CI, 3.5%-5.3%) in 2005–2010 to 6.7% (95% CI, 5.3%-8.3%) in 2011–2016.

Conclusions
The prevalence of ALD in China has increased in recent decades, with population-related variations. Targeted public health strategies are needed, especially in high-risk groups, such as male with long-term alcohol drinking.

Trial registration
The registration number on PROSPERO is CRD42021269365.
Healthy city: global systematic scoping review of city initiatives to improve health with policy recommendations
Authors: Danielli Shaun , Ashrafian Hutan , Darzi Ara 
Published: July 2023

Abstract
Background
Global health will increasingly be determined by cities. Currently over half of the world’s population, over 4 billion people, live in cities. This systematic scoping review has been conducted to understand what cities are doing to improve health and healthcare for their populations.

Methods
We conducted a systematic search to identify literature on city-wide initiatives to improve health. The study was conducted in accordance with PRISMA and the protocol was registered with PROSPERO (CRD42020166210).

Results
The search identified 42,137 original citations, yielding 1,614 papers across 227 cities meeting the inclusion criteria. The results show that the majority of initiatives were targeted at non-communicable diseases. City health departments are making an increasing contribution; however the role of mayors appears to be limited.

Conclusion
The collective body of evidence identified in this review, built up over the last 130 years, has hitherto been poorly documented and characterised. Cities are a meta-system with population health dictated by multiple interactions and multidirectional feedback loops. Improving health in cities requires multiple actions, by multiple actors, at every level. The authors use the term ‘The Vital 5’. They are the five most important health risk factors; tobacco use; harmful alcohol use; physical-inactivity, unhealthy diet and planetary health. These ‘Vital 5’ are most concentrated in deprived areas and show the greatest increase in low and middle income countries. Every city should develop a comprehensive strategy and action plan to address these ‘Vital 5’.
Inflammation associated with lung function abnormalities in COVID-19 survivors
Authors: Mancilla-Ceballos Roberto , Milne Kathryn M. , Guenette Jordan A. , Cortes-Telles Arturo 
Published: July 2023

Abstract
Background
Activation of inflammatory pathways promotes organ dysfunction in COVID-19. Currently, there are reports describing lung function abnormalities in COVID-19 survivors; however, the biological mechanisms remain unknown. The aim of this study was to analyze the association between serum biomarkers collected during and following hospitalization and pulmonary function in COVID-19 survivors.

Methods
Patients recovering from severe COVID-19 were prospectively evaluated. Serum biomarkers were analyzed from admission to hospital, peak during hospitalization, and at the time of discharge. Pulmonary function was measured approximately 6 weeks after discharge.

Results
100 patients (63% male) were included (age 48 years, SD ± 14) with 85% having at least one comorbidity. Patients with a restrictive spirometry pattern (n = 46) had greater inflammatory biomarkers compared to those with normal spirometry (n = 54) including peak Neutrophil-to-Lymphocyte ratio (NLR) value [9.3 (10.1) vs. 6.5 (6.6), median (IQR), p = 0.027] and NLR at hospital discharge [4.6 (2.9) vs. 3.2 (2.9) p = 0.005] and baseline C-reactive protein value [164.0 (147.0) vs. 106.5 (139.0) mg/dL, p = 0.083). Patients with an abnormal diffusing capacity (n = 35) had increased peak NLR [8.9 (5.9) vs. 5.6 (5.7) mg/L, p = 0.029]; baseline NLR [10.0 (19.0) vs. 4.0 (3.0) pg/ml, p = 0.002] and peak Troponin-T [10.0 (20.0) vs. 5.0 (5.0) pg/ml, p = 0.011] compared to patients with normal diffusing capacity (n = 42). Multivariable linear regression analysis identified predictors of restrictive spirometry and low diffusing capacity, but only accounted for a low degree of variance in pulmonary function outcome.

Conclusion
Overexpression of inflammatory biomarkers is associated with subsequent lung function abnormalities in patients recovered from severe COVID-19.
Changes in the mean incidence and variance of orthopedic diseases before and during the COVID-19 pandemic in Korea: a retrospective study
Authors: Kim Joo-Hee , Kwon Mi Jung , Choi Hyo Geun , Lee Sang Jun , Hwang Sangwon , Lee Jaemin , Lee San-Hui , Lee Jung Woo 
Published: July 2023

Abstract
Background
During the coronavirus disease (COVID-19) pandemic, the amount of moderate- to high-intensity physical activity significantly decreased. Therefore, the epidemiology of musculoskeletal diseases could possibly have changed. We assessed changes in the incidence of and variance in non-traumatic orthopedic diseases before and after the COVID-19 pandemic in Korea.

Methods
This study included data from the Korea National Health Insurance Service, which covers the entire Korean population (approximately 50 million), from January 2018 to June 2021. Using International Classification of Diseases, Tenth Revision codes, 12 common orthopedic diseases were evaluated, including cervical disc disorders, lumbar disc disorders, forward head posture, myofascial pain syndrome, carpal tunnel syndrome, tennis elbow, frozen shoulder, rheumatoid arthritis, gout, hip fracture, distal radius fracture, and spine fracture diseases. “Pre-COVID-19” was the period until February 2020, and “COVID-19 pandemic period” was the period starting March 2020. Differences in the mean incidence and variance of diseases before and during the COVID-19 pandemic were compared.

Results
In most cases, the incidence of orthopedic diseases decreased at the beginning of the pandemic and then increased thereafter. Among the 12 diseases, the incidence of three diseases showed a statistically significant change. The incidence of myofascial pain syndrome (P < 0.001) was lower during the COVID-19 pandemic than during the pre-COVID-19 period. The incidences of frozen shoulder (P < 0.001) and gout (P = 0.043) were higher during the COVID-19 pandemic than during the pre-COVID-19 period. However, no statistical difference in disease variations was observed between the two periods.

Conclusions
The incidence of orthopedic diseases varied during the COVID-19 pandemic among the Korean population. Although the incidence of myofascial pain syndrome was lower, that of frozen shoulder and gout was higher during the COVID-19 pandemic than during the pre-COVID-19 period. No disease variations during the COVID-19 pandemic were found.
Spontaneous intramuscular hemorrhage in cancer-associated dermatomyositis: a case and literature review
Authors: Xing Rui , Xiang Fenfen , Dong Lingli , Shen Guifen 
Published: July 2023

Abstract
Background
Spontaneous intramuscular hemorrhage (SIH) is a rare but life-threatening complication of dermatomyositis (DM). The pathogenetic mechanism and management of intramuscular hematoma in these patients remains unclear. Here we discuss a case of recurrent hemorrhage in a patient with cancer-associated DM, and review the relevant literature for timely diagnosis and treatment.

Case presentation
A 53-year-old male patient presented with rashes, muscle weakness, and dysphagia and was diagnosed with DM. During treatment, he developed SIH of the arm and right psoas major muscle successively. MRI showed extensive edema of the right shoulder girdle muscle and muscle groups of the upper arm. During the second SIH, a CT scan showed new-onset hematoma formation in the right psoas major muscle. The detection of D-dimer, thrombin-antithrombin III complex (TAT), plasmin-α2-plasmininhibitor complex (PIC) and tissue plasminogen activator-inhibitor complex (t-PAIC) indicated predominant hyperfibrinolysis over thrombosis. Blood transfusion and supportive treatment were immediately performed, and the hematoma did not expand. However, his abdominal distension was not relieved after active treatment. Further electronic gastroscopy discovered gastric sinus ulcers, and histopathology of the biopsy confirmed signet-ring cell carcinoma.

Conclusions
Although patients with cancer-associated DM have an increased risk of thrombosis, prophylactic anticoagulation therapy needs deliberate consideration. It is important to monitor the coagulation parameters dynamically during anticoagulation therapy. Especially when the level of D-dimer is high, and it is uncertain whether the patient is in a state of thrombosis or hyperfibrinolysis, the detection of TAT, PIC, t-PAIC can help to determine whether to initiate anticoagulation therapy.
General correlation between neonatal factors, primary and permanent tooth eruption and their interrelation in a population in german orthodontic practices
Authors: Möhlhenrich Stephan Christian , Korkmaz Volkan-Cem , Chhatwani Sachin , Danesh Gholamreza 
Published: July 2023

Abstract
Background
The purpose of the study was to determine the possible relationship between the eruption of primary and permanent teeth and neonatal factors in German children according to gender.

Methods
A cross-sectional survey study was performed in 10 German orthodontic practices. Using a questionnaire information about gender, time of birth (week of pregnancy), birth weight (g) and height (cm), and the age of first primary and first permanent tooth eruption (months/years) of 405 children (230 girls and 175 boys) were collected. A Mann–Whitney U-test was used for group comparisons, and correlations were verified using a Pearson test.

Results
No correlation was found between neonatal factors (time of birth, birth weight, and birth height) and primary tooth eruption for male participants. However, for females a low correlation was found between the eruption of the first primary tooth and birth weight (r = -0.18, CI: -0.30 to -0.042, p = 0.011) and birth height (r = -0.19, CI: -0.32 to -0.054, p = 0.006). No correlations between neonatal factors and the eruption of the first permanent tooth were found for either gender. A moderate correlation was found between the first primary and first permanent tooth eruption (females: r = 0.30, CI: 0.16 to 0.43, p < 0.001; males: r = 0.22, CI: 0.059 to 0.35, p = 0.008).

Conclusions
An earlier eruption of the primary teeth can be assumed with greater body weight and height at the time of birth for girls. For boys, the tendency is the opposite. However, there seems to be a catch-up growth effect due to the missing differences between both permanent tooth eruption times. Nevertheless, the first primary and the first permanent tooth eruption correlates in a German children population.
Trusting relationships between patients with non-curative cancer and healthcare professionals create ethical obstacles for informed consent in clinical trials: a grounded theory study
Authors: Murphy Mary , McCaughan Eilís , Thompson Gareth , Carson Matthew A , Hanna Jeffrey R , Donovan Monica , Wilson Richard H , Fitzsimons Donna 
Published: July 2023

Abstract
Background
Clinical trial participation for patients with non-curative cancer is unlikely to present personal clinical benefit, which raises the bar for informed consent. Previous work demonstrates that decisions by patients in this setting are made within a ‘trusting relationship’ with healthcare professionals. The current study aimed to further illuminate the nuances of this relationship from both the patients’ and healthcare professionals’ perspectives.

Methods
Face-to-face interviews using a grounded theory approach were conducted at a regional Cancer Centre in the United Kingdom. Interviews were performed with 34 participants (patients with non-curative cancer, number (n) = 16; healthcare professionals involved in the consent process, n = 18). Data analysis was performed after each interview using open, selective, and theoretical coding.

Results
The ‘Trusting relationship’ with healthcare professionals underpinned patient motivation to participate, with many patients ‘feeling lucky’ and articulating an unrealistic hope that a clinical trial could provide a cure. Patients adopted the attitude of ‘What the doctor thinks is best’ and placed significant trust in healthcare professionals, focusing on mainly positive aspects of the information provided. Healthcare professionals recognised that trial information was not received neutrally by patients, with some expressing concerns that patients would consent to ‘please’ them. This raises the question: Within the trusting relationship between patients and healthcare professionals, ‘Is it possible to provide balanced information?’. The theoretical model identified in this study is central to understanding how the trusting professional-patient relationship influences the decision-making process.

Conclusion
The significant trust placed on healthcare professionals by patients presented an obstacle to delivering balanced trial information, with patients sometimes participating to please the ‘experts’. In this high-stakes scenario, it may be pertinent to consider strategies, such as separation of the clinician-researcher roles and enabling patients to articulate their care priorities and preferences within the informed consent process. Further research is needed to expand on these ethical conundrums and ensure patient choice and autonomy in trial participation are prioritised, particularly when the patient’s life is limited.