bluuebunny/crossref_metadata_2025_split huggingface dataset:
Extended Medicaid coverage will improve access but insufficient to enhance postpartum care utilization: a secondary analysis of the 2016–2019 Arizona Medicaid claims
Authors: Okechukwu Abidemi , Abraham Ivo , Okechukwu Chinedu , Magrath Priscilla , Marrero David G. , Farland Leslie V. , Alaofe Halimatou 
Published: January 2024

IntroductionPostpartum Medicaid eligibility extensions may increase access to healthcare for low-income women. However, its implications for healthcare utilization are unknown.MethodsWe analyzed the linked-infant birth certificate and claims data of women whose childbirths were paid for by Medicaid between 2016 and 2019 in Arizona, United States. We evaluated associations between postpartum care visits and Medicaid insurance type and assessed effect modification by the delivery route and type of residence.ResultsWomen with pregnancy-related Medicaid insurance were less likely to attend postpartum visits, with an adjusted odds ratio (aOR) of 0.70 and a 95% confidence interval (CI) of 0.66 to 0.74 than those with continuous Medicaid insurance. Younger age, rural residence [aOR 0.83, CI 0.78, 0.88], vaginal delivery route [aOR 0.11, CI 0.10, 0.12], and the absence of complications during/after childbirth [aOR 0.58, CI 0.49, 0.70] were associated with the absence of postpartum care visit. Low-income women who lost their pregnancy-related Medicaid coverage after 60 days in Arizona experienced lower rates of postpartum care utilization.DiscussionInterventions to improve postpartum utilization should be considered beyond extending postpartum Medicaid coverage for low-income women.
Association between household income levels and nutritional intake of allergic children under 6 years of age in Korea: 2019 Korea National Health and Nutrition Examination Survey and application of machine learning
Authors: Jeong Seungpil , Choi Yean Jung 
Published: January 2024

IntroductionThis study investigated the prevalence of allergic diseases in Korean children aged 6 and below, focusing on the interplay between nutritional status, household income levels, and allergic disease occurrence.MethodsThis study used data from the 2019 Korea National Health and Nutrition Examination Survey, a nationwide comprehensive survey, and included a representative sample of 30,382 children under the age of 6 to investigate in detail the relationship between allergic diseases, nutritional intake, and socioeconomic factors. Logistic regression analysis was performed to identify factors associated with allergic diseases, including gender, BMI, eating habits, dietary supplement intake, and nutrient consumption. To predict childhood asthma, 14 machine learning models were compared using the ‘pycaret’ package in Python.ResultsWe discerned that 24.7% were diagnosed with allergic conditions like atopic dermatitis, asthma, and allergic rhinitis. Notably, household income exhibited a significant influence, with the lowest income quartile exhibiting higher prevalence rates of asthma, allergic rhinitis, and multiple allergic diseases. In contrast, the highest income quartile displayed lower rates of allergic rhinitis. Children diagnosed with allergic diseases demonstrated compromised intake of essential nutrients such as energy, dietary fiber, vitamin B1, sodium, potassium, and iron. Particularly noteworthy were the deficits in dietary fiber, vitamin A, niacin, and potassium intake among children aged 3–5 with allergies. Logistic regression analysis further elucidated that within low-income families, female children with higher BMIs, frequent dining out, dietary supplement usage, and altered consumption of vitamin B1 and iron faced an elevated risk of allergic disease diagnosis. Additionally, machine learning analysis pinpointed influential predictors for childhood asthma, encompassing BMI, household income, subjective health perception, height, and dietary habits.DiscussionOur findings underscore the pronounced impact of income levels on the intricate nexus between allergic diseases and nutritional status. Furthermore, our machine learning insights illuminate the multifaceted determinants of childhood asthma, where physiological traits, socioeconomic circumstances, environmental factors, and dietary choices intertwine to shape disease prevalence. This study emphasizes the urgency of tailored nutritional interventions, particularly in socioeconomically disadvantaged populations, while also underscoring the necessity for comprehensive longitudinal investigations to unravel the intricate relationship between allergic diseases, nutritional factors, and socioeconomic strata.
Dietary habits, physical activity, and self-reported rhinosinusitis in children and adolescents
Authors: Pazdro-Zastawny Katarzyna , Krajewska Joanna , Kolator Mateusz , Basiak-Rasała Alicja , Górna Sara , Zatoński Tomasz 
Published: January 2024

BackgroundPediatric paranasal rhinosinusitis is one of the more common pediatric diseases of the upper respiratory tract and it entails significant morbidity. Most commonly, it is caused by a viral infection of the nasal mucosa, which spreads through the natural passages within the cavities of the paranasal sinuses, leading to inflammation of the mucosa that lines the nasal cavity and paranasal sinuses.MethodsThe objective of this cohort study was to assess whether there is a correlation between pediatric rhinosinusitis, physical activity, and selected dietary habits among pupils aged 6 to 16 years from elementary schools in Wrocław, Poland. This study – as part of the pro-health program “Let us Get the Kids Moving” – is also aimed at establishing factors that potentially predispose children to developing RS. The survey study was conducted on a group of 2,458 children and adolescents from elementary schools in Wrocław. The age of the examined children ranged from 6 to 17 years (mean = 10.8 years; standard deviation = 2.7).ResultsRhinosinusitis was more common in the children aged 13–17 years than in those aged 6–9 years (6.4% vs. 1.5%; p &lt; 0.001) or 10–12 years (6.4 vs. 2.6%; p &lt; 0.001). The study revealed a significant positive correlation between rhinosinusitis development and several variables: age &gt; 11 years, attending swimming classes fewer than 1–2 times a week, using a computer, consuming milk, salty snacks, and carbonated sweet drinks, consuming fruit fewer than 1–2 times a week, not attending physical education classes, eating fewer than 4 meals, and not eating breakfast at home (p &lt; 0.05).ConclusionIt is of great importance to establish preventive measures against recurrent upper respiratory tract infections that may predispose children to rhinosinusitis. Introducing healthier, traditional dietary habits and regular physical activity in children and adolescents may result in normal and adequate immune response and proper functioning of the inflammatory control system.
Determinants of factors affecting readiness of academic institutions to conduct knowledge translation in low- and middle-income countries
Authors: Kalbarczyk Anna , Rao Aditi , Alonge Olakunle O. 
Published: January 2024

IntroductionCapacity building strategies have been used to improve uptake of knowledge translation (KT) activities among academic institutions, but little is known about their effectiveness, contextual responsiveness, and adaptability. Many of these strategies target individuals while few address institutional gaps. This research describes the determinants for conducting KT (or readiness to conduct such activities) at the institutional level across diverse LMIC contexts to inform the development of capacity building strategies.MethodsWe conducted a survey to assess organizational readiness to conduct KT to public health researchers and practitioners from six academic institutions in Bangladesh, Ethiopia, DRC, India, Indonesia and Nigeria and members of a global knowledge-to-action working group. We assessed the frequency of barriers and facilitators to KT and their relationship to age, gender, country, and KT experience. We then performed logistic regression to identify determinants of five underlying factors demonstrated to influence KT readiness in LMICs (Institutional Climate, Organization Change Efficacy, Prioritization and Cosmopolitanism, Self-Efficacy and Financial Resource) along with their composite score, which represented an overall readiness score to conduct KT.ResultsA total of 111 responses were included in the final analysis. Participants represented 10 LMICs; a majority were 30–49 years old (57%) and most were male (53%). Most participants had professional foci in research (84%), teaching (62%), and project coordination (36%) and 59% indicated they had experience with KT. Common facilitators included motivated faculty (57%) and dedicated personnel (40%). Funding (60%), training (37%), and time (37%) were the most frequently reported barriers. In the adjusted model, age, gender, country, and professional focus were significantly associated with at least one factor. Prior experience with KT was significantly and positively (OR = 9.07; CI: 1.60–51.58; p &lt; 0.05) associated with the overall KT readiness to conduct KT.DiscussionDifferent KT readiness factors are relevant for younger (institutional climate) vs. older (self-efficacy) academic professionals, suggesting value in cross-generational collaborations. Leadership and gender were both relevant for organizational change efficacy indicating a need to engage leaders and promote women to influence organizational change. Institutions in different countries may be at different stages of change; readiness assessments can be used to systematically identify needs and develop targeted strategies.
Digital tool assessment for the community management of patients with pulmonary tuberculosis in Yiwu city, China: evidence from real world data in 2020
Authors: Zhou Lin , Zhou Yuli , Ding Yunfang , Peng Ying , Wang Wei , Chen Bin , Gong Shuiying , Liu Kui , Dong Xuanjun 
Published: January 2024

BackgroundHigh-quality medication compliance is critical for the cure of pulmonary tuberculosis (PTB); however, the implementation of directly observed treatment (DOT) under direct interview still faces huge difficulties. Assessment of the effect of digital tool during community management has not been performed in eastern China.MethodsAll drug-sensitive PTB cases notified in Yiwu city from June to December 2020 were divided into the routine group and digital tool group based on patients’ willingness. The variables influencing the on-time completion level of home visits, medication adherence and treatment outcomes were estimated.ResultsA total of 599 eligible patients were enrolled, with 268 participating in the routine group and 331 using a digital tool. Most participants were men (n = 357, 59.6%), and nearly all were new cases (n = 563, 94.0%). Participants’ mean age was 44.22 ± 20.32 years. There were significant differences in age, diagnostic type, and source of patients between the two groups. During the study period, the digital tool group had a higher on-time completion rate of home visits (91.5% vs. 82.5%) and medication adherence rate (94.3% vs. 89.6%) than the routine group, whereas there was no significant difference in the treatment success rate between the two groups (91.2% vs. 86.8%). Multivariate logistic regression analysis demonstrated that the digital tool group showed a more positive function in the on-time completion status of home visits, with an adjusted odds ratio of 0.41 (95% confidence interval: 0.25–0.70).ConclusionDigital tools can be employed to improve the on-time completion rate of home visits in Yiwu city. Further large-scale studies that use digital tools for community management are warranted.
The Acti-Pair program helps men with prostate cancer increase physical activity with peer support: a mixed method pilot study
Authors: Baudot Amandine , Barth Nathalie , Colas Claire , Garros Maël , Garcin Arnauld , Oriol Mathieu , Collange Fanny , Bongue Bienvenu , Roche Frederic , Chauvin Franck , Bourmaud Aurelie , Hupin David 
Published: January 2024

BackgroundAlthough the health benefits of physical activity (PA) are recognized, prostate cancer patients do not follow PA recommendations. Barriers to PA, whether physical, environmental or organizational, are known. Furthermore, even when these barriers are overcome, this achievement is not systematically accompanied by lifestyle change. Many strategies have shown to be effective in increasing patient adherence to PA. This study aims to assess the feasibility and the viability of the Acti-Pair program which combines three strategies: peer support, a personalized and realistic PA project, and support from health and adapted physical activity professionals in a local context.Methods and analysisWe conducted a pilot study utilizing a mixed qualitative and quantitative methodology, employing feasibility and viability assessments. Quantitative assessments included recruitment, retention adherence rates, process and potential effectiveness (PA and motivation) indicators; while qualitative methods were used to evaluate the program's practicality, suitability and usefulness. Indicators of potential effectiveness were assessed before and after the intervention using a Wilcoxon test for matched data. Qualitative data were collected through semistructured interviews conducted by two researchers with various program stakeholders. The study lasted for 3 years.ResultsTwenty-four patients were recruited over a 25-month period. Forty-two percent of patients completed the program 3 months after the beginning. We recruited 14 peers and trained nine peers over a 10-month period. The program was coordinated extensively by adapted PA professionals, while health professionals were involved in recruiting patients and peers. Self-reporting of moderate to vigorous PA was increased after the Acti-Pair program initiation [42.86 (30.76) at baseline to 53.29 (50.73)]. Intrinsic motivation significantly increased after participation in the Acti-Pair program [1.76 (1.32) before the intervention vs. 2.91 (1.13) after the intervention]. The key player to support the Acti-Pair program in the field has been the PA support system. The main challenge has been the difficulty of health professionals in promoting PA.DiscussionThis pilot study has shown that the Acti-Pair program is feasible and viable. It will allow us to extend the peer support intervention to other contexts and assess the effectiveness of this intervention and its generalization.
Association between urine uranium and asthma prevalence
Authors: Huang Dongdong , Wang Saibin 
Published: January 2024

BackgroundPrevious studies showed that urine uranium (U) is associated with asthma prevalence in adults. However, the association between them among the general population is unclear. Therefore, this study aimed to explore this unclear association.MethodsThe data of the participants were collected from the 2007–2016 National Health and Nutrition Examination Survey (NHANES) performed in the United States. Continuous variables with a skewed distribution were analyzed using Ln-transformation. The association between urine U and asthma prevalence was analyzed by multiple regression analysis, and the linear association between them was evaluated by smoothed curve fitting. The subgroup analysis was performed using the hierarchical multivariate regression analysis.ResultsA total of 13,581 participants were included in our analysis. The multivariate regression analysis showed that LnU was independently and positively correlated with asthma prevalence in the general population (OR = 1.12; 95% CI: 1.04–1.20; p = 0.002). The subgroup analysis revealed that college graduate or above showed a stronger association between LnU and asthma prevalence (&lt;9th grade: OR = 0.84; 95% CI: 0.61–1.14; 9–11th grade: OR = 1.23; 95% CI: 0.99–1.52; high school grade: OR = 1.00; 95% CI: 0.84–1.19; college: OR = 1.04; 95% CI: 0.91–1.19; ≥college graduate: OR = 1.32; 95% CI: 1.11–1.57; P for interaction = 0.0389).ConclusionOur research suggested that urinary U levels are positively associated with asthma prevalence among the general population of the United States, and the association is especially strong among people with high levels of education.
Which variables and determinants influence online food delivery consumption among workers and students? Results from the DELIvery Choice In OUr Society (DELICIOUS) cross-sectional study
Authors: Giacomini Gianmarco , Scacchi Alessandro , Ragusa Paolo , Prinzivalli Alessandro , Elhadidy Heba Safwat Mhmoued Abdo , Gianino Maria Michela 
Published: January 2024

IntroductionOnline food delivery (OFD) applications provide easy access to food, eliminating the need for cooking and meal planning. However, they predominantly promote processed and calorie-dense foods, potentially impacting diet and health. This study aimed to describe the use of OFD services in a sample of Italian workers and students, to explore potential determinants of OFD usage and to assess possible differences in use between these two categories.MethodsData were collected through an online survey (convenience sampling) distributed on social media platforms between July 12, 2022, and February 1, 2023. The sample included individuals aged 18 and above, currently residing in Italy. The sample was stratified according to worker/student status. Descriptive analyses were performed on key variables. A multivariable logistic regression analysis was conducted to assess the effects of variables on OFD usage, treated as a dichotomous variable (usage or non-usage).ResultsThis study analyzed 3,502 questionnaires (2,594 from workers and 908 from students) after excluding 323 non-student and non-worker responses. Positive associations with OFD use included higher income, remote working, smoking, elevated BMI, depression risk, and impulsive buying among workers, while being female, frequent screen-watching during meals, daily smoking, higher BMI, and impulsive buying were associated with OFD use among students. Factors negatively associated with OFD use included older age (workers and students), living in suburbs (workers and students) or in an outline town (workers), being single (workers and students), adhering to the Mediterranean diet (students), having low health literacy (students), and job dissatisfaction (workers).DiscussionOFD consumption was associated with some risky behaviors and conditions, such as high BMI or smoking, suggesting that it might be influenced by individual tendencies. Healthier habits, such as physical activity, did not significantly impact OFD usage, especially among workers. Whereas, among students, factors such as low health literacy and better eating habits were associated with less use of OFD, so that they could be more prone to use OFD in a measured way. Further research is needed to better understand potential associations between OFD and risky habits, as well as its role in promoting access to healthy food in underserved areas.
Towards integrated sustainability for China’s rural revitalization: an analysis of income inequality and public health
Authors: Lin Jie , Gong Kuiyuan , Chen Chuangbin 
Published: January 2024

IntroductionEnsuring healthy lives and promoting well-being are paramount among the priorities outlined in the 17 Sustainable Development Goals (SDGs) established by the United Nations. In China, rural revitalization stands as a pivotal national strategy aimed at fostering prosperity and sustainable development in rural areas. Despite its comprehensive evaluation system, which encompasses industry, ecology, culture, organization, and livelihood, the current index system overlooks the critical dimension of public health in rural areas. The existing body of literature predominantly focuses on the correlation between income and health, leaving a gap in understanding the relationship between income inequality and health from the perspective of villagers. This study addresses this gap by utilizing data from 3,771 villager samples and 302 village samples obtained from the 2019 China Rural Revitalization Survey (CRRS) to explore the correlation between income inequality and public health in China’s rural areas.MethodsWe employ the Ordered Logistic Regression (Ologit) model in the baseline regression and heterogeneity analysis. Additionally, a mediating effect analysis, using the Sobel test, examines the role of villagers’ health awareness as a mediating variable in the correlation between income inequality and villagers’ health.ResultsThe empirical findings of this study unveil a statistically significant adverse influence of income inequality on public health in China’s rural areas. Furthermore, the research identifies that participation in regular exercise and the attainment of higher education levels serve as effective measures to alleviate the detrimental impact of income inequality on the health of rural residents. Additionally, income inequality is observed to shape villagers’ health awareness, thereby influencing their overall health status.ConclusionThe study’s outcomes have significant implications for policymakers and governmental authorities, providing valuable insights into some pathways for enhancing public health in rural China. Ultimately, these insights contribute to the broader objective of achieving integrated sustainability in rural China.
Explaining graph convolutional network predictions for clinicians—An explainable AI approach to Alzheimer's disease classification
Authors: Tekkesinoglu Sule , Pudas Sara 
Published: January 2024

IntroductionGraph-based representations are becoming more common in the medical domain, where each node defines a patient, and the edges signify associations between patients, relating individuals with disease and symptoms in a node classification task. In this study, a Graph Convolutional Networks (GCN) model was utilized to capture differences in neurocognitive, genetic, and brain atrophy patterns that can predict cognitive status, ranging from Normal Cognition (NC) to Mild Cognitive Impairment (MCI) and Alzheimer's Disease (AD), on the Alzheimer's Disease Neuroimaging Initiative (ADNI) database. Elucidating model predictions is vital in medical applications to promote clinical adoption and establish physician trust. Therefore, we introduce a decomposition-based explanation method for individual patient classification.MethodsOur method involves analyzing the output variations resulting from decomposing input values, which allows us to determine the degree of impact on the prediction. Through this process, we gain insight into how each feature from various modalities, both at the individual and group levels, contributes to the diagnostic result. Given that graph data contains critical information in edges, we studied relational data by silencing all the edges of a particular class, thereby obtaining explanations at the neighborhood level.ResultsOur functional evaluation showed that the explanations remain stable with minor changes in input values, specifically for edge weights exceeding 0.80. Additionally, our comparative analysis against SHAP values yielded comparable results with significantly reduced computational time. To further validate the model's explanations, we conducted a survey study with 11 domain experts. The majority (71%) of the responses confirmed the correctness of the explanations, with a rating of above six on a 10-point scale for the understandability of the explanations.DiscussionStrategies to overcome perceived limitations, such as the GCN's overreliance on demographic information, were discussed to facilitate future adoption into clinical practice and gain clinicians' trust as a diagnostic decision support system.