bluuebunny/crossref_metadata_2025_split huggingface dataset:
Streamlining care in two neurosurgical practices in a rural trauma center
Authors: Gibson Kyle , Whitson Daniel , Filson John D. , Grunch Betsy , Pack Leigh 
Published: July 2023

ABSTRACT
To maximize cost-effective care and evaluate the use of physician associates/assistants (PAs) and NPs in an academic inpatient setting, we investigated the effect of streamlining care by using a common PA position between two neurosurgery groups. Trauma registry data were obtained and analyzed to gain insight into hospital length of stay (LOS) and clinical outcomes before and after implementing this new position. The average hospital LOS was reduced for less severely injured patients, and the time to initiation of venous thromboembolism prophylaxis decreased for injured neurosurgical patients. These results indicate the successful facilitation of time-sensitive, value-based healthcare for this specific clinical population at our Level 2 trauma center.
The Effect of Selective Dorsal Rhizotomy on Hip Displacement in Children With Cerebral Palsy
Authors: Miller Stacey D. , Juricic Maria , Bone Jeffrey N. , Steinbok Paul , Mulpuri Kishore 
Published: July 2023

Background:Hip displacement is common in children with cerebral palsy (CP). Spasticity in the hip adductor muscles, hip flexors, and medial hamstrings has been identified as a possible cause of progressive hip displacement. Selective dorsal rhizotomy (SDR) aims to reduce lower extremity spasticity in children with CP. Here, we investigate the influence of SDR on hip displacement in children with CP at long-term follow-up, a minimum of 5 years post-SDR.Methods:A retrospective review of children undergoing SDR at a Canadian pediatric hospital was completed. Migration percentage (MP) was measured on pelvis radiographs taken in the 6 months before SDR and minimum 5 years post-SDR or before hip surgery. The number of hips with displacement, defined as MP >30%, and the number of children with at least 1 hip displaced were determined. A linear mixed-effects model was used to assess potential risk factors for poor outcome post-SDR, defined as having MP >40% or surgical intervention for hip displacement.Results:Ninety children [50 males, 40 females, Gross Motor Function Classification System (GMFCS) levels I to V: 1/13/24/43/9] with a mean follow-up of 8.5 years (SD 5.1) were included. The mean age at SDR was 4.9 years (SD 1.5); more than half of children (52%) had hip displacement at the time of SDR. Post-SDR, MP exceeded 30% in 0 (0%) of children at GMFCS level I, 1 (8%) at II, 11 (46%) at III, 31 (72%) at IV, and 7 (78%) at V. A poor outcome was associated with preoperative MP, age, and GMFCS level.Conclusions:The incidence of hip displacement post-SDR was consistent with population-based studies when evaluated by GMFCS. Our findings suggest that SDR has neither a positive nor negative effect on hip displacement when assessed at least 5 years postintervention.Level of Evidence:Level IV.
Breast Implants Decrease Chest Wall Trauma in Low-speed, Unrestrained Motor Vehicle Crash: An Experimental Model
Authors: Pannucci Christopher J. , Wheeler Chad K. , Cyr Krista M. , Cyr Adam J. 
Published: July 2023

Introduction:
Breast implants improve quality of life in patients seeking improved breast aesthetics, and are known to minimize human injury in the less common scenario of penetrating trauma. People commonly sustain rib and sternum fractures and thoracic injury in motor vehicle crashes (MVC), a form of blunt traumatic injury. Whether breast implants minimize injury during MVC is unknown. This study examines the potential protective effect of breast implants in low speed, unrestrained MVC.

Methods:
Control (medical gel) and implant (medical gel with embedded breast implant) blocks were subjected to load approximating a low speed, 10mph MVC (n=12 blocks per group). Colormetric pressure film measured pressure at the neo-chest wall position in response to load, across the gel block base. Maximum pressure and average pressure across the gel block base were compared, by group.

Results:
Presence of an implant significantly decreased, by 22.8%, maximum pressure experienced by the neo-chest wall (333.0 ± 58.7 psi vs 431.6 ± 37.3 psi, p=0.0006). Average pressure experienced by the neo-chest wall across the gel block base was also significantly decreased, by 28.1%, in the implant group (53.4 ± 5.6 psi vs 74.3 ± 15.7 psi, p=0.0017). Subjective analysis of all implant and control blocks supported an overall reduction in pressure for the implant group.

Conclusions:
Presence of a breast implant decreased maximum pressure at the chest wall by 23%, and average pressure by 28%. Patients with breast implants involved in low speed, unrestrained MVC may be less likely to sustain rib and sternum fractures and thoracic injury, when compared to patients without implants.
Comparing Cesarean Birth Utilization Between US Hospitals
Authors: Smith Denise Colter , Phillippi Julia C. , Tilden Ellen L. , Lowe Nancy K. , Carlson Nicole S. , Neal Jeremy L. , Blankstein Breman Rachel 
Published: July 2023

Background:
The World Health Organization-endorsed Robson Ten-Group Classification System (TGCS) is a standard reporting mechanism for cesarean birth, yet this approach is not widely adopted in the United States.

Objective:
To describe the application and utility of the TGCS to compare hospital-level cesarean births rates, for use in quality improvement and benchmarking.

Methods:
We conducted a descriptive, secondary data analysis of the Consortium on Safe Labor dataset using data from 228 438 women's births, from 2002 to 2008, in 12 sites across the United States. We stratified births into 10 mutually exclusive groups and calculated within-group proportions of group size and cesarean birth rates for between-hospital comparisons of cesarean birth, trial of labor after cesarean (TOLAC), and labor induction utilization.

Results:
There is variation in use of cesarean birth, labor induction, and TOLAC across the 12 sites.

Conclusion:
The TGCS provides a method for between-hospital comparisons, particularly for revealing usage patterns of labor induction, TOLAC, and cesarean birth. Adoption of the TGCS in the United States would provide organizations and quality improvement leaders with an effective benchmarking tool to assist in reducing the use of cesarean birth and increasing the support of TOLAC.
“All I Can Say Is Thank You”
Authors: Walker Heather R. , Clarkson Gina , Alston Hailey , Chan Belinda 
Published: July 2023

Background:
COVID-19-associated visitor restrictions altered parents' involvement in their infant's care in the neonatal intensive care unit (NICU).

Purpose:
The purpose of this article is to explore how restrictions affected parents' perceptions of experience in the NICU and to build a conceptual model of communication flow during times of crisis.

Methods:
This qualitative study was set in a level III 52-bed NICU. Using data from an open-ended survey question, a multitiered thematic analysis was used.

Results:
Four broad themes emerged: communication, gratitude, release, and containment of emotionality. These 4 themes interacted codependently and manifested differently as COVID-related visitor policies were put in place. Parents' characterization of communication also varied depending on the visitation policies. Before COVID, parents were more likely to reflect on communication. During COVID, parents expressed more gratitude, while containing negative emotions—sometimes using gratitude to soften the blow of bad feedback.

Implications for Practice and Research:
Our theoretical model suggests that gratitude may serve as a form of “reciprocal care” to providers during a period of crisis and extreme stress. Use of high-quality communication between providers and parents in the NICU is necessary to understand parental concerns or negative experience.
Survey of Postpartum People in the United States During the First Wave of the COVID-19 Pandemic to Explore Their Perspective on Support After Discharge
Authors: Breman Rachel Blankstein , Neerland Carrie , Iobst Stacey E. , Bradford L. Latéy , Barr Eric , Malloy Shannon , Burgess Adriane 
Published: July 2023

Introduction:
The purpose of this study was to capture the experiences of postpartum people during the first wave of COVID-19, specifically their access to contraception and lactation support.

Methods:
This cross-sectional study surveyed individuals in the United States who used the Ovia Pregnancy and Parenting app. The survey was administered via an email Web link sent to postpartum people who gave birth between March 1, 2020, and June 11, 2020. Quantitative and qualitative analyses were conducted.

Results:
A total of 388 postpartum people completed the survey. Most participants had just given birth to their first baby (68.5%; n = 261) at term gestation (37-41 weeks) (92.9%; n = 355). From the qualitative data, using content analysis, we derived 6 themes and 2 subthemes: quarantine, changes in postpartum care, loneliness and isolation, stress, resource changes, and positive impact. The theme loneliness and isolation had 2 subthemes: depression/sadness/hopelessness and anxiety.

Discussion:
The experience of being postpartum during the COVID-19 pandemic brought unforeseen challenges. Providing care and support to postpartum people during a pandemic, specifically during a time of quarantine, should be reimagined. Increased use of virtual postpartum care services and expanded mental health support could serve to fill the gaps identified by participants.
Platelet-Rich Plasma for the Treatment of Stress Urinary Incontinence—A Randomized Trial
Authors: Grigoriadis Themos , Kalantzis Christos , Zacharakis Dimitrios , Kathopoulis Nikolaos , Prodromidou Anastasia , Xadzilia Sofia , Athanasiou Stavros 
Published: July 2023

ImportanceUrinary incontinence affects millions of women worldwide.ObjectiveThe aim of the current study was to evaluate the efficacy and safety of periurethral platelet-rich plasma (PRP) injections in women with stress urinary incontinence (SUI).Study DesignThis was a single-center, double-blind, randomized sham-controlled trial. Fifty participants with SUI and urodynamic stress incontinence were randomized in 2 equally sized groups. Women in the PRP group received 2 PRP injections at 3 levels of the urethra at 4- to 6-week intervals. Women in the sham group were injected with sodium chloride 0.9%. At baseline, participants underwent urodynamic studies and a 1-hour pad test and completed the International Consultation on Incontinence Questionnaire—Female Lower Urinary Tract Symptoms (ICIQ-FLUTS), the Patient Global Impression Scale of Improvement, and the King's Health Questionnaire. At follow-up visits (1, 3, and 6 months), women underwent the 1-hour pad test and completed the King's Health Questionnaire and the ICIQ-FLUTS. Primary outcome was the subjective evaluation as indicated by the response to question 11a of the ICIQ-FLUTS questionnaire. Secondary outcomes included scores of questionnaires and urine loss assessed on the 1-hour pad test. The level of discomfort during injections and any adverse events were also evaluated.ResultsDuring follow-up, the mean score of the 11a question decreased significantly in the PRP group compared with sham. Subjective cure was significantly higher in the PRP group (32% vs 4%,P< 0.001). A significant reduction of urine loss assessed on the 1-hour pad test was observed in the PRP group compared with the sham group at 6-month follow-up. No adverse events were observed.ConclusionsPeriurethral PRP injections were superior to sham injections in improving SUI symptoms with an excellent safety profile.
The impact of COVID-19 on community-dwelling people post-stroke and informal caregivers: a qualitative study
Authors: Dias Teresa , Cravo Patrícia , Santos Joana , Gomes Catarina , Santiago Marta , Pereira Carla Mendes 
Published: July 2023

AbstractBackground/ aimsLittle is known about the experience of people post-stroke and their informal caregivers during the COVID-19 pandemic. The aim of this study was to understand the challenges faced by people post-stroke and informal caregivers during the pandemic, as well as the impact on their healthcare support, lifestyle, and self-care behaviors.MethodsA multi-perspective qualitative study was undertaken, with semi-structured interviews being carried out to sixteen participants: eight stroke patients and eight informal caregivers, mostly performed online. Reflexive thematic analysis was used, with data being independently coded and categorized before consolidated into themes and subthemes.FindingsThree themes were derived from the data analysis: i) Perceived impact of COVID-19 pandemic, ii) What helped? - strategies to manage the distress provoked by COVID-19, and iii) The value of rehabilitation and physical activity, with findings highlighting the negative psychological impact of the pandemic. In response to the perceived lack of support and access to health and social services, participants highlighted the use of digital approaches and professional support.ConclusionsFindings suggest the importance of self-management support and/or digital content in order to mitigate the impact of COVID-19. The involvement of peers, family members, friends or others seems to be an important strategy to increase motivation in remote rehabilitation and physical activity.Key points-Due to the impact of COVID-19 on people post-stroke and informal caregivers’ daily routines, both highlighted the importance of finding new and alternative ways of communicating, which included the use of digital approaches.-For some informal caregivers the pandemic was perceived as an opportunity to spend more time with the family and with the person with stroke.-People post-stroke admit having decreased their levels of physical activity during COVID-19 and increased the value given to rehabilitation and physical activity.-Involving peers or others, digitally or in-person, seems to be an important strategy when planning physical activity recommendations.
Household Vulnerability in the urban slums of Mumbai, India: Analysis of a large cross-sectional Survey
Authors: Deshmukh Devika , Basu Saurav , Negandhi Preeti , Sharma Jyoti , D’Aquino Luigi , Singh Vivek , Gadhari Mangesh , Venu Vaishali , Chandrasekar Rajeshwari , Gomare Mangala , Zodpey Sanjay 
Published: July 2023

AbstractBackgroundImproving equitable health outcomes needs a further understanding of the social, economic, political, and legal determinants that shape human health and well-being, especially in the poor and marginalized communities in urban slums. Vulnerability represents a group of adverse social determinants that put a household at a greater risk of falling ill.The objective of this study was to determine the magnitude of health, residential, social, and occupational vulnerabilities amongst households in two urban slums in Mumbai, assess the sociodemographic factors associated with health vulnerability, and ascertain the linkage between health vulnerability and other vulnerabilities.MethodsA cross-sectional survey was conducted from May to August 2021 in the urban slums of Mumbai. One Urban Primary Health Center area each in two wards (M/East and G/North) of Mumbai city mostly inhabited by people living in slums was purposively selected. A total of 15,796 households were included in the vulnerability assessment survey. Four kinds of vulnerability (health, social, residential, and occupational) indices were created based on survey responses.ResultsHigh residential vulnerability was estimated in 73.5%, (95% C.I. 72.8, 74.2), high social vulnerability in 67.9% (95% C.I. 67.2, 68.7), and high occupational vulnerability in 59.5%, (95% C.I. 58.7, 60.2) households. The presence of health vulnerability was observed in 39.6% (95% C.I. 38.8, 40.4) households. On adjusted analysis, social, residential, and occupational vulnerability were all statistically significant predictors of health vulnerability (p<0.001). The health vulnerability increased by 0.492 units for each unit increase in social vulnerability, 0.605 for each unit increase in residential vulnerability and 0.081 unit for each unit increase in occupational vulnerability.ConclusionsHealth vulnerability is present in nearly four out of ten households in the urban slums of Mumbai, while a majority of the households experience residential, social, and occupational vulnerability. Overcrowding and poor ventilation were nearly universal, with high burden of poor sanitation and hygiene.
EXPLORING WOMEN’S PERSPECTIVES ON ABORTION LEGALIZATION IN NAMIBIA: INSIGHTS FROM RESIDENTS OF /GERERES, KEETMANSHOOP
Authors: Namukwambi Rauna , Sheehama Lovis , Sheehama Justice EK. , Nakambale Hilma N. 
Published: July 2023

ABSTRACTIntroductionAbortion is a globally controversial topic. Despite Namibia gaining independence in 1990, the country still upholds the apartheid inherited 1975 Abortion and Sterilization Act of South Africa, which places restrictions on abortion. There have been calls from many parliamentarians to legalize abortion on demand due to the alarming rate of backyard abortions that were putting Namibian women’s lives at risk. However, there is opposition from Pro-life advocates. This study assessed the perceptions of women in /Gereres, Keetmanshoop regarding the legalization of abortion in Namibia.MethodsThis study utilized a quantitative, descriptive cross-sectional design. A non-probability systematic sampling technique was used to select participants. A self-administered questionnaire was used to collect data. Participants’ perspectives were captured using structured three-point and five-point Likert scale checklists. Microsoft Excel was used to analyze data. Data were presented using frequency tables.ResultsThe study revealed a variation of views from participants, mostly opposing the legalization of abortion in Namibia. Most women acknowledged that illegal abortion poses risks to women; however, they would not advocate for the legalization of abortion. Notably, several participants appeared to justify abortion in certain circumstances such as in cases of rape or incest, or if continuation of the pregnancy poses a health risk to the woman. Cultural and religious beliefs appeared to be major factors influencing women’s opposing views on abortion.ConclusionThe study highlights the complex and diverse perspectives of women in /Gereres, Keetmanshoop regarding the legalization of abortion in Namibia. While recognizing the risks associated with illegal abortion, most participants opposed its legalization, which could mostly be attributed to cultural and religious beliefs. However, some participants acknowledged specific circumstances where abortion could be justified. This study provides women’s insights on the legalization of abortion in Namibia, useful for lawmakers, policymakers, and stakeholders in the field of reproductive health.
BCKDKrs14235 A allele is associated with milder motor impairment and altered network topology in Parkinson’s disease
Authors: Chen Zhichun , Wu Bin , Li Guanglu , Zhou Liche , Zhang Lina , Liu Jun 
Published: July 2023

AbstractBackgroundA multitude of genetic variants confer a risk of Parkinson’s disease (PD), however, whether these risk variants affected the motor symptoms of PD patients remain largely elusive. The objective of this study is to investigate the effects ofBCKDKrs14235 (G > A), a risk variant associated with PD risk, on the motor manifestations and brain networks of PD patients.MethodsPD patients (n = 146) receiving magnetic resonance imaging from Parkinson’s Progression Markers Initiative (PPMI) database were investigated. The effects ofBCKDKrs14235 on the motor manifestations and brain networks of PD patients were systematically evaluated.ResultsBCKDKrs14235 A allele was associated with milder motor symptoms in PD patients.BCKDKrs14235 significantly modified the topology of brain structural and functional network. The assortativity in structural network was negatively associated with rigidity in PD while the shortest path length of right pallidum was positively associated with Unified Parkinson’s Disease Rating Scale part III (UPDRS-III) scores. The mediation analysis suggested that assortativity in structural network mediated the effects ofBCKDKrs14235 on rigidity and the shortest path length of right pallidum mediated the effects ofBCKDKrs14235 on UPDRS-III scores.ConclusionsBCKDKrs14235 significantly shaped the motor impairment and network topology of PD patients. Differential network metrics mediated the effects ofBCKDKrs14235 on rigidity and UPDRS-III scores of PD patients. Future studies were required to identify the molecular mechanisms underlying the effects ofBCKDKrs14235 on motor impairment and brain network metrics of PD patients.
Shallow networks run deep: Peripheral preprocessing facilitates odor classification
Authors: Puri Palka , Wu Shiuan-Tze , Su Chih-Ying , Aljadeff Johnatan 
Published: July 2023

SummaryThe mammalian brain implements sophisticated sensory processing algorithms along multilayered (‘deep’) neural-networks. Strategies that insects use to meet similar computational demands, while relying on smaller nervous systems with shallow architectures, remain elusive. UsingDrosophilaas a model, we uncover the algorithmic role of odor preprocessing by a shallow network of compartmentalized olfactory receptor neurons. Each compartment operates as a ratiometric unit for specific odor-mixtures. This computation arises from a simple mechanism: electrical coupling between two differently-sized neurons. We demonstrate that downstream synaptic connectivity is shaped to optimally leverage amplification of a hedonic value signal in the periphery. Furthermore, peripheral preprocessing is shown to markedly improve novel odor classification in a higher brain center. Together, our work highlights a far-reaching functional role of the sensory periphery for downstream processing. By elucidating the implementation of powerful computations by a shallow network, we provide insights into general principles of efficient sensory processing algorithms.