bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does club convergence matter in health outcomes? Evidence from Indian states
Authors: Nag Ajit , Privara Andrej , Gavurova Beata , Pradhan Jalandhar 
Published: November 2023

Abstract
Background
Population health is vital to a nation’s overall well-being and development. To achieve sustainable human development, a reduction in health inequalities and an increase in interstate convergence in health indicators is necessary. Evaluation of the convergence patterns can aid the government in monitoring the health progress across the Indian states. This study investigates the progressive changes in the convergence and divergence patterns in health status across major states of India from 1990 to 2018.

Methods
Sigma plots (σ), kernel density plots, and log t-test methods are used to test the convergence, divergence, and club convergence patterns in the health indicators at the state level.

Results
The result of the sigma convergence suggests that life expectancy at birth has converged across all states. After 2006, however, the infant mortality rate, neonatal mortality rate, and total fertility rate experienced a divergence pattern. The study’s findings indicate that life expectancy at birth converges in the same direction across all states, falling into the same club (Club One). However, considerable cross-state variations and evidence of clubs’ convergence and divergence are observed in the domains of infant mortality rate, neonatal death rate, and total fertility rate. As suggested by the kernel density estimates, life expectancy at birth stratifies, polarizes, and becomes unimodal over time, although with a single stable state. A bimodal distribution was found for infant, neonatal, and total fertility rates.

Conclusions
Therefore, healthcare strategies must consider each club’s transition path while focusing on divergence states to reduce health variations and improve health outcomes for each group of individuals.
The relationship between depression and benign prostatic hyperplasia in middle-aged and elderly men in India: a large-scale population study
Authors: Liu Xiaoyang , Ma Kai , Yang Luchen , Peng Zhufeng , Song Pan , Liu Zhenghuan , Zhou Jing , Yu Yunfei , Dong Qiang 
Published: November 2023

Abstract
Background
There have been few investigations on the association between depression and benign prostatic hyperplasia (BPH). This study aims to explore the correlation between depression and BPH among middle-aged and older men in India.

Methods
We utilized data from male individuals aged 45 years and older who participated in the initial wave (2017–2018) of the Longitudinal Aging Study in India (LASI). The presence of BPH symptoms was based on self-reported information, while depressive symptoms were evaluated using CESD-10. The analysis was a cross-sectional study conducted on a final sample size of 30,108 male participants. To examine associations, we employed multivariate logistic regression analysis along with subgroup analysis and interaction tests.

Results
A total of 439 (1.46%) men reported BPH and had a higher depression score (10.18 ± 4.22 vs. 9.28 ± 4.00). The findings indicated a significant association between the depression score and the likelihood of developing BPH, even after accounting for all potential confounding variables (OR = 1.054, 95% CI: 1.030–1.078, p < 0.00001). The participants were then categorized into a depression group and a normal group based on their CESD-10 score, using a threshold of 10 to ascertain the existence or nonexistence of depression. After adjusting for all variables in model IV, the findings continued to exhibit statistical significance (OR = 1.611, CI: 1.327–1.955, p < 0.00001). Significant interaction effects of age, education level, caste or tribe, and alcohol consumption were observed (p for interaction < 0.05).

Conclusion
Our research found that BPH was significantly linked to the presence of depressive symptoms among middle-aged and elderly Indian men. Additional prospective research is necessary to clarify this association and investigate potential mechanisms.
Anti-protein glycation and free-radical scavenging properties of Sri Lankan antidiabetic medicinal plant Salacia reticulata l. (Kothala Himbutu)
Authors: Premakumara Galbada Arachchige Sirimal , Abeysekera Walimuni Kanchana Subhashini Mendis 
Published: November 2023

Abstract
Background
Decoctions of the root and stem of the medicinal plant Salacia reticulata is an indigenous remedy for diabetics and its complications in Sri Lanka. In diabetics, the formation of advanced glycation end products (AGEs) leads to many pathologies. Nevertheless, the anti-protein-glycation property of this plant is poorly documented. This study reports the anti-protein-glycation and radical scavenging potential of various plant parts of S. reticulata.

Methods
Hot water extracts (2g dried powder/50 ml) of root, stem, leaf, twigs, and fruits at various concentrations (15.6 to 500.0 µg/ml) were subjected to anti-glycation and glycation reversing assays in vitro. 1,1-diphenyl-2-picrylhydrazyl (DPPH) assay was used for free radical scavenging property.

Results
Various plant parts of S. reticulata showed anti-protein-glycation and free-radical scavenging activities. IC50 for the anti-glycation activity of root, stem, leaf, twigs, and fruit extracts were 11.92 ± 1.14, 35.18 ± 2.79, 113.3 ± 1.91, 149.59 ± 1.06, and 1120.37 ± 229.48 µg/ml respectively. IC50 of Rutin was 21.88 ± 2.82 µg/ml. EC50 of the root, stem, twigs, and leaf extracts for glycation reversing was 102.09 ± 6.23, 116.99 ± 5.82, 154.45 ± 5.79, and 278.78 ± 14.19 µg/ml respectively. The EC50 values for the radical scavenging activity of leaf, stem, and roots were 26.4±4.7, 9.0±1.2, and 9.1±1.3 respectively. Root had significantly (p<0.05) high activity for all the parameters tested.

Conclusion
Salacia reticulata possess anti-glycation, glycation-reversing, and free radical scavenging activities. Other than root and stem, the leaves and twigs too may be a useful source for anti-diabetic bioactive molecules.
The lockdown experience scale for students (LESS)
Authors: Conroy Ronán M. , Fitzgerald Karen 
Published: November 2023

Abstract
Background
The Covid-19 pandemic has resulted in many student populations learning online in lockdown. While the mental health consequences of lockdown are increasingly understood, the core features of ‘cabin fever’ – the experience of lockdown – are poorly described.

Methods
We conducted a questionnaire survey of 649 undergraduate medicine and health sciences students. Item content was developed based on current literature and input from student representatives.

Results
Mokken scaling identified seven questions that together formed a strongly unidimensional scale which comprised two domains: social isolation/cabin fever and demotivation / demoralisation. Scale scores were significantly associated with depression, self-rated mental health, impaired study efficacy and doomscrolling.

Conclusions
The adverse effects of lockdown on student wellbeing appear to be driven to an important extent by an experience of isolation and demotivation that corresponds to narrative descriptions of cabin fever. In the foreseeable event of future pandemics, these experiences are a promising target for health promotion in students studying in lockdown.
The development of an online serious game for oral diagnosis and treatment planning: evaluation of knowledge acquisition and retention
Authors: Buajeeb Waranun , Chokpipatkun Jirachaya , Achalanan Napas , Kriwattanawong Nawaphat , Sipiyaruk Kawin 
Published: November 2023

Abstract
Background
While serious games seem to be supportive in healthcare education, none of them had been designed to develop competence in diagnosis and treatment planning of oral lesions. Therefore, this research aimed to develop an online simulation-based serious game for training diagnosis and treatment planning of oral lesions (SimOL) and to evaluate its educational impact in terms of knowledge improvement and retention.

Methods
As a mandatory task in an oral lesion course, all 28 students were required to participate in SimOL activities. Participants were instructed to complete a pre-knowledge assessment following a one-week washout period prior to the game activity. Subsequent to the game completion, they were tasked to complete a post-knowledge assessment I (Full score = 15) and satisfaction questionnaire. A post-knowledge assessment II was administered a week later to evaluate knowledge retention.

Results
The findings demonstrated a significant increase in the assessment scores after interacting with the game (P < 0.001), where the pre- and immediate post-knowledge assessment scores were 8.00 (SD = 2.11) and 11.71 (SD = 2.39), respectively. The game also exhibited a positive impact on knowledge retention, as there was no significant difference between the scores of post-knowledge assessment I and II (P > 0.05). Additionally, students perceived the game as positively in all aspects, although the entertainment aspect achieved a slightly lower score of 3.70 (SD = 0.21), in comparison to the usefulness and ease of use with a score of 4.02 (SD = 0.11) and 4.02 (SD = 0.16), respectively.

Conclusion
SimOL demonstrated its potential as an effective learning tool for improving and retaining knowledge for diagnosis and treatment planning of oral lesions. The game was perceived positively by dental students in all aspects, however further improvements should prioritize the enhancement of entertaining components.
Smartwatches in healthcare medicine: assistance and monitoring; a scoping review
Authors: Masoumian Hosseini Mohsen , Masoumian Hosseini Seyedeh Toktam , Qayumi Karim , Hosseinzadeh Shahriar , Sajadi Tabar Seyedeh Saba 
Published: November 2023

AbstractSmartwatches have become increasingly popular in recent times because of their capacity to track different health indicators, including heart rate, patterns of sleep, and physical movements. This scoping review aims to explore the utilisation of smartwatches within the healthcare sector. According to Arksey and O'Malley's methodology, an organised search was performed in PubMed/Medline, Scopus, Embase, Web of Science, ERIC and Google Scholar. In our search strategy, 761 articles were returned. The exclusion/inclusion criteria were applied. Finally, 35 articles were selected for extracting data. These included six studies on stress monitoring, six on movement disorders, three on sleep tracking, three on blood pressure, two on heart disease, six on covid pandemic, three on safety and six on validation. The use of smartwatches has been found to be effective in diagnosing the symptoms of various diseases. In particular, smartwatches have shown promise in detecting heart diseases, movement disorders, and even early signs of COVID-19. Nevertheless, it should be emphasised that there is an ongoing discussion concerning the reliability of smartwatch diagnoses within healthcare systems. Despite the potential advantages offered by utilising smartwatches for disease detection, it is imperative to approach their data interpretation with prudence. The discrepancies in detection between smartwatches and their algorithms have important implications for healthcare use. The accuracy and reliability of the algorithms used are crucial, as well as high accuracy in detecting changes in health status by the smartwatches themselves. This calls for the development of medical watches and the creation of AI-hospital assistants. These assistants will be designed to help with patient monitoring, appointment scheduling, and medication management tasks. They can educate patients and answer common questions, freeing healthcare providers to focus on more complex tasks.
The perceived benefits and effectiveness of patient feedback systems in strengthening patient-provider relationships in Rural Tanzania
Authors: Isangula Kahabi , Pallangyo Eunice S. , Ndirangu-Mugo Eunice 
Published: November 2023

Abstract
Introduction
Patient feedback system (PFS) forms an important entry point for the medical personnel and healthcare administrators to identify healthcare service delivery gaps and develop responsive interventions. This may foster patient trust consequently increasing healthcare-seeking, engagement in decision, continuity, and satisfaction. However, research on the PFS in rural primary healthcare settings appears limited.

Objective
The paper examines the perceived role and effectiveness of PFS in improving therapeutic relationships building on the recent research on patient-provider relationships in rural Tanzania.

Methods
The paper examines the findings of qualitative descriptive research conducted in the Shinyanga Region which employed a human-centred design (HCD) approach to co-create an intervention package for improving nurse-client relationships between January and September 2022. The study used semi-structured interviews in Swahili to first explore drivers of poor provider-patient relationships with purposefully selected providers, patients, and administrators. The findings guided the co-designing of an intervention package in subsequent HCD steps. Interviews were concurrently translated and transcribed, then systematically coded to facilitate the development of themes using a deductive thematic analysis approach.

Results
PFS emerged as one of the key themes in the deductive analysis when examining factors shaping provider–client relationships. The PFS theme was characterized by three major subthemes, which included perceived benefits, availability and accessibility, and perceived effectiveness. The perceived benefits of PFS cited by most participants included: reducing patients’ confusion around the complaints process, promoting patients’ positivity towards providers and hospitals, and reducing tensions between patients and providers. Suggestion boxes (SBs) were the most frequently cited PFS, but there were widespread concerns and disagreements among participants about their accessibility and effectiveness. Despite the providers (nurses) and administrators describing SBs as widely available, they stated that they had not received feedback or complaints from patients for a very long time. In contrast, most patients stated that SBs were either unavailable or ineffective in many facilities, with concerns about non-user friendliness and lack of responsiveness as the main issues when discussing effectiveness.

Conclusion
Despite the many benefits of PFS in improving healthcare service quality, their availability, user-friendliness, and responsiveness still pose challenges. A call is made to providers, health administrators and researchers to prioritize the PFS as both a useful entry point to reducing tensions in therapeutic relationships and, a tool for improving patient service uptake, continuity of care and satisfaction.
Socioeconomic inequality in self-rated health and its determinants: an Oaxaca blinder decomposition in Ilam, West of Iran during 2023
Authors: Bazyar Mohammad , Kakaei Hojatollah , Jalilian Mohsen , Mirzaei Amin , Mansournia Mohammad Ali , Pakzad Reza 
Published: November 2023

Abstract
Aim
To determine inequality and decompose it’s in Self-Rated Health (SRH).

Method
This population-based cross-sectional study was undertaken on the entire population of the city of Ilam, Iran, in 2023. Multi-stage stratified cluster random sampling with proportion-to-size approach was used to select the participants. Oaxaca-Blinder decomposition technique was used to show the amount of inequity in SRH and to decompose of the gap of SRH between the poor and the rich group of participants.

Results
1370 persons participated in the study. The 59.38% of participants stated good SRH status and just 8.86% of participants had poor SRH status. The results of the Oaxaca-Blinder decomposition revealed a considerable gap (15.87%) in the poor status of SRH between the rich and the poor. A large proportion (89.66%) of this difference was described by explained portion of the model. The results of decomposition showed that economic status was directly responsible for explaining 27.98% of overall inequality gap between rich and poor people. Moreover, hopelessness to future (32.64%), having an underlying disease (18.34%) and difference in the education level (10.71%) were associated with an increase in inequality disfavoring the poor.

Conclusion
For people suffering from underlying disease, it is suggested to devise policies to improve access to/and remove healthcare utilization barriers. To address hopelessness to future, it is recommended to carry out further studies to reveal factors which affect it in more details. This can help policy makers to formulate more realistic and evidence-informed policies on order to lessen the current socioeconomic inequity in SRH.
Associations of ultra-processed food consumption, circulating protein biomarkers, and risk of cardiovascular disease
Authors: Li Huiping , Wang Yaogang , Sonestedt Emily , Borné Yan 
Published: November 2023

AbstractBackgroundWe aim to examine the association between ultra-processed foods (UPF) consumption and cardiovascular disease (CVD) risk and to identify plasma proteins associated with UPF.MethodsThis prospective cohort study included 26,369 participants from the Swedish Malmö Diet and Cancer Study, established in 1991–1996. Dietary intake was assessed using a modified diet history method, and UPF consumption was estimated using the NOVA classification system. A total of 88 selected CVD-related proteins were measured among 4475 subjects. Incident CVD (coronary heart disease and ischemic stroke) was defined as a hospital admission or death through registers. Cox proportional hazards regression models were performed to analyze the associations of UPF intake with risks of CVD. Linear regression models were used to identify the plasma proteins associated with UPF intake.ResultsDuring 24.6 years of median follow-up, 6236 participants developed CVD, of whom 3566 developed coronary heart disease and 3272 developed ischemic stroke. The adjusted hazard ratio (95% confidence interval) in the 4th versus 1st quartile of UPF was 1.18 (1.08, 1.29) for CVD, 1.20 (1.07, 1.35) for coronary heart disease, and 1.17 (1.03, 1.32) for ischemic stroke. Plasma proteins interleukin 18, tumor necrosis factor receptor 2, macrophage colony-stimulating factor 1, thrombomodulin, tumor necrosis factor receptor 1, hepatocyte growth factor, stem cell factor, resistin, C–C motif chemokine 3, and endothelial cell-specific molecule 1 were positively associated with UPF after correcting for multiple testing.ConclusionsOur study showed that high UPF intake increased the risk of CVD and was associated with several protein biomarkers. Future studies are warranted to validate these findings and assess the potential pathways between UPF intake and CVD.
Lyophilized apoptotic vesicle-encapsulated adhesive hydrogel sponge as a rapid hemostat for traumatic hemorrhage in coagulopathy
Authors: Jiang Yexiang , Hao Meng , Jiang Fenglin , Li Jiwu , Yang Kunkun , Li Can , Ma Lan , Liu Shiyu , Kou Xiaoxing , Shi Songtao , Ding Xin , Zhang Xiao , Tang Jianxia 
Published: November 2023

AbstractRapid hemostasis of uncontrolled bleeding following traumatic injuries, especially accompanied by coagulopathies, remains a significant clinical challenge. Extracellular vesicles (EVs) show therapeutic effects for fast clotting. However, low yield, specific storage conditions, and lack of proper carriers have hindered EVs’ clinical application. Herein, we establish an optimized procedure method to generate lyophilized mesenchymal stem cell-derived apoptotic vesicles (apoVs) with adhesive hydrogel sponge to show superior procoagulant activity for traumatic hemorrhage. Mechanistically, apoVs’ procoagulant ability stems from their high tissue factor (TF) and phosphatidylserine (PS) expression independent of hemocytes and circulating procoagulant microparticles (cMPs). Their stable hemostatic capability was maintained after 2-month room temperature storage. Subsequently, we mixed apoVs with both phenylboronic acid grafted oxidized hyaluronic acid (PBA-HA) and poly(vinyl alcohol) (PVA) simultaneously, followed by lyophilization to construct a novel apoV-encapsulated hydrogel sponge (apoV-HS). Compared to commercial hemostats, apoV-HS exhibits rapid procoagulant ability in liver-laceration and femoral artery hemorrhage in rat and rabbit models of coagulopathies. The combination of high productivity, physiological stability, injectability, plasticity, excellent adhesivity, biocompatibility, and rapid coagulant property indicates that apoV-HS is a promising therapeutic approach for heavy hemorrhage in civilian and military populations.
Graphical Abstract
Economic evaluation of dialysis and comprehensive conservative care for chronic kidney disease using the ICECAP-O and EQ-5D-5L; a comparison of evaluation instruments
Authors: Zahirian Moghadam Telma , Powell Jane , Sharghi Afshan , Zandian Hamed 
Published: November 2023

Abstract
Background
Chronic Kidney Disease (CKD) patients often require long-term care, and while Hemodialysis (HD) is the standard treatment, Comprehensive Conservative Care (CCC) is gaining popularity as an alternative. Economic evaluations comparing their cost-effectiveness are crucial. This study aims to perform a cost-utility analysis comparing HD and CCC using the EQ-5D-5L and ICECAP-O instruments to assessing healthcare interventions in CKD patients.

Methods
This short-term economic evaluation involved 183 participants (105 HD, 76 CCC) and collected data on demographics, comorbidities, laboratory results, treatment costs, and HRQoL measured by ICECAP-O and EQ-5D-5L. Incremental Cost-Effectiveness Ratios (ICERs) and Net Monetary Benefit (NMB) were calculated separately for each instrument, and Probabilistic Sensitivity Analysis (PSA) assessed uncertainty.

Results
CCC demonstrated significantly lower costs (mean difference $8,544.52) compared to HD. Both EQ-5D-5L and ICECAP-O indicated higher Quality-Adjusted Life Years (QALYs) for both groups, but the difference was not statistically significant (p > 0.05). CCC dominated HD in terms of HRQoL measures, with ICERs of -$141,742.67 (EQ-5D-5L) and -$4,272.26 (ICECAP-O). NMB was positive for CCC and negative for HD, highlighting its economic feasibility.

Conclusion
CCC proves a preferable and more cost-effective treatment option than HD for CKD patients aged 65 and above, regardless of the quality-of-life measure used for QALY calculations. Both EQ-5D-5L and ICECAP-O showed similar results in cost-utility analysis.