bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of the characteristics of noise from substations in buildings
Authors: Liu Xinyu , Liu Junjie , He Junyi , Zhang Jinxian 
Published: August 2021

The urbanization has resulted in an increasing number of transformer stations, which has resulted insignificant building noise problems. However, noise problems persist because of inadequate noise characterization and the use of imperfect noise evaluation indexes for centralized substations. Based on this problem, a transformer vibration noise coupling analysis method based on empirical mode decomposition (EMD) and spectrum analysis is proposed in this study. The proposed method accurately and effectively screens and characterizes transformer noise and provides a theoretical basis for transformer noise reduction. To verify the effectiveness of the proposed method, a transformer was reconstructed as an example. It was found that the low-frequency noise from the transformer was mainly caused by vibrations with a frequency below 500 Hz, particularly frequencies of 300 Hz and 100 Hz and 50 Hz. Through the calculation and analysis of eigenvalues, the noise reduction measures focusing on vibration reduction were proposed. In the end, a noise reduction of 10 dB was achieved, which meets the comfort requirements. This method can accurately and effectively identify the characteristics of transformer noise, which makes up for the insufficiency of transformer characteristics analysis in the past. Provide guidance for perfecting transformer noise evaluation index. Practical implication: The noise problem caused by substations is getting more and more serious. Conventional noise detection and noise reduction methods can no longer meet people’s requirements for sound comfort. The coupling analysis method of vibration and noise based on EMD and spectrum analysis proposed in this study can effectively extract the characteristics of transformer noise. It provides theoretical support for the noise reduction transformation of transformers, and solves the problem that the current engineering noise reduction transformation has no theoretical basis. Noise characteristic analysis can make up for the shortcomings of existing acoustic comfort indicators that only use sound pressure level as the evaluation indicator.
Clinical Observations of a Surgical Method Comprising a Combination of Cross Flap and Autologous Auricular Cartilage Transplantation in the Treatment of Type I to III Congenital Concha-Type Microtia
Authors: Sun Pengfei , Lu Meng , Wang Changchen , Pan Bo , Jiang Haiyue 
Published: August 2021

Objectives: The present study attempted to investigate the clinical efficacy of a surgical method involving a combination of cross flap with autologous auricular cartilage transplantation in the treatment of type I to III congenital concha-type microtia. Methods: The present retrospective study was conducted on the clinical and postoperative data of 50 patients with unilateral type I to III concha-type microtia treated with a combination of cross flap and autologous auricular cartilage transplantation at the Plastic Surgery Hospital of Chinese Academy of Medical Sciences from January 2018 to December 2021. Results: The postoperative perimeters of malformed ears were significantly larger than the preoperative perimeters ( P < .05). Of the total, 2 patients exhibited incision dehiscence, 3 patients exhibited incision infection, 2 patients exhibited flap hematoma, and 1 patient exhibited ischemic necrosis at the flap tip. The satisfaction rate of the patients and their families was 100%. Conclusions: The surgical method involving a combination of cross flap and autogenous auricular cartilage transplantation was effective in treating patients with type I to III congenital concha-type microtia, and therefore, this surgical approach can be applied widely to correct this deformity.
Longitudinal Associations Between Early Risk, Father Engagement, and Coparenting and Low-Income Fathers’ Engagement With Children in Middle Childhood
Authors: Fagan Jay 
Published: August 2021

The current investigation examined the longitudinal associations among low-income, urban fathers’ risk factors, engagement with children, and coparenting support during early childhood and paternal engagement with children at age 9 years. Using Fragile Families and Child Wellbeing data ( N = 2104), the results showed that additive individual and family risk when children were infants and preschool-age negatively predicted father engagement at age 9. Father engagement with toddlers and preschoolers positively predicted later paternal involvement with children, but coparenting support during early childhood did not predict father engagement at age 9. There was one significant moderation effect: fathers who were highly engaged with toddlers reported lower levels of engagement during middle childhood when they experienced a higher level of risk factors at age 5. Implications for researchers, practitioners, and policy makers are discussed.
Magnitude of spontaneous preterm birth and its associated factors among preterm birth in NICU wards in Asella Teaching and Referral Hospital, Asella, Oromia, Ethiopia
Authors: Tuji Techane Sisay , Wake Addisu Dabi , Adere Gezahegn Badeg , Wedajo Aselefu Beka , Obole Batu Dekeba , Jenka Derartu Tesfaye , Gebriye Selamawit T/Birehan 
Published: August 2021

Objective To assess the prevalence of spontaneous preterm births and to identify the associated risk factors. Methods This single-centre cross-sectional study enrolled women that experienced a preterm birth as registered on the neonatal log-book between 30 December 2019 and 30 December 2020. A pre-tested structured checklist was used to collect data (sociodemographic characteristics; obstetric-related factors; medical history; and pregnancy-related factors). Bivariate logistic regression analyses were applied to identify factors associated with spontaneous preterm birth. A multivariate model identified significant independent risk factors. Results A total of 310 patients participated in the study. The prevalence of spontaneous preterm birth in this population was 67.1% (208 of 310; 95% confidence interval [CI] 61.5, 71.9). Patients without a partner (adjusted odds ratio [AOR] = 1.470, 95% CI 1.23, 4.42), patients residing in a rural area (AOR = 2.51, 95% CI 1.123, 5.513) and those with a history of PIH during their current pregnancy (AOR = 0.104, 95% CI 0.053, 0.014) were significantly more likely to have a spontaneous preterm birth. Conclusion The prevalence of spontaneous preterm birth in in this study was high. Healthcare providers and all stakeholders should focus on screening pregnant women at the risk of spontaneous preterm birth.
Participation experience for persons with oculomotor impairments after acquired brain injury
Authors: Wagener Sharon G 
Published: August 2021

Introduction While individuals with acquired brain injury (ABI) often receive occupational therapy, relatively little is known about how those with related oculomotor problems characterize their ability to participate in everyday activities and life roles. This study describes the difficulties experienced by this population. Method This study is a thematic analysis of qualitative responses to open-ended questions based on answers to a standardized assessment. Thirty rehabilitation outpatients with ABI-related oculomotor impairments participated in semi-structured interviews to describe their experiences of difficulties in everyday activities. Results Difficulties were associated with three themes: challenges of the activities and environments (activity requirements, physical and socioeconomic environments, and time), self-identified personal difficulties (physical, cognitive, and socioemotional), and changes in habits/roles/priorities (modifications to activities and environments, loss and negative consequences, and life management changes). Conclusion How people with ABI-related oculomotor impairments experience difficulties while participating in activities is dynamic and complex. Challenging activity requirements and environments often led to personal difficulties, which limited participation. Activity modifications, changes in priorities, and managing energy budget enhanced participation. A model of the experience is proposed. Findings suggest using activity analysis and teaching compensatory methods and life management strategies with individuals may assist in ability to participate.
Predicted Effects and Cost-Effectiveness of Wheat Flour Fortification for Reducing Micronutrient Deficiencies, Maternal Anemia, and Neural Tube Defects in Yaoundé and Douala, Cameroon
Authors: Noshirvan Arram , Wu Brenda , Luo Hanqi , Kagin Justin , Vosti Stephen A. , Ndjebayi Alex , Assiene Jules Guintang , Teta Ismael , Nankap Martin , Engle-Stone Reina 
Published: August 2021

Background: Policy makers aiming to reduce micronutrient deficiencies (MNDs) and their health effects must choose among alternative definitions of impact when evaluating cost-effectiveness. Objective: Estimate the cost-effectiveness of a mandatory wheat flour fortification program for reducing cases of MNDs (iron, zinc, folate, vitamin B12), anemia and neural tube defects (NTDs) averted, and disability-adjusted life years (DALYs) averted in urban Cameroon. Methods: A 13-year predictive model was developed, including a 3-year start-up period and 10 years of program activity. Costs were estimated using historical program budgets. Effects were calculated based on observed changes in prevalence of MND and anemia 1 year postfortification and predicted reductions in NTDs based on NTD burden and wheat flour intake. Total DALYs averted were estimated for anemia and NTDs. Results: The program cost ∼$2.4 million over 13 years and averted an estimated ∼95 000 cases of maternal anemia and ∼83 500 cases of iron deficiency among children after 1 year. Cost/case-year averted for MNDs ranged from $0.50 for low plasma folate to $3.30 for iron deficiency and was $2.20 for maternal anemia. The program was predicted to avert 1600 cases of NTDs over 10 years at ∼$1500 per case averted. Estimated cost/DALY averted was $50 for NTDs and $115 for anemia. Conclusions: In Cameroon, cost-effectiveness of wheat flour fortification varied by the measure of impact employed, but was classified as “very cost-effective” for all outcomes using World Health Organization criteria. Policy makers and their advisors must determine how best to use information on program costs and benefits to inform their decisions.
An algorithm mimicking pancreas pulsatile behavior improves artificial pancreas performance
Authors: Cocha Guillermo , Tedesco Victor , D’Attellis Carlos , Amorena Carlos 
Published: August 2021

Background: Artificial pancreas design using subcutaneous insulin infusion without pre-meal feed-forward boluses often induces an over-response leading to hypoglycemia due to the increase of blood insulin concentration sustained in time. The objective of this work was to create an algorithm for controlling the function of insulin pumps in closed-loop systems to improve blood glucose management in type 1 diabetic patients by mimicking the pulsatile behaviour of the pancreas. Methods: A controller tuned in a pulsatile way promotes damped oscillations of blood insulin concentration injected through an insulin pump. We tested it in a simulated environment, using nine ‘in silica’ subjects. The control algorithm is founded on feedback linearization where through a change of variables, the nonlinear system turns into an equivalent linear system, suitable for implementing through a PID controller. We compared the results obtained ‘in silica’ with the volume injected by an insulin pump controlled by this algorithm. Results: The use of this algorithm resulted in a pulsatile control of postprandial blood glucose concentration, avoiding hypoglycaemic episodes. The results obtained ‘in silica’ were replicated in a real pump ‘in vitro’. Conclusions: With this proposed linear system, an appropriate control input can be designed. The controller works with a damped pulsatile pattern making the insulin infusion from the pump and blood insulin concentration pulsatile. This operational would improve the performance of an artificial pancreas.
A comparison of DAP and RENAL scoring systems in the achievement of trifecta in laparoscopic partial nephrectomy
Authors: Mishra Sumanta Kumar , Boaz Ranil Johann , Jayasimha Sudhindra , Mukha Rajiv Paul , Kekre Nitin Sudhakar , Singh Santosh Kumar 
Published: August 2021

Purpose: The concept of ‘trifecta’ outcome postulated for radical prostatectomy has been adopted for partial nephrectomy, the gold standard for management of small renal masses. We sought to evaluate the role of nephrometry scores in predicting outcomes in terms of the trifecta. We compared two scoring systems for renal tumour complexity (RENAL and DAP) in the prediction of trifecta outcomes. Materials and methods: Sixty-nine patients who underwent laparoscopic PN (LPN) were evaluated in a single-centre retrospective study (2010–2017). RENAL and DAP scores were measured. Parameters relevant to the trifecta were tabulated. Results: When comparing the two scoring systems in terms of warm ischaemia time (WIT), the DAP score could predict with statistically significant accuracy the completion of resection within 25 mins of WIT. Tumours were more evenly distributed according to anatomical characteristics with the DAP scoring system than with the RENAL scoring system. When comparing these systems in terms of complications, neither predicted complications based on complexity with significant accuracy. A low RENAL score predicted trifecta achievement in three-fourth (71.4%) of patients, while a medium RENAL score predicted trifecta achievement in half (54%) of patients. DAP score predicted trifecta achievement in all tumours with a low score, two-third (66%) in medium and less than half (42%) with a high score. Predictions based on DAP were accurate and significantly so ( p = 0.024). Conclusions: DAP score predicted the outcomes of LPN in terms of trifecta significantly better than the RENAL score. In our experience, the DAP score was able to distribute tumour complexity among its groups more effectively than the RENAL score. There is early evidence that the DAP score may be more useful than the RENAL score for decision-making in nephron sparing surgery. This is especially pertinent for small renal masses at the upper limits of tumour complexity for which minimally invasive techniques can be safely applied.
Examining Race and Gender Differences in Associations Among Body Appreciation, Eudaimonic Psychological Well-Being, and Intuitive Eating and Exercising
Authors: Romano Kelly A. , Heron Kristin E. 
Published: August 2021

Purpose: The present study examined race and gender differences among positive psychological constructs, and adaptive eating and exercise behaviors. Design: Cross-sectional. Setting: Online. Sample: College students ( N = 1,228; Mage = 22.27, SD = 5.83). Measures: Participants completed measures assessing positive body image, eudaimonic psychological well-being, and health behaviors. Analyses: Multi-group structural equation modeling was used to examine whether White versus Black race and, separately, woman versus man gender identity moderated associations among body appreciation, eudaimonic psychological well-being, and intuitive eating and intuitive exercising. Results: Results generally indicated that greater body appreciation was associated with greater eudaimonic psychological well-being (βs = 0.48, 0.56) and, in turn, intuitive eating (βs = −0.20, 0.25) and intuitive exercising (βs = −0.06, 0.23). However, notable variations in this pattern of results were identified based on the facet of intuitive eating and exercising under investigation, and participants’ racial identities. For example, greater eudaimonic psychological well-being strictly mediated a positive association between body appreciation and reliance on hunger and satiety cues intuitive eating behaviors among participants who identified as Black (95%CI: 0.01, 0.12), but not White (95%CI: −0.08, 0.04). Conclusions: Although the present findings warrant replication using longitudinal designs due to the cross-sectional nature of the present study, these findings suggest that increasing adults’ eudaimonic psychological well-being may help improve health-promoting eating and exercise behaviors, and should be assessed as a mechanism of change in future clinical research.
The impact of amino acid dialysate on anthropometric measures in adult patients on peritoneal dialysis: A systematic review and meta-analysis
Authors: Iyasere Osasuyi , Nagar Ravi , Jesus-Silva Jorge Antonio , Pepereke Shingai , MacConaill Kateryna , Eid Ahmed , Major Rupert W 
Published: August 2021

Background: Glucose-containing dialysate underpins peritoneal dialysis (PD) therapy. However, its use is associated with amino acid loss in the dialysis effluent, a risk factor for protein-energy wasting (PEW) in PD patients. Amino acid-based dialysis solutions (AAD) may ameliorate this loss. However, the evidence of clinical benefit in preventing PEW is unclear. The aim of this review was to assess the effect of AAD versus standard dialysis solutions (STD) on anthropometric measures and serum albumin. Methods: Studies up until 30 September 2020 were identified from databases including MEDLINE and Embase, using a prespecified protocol (PROSPERO – CRD42020209581). Studies evaluating adults on PD were included. Data pertaining to muscle mass (primary outcome), other anthropometric measures and serum albumin were extracted. A meta-analysis of the eligible studies was conducted. Results: A total of 6945 abstracts were reviewed, from which 14 studies (9 randomised and 5 non-randomised) were included. There was no significant difference in any of the anthropometric measures, between AAD and STD during follow-up. Serum albumin at 6 months was statistically lower with AAD compared to STD [mean difference = −0.89 (95%CI −1.77 to −0.01, p = 0.046)]. The quality of evidence was graded low for each outcome. Conclusions: AAD may not alter anthropometric measures when compared to STD. The impact on serum albumin is uncertain, with an estimated difference that is unlikely to be of clinical value. These findings should be cautiously interpreted due to low quality of the evidence. Robust studies are needed to address the limitations in evidence.
Roleplay as an Educational Strategy in Palliative Care: A Systematic Integrative Review
Authors: Novaes Lucas Mariano Santos , Paiva Eliza Mara das Chagas , O’Mahony Aoife , Garcia Ana Cláudia Mesquita 
Published: August 2021

Introduction: Simulation activities, such as roleplay, have become established in undergraduate and graduate education in several subjects of healthcare. The objective of this study was to synthesize the evidence available in the literature on the use of roleplay as an educational strategy in palliative care. Methods: Using the method proposed by Whittemore and Knafl, this integrative systematic review was carried out based on the following guiding question: “What is the available evidence in the literature on the use of roleplay as an educational strategy in the teaching of palliative care?” The databases used for the selection of articles were the following: Web of Science, Scopus, Cochrane Library, PubMed, CINAHL, EMBASE, and LILACS. There were no limitations regarding the year of publication or language. Results: The articles (n = 34) were grouped into 3 categories, according to the purpose of roleplay use: 1) Use of roleplay as an educational strategy to teach communication in palliative care; 2) Use of roleplay as an educational strategy to teach the communication of bad news, and 3) Use of roleplay as an educational strategy to teach end-of-life care. Conclusion: Roleplay has been employed in the teaching of palliative care in order to develop skills related to communication and to the provision of end-of-life care. These educational activities have mainly been directed to healthcare students and professionals. Future investigations should further evaluate the efficacy of this teaching strategy, based on studies with more robust designs that allow the establishment of cause-and-effect relationships.
Lessons Learned From a Pilot Project on Telemedicine Advance Care Planning in an Urban Geriatric Primary Care Office
Authors: Seecof Olivia M. , Allanoff Molly , Liantonio John , Parks Susan 
Published: August 2021

Purpose: There is a dearth of literature regarding the documentation of advance care planning (ACP) in the geriatric population, despite the controversial, yet well-studied need for ACP. The purpose of this pilot study was to provide an update to a prior study from our institution that outlined the need for increased documentation of advance care planning (ACP) in an urban geriatric population. Methods: Our study involved using telemedicine to conduct dedicated ACP visits and an electronic medical record (EMR) note-template specifically designed for these visits in an attempt to increase the amount of documented ACP in the EMR in this population. Results: The study did not yield significant results due to the inability to schedule enough patients for these dedicated visits. Discussion: While our study was ultimately unsuccessful, 3 crucial lessons were identified that will inform and fuel future interventions by the authors to further the study of documentation of ACP.
Biomechanical Evaluation of Tarsometatarsal Fusion Comparing Crossing Lag Screws and Lag Screw With Locking Plate
Authors: Ettinger Sarah , Hemmersbach Lisa-Christin , Schwarze Michael , Stukenborg-Colsman Christina , Yao Daiwei , Plaass Christian , Claassen Leif 
Published: August 2021

Background: Tarsometatarsal (TMT) arthrodesis is a common operative procedure for end-stage arthritis of the TMT joints. To date, there is no consensus on the best fixation technique for TMT arthrodesis and which joints should be included. Methods: Thirty fresh-frozen feet were divided into one group (15 feet) in which TMT joints I-III were fused with a lag screw and locking plate and a second group (15 feet) in which TMT joints I-III were fused with 2 crossing lag screws. The arthrodesis was performed stepwise with evaluation of mobility between the metatarsal and cuneiform bones after every application or removal of a lag screw or locking plate. Results: Isolated lag-screw arthrodesis of the TMT I-III joints led to significantly increased stability in every joint ( P < .05). Additional application of a locking plate caused further stability in every TMT joint ( P < .05). An additional crossed lag screw did not significantly increase rigidity of the TMT II and III joints ( P > .05). An IM screw did not influence the stability of the fused TMT joints. For TMT III arthrodesis, lag-screw and locking plate constructs were superior to crossed lag-screw fixation ( P < .05). TMT I fusion does not support stability after TMT II and III arthrodesis. Conclusion: Each fixation technique provided sufficient stabilization of the TMT joints. Use of a lag screw plus locking plate might be superior to crossed screw fixation. An additional TMT I and/or III arthrodesis did not increase stability of an isolated TMT II arthrodesis. Clinical Relevance: We report the first biomechanical evaluation of TMT I-III arthrodesis. Our results may help surgeons to choose among osteosynthesis techniques and which joints to include in performing arthrodesis of TMT I-III joints.