bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk factors for postpartum maternal mortality and hospital readmission in low- and middle-income countries: a systematic review
Authors: Symonds Nicola E. , Vidler Marianne , Wiens Matthew O. , Omar Shazmeen , English L. Lacey , Ukah U. Vivian , Ansermino J. Mark , Ngonzi Joseph , Bebell Lisa M. , Hwang Bella , Christoffersen-Deb Astrid , Kissoon Niranjan , Payne Beth A. 
Published: April 2023

Abstract
Background
In low- and middle-income countries, approximately two thirds of maternal deaths occur in the postpartum period. Yet, care for women beyond 24 h after discharge is limited. The objective of this systematic review is to summarize current evidence on socio-demographic and clinical risk factors for (1) postpartum mortality and (2) postpartum hospital readmission.

Methods
A combination of keywords and subject headings (i.e. MeSH terms) for postpartum maternal mortality or readmission were searched. Articles published up to January 9, 2021 were identified in MEDLINE, EMBASE, and CINAHL databases, without language restrictions. Studies reporting socio-demographic or clinical risk factors for postpartum mortality or readmission within six weeks of delivery among women who delivered a livebirth in a low- or middle-income country were included.
Data were extracted independently by two reviewers based on study characteristics, population, and outcomes. Included studies were assessed for quality and risk of bias using the Downs and Black checklist for ratings of randomized and non-randomized studies.

Results
Of 8783 abstracts screened, seven studies were included (total N = 387,786). Risk factors for postpartum mortality included Caesarean mode of delivery, nulliparity, low or very low birthweight, and shock upon admission. Risk factors for postpartum readmission included Caesarean mode of delivery, HIV positive serostatus, and abnormal body temperature.

Conclusions
Few studies reported individual socio-demographic or clinical risk factors for mortality or readmission after delivery in low- and middle-income countries; only Caesarean delivery was consistently reported. Further research is needed to identify factors that put women at greatest risk of post-discharge complications and mortality. Understanding post-discharge risk would facilitate targeted postpartum care and reduce adverse outcomes in women after delivery.

Trial registration
PROSPERO registration number: CRD42018103955.
A tool to define and measure maternal healthcare acceptability at a selected health sub-district in South Africa
Authors: Bucyibaruta Joy Blaise , Peu Mmapheko Doriccah , Bamford Lesley , Musekiwa Alfred 
Published: April 2023

Abstract
Background
There are many factors during pregnancy and labor that influence women’s acceptability of maternal healthcare. Nevertheless, the concept of acceptability of maternal healthcare has unfortunately not been clearly defined and remains difficult to assess, affecting its implications and approaches from maternal health perspectives. In this study, we proposed a practical definition of maternal healthcare acceptability and developed a tool to measure maternal healthcare acceptability from patients’ perspective at a selected health sub-district in South Africa.

Methods
We applied known techniques to develop measurement tools in health settings. The concept development drew from the literature review leading to the proposed definition of maternal healthcare acceptability which was then refined and validated by experts through Delphi technique. Other techniques included specification of concept constructs; selection of indicators; formation of indices; measurement tool/scale construction; and testing of reliability and validity. Factor analysis and simple arithmetic equation were performed on secondary and primary datasets respectively.

Results
Experts in the field reached a consensual definition of maternal healthcare acceptability. Factor analysis revealed three factors retained to predict maternal healthcare acceptability indices, namely provider, healthcare and community. Structural equation model showed good fit (CFI = 0.97), with good reliability and validity. Hypothesis testing confirmed that items and their corresponding factors were related (p < 0.01). Simple arithmetic equation was recommended as alternative method to measure acceptability when factor analysis was not applicable.

Conclusion
This study provides new insights into defining and measuring acceptability of maternal healthcare with significant contributions on existing theories and practices on this topic and practical applications not only for maternal health but also across diverse health disciplines.
Office blood pressure versus ambulatory blood pressure measurement in childhood obesity
Authors: van der Heijden Laila B , Groothoff Jaap W. , Feskens Edith JM , Janse Arieke J 
Published: April 2023

Abstract
Background
The prevalence of obesity-related co-morbidities is rising parallel to the childhood obesity epidemic. High blood pressure (BP), as one of these co-morbidities, is detected nowadays at increasingly younger ages. The diagnosis of elevated BP and hypertension, especially in the childhood population, presents a challenge to clinicians. The added value of ambulatory blood pressure measurement (ABPM) in relation to office blood pressure (OBP) measurements in obese children is unclear. Furthermore, it is unknown how many overweight and obese children have an abnormal ABPM pattern. In this study we evaluated ABPM patterns in a population of overweight and obese children and adolescents, and compared these patterns with regular OBP measurements.

Methods
In this cross-sectional study in overweight or obese children and adolescents aged 4–17 years who were referred to secondary pediatric obesity care in a large general hospital in The Netherlands, OBP was measured during a regular outpatient clinic visit. Additionally, all participants underwent a 24-hour ABPM on a regular week-day. Outcome measures were OBP, mean ambulatory SBP and DBP, BP load (percentage of readings above the ambulatory 95th blood pressure percentiles), ambulatory BP pattern (normal BP, white-coat hypertension, elevated BP, masked hypertension, ambulatory hypertension), and BP dipping.

Results
We included 82 children aged 4–17 years. They had a mean BMI Z-score of 3.3 (standard deviation 0.6). Using ABPM, 54.9% of the children were normotensive (95% confidence interval 44.1–65.2), 26.8% had elevated BP, 9.8% ambulatory hypertension, 3.7% masked hypertension, and 4.9% white-coat hypertension. An isolated night-time BP load > 25% was detected in almost a quarter of the children. 40% of the participants lacked physiologic nocturnal systolic BP dipping. In the group of children with normal OBP, 22.2% turned out to have either elevated BP or masked hypertension on ABPM.

Conclusions
In this study a high prevalence of abnormal ABPM patterns in overweight or obese children and adolescents was detected. Additionally, OBP poorly correlated with the child’s actual ABPM pattern. Herewith, we emphasized the usefulness of ABPM as an important diagnostic tool in this population.
Active monitoring versus an abduction device for treatment of infants with centered dysplastic hips: study protocol for a randomized controlled trial (TReatment with Active Monitoring (TRAM)-Trial)
Authors: Mulder Frederike E. C. M. , Witlox M. Adhiambo , Dirksen Carmen D. , de Witte Pieter Bas , de Vos-Jakobs Suzanne , Ham Arno M. ten , Witbreuk Melinda M. E. H. , Sakkers Ralph , Drongelen Magritha M. H. P. Foreman-van , Robben Simon G. F. ,   TRAM-Trial Consortium, van Bergen Christiaan J. A. , Besselaar Arnold T. , Boot Marieke , Burger Bart J. , van Douveren Florens Q. M. P. , van Gelder J. H. , Hartog Yvon M.den , Oost Iris Koenraadt-van , van Linge Joost H. , Maathuis Patrick G. M. , Moerman Sophie , Pereboom Renske M. , Staal Heleen M. , van der Steen M. C. , Tolk Jaap J. , Vergroesen Diederik A. , Zeegers A. V. C. M. , Mathijssen Nina M. C. 
Published: April 2023

Abstract
Background
Developmental Dysplasia of the Hip (DDH) is one of the most common pediatric orthopedic disorders, affecting 1–3% of all newborns. The optimal treatment of centered DDH is currently under debate. This randomized controlled trial aims to study the (cost-)effectiveness of active monitoring versus abduction treatment for infants with centered DDH.

Methods
This is a multicenter, parallel-group, open-label, non-inferiority randomized controlled trial studying the (cost-)effectiveness of active monitoring versus abduction treatment for infants with centered DDH in fourteen hospitals in the Netherlands. In total, 800 infants with centered DDH (Graf IIa-/IIb/IIc), aged 10–16 weeks, will be randomly allocated to the active monitoring or abduction treatment group. Infants will be followed up until the age of 24 months. The primary outcome is the rate of normal hips, defined as an acetabular index lower than 25 degrees on an antero-posterior radiograph, at the age of 12 months. Secondary outcomes are the rate of normal hips at the age of 24 months, complications, time to hip normalization, the relation between baseline patient characteristics and the rate of normal hips, compliance, costs, cost-effectiveness, budget impact, health-related quality of life (HRQoL) of the infant, HRQoL of the parents/caregivers, and parent/caregiver satisfaction with the treatment protocol.

Discussion
The outcomes of this randomized controlled trial will contribute to improving current care-as-usual for infants with centered DDH.

Trial registration
Dutch Trial Register, NL9714, registered September 6, 2021. https://clinicaltrialregister.nl/en/trial/29596
JAGN1 mutation with distinct clinical features; two case reports and literature review
Authors: Hojabri Mahsa , Farsi Yeganeh , Jamee Mahnaz , Abolhassani Hassan , Khani Hedieh Haji Khodaverdi , Karimi Abdollah , Mesdaghi Mehrnaz , Chavoshzadeh Zahra , Sharafian Samin 
Published: April 2023

AbstractJagunal homolog 1 (JAGN1) has been recognized as an essential protein in neutrophil function. The mutated JAGN1 is responsible for immunodeficiency related to innate and humoral defense mechanisms. This deficiency impairs neutrophil development and function, leading to recurrent infections and facial dysmorphism as phenotypic consequences of severe congenital neutropenia (SCN). We report two siblings having the reportedJAGN1mutation with different clinical manifestations. Recurrent abscess formation unresponsive to antibiotic therapy, a history of delayed umbilical separation, frequent bacterial or fungal infection, dysmorphic face, failure to thrive, and other coexisting organ abnormalities should prompt physicians to syndromic immunodeficiencies involving neutrophils. Genetic investigations to elucidate the responsible mutation is critical as clinical management varies. Once the diagnosis is confirmed, a multi-disciplinary team should perform further workups to investigate other coexisting malformations and neurodevelopmental evaluation.
Relationship between cognitive functioning and physical fitness in regard to age and sex
Authors: González-Fernández Francisco Tomás , Delgado-García Gabriel , Coll Jesús Siquier , Silva Ana Filipa , Nobari Hadi , Clemente Filipe Manuel 
Published: April 2023

AbstractThe aim of this study was to analyze the relationships among physical cognitive ability, academic performance, and physical fitness regarding age and sex in a group of 187 students (53.48% male, 46.52% female) from one town of Norwest of Jaén, Andalusia (Spain), aged between 9 and 15 years old (M = 11.97, SD = 1.99). The D2 attention test was used in order to analyze selective attention and concentration. Physical fitness, reflected on maximal oxygen uptake (VO2max), was evaluated using the 6 min Walking Test (6MWT). The analysis taken indicated a significant relationship between physical fitness level, attention, and concentration, as in the general sample looking at sex (finding differences between boys and girls in some DA score in almost all age categories [p < 0.05]) and at age category (finding some differences between the younger age category groups and the older age category groups in some DA scores (p < 0.05), not finding any significant interaction between sex and age category (p > 0.05). In sum, the present study revealed that students with better aerobic fitness can present better-processed elements and smaller omission errors. Moreover, girls and older students seem to present better cognitive functioning scores than boys and younger. Our findings suggest that more research is necessary to elucidate the cognitive function between ages, sexes, and physical fitness and anthropometry levels of students.
The effect of azithromycin on sputum inflammatory markers in bronchiectasis
Authors: Terpstra L. C. , Altenburg J. , Doodeman H. J. , Piñeros Y. S. Sabogal , Lutter R. , Heijerman H. G. M. , Boersma W. G. 
Published: April 2023

Abstract
Background
Long term macrolide treatment has been found beneficial in bronchiectasis (BE) -pathogical bronchial dilatation- possibly due to a combined anti-bacterial and immunomodulatory effect. The exact mechanism of inflammatory response is unknown. Here, we investigated the effect of maintenance macrolide treatment on the inflammatory response in BE. In addition, we assessed the inflammatory profile in BE in relation to disease severity.

Methods
During the BAT randomized controlled trial (investigating the effect of 1 year of azithromycin (AZM) in 83 BE patients), data on BE severity, lung function and sputum microbiology was collected. For the current study, a wide range of inflammatory markers were analysed in 3- monthly sputum samples in all participants.

Results
At baseline, marked neutrophilic but also eosinophilic inflammation was present in both groups, which remained stable throughout the study and was not affected by AZM treatment. Significant upregulation of pro-inflammatory markers correlated with FEV1 < 50% (TNFα, ECP, IL-21, IL-1, p = 0.01- 0.05), H. influenzae (HI) colonization (MPO, ECP, MIP-1, TNFα, IL-21, Il-8, IL-1, IL-1α, p < 0.001 – 0.04) and number of exacerbations (MPO, ECP, VEGF, MMP-9, p = 0.003 – 0.01). Surprisingly, colonization with P. aeruginosa (PA) was found to correlate with an attenuated inflammatory response compared to non-PA colonized. In placebo-treated patients, presence of an infectious exacerbation was reflected by a significant excessive increase in inflammation as compared to a non-significant upregulation in the AZM-treated patients.

Conclusion
One year of AZM treatment did not result in attenuation of the inflammatory response in BE. Increasing disease severity and the presence of an exacerbation were reflected by upregulation of pro-inflammatory markers.
Reducing complications of femoral neck fracture management: a retrospective study on the application of multidisciplinary team
Authors: Liang Weiming , Qin Gang , Yu Lizhi , Wang Yingying 
Published: April 2023

Abstract
Background
Femoral neck fractures are associated with substantial morbidity and mortality for older adults. Multi-system medical diseases and complications can lead to long-term care needs, functional decline and death, so patients sustaining hip fractures usually have comorbid conditions that may benefit from application of multidisciplinary team(MDT).

Methods
This is a retrospective cohort study that incorporates medical record review with an outcomes management database. 199 patients were included who had surgery for a new unilateral femoral neck fracture from January 2018 to December 2021 (96 patients in usual care (UC) model and 103 patients in MDT model. High-energy, pathological, old and periprosthetic femoral neck fracture were excluded. Age, gender, comorbidity status, time to surgery, and postoperative complication, length of stay, in-hospital mortality, 30-day readmission rate, 90-day mortality data were collected and analyzed.

Results
Preoperative general data of sex, age, community dwelling and charlson comorbidity score of MDT group (n = 103) have no statistically significant difference with that of usual care (UC) group. Patients treated in the MDT model had significantly shorter times to surgery (38.5 vs. 73.4 h;P = 0.028) and lower lengths of stay (11.5 vs. 15.2 days;P = 0.031). There were no significant differences between two models in In-hospital mortality (1.0% vs. 2.1%; P = 0.273), 30-day readmission rate (7.8% vs. 11.5%; P = 0.352) and 90-day mortality (2.9% vs. 3.1%; P = 0.782). The MDT model had fewer complications overall (16.5% vs. 31.3%; P = 0.039), with significantly lower risks of delirium, postoperative infection, bleeding, cardiac complication, hypoxia, and thromboembolism.

Conclusion
Application of MDT can provide standardized protocols and a total quality management approach, leading to fewer complications for elderly patients with femoral neck fracture.

Trial registration
No.
Performing a sperm DNA fragmentation test in addition to semen examination based on the WHO criteria can be a more accurate diagnosis of IVF outcomes
Authors: Okubo Tsuyoshi , Onda Noriyuki , Hayashi Teruaki , Kobayashi Tatsuya , Omi Kenji , Segawa Tomoya 
Published: April 2023

Abstract
Background
We analyzed the sperm DNA fragmentation index (DFI) and general semen test based on the World Health Organization (WHO) criteria and compared the two tests using semen factors. In addition, we examined whether DFI is a reliable parameter associated with in vitro fertilization (IVF) outcomes.

Methods
Sperm chromatin dispersion (SCD) and general semen tests were conducted in accordance with the WHO 2010 guidelines, and correlations between the two tests were investigated. The WHO criteria were set as the cutoff values for each of the following factors: semen volume, concentration, total sperm count, motility, and normal morphology, and compared with the DFI results.

Results
The subjects had a mean sperm DFI of 15.3% ± 12.6%, and the DFI increased with age. In contrast, motility and normal morphology decreased as the DFI increased. Patients who satisfied the WHO criteria in terms of concentration, total sperm count, and motility had a significantly lower DFI than those who did not satisfy the criteria. Therefore, evaluation with a general semen test based on the WHO criteria should be regarded as a qualitative evaluation of all factors other than semen volume and normal morphology.

Conclusions
High DFI (≥ 30%) caused a low blastocyst development rate following intracytoplasmic sperm injection. Male infertility due to DFI should be suspected when IVF results are poor despite normal semen findings based on the WHO criteria. The results of this study suggest that the SCD test may more accurately evaluate the correlation between IVF clinical outcomes and male infertility. Therefore, it is important to focus on DFI measurements.
Indicators of integrating oral health care within universal health coverage and general health care in low-, middle-, and high-income countries: a scoping review
Authors: Jashni Yassaman Karimi , Emari Fatemeh , Morris Martin , Allison Paul 
Published: April 2023

AbstractBackgroundThe World Health Organization (WHO) has recently devoted special attention to oral health and oral health care recommending the latter becoming part of universal health coverage (UHC) so as to reduce oral health inequalities across the globe. In this context, as countries consider acting on this recommendation, it is essential to develop a monitoring framework to measure the progress of integrating oral health/health care into UHC. This study aimed to identify existing measures in the literature that could be used to indicate oral health/health care integration within UHC across a range of low-, middle- and high-income countries.MethodsA scoping review was conducted by searching MEDLINE via Ovid, CINAHL, and Ovid Global Health databases. There were no quality or publication date restrictions in the search strategy. An initial search by an academic librarian was followed by the independent reviewing of all identified articles by two authors for inclusion or exclusion based on the relevance of the work in the articles to the review topic. The included articles were all published in English. Articles concerning which the reviewers disagreed on inclusion or exclusion were reviewed by a third author, and subsequent discussion resulted in agreement on which articles were to be included and excluded. The included articles were reviewed to identify relevant indicators and the results were descriptively mapped using a simple frequency count of the indicators.ResultsThe 83 included articles included work from a wide range of 32 countries and were published between 1995 and 2021. The review identified 54 indicators divided into 15 categories. The most frequently reported indicators were in the following categories: dental service utilization, oral health status, cost/service/population coverage, finances, health facility access, and workforce and human resources. This study was limited by the databases searched and the use of English-language publications only.ConclusionsThis scoping review identified 54 indicators in a wide range of 15 categories of indicators that have the potential to be used to evaluate the integration of oral health/health care into UHC across a wide range of countries.
The effect of dentin surface pretreatment using dimethyl sulfoxide on the bond strength of a universal bonding agent to dentin
Authors: Mirzaei Kianoosh , Ahmadi Elham , Rafeie Niyousha , Abbasi Mahdi 
Published: April 2023

Abstract
Background
This study aimed to evaluate the effect of dentin pretreatment by Dimethyl Sulfoxide (DMSO) on the bond strength and microleakage of a universal bonding agent to dentin.

Methods
Fifty-six dentinal discs (thickness = 2 mm) were obtained from the crowns of the human third molars. The disks were assigned into 4 groups and treated as follows; self-etch-control group: G-Premio universal adhesive was used in self-etch mode, total-etch-control: G-Premio universal adhesive was used in total-etch mode, self-etch-DMSO: Water-based DMSO (50% volume) was applied on the samples for 60 s followed by application of G-Premio universal adhesive in self-etch mode, and Total-etch-DMSO: The samples were etched, and then, water-based DMSO was applied on them for 60 s followed by the application of G-Premio universal adhesive in total-etch mode. Afterward, resin composite was placed on all samples and light-cured. The samples were kept in distilled water and subjected to 5000 thermal cycles. Microshear bond strength was measured using the universal testing machine and failure modes were analyzed using a stereomicroscope. Forty-eight human third molars were used for microleakage evaluation and a standardized class five cavity was prepared on the buccal surface of each tooth. The teeth were assigned into 4 groups and received aforementioned surface treatment and the cavities were filled with resin composite. After storing in water for 24 h, the samples were subjected to 5000 cycles of thermocycling and the microleakage level of the samples was evaluated using silver nitrate uptake at the bonded interface. Two-way ANOVA test was used to analyze the effect of bonding technique (self-etch/ total-etch) and DMSO pretreatment on the microshear bond strength and microleakage of G-Premio adhesive to dentin.

Results
Bonding technique had no effect on the bond strength values (p = 0.17) while DMSO pretreatment significantly decreased the microshear bond strength of the samples (p = 0.001). DMSO application increased microleakage significantly in total-etch (P-value = 0.02) while it had no effect in self-etch mode (P-value = 0.44).

Conclusions
Pretreatment of dentin using 50% DMSO significantly reduced the bond strength of G-Premio Bond in both self-etch and total-etch modes. DMSO effect on microleakage depended on the etching technique; DMSO increased the microleakage level when the adhesive was used in total-etch mode while did not affect the microleakage in self-etch mode.