bluuebunny/crossref_metadata_2025_split huggingface dataset:
FEA-based Virtual Operation and Stress Distribution Analysis of DHS Screws in Proximal Femoral Bone Fractures: A Strategic Guide for Orthopedic Surgeons in Operational Planning
Authors: Joshi Aashish , Karande Kailash , Gunaki Ravindra 
Published: December 2024

Background Accidents are the major reasons causing hip bone fractures. These are due to reduced bone density due to aging effect which may cause fractures typically in proximal part of the femur bone. Purpose The purpose of this work is to concentrate on preoperative planning by using a 3D model developed with a virtual operation using a dynamic hip screw (DHS). Methods DHS is generally preferred for the stabilization of stable fractures. The virtual operation was performed on the proximal femoral fracture site, typically for stable fractures. Finite element analysis (FEA) of operated bone was performed to estimate Von Misses stress distribution on the implant post-operatively, resulting in less stress on the fracture site. Results FEA indicates a transfer of stress of the fracture site (35–62%) on the implant, resulting in the operation’s success. Such work will assist orthopedic surgeons in determining load-bearing capacities after the mobilization of the patient. Conclusion Virtual surgery helps the surgeon to identify fracture geometry, the success of the operation, and proper fixation of the implant to avoid post-surgery complications. This aids in the quick recovery of patients, resulting in early rehabilitation.
Advanced Diagnostic and Therapeutic Approaches for Effective Management of Bladder Malignancies
Authors: Alotaibi Badriyah Shadid , Ibrahim Nihal Abdalla , Azhar Saira , Shah Aamna , Omar Hamdah , Ijaz Munaza 
Published: December 2024

Background Effectual management of bladder malignancies (BMs) is currently a global challenge due to their expensive therapeutic and diagnostic cost burden, together with augmented progression/recurrence rate. Purpose This review aimed to explore cutting-edge diagnostic and therapeutic techniques for meeting the current clinical requirements for effectively managing BMs encompassing dual muscle-invasive bladder tumors (MIBT) and nonmuscle-invasive bladder tumors (NMIBT). Methods A comprehensive review of relevant literature (including data review from 2019 to 2024) was performed to collect valuable information regarding the utilization of advanced diagnostic and therapeutic techniques for the effective management of BMs. Results Studies investigating the potential applications and possible limitations of various methods, including UroVysion, continuous bladder irrigation (CBI), transurethral resection of bladder tumor (TURBT), laparoscopic, and robot-abetted extended pelvic lymph node dissection (PLND), 3D culture models and nerve spring technique (NST) in robotic intracorporeal Studer’s orthotopic neobladder (RISON) have been examined. Similarly, the role of Urothelial Piezo channels (Piezo1 and Piezo2) in urinary system modulation, human epidermal growth factor receptor (HER2)-selective therapy in metastatic urothelial carcinoma (MUC) patients, and diagnostic benefits of fluorescence in situ hybridization (FISH) in BMs have been analyzed. Current report enlisted the major clinical applications associated with the advanced diagnostic and therapeutic techniques with consequent management of lower urinary tract malfunctions (LUTMs), stress urinary incontinence, and BMs, including both MIBT, NMIBT, and MUC. Conclusion This review provided detailed information on numerous benefited outcomes attained from different approaches such as augmented bladder functioning, implementation of collective optical and cancer-specific imaging systems, utilization of tumor-specific biomarkers, precise tumor amputation, reduced urinary complications and hospital stay, postoperative comfort, limited invasiveness, limited blood loss, and ultimately reduced recurrence rates. BMs management at the clinical level needs to be effectively rationalized to enhance the patient’s quality of life and reduce the ultimate cost burden over bladder cancer patients together with appropriate management of associated limitations like urinary tract infections, bladder perforation, bladder infections, and carcinoma relapse in postoperative cases should effectively be encountered to further improve the therapeutic potential of advanced techniques in the near future.
Enhancing menstrual equity: An observational study assessing the impact of free little period product pantries
Authors: Glayzer Jennifer E , Glayzer Edward J , Jennings Claire T , Schlaeger Judith M , Lee Adriene , Bray Bethany C 
Published: December 2024

Background: Two in five menstruators struggle to afford period products at some point in their lives. Menstruators experiencing period poverty are often dictated which and how many period products they receive. Products received by menstruators experiencing period poverty may not be the right type or absorbency and are discarded without use. To address period poverty in Dayton, Ohio, USA the Free Flo Box (FFB) organization created period product pantries, which allow menstruators to choose which and how many products they need. FFB operates two-period product pantries, which are free-standing cabinets. Pads, tampons, and menstrual cups are available anonymously, 24 h a day, and 7 days a week. Objective: This article aims to: (1) determine if FFB pantries are an effective model for period product distribution (2) analyze pantry utilization trends, and (3) compare the pantry model of distribution to existing methods of period product distribution. Design: This is a longitudinal observational study of period product pantry utilization. Methods: Descriptive statistics and zero-inflated binomial regressions were conducted to analyze FFB utilization. Results: FFB pantries have provided over 30,000 products in less than 2 years, with a monthly average of 1736. Utilization of the pantries continues to grow. As gas prices increased, significantly more reusable and significantly less single-use products were taken. Pantries were more likely to be utilized on days when it rained but utilization was not affected by temperature. The pantry model overcomes barriers of fixed hours, perquisites for use, regular and reliable supply, and predetermined amounts and types of products provided. Conclusion: Period product pantries are an effective model of period product distribution and highlight the need for greater access to period products. While period product pantries will not solve period product poverty, they can help menstruators in need on a local level.
Observational study on the prescription practices of family and pulmonary physicians for airway clearance devices in chronic obstructive pulmonary disease management
Authors: Alghamdi Saeed Mardy , Alzahrani Abdulaziz A. , Dairi Mohammad S. , Alwafi Hassan , Aldhahir Abdulelah M. , Alqahtani Jaber S. , Alqahtani Mohammed M. , Alanazi Abdullah M. , Alqarni Abdullah A. , Siraj Rayan A. , Alghamdi Noha Saeed , Alzahrani Hassan A. , Alhindi Abdulghani A. 
Published: December 2024

Background: Productive cough with sputum is a prominent sign generally associated with respiratory diseases, including chronic obstructive pulmonary disease (COPD). Airway clearance devices are an option for COPD management, but physicians’ preferences for and clinical practice with them are not known. Objective: This study aims to explore preferences for and clinical practice with airway clearance devices among physicians in Saudi Arabia. Design: An observational, cross-sectional survey. Methods: A self-administered questionnaire was conducted between October 2022 and September 2023, which included a review of respiratory medication prescriptions by physicians for patients with COPD. The analysis was performed using the Statistical Package for the Social Sciences. Results: The participants were 445 physicians. The majority were female, accounting for 64.3% of the sample. Flutter and Acapella were the most commonly preferred airway clearance devices (45.8% and 20.7%, respectively). Among the participants, 12.6% reported unfamiliarity with any of the mentioned devices. Of the participants, 43.6% “usually” suggested the devices for patients with daily, difficult-to-clear, thick sputum, while 27% “sometimes” recommended them to COPD patients who had experienced four exacerbations or more. In routine clinical practice, physicians prescribe pharmacological therapies as the main treatment. The prescribing data showed that in the last year, there was no record of prescribed airway clearance devices for COPD by physicians. Conclusion: Family and pulmonary physicians prefer Flutter and Acapella devices, but a significant number of physicians are unaware of such devices. Prescribing data showed no record of prescribed airway clearance devices for COPD management. Further initiatives are needed to increase awareness in clinical practice.
Influence of social media fitness influencers’ credibility on users’ physical activity intentions
Authors: Wang Lidong , Li Xiuhong , Wang Donghai , Zhu Jianyong 
Published: December 2024

Objective This study explores how trustworthiness, expertise, and attractiveness of fitness influencers affect Chinese users’ attitudes, subjective norms, perceived behavioral control, and intentions to engage in fitness activities on social media. By integrating the Theory of Planned Behavior with source credibility theory, this research examines the effectiveness of digital health communication in China, offering a novel approach. Methods Data were collected through a cross-sectional survey using convenience sampling, targeting 339 active fitness video viewers on DouYin, China's premier short video platform. The survey was administered via the professional online platform Sojump.com. Participants, active followers of various fitness influencers, engaged with diverse types and durations of fitness videos. Confirmatory factor analysis and structural equation modeling validated the measurement and structural models, rigorously examining the hypothesized relationships within the study. Results Trustworthiness and expertise of influencers significantly influenced users’ attitudes and perceived behavioral control, crucially affecting their intentions to engage in fitness activities. Unlike trustworthiness and expertise, attractiveness had no significant impact on subjective norms. Gender did not moderate these effects, indicating a consistent influencer impact across male and female users. Conclusions This research underscores the critical role of credible fitness influencers in enhancing engagement with health-promotive behaviors on social media. It emphasizes that authenticity and reliability are more influential than attractiveness in promoting health behaviors. This study advances our understanding of effective health communication on social media and offers practical insights for leveraging influencer credibility in public health campaigns.
Critical design decisions and user demographics in enhancing real-time digital mental health interventions: A systematic review
Authors: Fouyaxis John , Bidargaddi Niranjan , Du Wei , Looi Jeffrey C.L. , Lipschitz Jessica 
Published: December 2024

Background Real-time digital mental health interventions, primarily enabled by smartphone technology offer continuous, personalised support, that adapts in response to the changing needs of individuals. Despite being prominently explored in populations with psychiatric disorders, there remains a notable gap in the systematic analysis of demographic characteristics, as well as the foundational design decisions or rules that underpin the personalisation of these interventions. Objectives (a) Identifying the prevalent design decisions to enable personalisation within real-time digital mental health interventions, (b) the influence of these design decisions on the clinical outcomes of the interventions, and (c) the demographic characteristics of populations with psychiatric disorders targeted by real-time digital health interventions. Methods Following PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines, a systematic literature review was conducted of peer-reviewed literature focusing on real-time digital interventions in populations with clinically diagnosed psychiatric disorders. We undertook a narrative synthesis to derive the demographics and personalisation design decisions of the interventions and conducted a pooled meta-analysis to evaluate clinical outcomes. Results Interventions predominantly targeted female and Caucasian demographics, yielding modest clinical improvements. Our analysis identified nine critical personalisation design decisions concerning measurement, intervention, and interactions with health professional with varying influence on clinical outcomes. Conclusion Understanding the complex nuances of design decisions that shape real-time digital health interventions, as well as identifying which patient demographics benefit most, is fundamental for their effective clinical impact and safe use. Prospero Registration PROSPERO CRD42020161663.
Systematic Automated Population-Based Surveillance to Improve Outcomes in Primary Cutaneous Melanoma
Authors: Ching Allison , Pedula Kathryn , Devere Theresa , Aruga Cheryl , Honda Stacey , Ching Karen 
Published: December 2024

Importance: Patients with a primary cutaneous melanoma (PCM) are at increased risk of developing a second primary melanoma (SPM). Earlier stage at diagnosis is associated with better 5-year mortality, yet low compliance with recommended follow-up after treatment for PCM and high rates of patients lost to follow-up are reported in the literature. Strategies to enhance population-based surveillance for SPM have not been well described. Objective: To determine whether the implementation of a systematic automated population-based program (SAPP) to ensure dermatologist total body skin exams (TBSEs) in the PCM population compared to the pre-automated period and pre-database periods improves compliance with follow-up, detects more SPMs, or affects mortality? Design: Quality Improvement Study. Setting: Large integrated health care system with internalized Dermatology services. Participants: Members with a PCM prior to, or during the study periods of interest, were included in this quality improvement study. There were 6317 eligible individuals with PCMs in 3 study periods: pre-Database (1/1/2005-11/1/2009), pre-Automation (11/1/09-7/31/15), and post-Automation (8/1/15-12/31/2021), respectively. Intervention(s) or Exposure(s): Manual registry for melanoma patients (pre-Automation) and systematic automated population-based program for PCM patients (post-Automation). Main Outcome(s) and Measure(s): Mean number of TBSE per person-year. Time Between TBSE. Incidence of SPM detection. Stage of SPM at diagnosis. Melanoma Death and All-Cause Mortality. Results: In patients with PCM, a SAPP to ensure dermatologist TBSE, reduces median time (months) between TBSEs from 12.3 pre-Database to 8.2 post-Automation (stage 0-2a PCM) and from 10.3 to 6.8 (stage 2b-4 PCM; P < .0001), improves number of TBSEs per person-year with each successive study period (pre-Database mean [SD] 0.56 [1.07]; pre-Automation 0.80 [1.25]; post-Automation 1.78 [4.17]; P < .0001), and improves SPM detection rates per 1000 person-years (pre-Database 20.2 [95% CI 12.2-30.9]; pre-Automation 27.5 [18.2-39.9]; post-Automation 27.5 [26.6-51.8], P < .0001 for trend) at earlier cancer stages. There is an associated annual reduction in all-cause (1.4 per 1000 person-years, P = .0004) and melanoma-cause mortality (0.2 per 1000 person-years, P = .0197). Conclusion: Implementing a systematic, automated population-based Melanoma program to ensure dermatologist TBSEs improves compliance with follow-up in patients with PCM. More patients received at least annual dermatologist TBSEs and more SPMs were detected at earlier stages. Improvements were sustained and there were significantly lower all-cause and melanoma-cause mortality. The system facilitates prioritization of higher risk patients for intervention and is a unique strategy enhancing patient safety, efficiency, and timeliness of care.
Risk Factors in Optimal Management of Hypertension in Elderly Patients Following 2017 American College of Cardiology—American Heart Association Guidelines
Authors: Walder Zachary , Prasad Satwiki , Guevara Adriana , Souedy Amine Al , Martirosyan Diana , Moshman Rachel , Porter Ashley , Morris Natalie , Khatiwala Pooja , Thampi Subhadra , Hunter Krystal , Roy Satyajeet 
Published: December 2024

Introduction/Objectives: The 2017 American Heart Association hypertension management guidelines recommended optimal control of blood pressure under 130/80 mmHg. We aimed to study the factors associated with suboptimal and uncontrolled hypertension in the elderly patients. Methods: We performed a retrospective review of suburban outpatient records of patients with hypertension, aged 65 years and older, and grouped into optimally controlled (OC; BP <130/80 mmHg), sub-optimally controlled (SOC; BP 130-139/80-89 mmHg), and uncontrolled (UC; BP≥140/90 mmHg) groups; and compared the associations of variables. Results: Among 1311 patients, there were 610 (46.5%) patients in OC, 391 (29.9%) in SOC, and 310 (23.6%) in UC groups. Mean ages were comparable (OC = 78 ± 8.1, SOC = 77 ± 7.4, UC = 78 ± 7.3 years; P = .760). In all groups, the majority of patients were White followed by BIPOC (Black-indigenous-and-other-people-of-color; OC = 78.5% vs 21.5%, SOC = 78.3% vs 21.7%, and UC = 71% vs 29%, respectively). There were more BIPOC patients in UC compared to OC group (29.0% vs 21.5%; P = .011). Mean body-mass-index (BMI) of patients in SOC and UC groups were greater than OC group (27.9 ± 6.3 vs 26.9 ± 6.3 kg/m2; P = .047; 28.1 ± 6.3 vs 26.9 ± 6.3 kg/m2; P = .027; respectively). There were significantly higher associations of certain comorbidities in SOC compared to OC group, such as transient ischemic attack (12.3% vs 3.6%; P < .001), hyperlipidemia (72.4% vs 56.2%; P < .001), atrial fibrillation (19.2% vs 11%; P < .001), HFpEF (5.4% vs 1.5%; P < .001), osteoarthritis (38.9% vs 30.5%; P = .006), malignancy (32.2% vs 19.5%; P < .001), and left ventricular hypertrophy (LVH; 27.4% vs 15.9%; P < .001). Logistic regression analysis showed that when compared to BIPOC, White race had lower odds of UC (OR = 0.63, 95% CI = 0.45-0.90). For every unit increase in BMI, there were greater odds of SOC (OR = 1.04, 95% CI = 1.01-1.06) and UC (OR = 1.04, 95% CI = 1.01-1.16). Patients with hyperlipidemia and LVH had greater odds of SOC (OR = 1.72, CI = 95% 1.25-2.37; and OR = 2.13, 95% CI = 1.02-4.43; respectively). Conclusion: In patients with sub-optimal and uncontrolled hypertension, there is a significantly higher association of BIPOC race, elevated BMI, hyperlipidemia, and left ventricular hypertrophy.
The Experience of Staff Working in Migrants’ Reception Project: Phenomenological Study in a Multicultural Context
Authors: Arcadi Paola , Figura Mariachiara , Vellone Ercole , Simeone Silvio , Piervisani Loredana , Pucciarelli Gianluca , Alvaro Rosaria 
Published: December 2024

Introduction Migrants and refugees belong to the most marginalized groups in the world. Barriers related to the determinants of health can often preclude access to basic human rights, and have a negative impact on health. Therefore, it is essential to understand how to properly interface with people with different perceptions of health and disease and how to design programs based on available resources. Aim To explore the experience of socio-health workers who work in the context of a reception project in Italy related to taking care of the health needs of a migrant population in a multicultural context. Methods This research was a qualitative phenomenological study with an interpretive approach adhering to the Consolidated Criteria for Reporting Qualitative Research guidelines. The conversations were audio-recorded, transcribed, and read in depth. Reflexive analysis was used to analyze the data. Results Sixteen health and social workers were interviewed. Three main themes were extracted: (1) nature of needs and their facets; (2) interconnection between skills and in relationships; (3) struggles against shortages. The results highlight the participants’ attribution of meaning to the needs and requirements of migrants, their experience in the relationship with the team and the migrants, and the difficulties in carrying out their role. Discussion What the study found underscores the importance of designing interventions that consider the unique perceptions and experiences of professionals who engage with migrants in daily practice. The complex health needs, experiences, and different cultural representations of health and illness must be read and approached with a culturally competent vision. Conclusion The study reveals how much the strengths of taking care of migrants’ health lie in the ability to interconnect various competencies. This study gives elements for professionals and health organizations to understand the complexity of caring for the migrant population.
Prevalence and Associating Factors of Ischemic Heart Disease Among Type 2 Diabetes Mellitus: A Cross-sectional Study in a Rural Community
Authors: Joarder Ariful Islam , Khaled Fakhrul Islam , Barman Nilima , Tasnim Anika , Chowdhury Taslima , Ishra Rakia , Haque Atiqul 
Published: December 2024

Background Ischemic Heart Disease (IHD) is the leading cause of mortality among cardiovascular disorders. There is inadequate knowledge about the prevalence of IHD in Bangladesh, particularly in diabetes mellitus patients. This research aimed to ascertain the frequency of IHD in diabetic individuals and to identify risk factors for IHD in rural areas. Methods A cross-sectional survey was in a rural community in a diabetic cohort. Simple random sampling was used to select 150 diagnosed diabetic patients of both genders, aged 30 to 65, from registration numbers within the diabetic cohort. Diagnosis of IHD was based on the history of established IHD and ECG and echocardiography findings. Results The results showed that the prevalence of IHD among diabetic patients is 4%. The univariate binary logistic regression analysis identified significant factors associated with IHD, including older age (OR 1.15; 95% CI 1.01-1.31), higher body mass index (BMI) (OR 1.30; 95% CI 1.07-1.52), increased duration of diabetes (OR 1.13; 95% CI 1.00-1.28), and smokeless tobacco use (OR 5.26; 95% CI 1.00-27.7). However, after adjustment in the logistic regression model, a significantly higher risk of IHD was found to be associated with patients having a higher BMI (AOR 1.43, 95% CI 1.14-1.80) and a longer duration of diabetes (AOR 1.26, 95% CI 1.07-1.48). Conclusion The present data indicate that the prevalence of IHD in Bangladesh is 4%, which is a significant issue for diabetic individuals. Regular screening and careful monitoring are necessary among diabetic patients to reduce the risk of cardiovascular diseases, including IHD.