bluuebunny/crossref_metadata_2025_split huggingface dataset:
Study on awareness of health insurance among the adult population of rural areas in the Wardha district of Maharashtra: a protocol
Authors: Bhoi Sudha Rani , Nagtode Nikhilesh 
Published: September 2023

Introduction: Globally, the foundation of health insurance is substantial. However, the Indian health insurance sector lags. Only 14.1% of the rural population is covered by health insurance. That is, 85.9% of individuals in rural India still lack any form of health expenditure coverage and are unaware and thus are uninsured. Despite all the efforts made by the health system to assist the Indian population with supporting their healthcare finances, the public is unable to use these services simply because they are unaware of them. Individuals without health insurance will experience impoverishment due to health-related problems. Increased health insurance awareness can also be an indicator of universal health coverage. The objective is to study rural community individuals' awareness, perception, and utilisation of health insurance and to determine the association between sociodemographic variables and awareness of health insurance. Methods: The study will be a community based cross-sectional and observational study design in the Wardha district of Maharashtra from September 2023. Individuals within the region who are over 18 and at home during the visit will be included in the study. Individuals under the age requirement, and any empty households during the visits will be excluded. A pre-designed and semi structured questionnaire will be used. House-to-house visits will be done and information will be obtained by interviews. SPSS 24.0 software will be used for the data analysis. Variables included are name, age, sex, type of family, occupation, and knowledge of health insurance. Conclusions: The results of this study will involve an assessment of the participant’s awareness, perception, and utilisation of health insurance, and the association between socio demographic variables and awareness of health insurance. Descriptive statistics like frequency and percentages will be calculated. Chi-square test will be used for association between variables.
'It’s become a theatre’: relational experiences of family carers and people with Amyotrophic lateral sclerosis (ALS) after cognitive impairment emerges
Authors: Oseland Marit Sofie , Sveen Unni , Taule Tina 
Published: September 2023

Background: Amyotrophic lateral sclerosis (ALS) can lead to emotional and psychological distress between patients and their family carers. Many people with ALS develop cognitive impairment, which limits their ability to process complex information, interact, and communicate. This cognitive decline adds to caregiver burden. Few studies have explored interpersonal relations between people with ALS and their carers. Aim: To better understand how ALS-associated cognitive impairment influences close relations. Methods: Individual semi-structured in-depth, interviews were conducted once, with four patients and four family carers. Thematic analysis was used. Results: Increased distance of close relations was identified as the core theme. Differences and similarities within the data were identified according to the subthemes, (1) Everyday life together but apart: a demanding role to play, and (2) Coping with a lost future: living in the ‘normal’ present and searching for hope through a well-lived life. Conclusions and significance: Cognitive impairment following ALS can lead to increased relational distance between patients and their family carers. To ease their burden, professionals should recognize patients’ and carers’ relational issues and grief at an early stage. Focusing on their occupational identity and highly valued occupations that are still-accessible may help patients and carers regain meaning in everyday life.
Food consumption and adherence to dietary guidelines among Jordanian children and adolescents
Authors: Alkhatib Buthaina , Al Hourani Huda , Al-Shami Islam K. , Al-Jawaldeh Ayoub 
Published: September 2023

Background: To evaluate the energy and macronutrient intake of Jordanian children and adolescents, and how closely they adhere to dietary recommendations. Methods: This cross-sectional study used data from Jordan's Population-based Food Consumption Survey, a household population-based study that was conducted in Jordan between 2021-2022 (561 children and adolescents 8-19 years). Dietary intake was assessed using the two non-consecutive 24-hour dietary recall method (24-h DR). The estimated food group and nutrient intakes were compared to nutritional recommendations, including MyPlate dietary guidelines. Results: The prevalence of overweight/obese individuals based on body mass index (BMI) was 44%, and the average waist-to-height ratio (WHtR) was 24.7%. Compared to MyPlate dietary guidelines, children and adolescents had a higher added sugar intake (57g/day). Also, the consumption of vegetables, fruits, and dairy fell short of MyPlate dietary guidelines. The total discretionary calorie intake in children and adolescents was approximately one-third of the total energy intake. Conclusion: The food consumption of Jordanian children and adolescents includes high intakes of discretionary calories, with a low intake of fruits, vegetables, and dairy products. The prevalence of overweight/obesity was elevated compared to international norms.
Methylation risk score in peripheral blood predictive of conversion from mild cognitive impairment to Alzheimer's Disease
Authors: Morrow Jarrett D. 
Published: September 2023

Background: Alzheimer’s disease (AD) is a neurodegenerative and heterogeneous disorder with complex etiology. Mild cognitive impairment (MCI) may represent an intermediate stage of AD, and the ability to identify MCI patients at greater risk of conversion to AD could guide personalized treatments. This study sought to develop a methylation risk score predictive of conversion from MCI to AD using publicly available blood DNA methylation (DNAm) data. Methods: Using blood DNA methylation data from an epigenome-wide association study of AD that included 111 subjects with MCI, a methylation risk score of MCI conversion was created using an elastic-net framework. The elastic-net model was trained with a high-variance subset of the DNAm data, age and sex as predictors. Results: The final model included four CpG sites: PNCK (cg01231576), SLC6A3 (cg09892121), and TRIM62 (cg25342005), with a fourth (cg17292662) near the genes ATP6V1H and RGS20. A significant difference (p < 0.0001, t-test) was observed in the scores for MCI stable subjects compared with MCI converters. No statistically significant difference was observed between AD subjects and controls, suggesting specificity of the risk score for susceptibility to conversion. Conclusions: The ability to identify MCI patients at greater risk of progression could inform early interventions and is a critical component in mitigation strategies for AD. This study provides insight into a potential role for epigenetics in the development of a multi-omic risk score of conversion.
Experience and perceptions of Social Prescribing interventions; a qualitative study with people with long-term conditions, link workers and health care providers
Authors: O'Sullivan Declan J. , Bearne Lindsay M. , Harrington Janas M. , McVeigh Joseph G. 
Published: September 2023

Background Long-term conditions (LTC) are a leading cause of reduced quality of life and early mortality. People with LTC are living longer with increasing economic and social needs. Novel patient centred care pathways are required to support traditional medical management of these patients. Social Prescribing (SP) has gained popularity as a non-medical approach to support patients with LTC and their unmet health needs. The current focus group study aims to explore the experiences and perceptions to SP interventions from the perspective of people with long-term conditions, link workers, healthcare providers and community-based services. Methods Six-eight participants will be recruited into three specific 60-minute focus groups relative to their role as a patient, link worker and community-based service. Eight-12 participants with a Health care provider and GP background will be interviewed individually online. The participants within these focus groups and semi-structured interviews will be invited to provide opinions on what factors they think are important to the successful implementation of a SP service from their respective stakeholder positions. The data will be recorded and exported to NVivo software for further analysis using Thematic Reflexive analysis methods. Coded categorical data will inform emerging themes from which a narrative summary will be consolidated and presented for dissemination. Conclusion The conclusions made from this study will help inform the next study, which will aim to develop a pilot SP service for patients with LTC, as part of an overall larger project.
Delaying anterior cruciate ligament reconstruction increases the rate and severity of medial chondral injuries
Authors: Cance Nicolas , Erard Julien , Shatrov Jobe , Fournier Gaspard , Gunst Stanislas , Martin Guillaume L. , Lustig Sébastien , Servien Elvire 
Published: September 2023

AimsThe aim of this study was to evaluate the association between chondral injury and interval from anterior cruciate ligament (ACL) tear to surgical reconstruction (ACLr).MethodsBetween January 2012 and January 2022, 1,840 consecutive ACLrs were performed and included in a single-centre retrospective cohort. Exclusion criteria were partial tears, multiligament knee injuries, prior ipsilateral knee surgery, concomitant unicompartmental knee arthroplasty or high tibial osteotomy, ACL agenesis, and unknown date of tear. A total of 1,317 patients were included in the final analysis, with a median age of 29 years (interquartile range (IQR) 23 to 38). The median preoperative Tegner Activity Score (TAS) was 6 (IQR 6 to 7). Patients were categorized into four groups according to the delay to ACLr: < three months (427; 32%), three to six months (388; 29%), > six to 12 months (248; 19%), and > 12 months (254; 19%). Chondral injury was assessed during arthroscopy using the International Cartilage Regeneration and Joint Preservation Society classification, and its association with delay to ACLr was analyzed using multivariable analysis.ResultsIn the medial compartment, delaying ACLr for more than 12 months was associated with an increased rate (odds ratio (OR) 1.93 (95% confidence interval (CI) 1.27 to 2.95); p = 0.002) and severity (OR 1.23 (95% CI 1.08 to 1.40); p = 0.002) of chondral injuries, compared with < three months, with no association in patients aged > 50 years old. No association was found for shorter delays, but the overall dose-effect analysis was significant for the rate (p = 0.015) and severity (p = 0.026) of medial chondral injuries. Increased TAS was associated with a significantly reduced rate (OR 0.88 (95% CI 0.78 to 0.99); p = 0.036) and severity (OR 0.96 (95% CI 0.92 to 0.99); p = 0.017) of medial chondral injuries. In the lateral compartment, no association was found between delay and chondral injuries.ConclusionDelay was associated with an increased rate and severity of medial chondral injuries in a dose-effect fashion, in particular for delays > 12 months. Younger patients seem to be at higher risk of chondral injury when delaying surgery. The timing of ACLr should be optimally reduced in this population.Cite this article: Bone Joint J 2023;105-B(9):953–960.
Standardization of global hip fracture audit could facilitate learning, improve quality, and guide evidence-based practice
Authors: Johansen Antony , Hall Andrew J. , Ojeda-Thies Cristina , Poacher Arwel T. , Costa Matthew L. 
Published: September 2023

AimsNational hip fracture registries audit similar aspects of care but there is variation in the actual data collected; these differences restrict international comparison, benchmarking, and research. The Fragility Fracture Network (FFN) published a revised minimum common dataset (MCD) in 2022 to improve consistency and interoperability. Our aim was to assess compatibility of existing registries with the MCD.MethodsWe compared 17 hip fracture registries covering 20 countries (Argentina; Australia and New Zealand; China; Denmark; England, Wales, and Northern Ireland; Germany; Holland; Ireland; Japan; Mexico; Norway; Pakistan; the Philippines; Scotland; South Korea; Spain; and Sweden), setting each of these against the 20 core and 12 optional fields of the MCD.ResultsThe highest MCD adherence was demonstrated by the most recently established registries. The first-generation registries in Scandinavia collect data for 60% of MCD fields, second-generation registries (UK, other European, and Australia and New Zealand) collect for 75%, and third-generation registries collect data for 85% of MCD fields. Five of the 20 core fields were collected by all 17 registries (age; sex; surgery date/time of operation; surgery type; and death during acute admission). Two fields were collected by most (16/17; 94%) registries (date/time of presentation and American Society of Anesthesiologists grade), and five more by the majority (15/17; 88%) registries (type, side, and pathological nature of fracture; anaesthetic modality; and discharge destination). Three core fields were each collected by only 11/17 (65%) registries: prefracture mobility/activities of daily living; cognition on admission; and bone protection medication prescription.ConclusionThere is moderate but improving compatibility between existing registries and the FFN MCD, and its introduction in 2022 was associated with an improved level of adherence among the most recently established programmes. Greater interoperability could be facilitated by improving consistency of data collection relating to prefracture function, cognition, bone protection, and follow-up duration, and this could improve international collaborative benchmarking, research, and quality improvement.Cite this article: Bone Joint J 2023;105-B(9):1013–1019.
September 2023 Pulmonary Case of the Month: A Bone to Pick
Authors:   Mayo Clinic Arizona, Phoenix, AZ USA, Wesselius Lewis 
Published: September 2023

No abstract available. Article truncated after 150 words. History of Present Illness A 56-year-old man presented acute onset of shortness of breath. He denied cough, fever or other symptoms Past Medical History, Family History and Social History •	Occasional gout •	No relevant family history •	Never smoked Medications •	Allopurinol •	Multivitamin Physical Examination •	Other than tachypnea and mild shortness of breath, no significant abnormalities. Chest X-ray An AP chest X-ray was performed (Figure 1). Which abnormality is suggested by the chest X-ray? 1.	Calcified micronodules in the right lung 2.	Retained secretions with atelectasis left lung 3.	Right pneumothorax 4.	1 and 3 5.	None. The chest X-ray is within normal limits. Correct! 4. 1 and 3 There is a deep sulcus sign on the right and hyperexpansion of the right hemithorax suggesting a right pneumothorax. A deep sulcus sign may be the only indication of a pneumothorax, especially in a supine film, when air collects anteriorly and basally within the …
Low seroprevalence of Ebola virus in health care providers in an endemic region (Tshuapa province) of the Democratic Republic of the Congo
Authors: Zola Matuvanga Trésor , Mariën Joachim , Larivière Ynke , Osang’ir Bernard Isekah , Milolo Solange , Meta Rachel , Esanga Emmanuel , Maketa Vivi , Matangila Junior , Mitashi Patrick , Ahuka Mundeke Steve , Muhindo-Mavoko Hypolite , Muyembe Tamfum Jean-Jacques , Van Damme Pierre , Van Geertruyden Jean-Pierre 
Published: September 2023

Introduction
A serosurvey among health care providers (HCPs) and frontliners of an area previously affected by Ebola virus disease (EVD) in the Democratic Republic of the Congo (DRC) was conducted to assess the seroreactivity to Ebola virus antigens.

Methods
Serum samples were collected in a cohort of HCPs and frontliners (n = 698) participants in the EBL2007 vaccine trial (December 2019 to October 2022). Specimens seroreactive for EBOV were confirmed using either the Filovirus Animal Nonclinical Group (FANG) ELISA or a Luminex multiplex assay.

Results
The seroreactivity to at least two EBOV-Mayinga (m) antigens was found in 10 (1.4%: 95% CI, 0.7–2.6) samples for GP-EBOV-m + VP40-EBOV-m, and 2 (0.3%: 95% CI, 0.0–1.0) samples for VP40-EBOV-m + NP-EBOV-m using the Luminex assay. Seroreactivity to GP-EBOV-Kikwit (k) was observed in 59 (8.5%: 95%CI, 6.5–10.9) samples using FANG ELISA.

Conclusion
In contrast to previous serosurveys, a low seroprevalence was found in the HCP and frontline population participating in the EBL2007 Ebola vaccine trial in Boende, DRC. This underscores the high need for standardized antibody assays and cutoffs in EBOV serosurveys to avoid the broad range of reported EBOV seroprevalence rates in EBOV endemic areas.
Sozialräumliche Unterschiede im Engagement älterer Großstadtbewohner gegen Verkehrslärm? Schlussfolgerungen für eine verteilungs- und verfahrensgerechte Lärmaktionsplanung
Authors: Riedel Natalie , Brunswieck Ramona , Hartig Christina , Moebus Susanne , Jöckel Karl-Heinz , Bolte Gabriele 
Published: September 2023

Exposure to transportation noise is a highly prevalent health burden in urban areas. Social-spatially unequal distributions of transportation noise exposure can contribute to health inequalities (distributional environmental justice). Noise action planning according to the EU Environmental Noise Directive is the instrument for noise abatement at the local level. In this context, public participation in terms of procedural environmental justice becomes relevant. Socio-spatial indicators used to describe environmental justice mainly deal with the distributional aspect. The question is to what extent both unequal environmental quality on the one hand and unequal participation on the other can be traced by indicators and spatial units typically used in social monitoring at the local level. Using the distance measure index of German social welfare rates and the local voter turnout in 2014, the socio-spatial distribution of factors of objective environmental quality, subjective noise exposure and engagement against transportation noise among older residents in three major cities in the German Ruhr region was examined. In order to address the observed inequalities within noise action planning, distributional and procedural aspects have to be integrated in noise action planning.
Ethical and Professional Dilemmas encountered by Doctors in the National Health Insurance System
Authors: Dhanardhono Tuntas , Anggreliana Wian Pisia , Rohmah Intarniati Nur , Bhima Sigid Kirana Lintang 
Published: September 2023

Background: The implementation of the National Health Insurance System in Indonesia has not only increased access to medical services but also raised various dilemmas among doctors. Objective: This study aims to analyse various ethical and professional dilemmas among physicians in the National Health Insurance System (NHIS).Methods: This is a cross-sectional descriptive study with a purposive sampling method. A questionnaire was distributed online between June to December 2019 to physicians practicing in Indonesia.Results: Of the 87 doctors who participated in this study, 60.92% were general practitioners and 39.08% were specialists. The inability to maintain professional independence (63.41%) is the most common ethical dilemma faced by doctors with 65.38% of them experienced in advanced level health facilities. Meanwhile, the limitation of adequate medical care in an emergency (25.45%) is the most dilemmatic situation experienced in terms of professionalism with 85.71% occurring in advanced level health facilities.Conclusion: Physicians in Indonesia were deal with various dilemmas while practicing in the NHIS. The high rate of dissatisfaction and the various ethical problems and professional disciplines require a review of the health system to improve the quality of services and maintain the professionalism of doctors.
Untargeted metabolomics reveals sour jujube kernel benefiting the nutritional value and flavor of Morchella esculenta
Authors: Wu Fenfang , Li Zhiyuan , Chen Xiaoni , Si Xinlei , Lin Shan 
Published: September 2023

Abstract
Nucleosides, organic acids, and amino acids separated from Morchella esculenta are well known for their nutritional value and flavor. However, how to increase their content in a better way has been a challenge. In this study, the effect of adding jujube kernel on the active components of M. esculenta was investigated by untargeted metabolomics using UPLC-MS/MS. A total of 1,243 metabolites were identified, of which 262 metabolites (21.078%) were organic acids and derivatives, 245 metabolites (19.71%) were lipids and lipid-like molecules, and 26 metabolites (2.092%) were nucleosides, nucleotides, and analogues. Subsequently, differential metabolites between groups were screened by the orthogonal partial least squares-discriminant analysis model, which showed that 256 metabolites were identified as significantly different for the positive ion model and 149 for the negative ion model. Moreover, significant differential metabolites (VIP > 1, P < 0.05) in annotation of kyoto encyclopedia of genes and genomes pathway were investigated, which showed that ABC transporters were the most commonly observed transporters, followed by pyrimidine metabolism and purine metabolism. The results indicated that the main components of jujube kernel might be conducive to the accumulation of nucleoside organic acids and amino acid metabolites in M. esculenta. These results provide important information for the understanding of more suitable way for cultivation of M. esculenta.
Structural function analysis of shear walls in sustainable assembled buildings under finite element model
Authors: Cao Yaxian 
Published: September 2023

Abstract
With the quick progress of industrialization and urbanization, the construction industry has become one of the largest energy-consuming industries. However, the current prefabricated shear wall focuses on the upgrade of seismic function, with less analysis of the energy efficiency of the overall structure. In this study, a sustainable prefabricated building shear wall that takes into account both energy conservation and stress is first proposed, and then the shear wall is modelled by finite element method (FEM) software. Meanwhile, the force functions of the shear wall model, including concrete strength, axial condensability rate, and aspect rate, and finally the seismic function are verified. The experimental outcomes demonstrate that the maximum difference between the FEM analysis outcomes and the test data is only 10.66%, and the overall difference in the outcomes is relatively small. The larger the aspect rate of the proposed sustainable assembled shear wall model, the better the ductility of the member, and the bigger the axial condensability rate and concrete strength, the lower the ductility of the member. In the seismic function analysis, the maximum layer displacement angles of this shear wall are all less than 1/120, which is in line with the national seismic code. This indicates its good seismic function and provides a methodological reference for the upgrade of the structural function of shear walls.