bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predicting healthcare expenditure based on Adjusted Morbidity Groups to implement a needs-based capitation financing system
Authors: Martínez-Pérez Jorge-Eduardo , Quesada-Torres Juan-Antonio , Martínez-Gabaldón Eduardo 
Published: May 2024

Abstract
Background
Due to population aging, healthcare expenditure is projected to increase substantially in developed countries like Spain. However, prior research indicates that health status, not merely age, is a key driver of healthcare costs. This study analyzed data from over 1.25 million residents of Spain's Murcia region to develop a capitation-based healthcare financing model incorporating health status via Adjusted Morbidity Groups (AMGs). The goal was to simulate an equitable area-based healthcare budget allocation reflecting population needs.

Methods
Using 2017 data on residents' age, sex, AMG designation, and individual healthcare costs, generalized linear models were built to predict healthcare expenditure based on health status indicators. Multiple link functions and distribution families were tested, with model selection guided by information criteria, residual analysis, and goodness-of-fit statistics. The selected model was used to estimate adjusted populations and simulate capitated budgets for the 9 healthcare districts in Murcia.

Results
The gamma distribution with logarithmic link function provided the best model fit. Comparisons of predicted and actual average costs revealed underfunded and overfunded areas within Murcia. If implemented, the capitation model would decrease funding for most districts (up to 15.5%) while increasing it for two high-need areas, emphasizing allocation based on health status and standardized utilization rather than historical spending alone.

Conclusions
AMG-based capitated budgeting could improve equity in healthcare financing across regions in Spain. By explicitly incorporating multimorbidity burden into allocation formulas, resources can be reallocated towards areas with poorer overall population health. Further policy analysis and adjustment is needed before full-scale implementation of such need-based global budgets.
Geodetic plate coupling and seismic potential on the main Himalayan thrust in Nepal
Authors: Tabei Takao , Ohzono Mako , Silwal Bishow R. , Bhandari Rajendra P. , Adhikari Lok B. , Chand Janak B. , Kandel Thakur P. 
Published: May 2024

AbstractWe model interseismic plate coupling distribution on the Main Himalayan Thrust (MHT) in Nepal through the inversion of secular GNSS velocity data. To complement previously published data, we compile velocity data from ten additional continuous stations to improve spatial resolution in central and mid-western Nepal. A regional non-planar structural model is adopted to reproduce the MHT fault plane. In general, the coupling pattern seems nearly binary, indicating that transition from full coupling to decoupling is occurring sharply in very narrow zones. In eastern Nepal (> 84.5ºE), plate coupling is very strong from the surface to intermediate depths, including the source region of the 2015 Mw 7.8 Gorkha earthquake. Geodetically estimated slip deficit rates are consistent with the rupture history of great earthquakes in the east revealed by geomorphological observations. In the west (< 83.0ºE), a weakly coupled zone extends laterally at intermediate depths, whereas the coupling in the shallower part remains very strong. Although the slip deficit rate in the west is significantly smaller than that in the east, seismic moment accumulated, since the last complete rupture in 1505 may be capable of generating a future great event. In central Nepal, estimated slip deficit rates are comparable with those in the east, and no great event has been documented over the past several centuries. Thus, the seismic risk may be most urgent in central Nepal. The development of local seismicity and crustal deformation should be carefully monitored.
Graphical Abstract
Healthy eating among people on opioid agonist therapy: a qualitative study of patients’ experiences and perspectives
Authors: Furulund Einar , Druckrey-Fiskaaen Karl Trygve , Carlsen Siv-Elin Leirvåg , Madebo Tesfaye , Fadnes Lars T. , Lid Torgeir Gilje 
Published: May 2024

AbstractPeople with substance use disorders often have unhealthy diets, high in sweets and processed foods but low in nutritious items like fruits and vegetables, increasing noncommunicable disease risks. This study investigates healthy eating perceptions and barriers among individuals with opioid use disorder undergoing opioid agonist therapy. Interviews with 14 participants at opioid agonist therapy clinics in Western Norway, using a semi-structured guide and systematic text condensation for analysis, reveal that most participants view their diet as inadequate and express a desire to improve for better health. Barriers to healthy eating included oral health problems, smoking habits, and limited social relations, while economic factors were less of a concern for the participants. Participants did find healthy eating easier when they were in social settings. This study underscores the importance of understanding and addressing these barriers and facilitators to foster healthier eating patterns in this population, potentially enhancing overall health and well-being.
Accuracy of the recording of pneumonia events in English electronic healthcare record data in patients with chronic obstructive pulmonary disease
Authors: Adamson Alexander J. , Kallis Constantinos , Douglas Ian , Quint Jennifer K. 
Published: May 2024

Abstract
Background
In primary care, identifying pneumonia events in people with chronic obstructive pulmonary disease (COPD) may be challenging due to similarities in symptoms with COPD exacerbations and lack of diagnostic testing. This study explored the accuracy of pneumonia diagnosis coded in primary care by comparing diagnosis in primary care with diagnosis in hospital.

Methods
A study population of people with COPD in England was created using the Clinical Practice Research Datalink Aurum database linked with Hospital Episode Statistics inpatient data. Pneumonia codes only, and pneumonia code with associated clinical and/or treatment codes (chest x-ray, symptoms, antibiotics, sputum and blood culture) were used to determine pneumonia events in primary care. Events that were followed by hospitalisation within 7 days were used to estimate the positive predictive value (PPV) of pneumonia coding in primary care, using primary diagnosis of pneumonia in secondary care as the gold standard. The PPV of primary care recording of hospitalised pneumonia was also calculated.

Results
Two hundred seventy-four thousand one hundred fifty-six COPD patients were eligible for inclusion, of whom 7,560 had an eligible pneumonia event in primary care diagnosed between 2015–2019 which was not ‘hospital-acquired’ and was diagnosed and entered on the same day. Of the 2,094 events which were followed by hospitalisation within 7 days, 1,208 had a primary diagnosis of pneumonia in hospital, representing a PPV of pneumonia coding in primary care of 57.7% (95% CI 55.6%-59.8%). Another 284 (13.6%) were diagnosed as a COPD exacerbation and 114 (5.4%) were diagnosed as another respiratory disease. Use of additional pneumonia clinical and treatment codes had a modest effect on the PPV but substantially lowered the number of events. Of the 33,603 eligible pneumonia events identified in secondary care, only 11,445 were recorded in primary care within 42 days, representing a sensitivity of 34.1% (95% CI 33.6%-34.6%).

Conclusions
Use of primary care pneumonia codes and associated clinical and treatment codes to determine pneumonia is not recommended due to significant levels of misdiagnosis and many hospitalised events failing to be recorded in primary care.
ALL-COMPONENT REVISION FOR FAILED TOTAL ANKLE ARTHROPLASTY: EARLY RESULTS AND COMPLICATIONS
Authors: Cunningham I.K.T. , Kumar C.S. 
Published: May 2024

AimSurgical options for management of a failed ankle arthroplasty are currently limited; typically conversion to fusion is recommended with only a few patients being considered for revision replacement surgery. This paper presents our experience of revision ankle replacements in a cohort of patients with failed primary replacements.MethodA total of 18 revision TAR in 17 patients were performed in patients with aseptic loosening. The technique was performed by a single surgeon (CSK) over a 4 year period between July 2014 and August 2018 using the Inbone total ankle replacement system. Patient demographics and clinical outcomes were collected retrospectively using - MOXFQ, EQ5D, VAS pain score and patient satisfaction questionnaires.Results12 right and 6 left ankle replacements were revised in 17 patients (11 male/ 6 female). The mean age at revision was 69.1 years (range 56–81 years) with a mean BMI of 31. The mean surgical time was 171 minutes with 22% of cases requiring bone grafting. 6 patients had early wound complications, all superficial and settled with dressings. There were no deep infections, 2 patients had further surgery for exploration for possible nerve injuries. At a mean follow up of 20.6 months, 4 patients had mild/moderate ongoing pain with the majority of patients being satisfied with the outcome of their surgery.ConclusionThis study represents one of the largest group of patients reported to have undergone revision total ankle arthroplasty. Our experience shows that this results in acceptable level of complications and provides satisfactory function in most patients. We feel revision TAR is a viable option in patients with failed primary arthroplasty who wish to continue to maintain mobility at the ankle joint.
FIVE-YEAR OUTCOMES OF A SYNTHETIC CARTILAGE IMPLANT FOR THE FIRST METATARSOPHALANGEAL JOINT IN ADVANCED HALLUX RIGIDUS
Authors: Daniels T. 
Published: May 2024

Introduction/PurposeA randomized clinical trial of first MTP joint hemiarthroplasty with a synthetic cartilage implant demonstrated equivalent pain, function and safety outcomes to first MTP joint arthrodesis at 2 years. Recognizing that many hemiarthroplasty and total toe implants have initially good results that deteriorate over time, the purpose of this study was to prospectively assess the safety and efficacy outcomes for the synthetic cartilage implant population and to determine if the excellent outcomes were maintained at >5 years.MethodsOne hundred nineteen patients were evaluated at 5+ years; 23 could not be reached for follow-up, but implant status was available for 7 of these subjects. Patients completed a pain visual analogue scale (VAS) and Foot and Ankle Ability Measure (FAAM) Sports and Activities of Daily Living (ADL) scores, preoperatively and at 2, 6, 12, 26, 52, 104 and 260 weeks postoperatively. Minimal clinically important differences are: ≥30% difference for pain VAS, 9 points for FAAM Sports, and 8 points for FAAM ADL. Great toe active dorsiflexion, weight-bearing radiographs, secondary procedures, and safety parameters were evaluated.ResultsOf 119 patients available at mean 5.8 years follow-up (SD ±0.7; range: 4.4–8.0), 9 underwent implant removal and conversion to fusion in years 2–5, leaving 106 patients. The implant survival rate was 92.4% at 5.8 years. Pain and function outcomes at 5.8 years were similar to those at 2 years. VAS Pain, FAAM Sports, ADL Scores were maintained or improved at 5.8 years. No evidence of avascular necrosis, device migration or fragmentation was observed. There were no unanticipated safety events through 5.8 years. Ninety-three (93%) percent would have the procedure again.ConclusionThe synthetic cartilage hemiarthroplasty implant continues to demonstrate safety and efficacy for the treatment of advanced first MTP joint osteoarthritis with evidence of therapeutic effect and acceptable safety profile at 5.8 years.
THE ROLE OF THE LATERAL ANKLE COMPLEX IN CONTROLLING LAXITY OF THE ANKLE JOINT: A BIOMECHANICAL INVESTIGATION
Authors: Miller D. , Stephen J. , Calder J. , el Daou H. 
Published: May 2024

BackgroundLateral ankle instability is a common problem, but the precise role of the lateral ankle structures has not been accurately investigated. This study aimed to accurately investigate lateral ankle complex stability for the first time using a novel robotic testing platform.MethodA six degrees of freedom robot manipulator and a universal force/torque sensor were used to test 10 foot and ankle specimens. The system automatically defined the path of unloaded plantar/dorsi flexion. At four flexion angles: 20° dorsiflexion, neutral flexion, 20° and 40° of plantarflexion; anterior-posterior (90N), internal-external (5Nm) and inversion-eversion (8Nm) laxity were tested. The motion of the intact ankle was recorded first and then replayed following transection of the lateral retinaculum, Anterior Talofibular Ligament (ATFL) and Calcaneofibular Ligament (CFL). The decrease in force/torque reflected the contribution of the structure to restraining laxity. Data were analysed using repeated measures of variance and paired t-tests.ResultsThe ATFL was the primary restraint to anterior drawer (P< 0.01) and the CFL the primary restraint to inversion throughout range (P< 0.04), but with increased plantarflexion the ATFL's contribution increased. The ATFL had a significant role in resisting tibial external rotation, particularly at higher levels of plantarflexion, contributing 63% at 40° (P< 0.01). The CFL provided the greatest resistance to external tibial rotation, 22% at 40° plantarflexion (P< 0.01). The extensor retinaculum and skin did not offer significant restraint in any direction tested.ConclusionThis study shows accurately for the first time the significant role the ATFL and CFL have in rotational ankle stability. This significant loss in rotational stability may have implications in the aetiology of osteophyte formation and early degenerative changes in patients with chronic ankle instability. This is the first time the role of the lateral ankle complex has been quantified using a robotic testing platform.
Selected music-liturgical traditions of Opolskie Silesia and religious everyday life after 1972 – process of satisfying religious needs
Authors: Świecarz Grzegorz 
Published: May 2024

Students have various needs. One of them is the need for religion. It is precisely religion that allows for the satisfaction of the need for transcendence and enables, at least some people, to cope with the problems of their existence. The process of education and upbringing, as well as care for the student takes place in various places and is carried out by various institutions. One of them can be churches and religious entities. This religious need can be fulfilled through the student’s access to liturgy and participation in liturgical and musical traditions. The aim of the work is to present selected musical and liturgical traditions of Opole Silesia and the changes that took place after the reform of the Second Vatican Council. The source materials for this publication will be the Constitution on the Holy Liturgy Sacrosanctum Concilium and the Instruction on Music in the Holy Liturgy Musicam Sacram. The point of support will be the documents located in the Diocesan Archives in Opole. The author will also use documents of the Polish Episcopate, which provide detailed guidelines regarding changes in liturgical music after the Second Vatican Council, as well as documents regarding organists, choirs and the musical formation of the WMSD in Opole. The collected material will allow for the synthetic implementation of the indicated purpose of the work using the analytical and critical method. The repertoire of church songs in the Opole diocese reflects new liturgical creativity. It also indicates the practice of constantly maintaining a specific canon of old songs. The tradition of church songs in Silesia was preserved thanks to the songbook Droga do nieba. Musically, they prefer psalmodic, responsorial and dialogue structures. In performance practice, this requires more frequent participation of the schola, choir or cantor. The Church in Poland has chosen the path of reception of the reform and renewal of the post-conciliar liturgy. This does not mean that this road has been completed. The reception process is still ongoing and awaits our active participation in it. Research on the reception of the conciliar Constitution on the liturgy in the diocese of Opole showed that the post-conciliar liturgical renewal had to take into account local historical conditions and the resulting specificity of religious and liturgical life (including the current bilingualism of the liturgy).
Self-mutilation among high school youth
Authors: Lukasek Aleksandra , Chwierut Agnieszka 
Published: May 2024

The article is devoted to the issue of self-mutilation among high school students staying in the Mazowiecki Neuropsychiatry Center in Józefów. The undertaken research was aimed at understanding the phenomenon of self-mutilation, its symptoms, conditions and consequences among the above-mentioned group. The study used the method of diagnostic survey in a group representing a selected population.
Female genital schistosomiasis burden and risk factors in two endemic areas in Malawi nested in the Morbidity Operational Research for Bilharziasis Implementation Decisions (MORBID) cross-sectional study
Authors: Lamberti Olimpia , Kayuni Sekeleghe , Kumwenda Dingase , Ngwira Bagrey , Singh Varsha , Moktali Veena , Dhanani Neerav , Wessels Els , Van Lieshout Lisette , Fleming Fiona M. , Mzilahowa Themba , Bustinduy Amaya L. 
Published: May 2024

Background
Female genital schistosomiasis (FGS), caused by the parasite Schistosoma haematobium (Sh), is prevalent in Sub-Saharan Africa. FGS is associated with sexual dysfunction and reproductive morbidity, and increased prevalence of HIV and cervical precancerous lesions. Lack of approved guidelines for FGS screening and diagnosis hinder accurate disease burden estimation. This study evaluated FGS burden in two Sh-endemic areas in Southern Malawi by visual and molecular diagnostic methods.

Methodology/Principal findings
Women aged 15–65, sexually active, not menstruating, or pregnant, were enrolled from the MORBID study. A midwife completed a questionnaire, obtained cervicovaginal swab and lavage, and assessed FGS-associated genital lesions using hand-held colposcopy. ‘Visual-FGS’ was defined as specific genital lesions. ‘Molecular-FGS’ was defined as Sh DNA detected by real-time PCR from swabs. Microscopy detected urinary Sh egg-patent infection.
In total, 950 women completed the questionnaire (median age 27, [IQR] 20–38). Visual-and molecular-FGS prevalence were 26·9% (260/967) and 8·2% (78/942), respectively. 6·5% of women with available genital and urinary samples (38/584) had egg-patent Sh infection. There was a positive significant association between molecular- and visual-FGS (AOR = 2·9, 95%CI 1·7–5·0). ‘Molecular-FGS’ was associated with egg-patent Sh infection (AOR = 7·5, 95% CI 3·27–17·2). Some villages had high ‘molecular-FGS’ prevalence, despite <10% prevalence of urinary Sh among school-age children.

Conclusions/Significance
Southern Malawi carries an under-recognized FGS burden. FGS was detectable in villages not eligible for schistosomiasis control strategies, potentially leaving girls and women untreated under current WHO guidelines. Validated field-deployable methods could be considered for new control strategies.
Efficacy and safety of mirror therapy for post-stroke aphasia: A systematic review and meta-analysis protocol
Authors: Peng Yufeng , Huang Shouqiang , Yang Xiaotong , Ma Jiao 
Published: May 2024

Background
Aphasia is one of the most common complications of stroke. Mirror therapy (MT) is promising rehabilitation measure for the treatment of post-stroke aphasia. Although some studies suggested that MT is effective and safe for aphasia, the effects and safety remain uncertain due to lacking strong evidence, such as the relevant systematic review and meta- analysis.

Methods
This study will search PubMed, Web of Science, Cochrane Library, EMBASE, Medline, China Knowledge Network (CNKI), WANFANG, China Biomedical Literature Database (CBM), from inception to 1th May 2023 to identify any eligible study. No language or date of publication shall be limited. We will only include randomised controlled trials of MT in the Treatment of poststroke aphasia. Two investigators will work separately on the study selection, data extraction, and study quality assessment. The western aphasia battery (WAB) and aphasia quotient (AQ) will be included as the main outcomes. Boston diagnostic aphasia examination method (BDAE), Chinese standard aphasia examination (CRRCAE) will be included as the secondary outcomes. The statistical analysis will be conducted by RevMan V.5.4 software. The risk of bias of included studies will be assessed by the Cochrane ‘Risk of bias’ tool. The quality of proof of the results will be evaluated by using the Grading of Recommendations Assessment, Development and Evaluation guidelines.

Results
The finding will be presented in a journal or related conferences.

Conclusion
This study will provide a basis for whether mirror therapy (MT) is effective and safe in the treatment of post-stroke aphasia.

Trial registration
Systematic review registration
INPLASY registration number: INPLASY 202340054.
Demographics, culture and participatory nature of multi-marathoning—An observational study highlighting issues with recommendations
Authors: Lundy Leo , Reilly Richard B. 
Published: May 2024

Objectives
The defining achievement of a multi-marathoner is completing 100 marathons. This study aimed to comprehensively document the phenomenon of multi-marathoning, addressing its demographics, culture and participatory nature, filling a gap in peer-reviewed research on the topic. Additionally, it aimed to provide recommendations for multi-marathon governing bodies, event organisers, health professionals and participants to address identified issues.

Methods
A global survey was distributed to participants and individuals interested in multi-marathoning. It was distributed with support from major national and international multi-marathon clubs through their social media channels, email groups and newsletters. The survey was conducted anonymously and online.

Results
The survey garnered responses from 830 participants across 40 countries, with an average marathon completion count of 146.54 (SD 201.83) per respondent. Gender distribution showed 60.69% men, 39.3% women and 0.1% gender variant/non-conforming. Respondents’ average ages were 51.6 (SD 9.96) years for men, 48.83 (SD 9.15) years for women and 35.00 (SD 8.76) years for gender variant/non-conforming. As participants age, social and travel motivations surpass competitiveness. A majority (57%) of respondents had at least one contravention to the pre-participation screening questionnaire PARQ-+ and 67% reported taking pain relief medication around events. Notably, 93% of respondents reported multi-marathoning as beneficial for their mental health.

Discussion
Multi-marathoning accommodates older athletes, but a significant gender imbalance exists in participation levels. Long-term health implications warrant attention from governing bodies, event organisers, health professionals and participants alike. Multi-marathoners should seek medical advice before participation, utilise modern equipment for health monitoring and optimise training accordingly.

Conclusion
Recommendations include encouraging diversity at events, ensuring event directors have well-resourced health plans and promoting participants’ proactive health management before and during their involvement in the sport. This study not only advances our understanding of multi-marathoning as a sport but also contributes to theoretical frameworks such as SDT and HBM.