bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of health insurance on hypertension care: a household fixed effects study in India
Authors: Feng Zixuan , Chen Qiushi , Jiao Lirui , Ma Xuedi , Atun Rifat , Geldsetzer Pascal , Bärnighausen Till , Chen Simiao 
Published: August 2024

Abstract
Introduction
Hypertension is highly prevalent in India, but the proportion of patients achieving blood pressure control remains low. Efforts have been made to expand health insurance coverage nationwide with the aim of improving overall healthcare access. It is critical to understand the role of health insurance coverage in improving hypertension care.

Methods
We used secondary data from the nationally representative sample of adults aged 15–49 years from the 2015–2016 National Family Health Survey (NFHS) in India. We defined the hypertension care cascade as four successive steps of (1) screened, (2) diagnosed, (3) treated, and (4) controlled, and operationalized these variables using blood pressure measurements and self-reports. We employed household fixed effect models that conceptually matched people with and without insurance within the household, to estimate the impact of insurance coverage on the likelihood of reaching each care cascade step, while controlling for a wide range of additional individual-level variables.

Results
In all 130,151 included individuals with hypertension, 20.4% reported having health insurance. For the insured hypertensive population, 79.8% (95% Confidence Interval: 79.3%-80.3%) were screened, 49.6% (49.0%-50.2%) diagnosed, 14.3% (13.9%-14.7%) treated, and 7.9% (7.6%-8.2%) controlled, marginally higher than the percentages for the uninsured 79.8% (79.5%-80.0%), 48.2% (47.9%-48.6%), 13.3% (13.1%-13.5%), and 7.5% (7.4%-7.7%) for each cascade step, respectively. From the household fixed effects model, health insurance did not show significant impact on the hypertension care cascade, with the estimated relative risks of health insurance 0.97 (0.93–1.02), 0.97 (0.91–1.03), 0.95 (0.77–1.30), and 0.97 (0.65–1.10) for each cascade step, respectively. We further performed stratified analyses by sociodemographic and behavioral risk factors and a sensitivity analysis with district fixed effects, all of which yielded results that confirmed the robustness of our main findings.

Conclusions
Health insurance did not show significant impact on improving hypertension care cascade among young and middle-aged adults with hypertension in India. Innovative strategies for overcoming practical barriers to healthcare services in addition to improving financial access are needed to address the large unmet need for hypertension care.
Rehab-AMD: co-design of an application for visual rehabilitation and monitoring of Age-related Macular Degeneration
Authors: González-Montero Guadalupe , Guijarro Mata-García María , Moreno Martínez Carlos , Recas Piorno Joaquín 
Published: August 2024

Abstract
Background
The increasing demand for remote medical care, driven by digital healthcare advancements and the COVID-19 pandemic, necessitates effective solutions tailored to patients and healthcare practitioners. Co-design, involving collaboration between software developers, patients, and healthcare practitioners, prioritizes end-user needs. Research indicates that integrating patient perspectives enhances user experience and usability. However, its application in healthcare has been limited to small projects. This work focuses on co-designing a technological solution to enhance the monitoring and visual rehabilitation of individuals with Age-Related Macular Degeneration (AMD), a condition that significantly impacts the quality of life in people over 60. Current vision rehabilitation systems lack personalization, motivation, and effective progress monitoring. Involving patients and healthcare practitioners in the design process aims to ensure the final product meets their needs.

Methods
The project employs iterative and collaborative principles, involving a vision rehabilitation expert and two AMD patients as active users in the application’s development and validation. The process begins by establishing requirements for user accounts and rehabilitation exercises. It continues with an initial approach extended through user validation. Co-design is facilitated by specific workshops marking each project iteration, totaling four workshops, along with continuous communication sessions between experts and developers to validate design decisions. Initial requirements gathering and constant feedback from end-users, the visual rehabilitator, and patients are crucial for refining the product effectively.

Results
The workshops produced a prototype featuring a test to monitor changes and progression and 15 visual rehabilitation exercises. Numerous patient and vision rehabilitation-driven software modifications led to a final design that is responsive and adaptive to end-user needs.

Conclusions
The Rehab-AMD pilot project aims to develop a collaborative and adaptive software solution for AMD rehabilitation by actively involving stakeholders and applying iterative design principles. Co-design in the Rehab-AMD solution proves to be a methodology that identifies usability issues and needs from the initial design stages. This approach ensures that software developers create a final product that is genuinely useful and manageable for people with AMD and the targeted vision rehabilitators.
Implementing workplace health promotion in nursing – A process evaluation in different care settings
Authors: Lützerath Jasmin , Bleier Hannah , Gernert Madeleine , Schaller Andrea 
Published: August 2024

Abstract
Objective
Workplace health promotion (WHP) in Germany is receiving increasing support from health insurance funds. Nevertheless, there is hardly any knowledge on the process of how health outcomes are achieved, especially in nursing. The aim of the study was to find out how and what can be implemented in different care settings and to examine the reactions and interactions of the participants under routine conditions.

Methods
Guided by a logic model, a holistic WHP approach was implemented in four acute care hospitals, seven inpatient care facilities and four outpatient care services from April 2021 to October 2022. Data on realized WHP interventions, participant assessment and topics of work design was collected and analyzed descriptively.

Results
The realized WHP interventions were adapted depending on the content and context. Mainly short relaxation interventions were delivered or those with an event character were received by participants. The highest participation rate of planned participants was achieved in team building training. Participants predominantly assessed WHP interventions as useful, the quality as (very) good and were generally (very) satisfied with the intervention components. For work design topics, intentions for the design of work organization were mainly documented in action plans.

Conclusion
Cooperation with practitioners in research should be continued as a contribution to quality development. This could provide suggestions as to which content adjustments lead to greater acceptance by the target group in a specific context.

Trial registration
The project was registered in the German Clinical Trial Register (DRKS00024961, 2021/04/09).
Modeling of the native knee with kinematic data derived from experiments using the VIVO™ joint simulator: a feasibility study
Authors: Henke Paul , Meier Johanna , Ruehrmund Leo , Brendle Saskia A. , Krueger Sven , Grupp Thomas M. , Lutter Christoph , Woernle Christoph , Bader Rainer , Kebbach Maeruan 
Published: August 2024

Abstract
Background
Despite advances in total knee arthroplasty, many patients are still unsatisfied with the functional outcome. Multibody simulations enable a more efficient exploration of independent variables compared to experimental studies. However, to what extent numerical models can fully reproduce knee joint kinematics is still unclear. Hence, models must be validated with different test scenarios before being applied to biomechanical questions.

Methods
In our feasibility study, we analyzed a human knee specimen on a six degree of freedom joint simulator, applying a passive flexion and different laxity tests with sequential states of ligament resection while recording the joint kinematics. Simultaneously, we generated a subject-specific multibody model of the native tibiofemoral joint considering ligaments and contact between articulating cartilage surfaces.

Results
Our experimental data on the sequential states of ligament resection aligned well with the literature. The model-based knee joint kinematics during passive flexion showed good agreement with the experiment, with root-mean-square errors of less than 1.61 mm for translations and 2.1° for knee joint rotations. During laxity tests, the experiment measured up to 8 mm of anteroposterior laxity, while the numerical model allowed less than 3 mm.

Conclusion
Although the multibody model showed good agreement to the experimental kinematics during passive flexion, the validation showed that ligament parameters used in this feasibility study are too stiff to replicate experimental laxity tests correctly. Hence, more precise subject-specific ligament parameters have to be identified in the future through model optimization.
Hydrogel-coated and active clearance chest drains in cardiac surgery: real-world results of a single-center study
Authors: Jenkins Freya Sophie , Morjan Mohammed , Minol Jan-Philipp , Farkhondeh Nora , Dalyanoglu Ismail , Yilmaz Esma , Immohr Moritz Benjamin , Korbmacher Bernhard , Boeken Udo , Lichtenberg Artur , Dalyanoglu Hannan 
Published: August 2024

Abstract
Purpose
Cardiac surgery patients require chest drains for postoperative fluid drainage. Innovations in this field include chemical drain coating and manual clot extraction systems, aiming to provide reduced clotting and improved patient comfort. This study compares outcomes using hydrogel-coated, active clearance and conventional chest drains.

Methods
Patients with cardiac surgery at our institution from January 2023 to September 2023 were included. Drain allocation was based on surgeon’s choice, with either a combination of hydrogel-coated and conventional, active clearance and conventional, or conventional drains alone. Drain data and clinical outcomes were recorded prospectively.

Results
One hundred seventy-eight patients (62.9 ± 11.7 years, 67.4% male) received a total of 512 chest drains intraoperatively. Hydrogel-coated and active clearance drains showed higher drainage volumes than conventional drains (p < 0.001, respectively). Patency was lowest in conventional drains (36.7% vs. 98.8% for hydrogel-coated, p < 0.001, and vs. 96.6% for active clearance drains, p < 0.001). Conventional drains showed 5.9 times the odds (95% CI 2.0–25.2) of large pleural effusions compared to hydrogel-coated and 12.0 times the odds (95% CI 1.9–504.1) compared to active clearance drains. Patients with hydrogel-coated drains had the shortest length of stay (p < 0.001).

Conclusion
Hydrogel-coated and active clearance drains show improved outcomes compared to conventional drains in cardiac surgery.
Exploring the relationship between media use and depressive symptoms among gender diverse youth: findings of the Mental Health Days Study
Authors: Klinger Diana , Plener Paul L. , Marboe Golli , Karwautz Andreas , Kothgassner Oswald D. , Dienlin Tobias 
Published: August 2024

Abstract
Background
Over the past decades, media use has become a key aspect of young people’s daily lives, significantly shaping their social interactions, learning processes, and recreational pursuits. At the same time, healthcare professionals and researchers are increasingly concerned about the impact of media use on young people’s mental health. This concern is particularly relevant for gender diverse youth who may have distinct experiences with media that could impact their mental health uniquely compared to their peers, such as increased exposure to cyberbullying and negative content regarding their gender identity. This study aims to explore the associations between media use and depressive symptoms among youth and examine if gender moderates this association.

Methods
This study utilized a cross-sectional design involving a school-based sample of 8158 participants (Mage = 14.05 years, SD = 2.45, Ndiverse = 144) from Austria. Participants completed a survey assessing their media use and depressive symptoms using the Patient Health Questionnaire-9 (PHQ-9). Media use was measured by asking participants to report their daily usage in hours and minutes across various categories, including smartphone use, streaming services, social networks, and other media types. Multiple regression analyses were conducted to examine relationships between different forms of media use and depressive symptoms. Moderation analyses were performed using the PROCESS macro for SPSS to explore the role of gender.

Results
For gender diverse youth, multiple regression analysis identified streaming services (β = 0.265, p = .005) and social networks (β = 0.189, p = .037) as significant predictors of depressive symptoms in gender diverse youth. Moderation analyses conducted with the entire sample showed that gender moderates the relationship between depressive symptoms and smartphone use (B = - 0.008, p = .014), with the effect being the most negative for gender diverse individuals.

Conclusion
The findings underscore the complex relationship between media use and depressive symptoms among gender diverse youth, emphasizing the moderating role of gender. These results underline the need for gender-sensitive approaches in media literacy and mental health interventions. Stakeholders should be aware of risks and benefits of different media types to foster healthy media engagement.
Possible link between familial susceptibility to cancer and the level of oxidative stress in thyroid cancer patients
Authors: Javakhishvili Ivane , Mardaleishvili Kote , Buleishvili Maka , Mantskava Maia , Chkhikvishvili Irakli , Kalmakhelidze Sophio , Kipiani Nina , Sanikidze Tamar 
Published: August 2024

Abstract
Background
Hereditary cancer is estimated to account for up to 10% of the worldwide cancer burden; 5% of all thyroid cancers are thought to be genetic. Inheritance of a deleterious mutation in genes associated with a high lifetime risk of developing cancer. Cancer-predisposing genes can promote the initiation and progression of thyroid cancer by enhancing the activation of major signaling pathways through oxidative stress mechanisms.

Aim
Identification of the possible link between familial susceptibility to cancer and the level of oxidative stress in thyroid cancer patients.

Methods
Patients with thyroid cancer (with and without genetic predisposition) were investigated. Study participants were treated in Limited Liability Company (LLC) “Oncology Scientific Research Center” (Tbilisi, Georgia). The study group was collected between 2020 and 2021. In patients’ blood, the thyroid hormones content (free Triiodothyronine (fFT3), free Thyroxine (fFT4), bound Triiodothyronine (FT3), bound Thyroxine (FT4), Thyroid-stimulating hormone (TSH)), and oxidative stress intensity (total activity of non-enzymatic antioxidant system (TAA) and the lipid peroxidation product, malondialdehyde (MDA), content) were investigated.

Results
The difference in free and bound forms of T3 and T4 levels in the blood serum between patients with thyroid cancer (Group 2 and Group 3) and the control group (Group 1) was not statistically significant (F1,2=0.5, p1,2=0.8, F1,3=2.31, p1,3=0.16). In patients with thyroid cancer the TSH level significantly increased compared to the control group (Group 1) (TSH (mean ± Std error): Group 1– 1.21 ± 0.12, Group 2–2.45 ± 0.11 (F1,2=107, p1,2<0.001), Group 3–2.47 ± 0.17 (F1,3=150, p1,3<0.001)) and the MDA levels increased by 4–5 fold. In patients with thyroid cancer from families with cancer aggregation(Group 2), the level of TAA statistically significantly decreased (F1 − 2=200; p1 − 2<0.001), in patients without genetic predisposition to cancer(Group 3), the level of TAA did not change compared to the control (F1 − 3= 2.13; p1 − 3=0.15),

Conclusions
Oxidative stress plays a critical role in tumorigenesis, and antioxidant/oxidant imbalance may contribute to the malignant transformation of normal tissue. In patients with familial susceptibility to cancer mutations of several genes, which are involved in the regulation of oxidative metabolism, may contribute to the disruption of the redox balance, increase the level of oxidative stress, and contribute to the development of thyroid cancer.
Association of anti-Ro-52 antibodies with occurrence of interstitial lung disease in patients with idiopathic inflammatory myopathy
Authors: Weng Chia-Tse , Huang Tang-Hsiu , Wu Chun-Hsin , Sun Yuan-Ting 
Published: August 2024

Abstract
Background
Anti-Ro-52 antibodies have been associated with interstitial lung disease (ILD) in various autoimmune diseases. However, their role in ILD among patients with idiopathic inflammatory myopathies (IIMs) is relatively underexplored. This study aimed to investigate the association between anti-Ro-52 antibodies and the occurrence of ILD in individuals with IIMs.

Methods
This retrospective observational study included 604 patients who underwent myositis autoantibody testing between July 2018 and January 2021 at our hospital and were diagnosed with either IIMs or IIM-mimics. Comparative analyses were conducted between IIMs and IIM-mimics, as well as within the IIM group between cases with and without ILD. Logistic regression or Firth’s logistic regression analyses were employed to assess the risk of ILD development in different IIM subgroups and myositis antibody categories.

Results
This study included 190 patients with IIM and 414 patients with IIM-mimics. Patients with IIM demonstrated higher incidence of ILD, concurrent autoimmune disease, and a greater likelihood of various myositis autoantibodies when compared to the IIM-mimics group. Within the IIM patient cohort, those with ILD exhibited a later age of onset of IIM, an increased mortality rate, and a more frequent presence of anti-aminoacyl-tRNA synthetase (ARS) antibodies compared to those without ILD. The presence of any myositis-specific antibody (MSA) was associated with a six-fold increased risk of ILD, while dual positivity for MSA and anti-Ro-52 antibodies conferred a twenty-fold risk. Anti-ARS antibodies carried a 14-fold increased risk of ILD, which escalated to 38-fold in cases of dual positivity for anti-ARS and anti-Ro-52 antibodies. Anti-Ro-52 antibodies alone increased the risk eight-fold.

Conclusions
Among patients with IIM, the presence of ILD was linked to higher mortality. Certain autoantibodies, notably anti-ARS and anti-Ro-52 antibodies, were associated with an increased risk of ILD. The greatest risk of ILD was observed in cases of dual positivity for anti-ARS and anti-Ro-52 antibodies.
Structural visualization analysis applied to the preservation of architectural heritage: the case of stilted houses in southwest Hubei, China
Authors: Qian Cheng , Wang Tong , Yu Sihan 
Published: August 2024

Abstract
Wooden buildings represent a unique aspect of China’s architectural heritage. However, over time, these buildings have suffered varying degrees of structural damage, particularly those located in China’s mountainous regions. Frequent natural disasters and inconvenient transportation further exacerbate the vulnerability of these structures. This study focuses on the typical wooden stilt houses found in the Wuling Mountain area of southwest Hubei. The different forms of columns and beams, as well as the overall structural symmetry of the stilt houses, were classified into five common structural types. Precise digital models were established via real photos and collected dimensional data, and these five models were evaluated for static, buckling, utilization, and ultimate limit states. The results indicate that: (1) overall symmetrical structures perform better than asymmetrical ones; (2) structures where all columns are grounded and act as support columns exhibit the best overall mechanical performance; and (3) transverse-tie beams(chuanfang) primarily serve a connecting role rather than a load-bearing role, thus an excess of transverse-tie beams(chuanfang) can reduce the stability of the building structure. Based on the analysis results, targeted protective measures and recommendations were proposed and verified through structural evaluations. These initiatives provide new methods and insights for the protection of architectural heritage.
Optical coherence tomography angiography based prognostic factors and visual outcomes in primary rhegmatogenous retinal detachment after pars plana vitrectomy
Authors: Torres-Costa Sónia , Ribeiro Margarida , Tavares-Correia João , Godinho Gonçalo , Alves-Faria Pedro , Falcão Manuel , Sousa Amândio Rocha 
Published: August 2024

Abstract
Purpose
To evaluate the visual outcomes and changes in the retinal microcirculation in patients with primary rhegmatogenous retinal detachment (RRD) following successful pars plana vitrectomy (PPV).

Methods
Nine macula-on RRD and 23 macula-off RRD eyes were retrospectively evaluated. Clinical data was collected at admission and 3 months after PPV. Optical coherence tomography angiography (OCTA) was performed 3 months after PPV. Superficial vascular plexus data obtained with OCTA was compared between affected and fellow eyes and according to macular involvement. Quantitative measurements of the superficial retinal capillary associated with the preoperative and intraoperative factors were analyzed.

Results
Overall RRD inner vessel densities (IVD), full vessel densities (FVD), inner perfusion densities (IPD) and full perfusion densities (FPD) were significantly and positively correlated with best corrected visual acuity (BCVA)(p = 0.002, p = 0.006, p = 0.009, p = 0.023, respectively). In the macula-off RRD, IVD and FVD were significantly decreased compared with macula-on RRD (p = 0.014 and p = 0.034, respectively) and significantly correlated with a longer duration and larger extension of detachment. Higher differences of IVD and FVD between the fellow and affected eyes were significantly correlated with worse BCVA in the macula-off subgroup.

Conclusion
Macula-off RRD presented worse OCTA superficial vascular parameters compared with the macula-on group and fellow eyes, which were correlated with a poorer visual outcome and exacerbated by a longer duration and larger extension of the detachment. Macula-off RRD causes not only retinal structural damage but also a reduction in retinal perfusion despite successful anatomical repair.