bluuebunny/crossref_metadata_2025_split huggingface dataset:
Childbirth experience in induced labor: A prospective study using a validated childbirth experience questionnaire (CEQ) with a focus on the first birth
Authors: Place Katariina , Rahkonen Leena , Verho-Reischl Niina , Adler Katti , Heinonen Seppo , Kruit Heidi 
Published: October 2022

Objective
First birth and labor induction are risk factors for negative childbirth experiences. As labor inductions are increasing, research into this high-risk group’s childbirth experiences is important. We aimed to investigate whether nulliparity or factors related to labor induction, labor, and delivery explain the association.

Methods
This was a prospective study of 711 women undergoing labor induction at Helsinki University Hospital, Finland, between January 1, 2019, and January 31, 2020. The participants answered the Childbirth Experience Questionnaire (CEQ) after delivery (response rate 69.4%). The patient characteristics and delivery outcomes were collected from patient records. We analyzed the results for nulliparous and parous women.

Results
The mean CEQ scores were 2.9 (SD 0.5) for nulliparous women (n = 408) and 3.2 (SD 0.5) for parous women (n = 303), on a scale of 1–4; higher scores represent more positive experiences. However, 7.3% of the women had negative childbirth experiences (8.8% nulliparous; 5.3% parous, p = 0.08). Negative experiences were associated with a cesarean section (OR 6.7, 95% CI 1.8–9.3, p < 0.001) and a hemorrhage ≥ 1500 ml in vaginal delivery (OR 2.8, 95% CI 1.1–7.5, p = 0.03). In the separate CEQ domains analyses, nulliparity was associated with negative experiences in the “Own Capacity” domain (OR 1.6, 95% CI 1.0–2.4, p = 0.03). Cervical ripening, oxytocin use, and daytime delivery were associated with negative experiences in at least one domain, whereas epidural or spinal analgesia was regarded positively in two domains and negatively in one.

Conclusions
Nulliparous women undergoing labor induction risk negative childbirth experiences mainly due to labor and delivery-related factors, similar to parous women. Their perceptions of their capacity and preparedness for labor and delivery should be enhanced antenatally. An effective labor induction protocol promoting as high a rate of vaginal delivery as possible and preparedness to promptly respond to postpartum hemorrhage are key for avoiding negative childbirth experiences.
GSDM gene polymorphisms regulate the IgE level in asthmatic patients
Authors: Imraish Amer , Abu-Thiab Tuqa , Alhindi Tareq , Zihlif Malek 
Published: October 2022

Background
Gasdermin A (GSDMA) and gasdermin B (GSDMB) have been associated with childhood and adult asthma in many populations including the Jordanian population. It is also known that IgE plays a crucial role in various allergic disorders, such elevated levels of total serum IgE were detected in asthma and allergic rhinitis. IgE immunoglobulin is responsible for the release of numerous inflammatory mediators, such as histamine and prostaglandins, from mast cells in asthmatic patients.

Objective
In this study, single nucleotide polymorphisms of GSDMA (rs7212938, T/G) and GSDMB (rs7216389, T/C) in Jordanian population were investigated for their association with total IgE levels in serum of asthmatic children and adult subjects.

Methods
The genetic polymorphism analysis for SNPs was performed using the polymerase chain reaction (PCR)/restriction fragment length polymorphism method (RFLP). Three analysis models were applied to the genotype data: co-dominant, dominant and recessive.

Results
Our data demonstrate a significant correlation between GSDMB genetic SNP (rs7216389) and the total IgE serum level. Where one minor allele in the GSDMB gene is sufficient to induce significant changes in the IgE serum levels and plays a role in the pathogenesis of asthma in asthmatic children of the Jordanian population. Suggesting that this polymorphism might have a protective effect against asthma risk. While the presence of the GSDMB polymorphism alone might not be sufficient to associate with the high risk of developing asthma or responding to it in adults in Jordanian population.

Conclusion
In conclusion, the current study confirms the significant association of GSDMB genetic SNP (rs7216389) with IgE levels in asthma patients in Jordanian population, while no significant correlation of GSDMA and IgE level was found in both child and adult asthmatic patients.
The association between the parameters of uroflowmetry and lower urinary tract symptoms in prostate cancer patients after robot-assisted radical prostatectomy
Authors: Takeshima Yuta , Yamada Yuta , Takemura Kotaro , Kimura Naoki , Hakozaki Yuji , Miyakawa Jimpei , Taguchi Satoru , Akiyama Yoshiyuki , Sato Yusuke , Kawai Taketo , Yamada Daisuke , Fujimura Tetsuya , Kume Haruki 
Published: October 2022

Objective
To investigate changes in uroflowmetry parameters in men undergoing robot-assisted radical prostatectomy (RARP) for prostate cancer.

Materials and methods
Four hundred and twenty-eight patients received uroflowmetry testing before and after RARP from November 2011 to December 2018. Clinicopathological data, including age, initial prostate-specific antigen (PSA), prostate volume, clinical stage, body mass index (BMI), uroflowmetry parameters, and core lower urinary tract symptom scores (CLSS) were retrospectively obtained from clinical records. Changes in uroflowmetry parameters were analyzed for statistical predictors and effects on post-operative outcomes.

Results
A significant increase in maximum flow rate (MFR) and decreases in voided volume (VV) and post-void residual urine (PVR) were seen. In multivariate analysis, age was a negative predictor of MFR increase, while prostate volume was a positive predictor of PVR decrease and MFR increase. VV decrease led to worse incontinence symptoms, while PVR decrease and MFR increase led to improvement in voiding symptoms such as slow stream and straining. Continence recovery curves showed that VV decrease were associated with a delay in continence recovery.

Conclusions
Significant changes were seen in uroflowmetry results after RARP, each parameter directly related to urinary symptoms. In particular, VV decrease was associated with a worsening of incontinence symptoms and continence recovery.
Sickle cell disease and pregnancy profile of complicated malaria in 982 pregnancies in Kinshasa
Authors: Mikobi Tite Minga , Kamuanya Nelly Ciombo , Akilimali Pierre Zalagile , Lukusa Prosper Tshilobo 
Published: October 2022

Introduction
Malaria is associated with high morbidity during pregnancy. Homozygous sickle cell pregnant women are even more exposed during complicated malaria. The objective of the study was to evaluate the maternal and fetal morbidity of homozygous sickle cell pregnant pregnant women with complicated malaria.

Methods
We conducted a retrospective case-control study of 982 pregnancies in sickle cell pregnant women, during which a group of sickle cell pregnant women who received antimalarial chemoprophylaxis was compared to another group without chemoprophylaxis. We analyzed the clinical evolution of pregnant women (VOCs and transfusions, pregnancy weight gain) and parasite (parasite density at the time of diagnosis of complicated malaria and during treatment for three days). We analyzed the parameters of newborns at birth (age of pregnancy at the time of delivery, birth weight, weight of the placenta and histopathological examination of the placenta.

Results
Out of 982 pregnancies, 15% of pregnant women suffered from complicated malaria, 57% suffered from uncomplicated malaria and 28% did not suffer from malaria. Pregnancy weight gain, birth weight, was better in the group of pregnant women who received chemoprophylaxis and the placenta had less histological lesions. Parasite density was low. There was a significant positive correlation between parasite density and the number of CVOs and transfusions and between parasite density and histological lesions of the placenta and low birth weight.

Conclusion
Complicated malaria is associated with high maternal and fetal morbidity in sickle cell patients. Malaria chemoprophylaxis can reduce maternal and fetal complications and parasite density during malaria infection.
Delayed diagnostic evaluation of symptomatic breast cancer in sub-Saharan Africa: A qualitative study of Tanzanian women
Authors: Sakafu Lulu Lunogelo , Philipo Godfrey Sama , Malichewe Christina V. , Fundikira Lulu S. , Lwakatare Flora A. , Van Loon Katherine , Mushi Beatrice P. , DeBoer Rebecca J. , Bialous Stella A. , Lee Amie Y. 
Published: October 2022

Background
Women with breast cancer in sub-Saharan Africa are commonly diagnosed at advanced stages. In Tanzania, more than 80% of women are diagnosed with stage III or IV disease, and mortality rates are high. This study explored factors contributing to delayed diagnostic evaluation among women with breast cancer in Tanzania.

Methods
A qualitative study was performed at Muhimbili National Hospital in Dar es Salaam, Tanzania. Twelve women with symptomatic pathologically proven breast cancer were recruited. In-depth, semi-structured interviews were conducted in Swahili. Interviews explored the women’s journey from symptom recognition to diagnosis, including the influence of breast cancer knowledge and pre-conceptions, health seeking behaviors, psychosocial factors, preference for alternative treatments, and the contribution of culture and norms. Audio-recorded interviews were transcribed and translated into English. Thematic analysis was facilitated by a cloud-based qualitative analysis software.

Results
All women reported that their first breast symptom was a self-identified lump or swelling. Major themes for factors contributing to delayed diagnostic presentation of breast cancer included lack of basic knowledge and awareness of breast cancer and misconceptions about the disease. Participants faced barriers with their local primary healthcare providers, including symptom mismanagement and delayed referrals for diagnostic evaluation. Other barriers included financial hardships, fear and stigma of cancer, and use of traditional medicine. The advice and influence of family members and friends played key roles in healthcare-seeking behaviors, serving as both facilitators and barriers.

Conclusion
Lack of basic knowledge and awareness of breast cancer, stigma, financial barriers, and local healthcare system barriers were common factors contributing to delayed diagnostic presentation of breast cancer. The influence of friends and family also played key roles as both facilitators and barriers. This information will inform the development of educational intervention strategies to address these barriers and improve earlier diagnosis of symptomatic breast cancer in Tanzania.
Development and validation of the Self-Efficacy in Addressing Menstrual Needs Scale (SAMNS-26) in Bangladeshi schools: A measure of girls’ menstrual care confidence
Authors: Hunter Erin C. , Murray Sarah M. , Sultana Farhana , Alam Mahbub-Ul , Sarker Supta , Rahman Mahbubur , Akter Nazrin , Mobashara Moshammot , Momata Marufa , Winch Peter J. 
Published: October 2022

Objective
Qualitative studies have described girls’ varying levels of confidence in managing their menstruation, with greater confidence hypothesized to positively impact health, education, and social participation outcomes. Yet, measurement of this and other psychosocial components of adolescent girls’ menstrual experiences has been weak in global health research, in part due to a dearth of appropriate psychometric tools. We describe the development and validation of the Self-Efficacy in Addressing Menstrual Needs Scale (SAMNS-26).

Methods
We conducted nine focus group discussions with girls in schools in rural and urban Bangladesh to identify tasks involved in menstrual self-care. This informed our creation of an initial pool of 50 items, which were reviewed by menstrual health experts and refined through 21 cognitive interviews with schoolgirls. Using a self-administered survey, we administered 34 refined items plus additional validation measures to a random sample of 381 post-menarcheal girls (ages 9–17) and retested a subsample of 42 girls two weeks later. We examined the measure’s dimensionality using exploratory factor analysis and assessed internal consistency, temporal stability, and construct validity.

Results
Exploratory factor analysis suggested a 26-item scale comprising three correlated sub-scales: the 17-item Menstrual Hygiene Preparation and Maintenance (α = 0.86), the 5-item Menstrual Pain Management (α = 0.87), and the 4-item Executing Stigmatized Tasks (α = 0.77). Sub-scales exhibited good temporal stability. SAMNS-26 scores correlated negatively with measures of anxiety, and girls who preferred to stay at home during their periods had lower SAMNS-26 scores than those who did not.

Conclusion
The SAMNS-26 provides a reliable measure of a schoolgirl’s confidence in her capabilities to address her menstrual needs. There is initial evidence to support the measure’s construct validity in the Bangladesh context as indicated by its relationships with other factors in its theorized nomological network. The tool enables incorporation of self-efficacy into multivariate models for exploring the relationships among antecedents to menstrual experiences and hypothesized impacts on health, wellbeing, and education attainment. Further testing of the tool is recommended to strengthen evidence of its validity in additional contexts.
Increasing Alkaline Phosphatase as the Primary Manifestation of Disseminated Histoplasmosis in an AIDS Patient Without Pulmonary Disease
Authors: Berger Triston , Borja Sebastian , Kandiah Jonathan , Suri Jaspreet , Riback Harvey 
Published: October 2022

ABSTRACT
Histoplasmosis is an infection caused by the dimorphic fungi Histoplasma. Hepatic involvement in the setting of disseminated histoplasmosis from a pulmonary source is well documented. Hepatic involvement as the primary manifestation in the absence of pulmonary disease is rare. We present a patient with acquired immune deficiency syndrome found to have disseminated histoplasmosis with worsening alkaline phosphatase as the primary manifestation of disease, which has not been reported in a review of the literature. After diagnosis, the patient was started on appropriate therapy with alkaline phosphatase return to baseline.
Acute Liver Failure Secondary to Remdesivir in the Treatment of COVID-19
Authors: Lin Kevin , Gausman Valerie , Poles Michael , Popov Violeta 
Published: October 2022

ABSTRACT
Remdesivir has been the mainstay of coronavirus disease 2019 treatment since the start of the severe acute respiratory syndrome coronavirus 2 pandemic. Despite its growing use, safety data are limited. We present the case of an elderly man with obesity and coronavirus disease 2019 who developed acute liver failure after initiation of remdesivir. This report broadens our knowledge of the side effect profile of remdesivir and discusses potential risk factors and an approach to remdesivir-induced liver failure. Our case also highlights the importance of monitoring hepatic function after initiation of therapy with remdesivir.
Virtual Reality and Mindfulness Approaches in the Treatment of Rumination Syndrome
Authors: Taclob Jeff Angelo , Kalas M Ammar , Esteban Marcus Juan , Didia Claudia , McCallum Richard 
Published: October 2022

ABSTRACT
Rumination syndrome (RS) is the repeated, effortless food regurgitation during or immediately after eating or drinking, which could be followed by rechewing, reswallowing, or spitting out of the regurgitant gastric contents. The mechanism by which RS ensues is because of the habitual contraction of the abdominal wall muscles leading to increased intra-abdominal pressure and regurgitation of gastric contents. Therefore, diaphragmatic breathing techniques and biofeedback are helpful in these patients to counteract the habitual abdominal contractions. We present a case of a 26-year-old woman diagnosed with RS unresponsive to conventional therapy (antiemetics and antispasmodics).
Routine Reflux Testing Guides Timely Antireflux Treatment to Reduce Acute and Chronic Rejection After Lung Transplantation
Authors: Lo Wai-Kit , Goldberg Hilary J. , Sharma Nirmal , Wee Jon O. , Chan Walter W. 
Published: October 2022

INTRODUCTION:
Gastroesophageal reflux has been associated with poorer lung transplantation outcomes, although no standard approach to evaluation/management has been adopted. We aimed to evaluate the effect of timely antireflux treatment as guided by routine reflux testing on postlung transplant rejection outcomes.

METHODS:
This was a retrospective cohort study of lung transplant recipients at a tertiary center. All patients underwent pretransplant ambulatory pH monitoring. Timely antireflux treatment was defined as proton pump inhibitor initiation or antireflux surgery within 6 months of transplantation. Patients were separated into 3 groups: normal pH monitoring (−pH), increased reflux (+pH) with timely treatment, and +pH with delayed treatment. Rejection outcomes included acute rejection, bronchiolitis obliterans syndrome, and chronic lung allograft dysfunction per International Society for Heart and Lung Transplantation criteria. Time-to-event analyses using Cox proportional hazard models were applied. Patients not meeting outcomes were censored at death or last clinic visit.

RESULTS:
One hundred seventy-five patients (59% men/mean 56.3 yr/follow-up: 496 person-years) were included. On multivariable analyses, +pH/delayed treatment patients had higher risks of acute rejection (adjust hazard ratio [aHR]:3.81 [95% confidence interval [CI]: 1.90–7.64], P = 0.0002), bronchiolitis obliterans syndrome (aHR: 2.22 [95% CI: 1.07–4.58], P = 0.03), and chronic lung allograft dysfunction (aHR: 2.97 [95% CI: 1.40–6.32], P = 0.005) than +pH/timely treatment patients. Similarly, rejection risks were increased among +pH/delayed treatment patients vs −pH patients (all P < 0.05). No significant differences in rejection risks were noted between +pH/timely treatment patients and −pH patients. Failure/complications of antireflux treatment were rare and similar among groups.

DISCUSSION:
Timely antireflux treatment, as directed by pretransplant reflux testing, was associated with reduced allograft rejection risks and demonstrated noninferiority to patients without reflux. A standardized peri-transplant test-and-treat algorithm may guide timely reflux management to improve lung transplant outcomes.
Comparison Between Preincision Traction and On-Demand Traction in Assisting Colorectal Endoscopic Submucosal Dissection
Authors: Li Jun , Wei Yunlei , Zhang Di , Hou Xiaojia , Shen Ming , Chen Kan , Wu Ruijin , Peng Kangsheng , Liu Feng 
Published: October 2022

INTRODUCTION:
Adequate exposure of the dissection site is very important for colorectal endoscopic submucosal dissection (ESD). We aimed to investigate the safety and efficacy of the preincision traction (PIT) method using an internal clip-with-spring device in comparison with the conventional on-demand traction (ODT) method in assisting colorectal ESD.

METHODS:
This was a prospective nested case-control study. A total of 26 patients for PIT-ESD and other 26 patients for ODT-ESD were involved. Data on clinical characteristics and therapeutic outcomes were collected and analyzed.

RESULTS:
The en bloc resection rate (both 100%) and curative resection rate (92.3% vs 96.2%) showed no significant difference between the 2 groups. Compared with ODT-ESD, PIT-ESD significantly reduced the procedure time (29.8 ± 18.4 vs 57.4 ± 33.7 minutes, P = 0.001) and submucosal injection volume (49.6 ± 32.3 vs 70.8 ± 37.6 mL, P = 0.034), decreased the rate of intraoperative bleeding (26.9% vs 57.7%, P = 0.025) and muscular injury (7.7% vs 34.6%, P = 0.038), and shortened the postoperative hospital stay (1.8 ± 0.8 vs 2.5 ± 1.2, P = 0.015).

DISCUSSION:
The PIT method could significantly improve the safety and efficacy of colorectal ESD.
Utrymme för det obestämbara
Authors: Höglund Heidi , Åkerholm Katrina 
Published: October 2022

Allowing Space for Undecidability: Complex Picturebooks in Literary Education
Previous research on children’s literature calls attention to picturebooks as a challenging art form, containing complex themes and sophisticated literary qualities. However, previous research shows that picturebooks in educational settings are still mainly explored with emergent readers. In this study, we elaborate on the relation between aesthetics and pedagogy by discussing how the complexity and undecidability of picturebooks can contribute to literary education by applying the concept of undecidability (Johansen, “Kunst”; Litteratur). Applying a thinking with theory approach (Jackson and Mazzei), we use the theoretical concept of undecidability, in relation to the picturebook Skuggorna (The Shadows, 2018) by Maija Hurme and Anssi Hurme as well as in relation to pedagogical considerations for literary education. The analysis of Skuggorna shows how it contains undecidabilities on several levels and how these undecidabilities cause the meaning of the narrative to shift. The study offers implications for literature teaching with this type of picturebook and, consequently, elaborates on what these undecidabilities can provide literary education. Moreover, the study shows how the challenging picturebook can provide spaces for upholding undecidabilities and negotiations in the literature classroom.
Neural‐hematopoietic‐inflammatory axis in nonsmokers, electronic cigarette users, and tobacco smokers
Authors: Ruedisueli Isabelle , Arastoo Sara , Gupta Pawan K. , Gornbein Jeffrey , Middlekauff Holly R. 
Published: October 2022

AbstractAmygdala activity in context of the splenocardiac model has not been investigated in healthy, young adults and has not been compared between nonsmokers, electronic cigarette users, and smokers. The purpose of the current study was to determine whether fluorodeoxyglucose positron emission tomography/computer tomography (FDG PET/CT) scans would demonstrate positively correlated metabolic activity in the amygdala, bone marrow, spleen, and aorta, elucidating activation of the splenocardiac axis in otherwise healthy young people who use tobacco products compared to nonusers. Moreover, the study was conducted to evaluate whether electronic cigarette users and tobacco smokers have similar levels of inflammation compared to nonusers. In 45 healthy adults (mean age = 25 years), including nonsmoker (n = 15), electronic cigarette user (n = 16), and smoker (n = 14) groups, metabolic activity in the amygdala, spleen, aorta, bone marrow of thoracic vertebrae, and adjacent erector spinae skeletal muscle was quantified through visualization of radioactive glucose (18FDG) uptake by FDG‐PET/CT. The maximum standardized uptake value for each region was calculated for correlation analyses and comparisons between groups. In correlation analyses, metabolic activity of the amygdala correlated with metabolic activity in the aorta (r = 0.757), bone marrow (r = 0.750), and spleen (r = 0.665), respectively. Metabolic activity in the aorta correlated with 18FDG uptake in the thoracic vertebrae (r = 0.703) and spleen (r = 0.594), respectively. Metabolic activity in the spleen also correlated with 18FDG uptake in the bone marrow (r = 0.620). Metabolic activity in the adjacent erector spinae skeletal muscle (our control tissue) was not positively correlated with any other region of interest. Finally, there were no statistically significant mean differences in metabolic activity between the three groups: nonsmokers, electronic cigarette users, and smokers in any target tissue. Amygdala metabolic activity, as measured by 18FDG uptake in FDG‐PET/CT scans, positively correlated with inflammation in the splenocardiac tissues, including: the aorta, bone marrow, and spleen, underscoring the existence of a neural‐hematopoietic‐inflammatory axis in healthy, young adults.