bluuebunny/crossref_metadata_2025_split huggingface dataset:
COVID-19 Vaccination Perception and Attitude among Healthcare Workers in Egypt
Authors: Fares Samar , Elmnyer Merihan M. , Mohamed Shimaa Sabry , Elsayed Radwa 
Published: April 2021

Introduction COVID-19 pandemic has affected the whole world, especially the frontline worriers. To get shielded through this war, the world is racing to reach and manufacture COVID-19 vaccines. Vaccination hesitancy is one of the significant obstacles to global health. Objectives This study aimed to assess the perception and attitude of healthcare workers in Egypt toward COVID-19 vaccines, acknowledge the determinants of their attitude, and the factors that could increase the acceptance of the vaccine. Methods an observational web-based anonymous survey was conducted on 385 Egyptian healthcare workers in different governorates. The questionnaire-based on Vaccine Hesitancy Survey Questions of the World Health Organization was available in Arabic and English languages and was tested for reliability. Results Regarding vaccination decision, 51% of the participants were undecided, 28% refused, and 21% accepted vaccination. Reasons for vaccine acceptance mainly were risks of COVID-19 (93%), safety (57.5%), and effectiveness (56.25%) of the vaccine. Simultaneously, the reasons for vaccine hesitancy were the absence of enough clinical trials (92.4%) and fear of side effects of the vaccine (91.4%). The leading factor that could increase vaccination acceptance among the participants was to get sufficient and accurate information about the available vaccines. The participants revealed a high mean level of concern for COVID-19 vaccines’ safety (3.8 of 5) that differs significantly among the different study groups ( P-value .002). Conclusion Despite the COVID-19 pandemic, only approximately 21% of Egyptian healthcare workers in our study accepted the COVID-19 vaccination. Vaccine hesitancy represents a major barrier to implementing vaccination programs.
The Role of Trust in the Strategic Management Process: A Case Study of Finnish Grocery Retail Company Kesko Ltd
Authors: Malkamäki Kirsti , Hiltunen Esa , Aromaa Eeva 
Published: April 2021

Previous strategy management studies have devoted scant attention to the role of trust in the strategic management process (SMP). The purpose of this study is to investigate trust in the management of a grocery trade business. Prior literature was reviewed to deepen the current understanding of trust in the SMP, and then explored through a case study on a Finnish grocery retail company, Kesko Ltd. The study was conducted by employing a qualitative research methodology and is based on an interview with the president of Kesko, who is intensively involved in the SMP. This study stresses the consideration of trust development in strategy work. The findings indicate that trust considerations in the strategic choices of the top management team can provide efficiency, innovation, and engagement in strategy implementation. Research Questions In this article, we ask how trust develops during three phases of the strategy process: strategy formulation, strategic choices, and strategy implementation. Links to Theory Our analysis of trust development focuses on the five most operationalized dimensions of trust: (a) ability and competence, (b) benevolence, (c) integrity, (d) affective-based trust, and (e) cognitive-based trust (McEvily & Tortoriello, 2011). Strategic management is separated into three interlinked phases: strategic formulation, strategic choice making, and strategy implementation (Johnson et al., 2008). Phenomenon Studied The case focuses on trust development in the strategy management process. Case Context The context of the case is a participatory strategic management process in a large Finnish grocery retail chain in a highly competitive and concentrated market. The role of trust development was studied in the case company between the K-retailers, who are independent entrepreneurs, and Kesko management staff and actors responsible for management and constant development of the business model. Findings This study shows how trust emerged as a result of participatory practices and dialogue between actors from different levels of organization in the strategy formulation phase. Increased understanding and contribution to strategy empowered top management to make new and brave strategic choices. This study illustrates how consistency between the strategic choices and actions for implementation enhanced trust among the organizational actors, who felt a sense of enhanced engagement in the implementation of the new strategy in their everyday work. Discussions This study highlights the role of trust in strategy formulation, strategic choices, and strategy implementation. It contributes to the understanding of trust in the SMP, which has not been widely researched in previous literature. Based on our results, we suggest that trust between parties is earned and evolves at each of the three stages of the SMP.
Simulation of Random Differential Periodontitis Outcome Misclassification with Perfect Specificity
Authors: Alshihayb T.S. , Heaton B. 
Published: April 2021

Introduction: Misclassification of clinical periodontitis can occur by partial-mouth protocols, particularly when tooth-based case definitions are applied. In these cases, the true prevalence of periodontal disease is underestimated, but specificity is perfect. In association studies of periodontal disease etiology, misclassification by this mechanism is independent of exposure status (i.e., nondifferential). Despite nondifferential mechanisms, differential misclassification may be realized by virtue of random errors. Objectives: To gauge the amount of uncertainty around the expectation of differential periodontitis outcome misclassification due to random error only, we estimated the probability of differential outcome misclassification, its magnitude, and expected impacts via simulation methods using values from the periodontitis literature. Methods: We simulated data sets with a binary exposure and outcome that varied according to sample size (200, 1,000, 5,000, 10,000), exposure effect (risk ratio; 1.5, 2), exposure prevalence (0.1, 0.3), outcome incidence (0.1, 0.4), and outcome sensitivity (0.6, 0.8). Using a Bernoulli trial, we introduced misclassification by randomly sampling individuals with the outcome in each exposure group and repeated each scenario 10,000 times. Results: The probability of differential misclassification decreased as the simulation parameter values increased and occurred at least 37% of the time across the 10,000 repetitions. Across all scenarios, the risk ratio was biased, on average, toward the null when the sensitivity was higher among the unexposed and away from the null when it was higher among the exposed. The extent of bias for absolute sensitivity differences ≥0.04 ranged from 0.05 to 0.19 regardless of simulation parameters. However, similar trends were not observed for the odds ratio where the extent and direction of bias were dependent on the outcome incidence, sensitivity of classification, and effect size. Conclusions: The results of this simulation provide helpful quantitative information to guide interpretation of findings in which nondifferential outcome misclassification mechanisms are known to be operational with perfect specificity. Knowledge Transfer Statement: Measurement of periodontitis can suffer from classification errors, such as when partial-mouth protocols are applied. In this case, specificity is perfect and sensitivity is expected to be nondifferential, leading to an expectation for no bias when studying periodontitis etiologies. Despite expectation, differential misclassification could occur from sources of random error, the effects of which are unknown. Proper scrutiny of research findings can occur when the probability and impact of random classification errors are known.
The Recognition of Business Opportunity in Female Entrepreneurship: State of Play in a Tunisian Context
Authors: Mokline Bechir 
Published: April 2021

The objective of this research is to formulate an analytical framework to identify the determinants of business opportunities in the field of female entrepreneurship based on a triple perspective: subjectivist, objectivist and constructive. More specifically, we will try to develop a research model that identifies the factors influencing the process of recognising business opportunities in women’s entrepreneurship in the Tunisian context. This work is exploratory, and we have adopted a qualitative approach through semi-directive interviews addressed to 12 Tunisian women entrepreneurs.
Machine learning to reveal an astute risk predictive framework for Gynecologic Cancer and its impact on women psychology: Bangladeshi perspective
Authors: Asaduzzaman Sayed , Ahmed Md. Raihan , Rehana Hasin , Chakraborty Setu , Islam Md. Shariful , Bhuiyan Touhid 
Published: April 2021

Abstract
Background
In this research, an astute system has been developed by using machine learning and data mining approach to predict the risk level of cervical and ovarian cancer in association to stress.

Results
For functioning factors and subfactors, several machine learning models like Logistics Regression, Random Forest, AdaBoost, Naïve Bayes, Neural Network, kNN, CN2 rule Inducer, Decision Tree, Quadratic Classifier were compared with standard metrics e.g., F1, AUC, CA. For certainty info gain, gain ratio, gini index were revealed for both cervical and ovarian cancer. Attributes were ranked using different feature selection evaluators. Then the most significant analysis was made with the significant factors. Factors like children, age of first intercourse, age of husband, Pap test, age are the most significant factors of cervical cancer. On the other hand, genital area infection, pregnancy problems, use of drugs, abortion, and the number of children are important factors of ovarian cancer.

Conclusion
Resulting factors were merged, categorized, weighted according to their significance level. The categorized factors were indexed using ranker algorithm which provides them a weightage value. An algorithm has been formulated afterward which can be used to predict the risk level of cervical and ovarian cancer in relation to women's mental health. The research will have a great impact on the low incoming country like Bangladesh as most women in low incoming nations were unaware of it. As these two can be described as the most sensitive cancers to women, the development of the application from algorithm will also help to reduce women’s mental stress. More data and parameters will be added in future for research in this perspective.
Dynamic model updating (DMU) approach for statistical learning model building with missing data
Authors: Jain Rahi , Xu Wei 
Published: April 2021

Abstract
Background
Developing statistical and machine learning methods on studies with missing information is a ubiquitous challenge in real-world biological research. The strategy in literature relies on either removing the samples with missing values like complete case analysis (CCA) or imputing the information in the samples with missing values like predictive mean matching (PMM) such as MICE. Some limitations of these strategies are information loss and closeness of the imputed values with the missing values. Further, in scenarios with piecemeal medical data, these strategies have to wait to complete the data collection process to provide a complete dataset for statistical models.

Method and results
This study proposes a dynamic model updating (DMU) approach, a different strategy to develop statistical models with missing data. DMU uses only the information available in the dataset to prepare the statistical models. DMU segments the original dataset into small complete datasets. The study uses hierarchical clustering to segment the original dataset into small complete datasets followed by Bayesian regression on each of the small complete datasets. Predictor estimates are updated using the posterior estimates from each dataset. The performance of DMU is evaluated by using both simulated data and real studies and show better results or at par with other approaches like CCA and PMM.

Conclusion
DMU approach provides an alternative to the existing approaches of information elimination and imputation in processing the datasets with missing values. While the study applied the approach for continuous cross-sectional data, the approach can be applied to longitudinal, categorical and time-to-event biological data.
Intraspecific convergence of floral size correlates with pollinator size on different mountains: a case study of a bumblebee-pollinated Lamium (Lamiaceae) flowers in Japan
Authors: Toji Tsubasa , Ishimoto Natsumi , Egawa Shin , Nakase Yuta , Hattori Mitsuru , Itino Takao 
Published: April 2021

Abstract
Background
Geographic differences in floral size sometimes reflect geographic differences in pollinator size. However, we know little about whether this floral size specialization to the regional pollinator size occurred independently at many places or occurred once and then spread across the distribution range of the plant species.

Results
We investigated the relationship between the local floral size of flowers and local pollinator size in 12 populations of Lamium album var. barbatum on two different mountains in the Japan Alps. Then, using 10 microsatellite markers, we analyzed genetic differentiation among the 12 populations. The results showed that local floral size was correlated with the average size of relevant morphological traits of the local pollinators: floral size was greater in populations visited frequently by the largest flower visitors, Bombus consobrinus queens, than it was in other populations. We also found that the degree of genetic similarity between populations more closely reflected interpopulation geographic proximity than interpopulation similarity in floral size.

Conclusions
Although genetic similarity of populations was highly associated with geographic proximity, floral size varied independently of geographic proximity and was associated with local pollinator size. These results suggest that in L. album var. barbatum, large floral size evolved independently in populations on different mountains as a convergent adaptation to locally abundant large bumblebee species.
Effects of peak time of myocardial injury biomarkers on mid-term outcomes of patients undergoing OPCABG
Authors: Hu Bo , Gao Fei , Lv Mengwei , Liu Ban , Shi Yu , Chen Xi , Feng Yipeng , Meng Xiaoqi , Li Zhi , Zhang Yangyang 
Published: April 2021

Abstract
Background
With the development of cardiac surgery techniques, myocardial injury is gradually reduced, but cannot be completely avoided. Myocardial injury biomarkers (MIBs) can quickly and specifically reflect the degree of myocardial injury. Due to various reasons, there is no consensus on the specific values of MIBs in evaluating postoperative prognosis. This retrospective study was aimed to investigate the impact of MIBs on the mid-term prognosis of patients undergoing off-pump coronary artery bypass grafting (OPCABG).

Methods
Totally 564 patients undergoing OPCABG with normal courses were included. Cardiac troponin T (cTnT) and creatine kinase myocardial band (CK-MB) were assessed within 48 h before operation and at 6, 12, 24, 48, 72, 96 and 120 h after operation. Patients were grouped by peak values and peak time courses of MIBs. The profile of MIBs and clinical variables as well as their correlations with mid-term prognosis were analyzed by univariable and multivariable Cox regression models.

Result
Continuous assessment showed that MIBs increased first (12 h after surgery) and then decreased. The peak cTnT and peak CK-MB occurred within 24 h after operation in 76.8% and 67.7% of the patients respectively. No significant correlation was found between CK-MB and mid-term mortality. Delayed cTnT peak (peak cTnT elevated after 24 h after operation) was correlated with lower creatinine clearance rate (69.36 ± 21.67 vs. 82.18 ± 25.17 ml/min/1.73 m2), body mass index (24.35 ± 2.58 vs. 25.27 ± 3.26 kg/m2), less arterial grafts (1.24 ± 0.77 vs. 1.45 ± 0.86), higher EuroSCORE II (2.22 ± 1.12 vs.1.72 ± 0.91) and mid-term mortality (26.5 vs.7.9%). Age (HR: 1.067, CI: 1.006–1.133), left ventricular ejection fraction (HR: 0.950, CI: 0.910–0.993), New York Heart Association score (HR: 1.839, CI: 1.159–2.917), total venous grafting (HR: 2.833, CI: 1.054–7.614) and cTnT peak occurrence within 24 h (HR: 0.362, CI: 0.196–0.668) were independent predictors of mid-term mortality.

Conclusion
cTnT is a better indicator than CK-MB. The peak value and peak occurrence of cTnT are related to mid-term mortality in patients undergoing OPCABG, and the peak phases have stronger predictive ability. Trial registration: Chinese Clinical Trial Registry, ChiCTR2000033850. Registered 14 June 2020, http://www.chictr.org.cn/edit.aspx?pid=55162&htm=4.
The Turkish version of the SPPIC validated among informal caregivers with a Turkish immigrant background
Authors: van Wezel Nienke , van der Heide Iris , Devillé Walter L. J. M. , Duran Gozde , Hoopman Rianne , Blom Marco M. , Pot Anne Margriet , Spreeuwenberg Peter , Francke Anneke L. 
Published: April 2021

Abstract
Background
This study assesses the internal consistency and known group validity of the Turkish version of the SPPIC, a measurement instrument to assess the self perceived pressure from informal care in family caregivers of people with dementia that was originally in Dutch.

Methods
The feasibility, comprehensibility and appropriateness of the Turkish SPPIC were assessed during a pilot test. Internal consistency was examined based on data from 117 family caregivers with a Turkish immigrant background by calculating Cronbach’s alpha and by conducting a single-factor Confirmatory Factor Analysis (CFA). Known group validity was determined to obtain an understanding of the validity of the translated instrument, testing differences in the self-perceived pressure from informal care, depending on frequency of caregiving, living with a person with dementia and level of education.

Results
The pilot test showed that the translated SPPIC was considered to be feasible, comprehensible and appropriate. The internal consistency appeared to be strong (Cronbach’s alpha: 0.94). The CFA indicated that the factor ‘Self-perceived Pressure from Informal Care’ explained varying levels of variance in the items of the SPPIC (ranging from .52 to .87). Family caregivers who provided care at least once a week and who shared a home with a person with dementia perceived a greater pressure from informal care (p = 0.007, p = 0.001).

Conclusions
The Turkish translation of the SPPIC can be used in future research and practice to obtain insight into self-perceived pressure from informal care of family caregivers with Turkish immigrant backgrounds. At the same time it is recommended to conduct more research on how the measurement of self-perceived pressure from informal care in this group can be further improved.
Nerve transfer surgery in spinal cord injury: online information sharing
Authors: Moltaji Syena , Novak Christine B. , Dengler Jana 
Published: April 2021

Abstract
Background
Nerve transfer to improve upper extremity function in persons with cervical spinal cord injury (SCI) is a new reconstructive option, and has led to more people seeking and sharing surgical information and experiences. This study evaluated the role of social media in information-sharing on nerve transfer surgery within the SCI community.

Methods
Data were collected from Facebook, which is the favored information-sharing platform among individuals seeking medical information. Searched terms included ‘spinal cord injury’ and ‘SCI’ and excluded groups with: less than two members (n = 7); closed groups (n = 2); not pertaining to SCI (n = 13); restricted access (n = 36); and non-English (n = 2). Within public and private accessed groups, searches were conducted for ‘nerve’, ‘transfer’, ‘nerve transfer’, and ‘nerve surgery’. Each post about nerve transfer, responses to posts, and comments about nerve transfer in response to unrelated posts were tabulated. Thematic content analyses were performed and data were categorized as seeking information, sharing information, sharing support, and sharing appreciation.

Results
The search yielded 99 groups; 35 met the inclusion criteria (average size = 2007, largest = 12,277). Nerve transfer was discussed in nine groups, with 577 total mentions. In the seeking information axis, posts were related to personal experience (54%), objective information (31%), surgeon/center performing the procedure (9%), and second opinion (4%). At least 13% of posts were from individuals learning about nerve transfers for the first time. In the sharing information axis, the posts: shared personal experience (52%); shared objective information (13%); described alternative treatment (3%); tagged someone to share information (11%); linked to outside resources (12%); and recommended a specific surgeon/center (9%).

Conclusion
Social media is an important source of information and support for people with SCI. There is a paucity of information on nerve transfers. These study findings will inform implementation of future education strategies.
Ultrasonographic study of fetal facial profile markers during the first trimester
Authors: Ji Chunya , Jiang Xiaoli , Yin Linliang , Deng Xuedong , Yang Zhong , Pan Qi , Zhang Jun , Liang Qing 
Published: April 2021

AbstractBackgroundTo establish reference ranges of fetal facial profile markers and study their correlations with crown-rump length (CRL) during the first trimester (11 ~ 13+ 6weeks’ gestation) in a Chinese population.MethodsUltrasonographic images of measuring fetal nuchal translucency (NT) were retrospectively selected randomly in normal fetuses whose parents were both Chinese. The facial markers included inferior facial angle (IFA), maxilla-nasion-mandible (MNM) angle, facial maxillary angle (FMA) and profile line (PL) distance. These markers were measured through ViewPoint 6 software by two experienced sonographers.ResultsThree hundred and eighty fetuses were selected. The ICCs (95 % CI) of intra-operator 1 reproducibility of IFA, MNM angle, FMA, PL distance were 0.944 (0.886 ~ 0.973), 0.804 (0.629 ~ 0.902), 0.834 (0.68 ~ 0.918) and 0.935 (0.868 ~ 0.969), respectively. The ICCs (95 % CI) of intra-operator 2 reproducibility of IFA, MNM angle, FMA, PL distance were 0.931 (0.857 ~ 0.967), 0.809 (0.637 ~ 0.904), 0.786 (0.600 ~ 0.892) and 0.906 (0.813 ~ 0.954), respectively. The ICCs (95 % CI) of inter-operator reproducibility of IFA, MNM angle, FMA, PL distance were 0.885 (0.663 ~ 0.953), 0.829 (0.672 ~ 0.915), 0.77 (0.511 ~ 0.891) and 0.844 (0.68 ~ 0.925), respectively. The average ± SD of IFA, MNM angle, FMA and PL distance were 80.2°±7.25°, 4.17°±1.19°, 75.36°±5.31°, 2.78 ± 0.54 mm, respectively. IFA and PL distance significantly decreased with CRL, while MNM angle and FMA significantly increased with CRL.ConclusionsIt was feasible to measure fetal facial markers during the first trimester. In Chinese population, the reference ranges of IFA, MNM angle, FMA and PL distance were 80.2°±7.25°, 4.17°±1.19°, 75.36°±5.31°, 2.78 ± 0.54 mm, respectively, and the measurements were found to correlate with CRL.