bluuebunny/crossref_metadata_2025_split huggingface dataset:
A brief overview of modern approaches to the therapy of resistant arterial hypertension
Authors: Lazarev P. O. 
Published: March 2024

Resistant hypertension is associated with increased mortality and morbidity. The optimal drug therapy for resistant hypertension has not been fully clarified, there are few studies on this issue in the literature. We compared the efficacy of nebivolol 5 mg, a third-generation beta-blocker, with spironolactone 25 mg in patients with resistant hypertension.
81 patients with resistant hypertension were included in the study. Resistant hypertension was defined as the presence of official blood pressure ≥ 140/90 mm Hg. when patients received 3 or more antihypertensive drugs, including diuretics. Blood pressure was recorded in office and outpatient settings at baseline and after 8 weeks of treatment.
Office systolic blood pressure and diastolic blood pressure at 24-hour ambulatory blood pressure monitoring were significantly lower compared to baseline values in the nebivolol and spironolactone groups. The decrease in 24-hour mean systolic and diastolic blood pressure in the nebivolol group was 14.9±19.8 mm Hg. Art. and 9.3±12.7 mm Hg. Art. compared to 19.5±16.4 mm Hg. Art. and 13.7±10.8 mm Hg. Art. in the spironolactone group, respectively. The reduction in 24-hour mean systolic and diastolic blood pressure was not significantly different between the nebivolol and spironolactone groups (P = 0.338 and P = 0.153).
Therefore, nebivolol is an effective treatment option for resistant hypertension, and the antihypertensive effect of this drug is similar to low doses of spironolactone.
The Disk Orientations of Perseus Protostellar Multiples at ∼8 au Resolution
Authors: Reynolds Nickalas K. , Tobin John J. , Sheehan Patrick D. , Sadavoy Sarah I. , Looney Leslie W. , Kratter Kaitlin M. , Li Zhi-Yun , Segura-Cox Dominique M. , Kaib Nathan A. 
Published: March 2024

Abstract
We present a statistical characterization of circumstellar disk orientations toward 12 protostellar multiple systems in the Perseus molecular cloud using the Atacama Large Millimeter/submillimeter Array at Band 6 (1.3 mm) with a resolution of ∼25 mas (∼8 au). This exquisite resolution enabled us to resolve the compact inner-disk structures surrounding the components of each multiple system and to determine the projected 3D orientation of the disks (position angle and inclination) to high precision. We performed a statistical analysis on the relative alignment of disk pairs to determine whether the disks are preferentially aligned or randomly distributed. We considered three subsamples of the observations selected by the companion separations a < 100 au, a > 500 au, and a < 10,000 au. We found for the compact (<100 au) subsample, the distribution of orientation angles is best described by an underlying distribution of preferentially aligned sources (within 30°) but does not rule out distributions with 40% misaligned sources. The wide companion (>500 au) subsample appears to be consistent with a distribution of 40%–80% preferentially aligned sources. Similarly, the full sample of systems with companions (a < 10,000 au) is most consistent with a fractional ratio of at most 80% preferentially aligned sources and rules out purely randomly aligned distributions. Thus, our results imply the compact sources (<100 au) and the wide companions (>500 au) are statistically different.
Probing the Nature of Rotation in the Pleiades, Alpha Persei, and Hyades Clusters
Authors: Hao C. J. , Xu Y. , Hou L. G. , Bian S. B. , Lin Z. H. , Li Y. J. , Dong Y. W. , Liu D. J. 
Published: March 2024

Abstract
Unraveling the internal kinematics of open clusters is crucial for understanding their formation and evolution. However, there is a dearth of research on this topic, primarily due to the lack of high-quality kinematic data. Using the exquisite-precision astrometric parameters and radial velocities provided by Gaia data release 3, we investigate the internal rotation in three of the most nearby and best-studied open clusters, namely the Pleiades, Alpha Persei, and Hyades clusters. Statistical analyses of the residual motions of the member stars clearly indicate the presence of three-dimensional rotation in the three clusters. The mean rotation velocities of the Pleiades, Alpha Persei, and Hyades clusters within their tidal radii are estimated to be 0.24 ± 0.04, 0.43 ± 0.08, and 0.09 ± 0.03 km s−1, respectively. Similar to the Praesepe cluster that we have studied before, the rotation of the member stars within the tidal radii of these three open clusters can be well interpreted by Newton’s theorem. No expansion or contraction is detected in the three clusters either. Furthermore, we find that the mean rotation velocity of open clusters may be positively correlated with the cluster mass, and the rotation is likely to diminish as open clusters age.
Facilitating Factors and Barriers to Physical Activity among Undergraduate Medical Students in North India: A Qualitative Study
Authors: Kumar Pentapati Siva Santosh , Goswami Kiran , Goswami Anil , Yadav Kapil , Vanni Poornima , Tayade Prashant 
Published: March 2024

Background:
Medical undergraduate students are the doctors of the future. Evidence supports that medical students who practice physical activity (PA) regularly will continue to perform PA in the future and are more likely to counsel patients about it in their practice. This study was planned to understand the facilitating factors and barriers to PA among Bachelor of Medicine and Bachelor of Surgery (MBBS) students using a qualitative approach.

Materials and Methods:
This study is part of a larger study on PA among undergraduate medical students from a medical college in North India. A cross-sectional study with a qualitative approach was conducted on undergraduate medical (MBBS) students enrolled from 2012 to 2017 at the All India Institute of Medical Sciences (AIIMS), New Delhi.

Results:
The most common facilitating factors identified in the study were self-motivation and personal preference, followed by health consciousness to maintain fitness and the continuation of habits from early childhood. Other facilitating factors reported are being good at sports, having sports-loving friends, an increase in self-confidence, the desire to build six packs, and reducing weight. Those with a concern for self-health, prevention of disease in the future, or a family member already suffering from a disease related to PA were also likely to practice it. Barriers found in the study broadly were competing for time, gender issues, resource-related issues, and sole focus on academics.

Conclusion:
Rigorous efforts are needed from the individual level to the system level to reinforce the facilitators and fight the barriers. Future studies should focus on finding ways to overcome the barriers and strengthen the facilitating factors for PA among medical students in India.
Regional Variation in the Prevalence of Undernutrition and its Correlates Among Under Five-Year Children in North India
Authors: Meshram Indrapal Ishwar , Kodavanti Mallikharjun Rao , Krishna K Sreerama , Laxmaiah Avula 
Published: March 2024

Background:
Undernutrition is an important public health problem affecting one-third of under five-year-old children in India.

Objectives:
To assess the nutritional status of under five-year-old children along with child feeding practices.

Materials and Methods:
We adopted a systematic sampling procedure to carry out this community-based, cross-sectional study in all the districts of Haryana. Data was collected on socioeconomic and demographic particulars along with anthropometric measurements. Analysis was done using SPSS Windows 23.

Results:
The overall prevalence of stunting, underweight, and wasting was 34%, 27.5%, and 11%, while that of severe undernutrition was 11%, 8%, and 3%, respectively. The odds of underweight were significantly higher among children of the Muslim religion, children of scheduled caste, children of illiterate mothers, lower per capita income, HHs without electricity, landless HHs, low birth weight, no ANC care, and those early ages at complementary feeding. Stunting was significantly higher among children whose mothers were illiterate, children whose fathers were laborers, among landless HHs, with no separate kitchen and lower birth weight, while wasting was higher among children of Muslim religion, children of scheduled caste, with no sanitary latrine facility, low-birth-weight children and early initiation of complementary feeding.

Conclusions:
Undernutrition is observed to be associated with religion, community, education of mother, per capita income, land holding status, birth weight, and age at complementary feeding. Thus, improving maternal nutrition can improve birth weight, improving maternal knowledge about child feeding, and the household’s socio-economic status may improve the nutritional status of children.
Measuring the Effect of Ayushman Bharat-Pradhan Mantri Jan Aarogya Yojna (AB-PMJAY) on Health Expenditure among Poor Admitted in a Tertiary Care Hospital in the Northern State of India
Authors: Kanwal Shweta , Kumar Dinesh , Chauhan Raman , Raina Sunil Kumar 
Published: March 2024

Background:

Ayushman Bharat-Pradhan Mantri Jan Aarogya Yojna (AB-PMJAY) as a financial risk protection scheme intends to reduce catastrophic health expenditure (CHE), especially among poor. The current study was carried out to assess the utility of AB-PMJAY in terms of reduction in CHE from before and after admission in a tertiary hospital in the northern state of India.

Methodology:
It was a hospital-based cross-sectional study carried out from August 2020 to October 2021 at a public tertiary hospital of Himachal Pradesh, India. Data were collected from surgery- and medicine-allied (SA and MA) specialties. Along with socio-demographic details, information for total monthly family expenditure (TMFE), out-of-pocket expenditure (OOPE), and indirect illness-related expenditure (IIE) was recorded before and after hospital admission. CHE was considered as more than 10.0% OOPE of THFE and more than 40.0% of capacity to pay (CTP).

Results:
A total of 336 participants with a mean age of 46 years were recruited (MA: 54.6%). The majority (~93.0%) of participants had illness of fewer than 6 months. The mean TMFE was observed to be INR 4213.1 (standard deviation: 2483.7) and found to be similar across specialties. The OOPE share of TMFE declined from 76.1% (before admission) to 30.0% (after admission). Before admission, CHE was found among 65.5% (10.0% of THFE) and 54.2% (40.0% of CTP) participants. It reduced to about 29.0% (based on both THE and CTP) after admission to hospital.

Conclusion:
AB-PMJAY scheme found to be useful in reducing CHE in a tertiary hospital.
Analysis of Health Ailments and Associated Risk Factors in Small-Scale Fisherfolk Community of Indian Sundarbans: A Cross-Sectional Study
Authors: Roy Aparna , De Angshuman , Aftabuddin Md. , Bera Asit K. , Bayen Supriti , Ghosh Abhishek , Das Basanta K. 
Published: March 2024

Background:
Small-scale fishers of Indian Sundarbans depend on open-water fisheries for their livelihoods. They often face health, occupational, and safety issues in their profession due to environmental, socio-economic, and policy changes. The morbidity pattern and related risk factors are important indicators of well-being for any community, hence applicable to small-scale fishers of Sundarbans. The present study was designed to assess patterns of morbidities, associated risk factors including occupational health hazards, and treatment-seeking behavior of small-scale fishers in the Indian Sundarbans.

Material and Methods:
Household surveys, focused group discussions, and personal interviews were conducted through a predesigned pretested structured questionnaire. Associated risk factors and the nature of seeking treatment were considered during the data collection covering 650 individuals from 132 fishers’ families.

Results:
Morbidities were more frequent in males (39.33%) than in females (28.5%). The fever (31%) was the most dominant reason for morbidities followed by ocular ailments (23%), musculoskeletal disorder (20%), dermatological ailments (17%), and respiratory illness (9%). The highest morbidities (25%) were recorded in the age group of 21-30 years in males while that was 20% in the 11-20 years age group in the case of the females. Physical labor for fishing activities predisposes to health ailments of the studied population.

Conclusions:
The prevalence of morbidity among the fishermen community was found to be 28.5%. The understanding of the morbidity profile of a population in general and specific age groups of both sexes in specific sheds light on the vulnerability of working groups that will help for effective healthcare planning and resource allocation.
Indocyanine green-enhanced transpupillary thermotherapy for juxtapapillary retinal capillary hemangioblastoma
Authors: Ketkar Manasi , Raval Vishal R , Reddy P Vijay Anand , Kannan Kiruthika , Kaliki Swathi 
Published: March 2024

Purpose:
To study the clinical presentation and treatment outcomes of indocyanine green-enhanced transpupillary thermotherapy (ICG-TTT) for treatment-naïve juxtapapillary retinal capillary hemangioblastoma (JRCH).

Methods:
A prospective interventional case series. The technique involved ICG dye infusion 45 seconds prior to application of TTT. The main study outcomes were local tumor control, resolution of subretinal fluid (SRF), and improvement in best-corrected visual acuity (BCVA).

Results:
Eight eyes of seven patients (5 males and 2 females) were included. The mean age was 26 years (range: 5–56 years). Systemic evaluation revealed von-Hippel Lindau (VHL) disease in five patients. The most common location was the temporal aspect of the optic disc (5 eyes). The mean basal diameter was 2.9 mm (range: 1–8 mm), and tumor thickness was 1.4 mm (range: 1–4 mm). All eight eyes were treated with multiple sessions of ICG-TTT (mean: 3 sessions). Six eyes received adjuvant intravitreal injection of dexamethasone implant (4 eyes) and/or bevacizumab (4 eyes). Post treatment, six eyes (75%) had tumor regression with reduction of SRF. One eye had a partial response with persisting SRF, and one eye showed poor response to TTT for which external beam radiotherapy was performed. At the last follow-up (median: 11 months; range: 6–29 months), the BCVA remained stable in seven eyes and improved in one eye (hand motion to 20/40).

Conclusion:
Multiple ICG-TTT sessions can be considered as an alternative treatment option for JRCH with effective local tumor control and SRF resolution.
Evaluation of agreement in macular vascular density measured by different protocols: 4.5 mm × 4.5 mm and 6 mm × 6 mm
Authors: Sagar Pradeep , Divya Pagidimarri , Biswal Suchitra , Kakunje Chaithra , Pradeep BC , Ravishankar HN 
Published: March 2024

Purpose:To evaluate the agreement in the macular vascular density (MVD) measured by two protocols: 4.5 mm × 4.5 mm and 6 mm × 6 mm.Design:Cross-sectional observational study.Methods:Healthy volunteers between the age group of 19 and 39 years were recruited. Topcon DRI OCT Triton plus (Topcon Corporation, Tokyo, Japan) was used to acquire the fovea-centered optical coherence tomography angiography (OCTA) image using two protocols: 4.5 mm × 4.5 mm and 6 mm × 6 mm. MVD was measured by the manufacturer software in the superficial capillary plexus slab in five regions: central, superior, nasal, inferior, and temporal subfields of early treatment diabetic retinopathy study grid in each protocol.Results:The study included 79 eyes of 40 healthy volunteers. The difference in the mean MVD between two protocols was 3.84% in right eye and 4.2% in left eye in central subfield, 0.93% in right eye and 1.13% in left eye in superior subfield, 0.06% in right eye and 1.45% in left eye in nasal subfield, 1.65% in right eye and 0.7% in left eye in inferior subfield, 0.4% in right eye and 0.54% in left eye in temporal subfield. The measurements were significantly higher in 6 mm × 6 mm in central subfield in both the eyes and in nasal field in the left eye. Whereas, the measurements were significantly higher in 4.5 mm × 4.5 mm in superior and inferior subfield in both the eyes and in temporal subfield in the left eye.Conclusion:The protocols should not be used interchangeably and it is necessary to include recommendation of the field of view to measure MVD while standardizing OCTA reporting.
Association of eGFR with stages of diabetic retinopathy and age-related macular degeneration in Indian population
Authors: Neelamegam Vidya , Surya R Janani , Venkatakrishnan Praveena , Sharma Tarun , Raman Rajiv 
Published: March 2024

Purpose:
To investigate the influence of glomerular filtration rate in renal disease decline and its association with diabetic retinopathy (DR) and age-related macular degeneration (ARMD) in patients in South India.

Methods:
A population-based cross-sectional study was conducted including participants with DR and ARMD recruited from urban and rural populations. The data collection included medical history, anthropometric measurements, and ophthalmic work-up. The estimated glomerular filtration rate (eGFR) was calculated using the equation of chronic kidney disease-epidemiology collaboration (CKD-EPI). The grading of AMD was done by a single experienced (more than 5 years) vitreoretinal surgeon as per the International ARM Epidemiological Study Group and it was staged based on grading in the worsened eye.

Results:
A decline in eGFR was observed as the severity of DR increased (P < 0.001). Baseline characteristics such as age (P < 0.001), duration of diabetes (P < 0.001), gender (P < 0.001), creatinine (P < 0.001), albumin to creatinine ratio (ACR; P < 0.001), albuminuria (P = 0.023), blood urea (P < 0.001), and high-density lipoprotein (HDL; P = 0.003) were found to be statistically significant. The risk for developing DR with CKD was found to be 5 times higher in male patients compared to female patients. Age and high blood urea level, diastolic blood pressure, mild and moderate DR were the risk factors associated with CKD. A decline in eGFR was observed as the severity of ARMD increased (P < 0.001). The risk factors associated with CKD were age, gender, smoking, alcohol consumed, presence of hypertension, duration of diabetes, systolic and diastolic blood pressure, history of diabetes, body mass index (BMI), serum triglycerides, and serum HDL cholesterol.

Conclusion:
Reduced eGFR values were associated with an increase in the severity of DR and ARMD.
Cataract surgery in children using intracameral mydriatic
Authors: Sukhija Jaspreet , Kaur Savleen , Kumari Kiran , Gupta Kajree , Gupta Parul Chawla 
Published: March 2024

Purpose:
To study the pupil dynamics with premixed intracameral anesthetic mydriatic combination of phenylephrine (0.31%), tropicamide (0.02%), and lidocaine (1%) in pediatric cataract surgery.

Methods:
Consecutive children aged ≤12 years planned for cataract surgery were recruited. A commercially available premixed combination of phenylephrine (0.31%), tropicamide (0.02%), and lidocaine (1%) was injected at the beginning of surgery without any topical/infusion drugs for mydriasis. Pupil sizes at various points of surgery were studied.

Results:
We recruited 75 patients with a mean age of 24.3 ± 33.4 months (range: 1 month–11 years). Adequate mydriasis with a single injection was achieved in 93.5% (n = 73 eyes of 70 patients) without additional pharmacotherapy or intervention. The mean pupillary diameter increased from 1.8 ± 0.79 to 6.1 ± 1.4 mm after injection (mean change of 4.2 ± 1.25 mm from baseline). The mean variability in pupillary diameter was 0.73 ± 1.3 mm. In five eyes, good dilatation was not possible even after repeat injection.

Conclusion:
Fixed-dose premixed intracameral injection is effective in pupil dilatation. It alleviates the need for any topical dilators or additional intraoperative supplementation for pediatric cataract surgery.
Prevalence of blindness and visual impairment in a coastal region of Southern India: A cross-sectional survey in Prakasam district, Andhra Pradesh
Authors: Kumar Hemanth , Pant Hira , Chaudhuri Sirshendu , Kalluri Viswanath , Sarvepally Vijay Kiran , Govindahari Vishal , Vashist Praveen , Tandon Radhika , Murthy GVS 
Published: March 2024

Purpose:
To estimate the magnitude, determinants, and causes of visual impairment (VI) and blindness among people >40 years.

Methods:
In this cross-sectional survey, 2,968 people >40 years from 34 clusters were examined. A cluster random sampling method with a compact segment sampling technique was used to select the study participants. Prevalence of any VI (presenting visual acuity (PVA) <6/12 in better eye), severe VI (PVA <6/60 – 3/60), and blindness (PVA <3/60 in better eye) were expressed as percentage with 95% confidence interval. Logistic regression was performed to determine the risk factors associated with blindness. A P value of less than 0.05 was considered statistically significant.

Results:
The mean age of the participants was 54.6 years (Standard deviation ± 11.2 years). The prevalence of mild, moderate, and severe visual impairment was 14.2% (12.95–15.49), 13.7% (12.46–14.97), and 0.7% (0.47–1.12), respectively. The prevalence of blindness was 1.3% (0.94–1.79, n = 39). The overall prevalence of VI (presenting Visual Acuity <6/12) was 12.0% (95% CI: 10.8–13.2%). The major causes of VI were cataract (78.08%), refractive error (12.07%), and optic atrophy (2.22%), and corneal opacity (2.22%) and the major cause of blindness was cataract (77.27%). Blindness was strongly associated with increasing age- OR 17.1 (95% CI: 4.9–59.8) for people >70 years, and OR 7.6 (95% CI: 2.2–26.5) for people aged between 60 and 69 years compared to those aged 41–50 years and people living near coastal regions (Within 50 km of coast) (OR: 3.9, 95% CI: 1.6–7.3).

Conclusion:
Blindness and vision impairment are of public health concern in this geographic region. Eye care services need to be augmented to address this challenge.
Evaluation of oral and dental health in Turkish and refugee pregnant women
Authors: Tavuz Kübra Aycan , Tavuz Aziz İhsan , Aycan Hanife Esra 
Published: March 2024

ABSTRACT

Objective:
Oral hygiene habits and demographic characteristics of refugees and Turkish citizens among pregnant women were investigated.

Materials and Methods:
This cross-sectional study, conducted at our university hospital, focused on pregnant women and collected data on demographic features and oral health characteristics. Information was gathered through a questionnaire administered to female patients at the dental clinic.

Results:
The study involved 197 volunteers and revealed that refugees tend to have more children than citizens of the Republic of Turkey. While 7% of women experienced positive changes in toothbrushing habits during pregnancy, 93% faced negative changes. Citizens of the Republic of Turkey exhibit significantly higher rates of going to the dentist for prepregnancy checkups compared to refugees (P < 0.05). No differences were observed between refugees and citizens regarding tooth loss or receiving dental treatment during pregnancy.

Conclusions:
Optimal oral hygiene, through collaboration between dentists and gynecologists, should be integrated into the prenatal care protocol. All pregnant women should receive invitations for oral and dental health screenings and undergo oral hygiene training before pregnancy. Dental and oral hygiene screening should be an essential component of the prenatal care protocol.