bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rabies-preventive health program for mothers in maternal and child health centers: quasi experimental study
Authors: Mabrouk Baraka Samia Ibrahim , Abo El Nour Rania Abd Elmohsen , Abdelzaher M. A. , Seif El–Nasr Eman Mahmoud 
Published: January 2025

Abstract

Background
Rabies spreads to people and animals via saliva, usually through bites, scratches, or direct contact with mucosa (e.g. eyes, mouth, or open wounds). Rabies remains a major public health problem in Egypt, with an estimated 60 people dying annually from the disease.

Aim
The aim of this study was to assess the effect of preventive program on mothers' awareness for prevention of rabies.

Study design
Quasi-experimental research design was utilized in this study.

Setting
This study was conducted at three major Maternal and child centers (Botors, Embaby and Segar) in Tanta City.

Sample
A total sample of 150 mothers who attended the child clinic with children aged 6–12 years.

Tools
Researchers developed three tools for data collection. The tools underwent content validity assessment, and their internal consistency was evaluated using Cronbach's alpha coefficient. Structured interviewing questionnaire for assessment of mothers’ knowledge, attitudes and practices regarding rabies Tool I, Mothers' knowledge regarding rabies questionnaire. This tool consisted of two parts: demographic characteristics of the studied mothers and mothers’ knowledge about rabies. Tool II, Rabies attitudinal Likert scale. Tool III, Mothers reported practice Questionnaire.

Results
From the obtained results, it was found that, a statistically significant correlation was found between mothers' total knowledge scores, attitude and total practice scores, both before and after the implementation of the rabies prevention program.

Conclusion
It was concluded that the rabies- preventive health program had a positive impact on mother’s knowledge, attitude and practices regarding rabies. The mean knowledge score improved from 14.08 before preventive program to 20.90 one month posttest. Negative attitude of the studied mothers was 48% before program but it reduced to 1.3% one month after preventive program. Only 13.35% of the participants had satisfactory level of practice before program and increased to 83.30% one month posttest.

Recommendations
Dissemination of the program through mass media campaigns and community outreach activities to enhance public knowledge, improve attitudes, and promote better practices regarding rabies prevention and control measures.
Acute Q Fever after Kidney Transplantation: A Case Report
Authors: Xie Junjie , Li Gang , Lin Fenwang , Bai Zhijie , Yu Lixin , Zhang Dongjing , Zhang Bolun , Ye Junsheng , Yu Ruohan 
Published: January 2025

Aims/Background Patients receiving kidney transplant experience immunosuppression, which increases the risk of bacterial, viral, fungal, and parasitic infections. Q fever is a potentially fatal infectious disease that affects immunocompromised renal transplant recipients and has implications in terms of severe consequences for the donor's kidney. Case Presentation A patient with acute Q fever infection following kidney transplantation was admitted to the Tsinghua Changgung Hospital in Beijing, China, in March 2021. Next-generation sequencing (NGS) was used to diagnose Q fever in the patient. Based on the patient's blood test, we detected Rickettsia, the causative agent of Q fever and a zoonotic disease that can manifest in acute or chronic forms in humans. Comprehensive data on clinical symptoms, blood tests, chest computed tomography (CT), NGS, Immunoglobulin G (IgG) antibody titer, and therapeutic efficacy associated with Q fever infection following renal transplantation in this patient were gathered. Conclusion This is the first reported case of acute Q fever occurring in a Chinese renal transplant recipient detected using metagenomic NGS. This case underscores the need to consider acute Q fever as a possible differential diagnosis in kidney transplant recipients with fever of unknown origin.
Translation, adaptation and validation of an epilepsy screening instrument in two Ghanaian languages
Authors: Darkwa Emmanuel Kwame , Asiamah Sabina , Awini Elizabeth , Sottie Cynthia , Godi Anthony , Williams John E. , Akpalu Albert , Cross J. Helen , Sander Josemir W. , Sen Arjune , Newton Charles R. , Danso-Appiah Anthony , Adjei Patrick 
Published: January 2025

Introduction
The prevalence of epilepsy in sub-Saharan Africa varies considerably, and the exact estimate for Ghana remains unclear, particularly in peri-urban areas where data are scarce. More community-based studies are required to understand better the actual burden of epilepsy in these areas and the difficulties in accessing healthcare.

Objective
To adapt and validate a household survey epilepsy-screening instrument in Shai-Osudoku and Ningo-Prampram District of Greater Accra Region, Ghana.

Methods
We developed a 17-item epilepsy screening instrument by modifying previously validated English language questionnaires. We included questions that could identify convulsive and non-convulsive seizures. Language experts forward- and back-translated the questionnaires into the two languages: Asante Twi and Dangme. Cases were people with confirmed epilepsy attending healthcare facilities where these languages are used. Controls were unaffected relatives of cases or people attending the same healthcare facilities for other medical conditions. We matched cases and controls for geographical location and ethnicity. An affirmative response to one of the seventeen questions by a participant was deemed a positive screen. The questionnaires were divided into two stages. The first stage consisted of broader, more general questions aimed at identifying potential cases of epilepsy. The second stage involved a more detailed and focused set of questions administered to those who screened positive in the first stage.

Results
One hundred and forty Dangme speakers (70 cases and 70 controls) and 100 Asante Twi speakers (50 cases and 50 controls) were recruited. The sensitivity and specificity for Dangme were: Stage 1, 100% and 80%, and Stage 2, 98.6% and 85.7%. The Dangme version reliably identified epilepsy with positive predictive values of 83.3% and 87.3% at stages 1 and 2. The questionnaire excluded epilepsy with 100% and 98.4% negative predictive values. For the Asante Twi version, the sensitivity and specificity were 98% and 92% (95% at Stage 1, and for Stage 2, 96% and 94%. The Asante Twi questionnaire reliably specified epilepsy with positive predictive values of 92.5% and 94.1% at stages 1 and 2. It excluded epilepsy with negative predictive values of 97.9% and 95.9% for the two stages

Conclusions
Our questionnaire is valid for the two languages and usable for community-based epilepsy surveys in Ghana. It can also be adapted for other resource-poor settings, although translation and iterative in-country testing will be needed to ensure its validity.
Unhealthy behaviours associated with uncontrolled hypertension among adults in India- Insights from a national survey
Authors: Sai Sushma Kuppli , Kumar Shubham , Gujjarlapudi Chaitanya , Bodhi Srividya Vennam , Verma Madhur , Nagamani N. G. , Jothula Kishore Yadav , Jaswal Nidhi , Goel Sonu 
Published: January 2025

Background
Non-communicable diseases (NCDs) are governed by a cluster of unhealthy behaviours and their determinants, like tobacco and alcohol, unhealthy diet, lack of physical activity, overweight and obesity, pollution (air, water, and soil), and stress. Regulation of these unhealthy behaviours plays a crucial role in blood pressure control among individuals on hypertensive treatment, especially those suffering from uncontrolled hypertension. Hence, the present study aims at identifying the unhealthy behaviours associated with uncontrolled hypertension.

Materials and methods
We did a secondary data analysis of the National Family Health Survey (NFHS) -5 data (2019–2021). Among those taking prescribed medication to lower blood pressure levels, SBP ≥140 mm Hg or DBP ≥90 mm Hg were considered uncontrolled hypertension. The other socio-demographic variables and unhealthy behaviours were used as independent variables for analysis.

Results
The proportion of uncontrolled hypertension was 49·5% (95% CI: 45·5–53·4) and 36·8% (95% CI: 35.8–37.8) among males and females, respectively. Alcohol consumption, clean fuel usage, and high BMI (≥30kg/m2) were the behavioural characteristics significantly associated with uncontrolled hypertension among males. In contrast, tobacco usage, alcohol consumption, coverage by Health insurance, presence of Diabetes, heart disease, usage of clean fuel, and high BMI (≥30kg/m2) were the behavioural characteristics significantly associated with uncontrolled hypertension among females. Regression results portrayed that higher age groups (45 and above) have found higher odds for men (OR: 7.6, CI: 4.6–12.3) and women (OR: 6.08, CI: 4.0–6.0) compared with 30 years and below age groups. Similarly, higher odds were found among the wealthiest wealth quintile than the poorest wealth quintile among men and women.

Conclusion
The current study reported a high proportion of uncontrolled hypertension. Providing opportunistic health education during blood pressure monitoring, regular screening, and targeted interventions will not only help to reduce its prevalence but also reduce the risk of developing related health implications.
Economic impact and clinical benefits of clinical pharmacy interventions: A six-year multi-center study using an innovative medication management tool
Authors: Alsetohy Watheq M. , El-fass Kareem A. , El Hadidi Seif , Zaitoun Mohammad F. , Badary Osama , Ali Kareem A. , Ezz-Elden Ahmed , Ibrahim Mohamed R. , Makhlouf Bahaa S. , Hamdy Asmaa , El Baghdady Noha S. , Eldien Maha Gamal , Allama Sherif , Alashkar Amr A. , Seyam Ahmed , Adel Nanees A. , Ibrahim Ahmed R. N. , Zaki Hany V. 
Published: January 2025

Background
Increasing healthcare costs, particularly in Low- and Middle-Income Countries (LMICs) like Egypt, highlight the need for rational economic strategies. Clinical pharmacy interventions offer potential benefits by reducing drug therapy problems and associated costs, thereby supporting healthcare system sustainability.

Objective
This study evaluates the economic impact and clinical benefits of clinical pharmacy interventions in four tertiary hospitals in Egypt by implementing an innovative tool for medication management, focusing on cost avoidance and return on investment (ROI), while accounting for case severity and drug therapy problem (DTP) resolution.

Methods
Utilizing a digital tool, cost avoidance was assessed by considering the severity of patient cases and the effectiveness of clinical pharmacists’ interventions in resolving identified DTPs. Additionally, ROI was calculated by incorporating both full-time equivalent (FTE) and non-FTE costs to evaluate the overall economic impact of clinical pharmacy services over a six-year period across four tertiary care hospitals in Egypt.

Results
Over six years, a total of 492,612 patients were reviewed, leading to 19,240 comprehensive clinical pharmacy interventions. These interventions achieved an 88.63% resolution of DTPs, significantly reducing patient risk by preventing adverse DTP consequences, resulting in a total cost avoidance of EGP 265.32 million (USD 8.60 million) and an average ROI of 7.6 (760%). This underscores the substantial economic impact of clinical pharmacy services, particularly in LMICs and countries transitioning to universal health insurance coverage, where cost efficiency and patient safety are critical.

Conclusion
This study underscores the importance of clinical pharmacy interventions in improving healthcare outcomes and generating significant economic benefits, particularly in low- and middle-income countries. By accounting for case severity and the level of DTP consequences, along with the efficiency of clinical pharmacist-led interventions in resolving DTPs, the economic impact of these services can be more accurately evaluated. These findings are essential for informing policy decisions, highlighting the critical role of clinical pharmacy services in supporting healthcare systems facing economic constraints.
Experiences and perceptions of respectful maternity care among mothers during childbirth in health facilities of Eastern province of Rwanda: An appreciative inquiry
Authors: Muhayimana Alice , Kearns Irene Josephine , Gishoma Darius , Tengera Olive , Uhawenimana Thierry Claudien 
Published: January 2025

Introduction
The World Health Organization (WHO) has emphasized the importance of ensuring respectful and dignified childbirth experiences. However, many countries, including Rwanda, have documented negative experiences during childbirth. Identifying best practices can help uncover sustainable solutions for resource-limited settings rather than focusing solely on the challenges and negative aspects. This study aimed to explore and describe how mothers in Rwanda’s Eastern Province perceived and valued their childbirth experiences during their most recent labour and delivery.

Methods
We conducted a qualitative, exploratory, descriptive study. Purposive sampling targeted mothers who reported receiving respectful care during labour and childbirth. We selected 30 mothers from five hospitals in the Eastern Province of Rwanda. Data collection involved in-depth interviews (IDIs) following the first four stages of the Appreciative Inquiry (AI) 5D cycle. We employed the thematic analysis and used NVivo 12 to organize codes and develop a codebook.

Results
Three main themes, each with subthemes, emerged from the analysis. The first theme, appreciated care, included compassionate care and emotional support, autonomy and self-determination, timely care, privacy and confidentiality, and a supportive environment. The second theme perceived respectful care, addressed the meaning of respectful care and the sources of the participants’ satisfaction. The third theme, strategies for improvement, focused on increasing women’s self-control, sustaining providers’ positive behaviours, and fostering caring leadership. Participants described receiving compassionate, empathetic, and dignified care, with timely attention to their needs. They expressed satisfaction with the services provided, noting that healthcare providers were kind, polite, and dedicated, often going beyond their duties. Mothers recommended to be more involved in decision-making, maintaining an optimal environment for childbirth, and enhancing community trust and professionalism in maternity care. They also acknowledged their responsibility to ensure proper birth spacing.

Conclusion
The aspects of care the participants appreciated could be consistently maintained and promoted. There is a need to build on the progress made in delivering RMC to strengthen community trust and elevate expectations. Given the sensitive nature of RMC, we recommend conducting further studies using the Appreciative Inquiry approach.
Inverse association of oxidative balance score with depression and specific depressive symptoms among cancer population: Insights from the NHANES (2005–2020)
Authors: Bu Hanli , Lv Mingzhen , Wang Linxian , Jiang Dan , Ding Yi , Wang Zheya , Hu Yaoyao , Zhuang Qin , Tian Zhenzhen 
Published: January 2025

Background
The rising prevalence of depression among cancer patients is alarming. This study examines the relationship between the Oxidative Balance Score (OBS)—a composite measure of dietary and lifestyle factors—and depression, including specific depressive symptoms in this population.

Methods
Data were analyzed from 3,280 adult cancer patients collected in NHANES from 2005–2020. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9), where a score of 10 or above indicated depression. Symptoms experienced frequently were classified as specific depressive symptoms. Weighted logistic regression models were utilized to explore the correlation between OBS and depression, along with distinctive depressive symptoms.

Results
There was a negative correlation between OBS and depression. The highest quartile of OBS (OR 0.313, 95% CI: 0.161–0.609), along with dietary OBS (OR 0.429, 95% CI: 0.234–0.786) and the third quartile of lifestyle OBS (OR 0.404, 95% CI: 0.226–0.722), was associated with reduced depression risk. OBS was correlated with lower risks of all four somatic depressive symptoms and one cognitive symptom. Dietary OBS was associated with fewer risks of three somatic symptoms and one cognitive symptom. Lifestyle OBS showed a negative correlation with two somatic symptoms. Stratified analyses indicated that the inverse relationship between OBS and depression risk was consistent across subgroups, including females and individuals under 65. a nonlinear association was observed between OBS (p = 0.024), dietary OBS (p<0.001), lifestyle OBS (p = 0.021), and depression.

Conclusions
OBS is inversely related to depression and specific depressive symptoms in cancer patients. Encouraging a diet and lifestyle rich in antioxidants may help reduce the risk of depression in this group.
Glaucoma detection and staging from visual field images using machine learning techniques
Authors: Akter Nahida , Gordon Jack , Li Sherry , Poon Mikki , Perry Stuart , Fletcher John , Chan Thomas , White Andrew , Roy Maitreyee 
Published: January 2025

Purpose
In this study, we investigated the performance of deep learning (DL) models to differentiate between normal and glaucomatous visual fields (VFs) and classify glaucoma from early to the advanced stage to observe if the DL model can stage glaucoma as Mills criteria using only the pattern deviation (PD) plots. The DL model results were compared with a machine learning (ML) classifier trained on conventional VF parameters.

Methods
A total of 265 PD plots and 265 numerical datasets of Humphrey 24–2 VF images were collected from 119 normal and 146 glaucomatous eyes to train the DL models to classify the images into four groups: normal, early glaucoma, moderate glaucoma, and advanced glaucoma. The two popular pre-trained DL models: ResNet18 and VGG16, were used to train the PD images using five-fold cross-validation (CV) and observed the performance using balanced, pre-augmented data (n = 476 images), imbalanced original data (n = 265) and feature extraction. The trained images were further investigated using the Grad-CAM visualization technique. Moreover, four ML models were trained from the global indices: mean deviation (MD), pattern standard deviation (PSD) and visual field index (VFI), using five-fold CV to compare the classification performance with the DL model’s result.

Results
The DL model, ResNet18 trained from balanced, pre-augmented PD images, achieved high accuracy in classifying the groups with an overall F1-score: 96.8%, precision: 97.0%, recall: 96.9%, and specificity: 99.0%. The highest F1 score was 87.8% for ResNet18 with the original dataset and 88.7% for VGG16 with feature extraction. The DL models successfully localized the affected VF loss in PD plots. Among the ML models, the random forest (RF) classifier performed best with an F1 score of 96%.

Conclusion
The DL model trained from PD plots was promising in differentiating normal and glaucomatous groups and performed similarly to conventional global indices. Hence, the evidence-based DL model trained from PD images demonstrated that the DL model could stage glaucoma using only PD plots like Mills criteria. This automated DL model will assist clinicians in precision glaucoma detection and progression management during extensive glaucoma screening.
Spatial epidemiological analysis based on township scale and analysis of influencing factors of pulmonary tuberculosis cure of Changshu city from 2015 to 2022
Authors: Xu Xiao-yan , Zhou Zheng-yuan , Gong Li-qiang , Xu Li-qiang , Jiao Xiao-kang , Yin Bian , Jiang Tian-hong 
Published: January 2025

Objective
This study aimed to enhance the prevention and control of pulmonary tuberculosis (PTB) and provide more effective and accurate methods in Changshu City.

Methods
The PTB patients’ information came from the China Information System for Disease Control and Prevention (CISDCP). The demographic data for Changshu city and towns came from the Suzhou Statistical Yearbook and the LandScan platform. ArcGIS was used for global spatial autocorrelation analysis and local spatial autocorrelation analysis. Univariate logistic regression and multivariate logistic regression were used to analyze the influencing factors of cured PTB patients. The receiver operating characteristic (ROC) curve and decision curve analysis (DCA) were used to analyze the predictive efficacy and clinical benefit of the indicators. XGBoost analysis was performed to explore the feature importance of key metrics for PTB outcome.

Results
A total of 3943 PTB cases were included. The annual incidence rate of new PTB in Changshu city was 27.081 per 100,000. Changshu High-tech Industrial Development Zone in Jiangsu Province and Shajiabang town were the high-high aggregation areas and hot spot areas. Diagnosis delay, TB strain types, and drug sensitivity were independent predictors of the cure of new PTB patients.

Conclusion
The central and southern areas of Changshu were the high-high cluster areas and hot spots for PTB. Shorter diagnosis delay days and mycobacterium tuberculosis (MTB) promote the cure of tuberculosis, while drug sensitivity was a risk factor for its cure.
Factors associated with quality of life of chronic spontaneous urticaria patients in a Vietnamese population
Authors: My Nguyen Thi Tra , My Le Huyen , Minh Vu Nguyet , Vinh Nguyen Thi Ha , Anh Mai Ba Hoang , Le Huu Doanh 
Published: January 2025

Objective
Chronic spontaneous urticaria (CSU) is a challenging condition that significantly impacts the affected patients. This study aimed to evaluate the quality of life (QoL) among patients with CSU in Vietnam and identify factors associated with QoL.

Methods
A cross-sectional study was conducted at the Vietnam National Dermatology and Venereology Hospital from June 2023 to March 2024. A total of 358 CSU patients aged 16 years or older were recruited. Data were collected using a structured questionnaire covering demographic, clinical, and laboratory characteristics. The Chronic Urticaria Quality of Life Questionnaire (CU-Q2oL) and the Weekly Urticaria Activity Score (UAS7) were utilized to assess QoL and disease severity. Multivariate Tobit regression models were performed.

Results
The CU-Q2oL total score had a mean of 48.67 (SD = 16.90) and a median of 46 (IQR = 35–59). The scores for individual CU-QoL subscales were as follows: pruritus (5.42±2.02), swelling (2.86±1.54), life activities (13.89±6.00), sleep problems (11.12±4.96), limits (6.52±2.66), and looks (8.85±4.09). Higher UAS7 scores were associated with lower QoL, and angioedema in the eyes and lips were associated with increased swelling domain and poorer overall QoL. Longer disease duration was associated with higher pruritus scores, while a history of allergy was related to poorer total QoL, sleep, and looks. Severe itching further degraded sleep quality. Positive Autologous Serum Skin Test (ASST) was correlated with lower overall QoL, particularly in swelling and limits domains. Positive Basophil Histamine Release Assay (BHRA) status was linked to poorer sleep quality domain.

Conclusion
CSU significantly impairs the QoL of patients, affecting physical, emotional, and social dimensions. Regular QoL assessments should be integrated into clinical practice to ensure comprehensive and patient-centered treatment strategies.