bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors Affecting Willingness to Pay for Outpatient Services at RSU Tangerang Selatan
Authors: Astrilia Farah Elena , Hadiwiardjo Yanti Harjono , Soeryo Gatot 
Published: May 2021

Background: The government established a national health insurance program (NHI) to increase access to health services but the program is still not optimal, it affects the number of hospital visits and income. Therefore it required an analysis of patient’s willingness to pay out of pocket for outpatient services. The purpose of this study was to determine factors affecting patient’s willingness to pay. Method: This research is a cross sectional study involving 124 internal medicine outpatients at General Hospital (RSU) South Tangerang City in November 2019. Data were obtained from a questionnaire. Patient’s income, information, treatment experience, health insurance, distance to hospital, health service, ability to pay, and willingness to pay was investigated using chi square and logistic regression analysis. Results: The results outcomes showed that the level of willingness to pay of respondents is quite high and is influenced by patient’s income (p = 0.001), information (p = 0.045), treatment experience (p = 0.010), and ability to pay (ATP) (p = 0.001). Factors that have the most significant associations were patient’s ability to pay (OR = 14,502). Conclusion: Patient’s income, information, treatment experience, and ATP affect the willingness to pay of patients.
Cutting edge selection: learning from high reliability organisations for virtual recruitment in surgery during the COVID-19 pandemic
Authors: Hardie JA , Green G , Bor R , Brennan PA 
Published: May 2021

Introduction National selection for higher surgical training (ST3+) recruitment in the UK is competitive. The process must prioritise patient safety while being credible, impartial and fair. During the COVID-19 pandemic, all face-to-face interviews were cancelled. Selection was based on a controversial isolated self-assessment score with no evidence checking taking place. From 2021, selection will take place entirely online. Although this has cost and time advantages, new challenges emerge. Methods We review surgical selection as it transitions to an online format and suggest validated methods that could be adapted from High Reliability Organisations (HRO). Findings Virtual selection methods include video interviewing, online examinations and aptitude testing. These tools have been used in business for many years, but their predictive value in surgery is largely unknown. In healthcare, the established online Multi-Specialty Recruitment Assessment (MSRA) examines generic professional capabilities. Its scope, however, is too limited to be used in isolation. Candidates and interviewers alike may have concerns about the technical aspects of virtual recruitment. The significance of human factors must not be overlooked in the online environment. Surgery can learn from HROs, such as aviation. Pilot and air traffic control selection is integral to ensuring safety. These organisations have already established digital selection methods for psychological aptitude, professional capabilities and manual dexterity. Conclusion National selection for higher surgical training (ST3+) can learn from HROs, using validated methods to prioritise patient safety while being acceptable to candidates, trainers and health service recruiters.
Hearing Evaluation of ARthroplasty Surgeons: results from the HEARS study
Authors: Palmer JS , Wilson C , Fraig H , Wilson D , Garrett S 
Published: May 2021

Aims The aim of this study was to investigate whether the prevalence of hearing loss among arthroplasty surgeons was comparable to clinicians from other medical specialties and to explore the factors associated with hearing loss. Methods A cross-sectional prevalence study was carried out. Arthroplasty surgeons and non-surgical clinicians were recruited from orthopaedic and medical conferences. All participants were given a paper questionnaire including demographic details, hearing history and the Tinnitus and Hearing Survey. All participants were screened for hearing loss in a quiet room using the HearCheck Screener™ (HCS; Siemens, Munich, Germany). Logistic regression was used to identify factors associated with hearing loss. All statistical models were adjusted for age, gender, smoking status and personal noise exposure. Results The HEARS (Hearing Evaluation of ARthroplasty Surgeons) study recruited 188 participants (106 arthroplasty surgeons; 82 non-surgical clinicians). Prevalence of hearing loss identified by the HCS was 31% for arthroplasty surgeons vs 11% for non-surgical clinicians. The odds of failing the HCS were 3.7 times higher in arthroplasty surgeons compared to their non-surgical colleagues (p < 0.004). The odds of self-reported hearing using the Tinnitus and Hearing Survey were 2.79 times higher among arthroplasty surgeons (p < 0.003). Conclusion The prevalence of hearing loss among arthroplasty surgeons is significantly higher than in their non-surgical colleagues. Noise generated during arthroplasty surgery should be recognised and managed to create safer working conditions.
QoT assessment of the optical spectrum as a service in disaggregated network scenarios
Authors: Kaeval Kaida , Fehenberger Tobias , Zou Jim , Jansen Sander Lars , Grobe Klaus , Griesser Helmut , Elbers Jörg-Peter , Tikas Marko , Jervan Gert 
Published: May 2021

The potential to operate third-party terminals over multi-domain transparent optical networks attracts operators and customers to implement optical spectrum as a service (OSaaS). Because infrastructure information cannot always be shared with OSaaS end customers, alternatives to off-line quality of transmission (QoT) estimation tools are required to assess the performance of the spectrum slot to estimate achievable throughput. In this paper, commercially available sliceable coherent transceivers are used to assess the generalized signal-to-noise ratio (GSNR) based QoT of the OSaaS in a live production network for both narrowband and wideband OSaaS configurations. Extended channel probing based on symbol rate variability is combined with spectral sweeping and operation regime detection to characterize OSaaS implementations on 17 links with different underlying infrastructure configurations to maximize capacity and increase service margins in a low-margin operation regime. We achieve 0.05 dB estimation accuracy in the GSNR for wideband spectrum services and 0.32 dB accuracy for narrowband spectrum services. Based on the GSNR profile, spectral misalignment, spectral ripple, and operation regime are detected and service margin improvements are demonstrated. Finally, we discuss the network optimization perspective based on acquired data from channel probing and propose use cases for continuous channel probing in transparent optical networks.
Inverse design of a Raman amplifier in frequency and distance domains using convolutional neural networks
Authors: Soltani Mehran , Da Ros Francesco , Carena Andrea , Zibar Darko 
Published: May 2021

We present a convolutional neural network architecture for inverse Raman amplifier design. This model aims at finding the pump powers and wavelengths required for a target signal power evolution in both distance along the fiber and in frequency. Using the proposed framework, the prediction of the pump configuration required to achieve a target power profile is demonstrated numerically with high accuracy in C-band considering both counter-propagating and bidirectional pumping schemes. For a distributed Raman amplifier based on a 100 km single-mode fiber, a low mean set (0.51, 0.54, and 0.64 dB) and standard deviation set (0.62, 0.43, and 0.38 dB) of the maximum test error are obtained numerically employing two and three counter-, and four bidirectional propagating pumps, respectively.
Optical camera communications link using an LED-coupled illuminating optical fiber
Authors: Teli Shivani Rajendra , Eollosova Klara , Zvanovec Stanislav , Ghassemlooy Zabih , Komanec Matej 
Published: May 2021

In this Letter, we propose and demonstrate a novel wireless communications link using an illuminating optical fiber as a transmitter (Tx) in optical camera communications. We demonstrate an indoor proof-of-concept system using an illuminating plastic optical fiber coupled with a light-emitting diode and a commercial camera as the Tx and the receiver, respectively. For the first time, to the best of our knowledge, we experimentally demonstrate flicker-free wireless transmission within the off-axis camera rotation angle range of 0–45° and the modulation frequencies of 300 and 500 Hz. We also show that a reception success rate of 100% is achieved for the camera exposure and gain of 200 µs and 25 dB, respectively.
An Introduction to Finite Element Methods for Inverse Coefficient Problems in Elliptic PDEs
Authors: Harrach Bastian 
Published: May 2021

AbstractSeveral novel imaging and non-destructive testing technologies are based on reconstructing the spatially dependent coefficient in an elliptic partial differential equation from measurements of its solution(s). In practical applications, the unknown coefficient is often assumed to be piecewise constant on a given pixel partition (corresponding to the desired resolution), and only finitely many measurement can be made. This leads to the problem of inverting a finite-dimensional non-linear forward operator $\mathcal{F}:\ \mathcal{D}(\mathcal{F})\subseteq \mathbb{R}^{n}\to \mathbb{R}^{m}$
F
:

D
(
F
)
⊆

R
n

→

R
m

, where evaluating ℱ requires one or several PDE solutions.Numerical inversion methods require the implementation of this forward operator and its Jacobian. We show how to efficiently implement both using a standard FEM package and prove convergence of the FEM approximations against their true-solution counterparts. We present simple example codes for Comsol with the Matlab Livelink package, and numerically demonstrate the challenges that arise from non-uniqueness, non-linearity and instability issues. We also discuss monotonicity and convexity properties of the forward operator that arise for symmetric measurement settings.This text assumes the reader to have a basic knowledge on Finite Element Methods, including the variational formulation of elliptic PDEs, the Lax-Milgram-theorem, and the Céa-Lemma. Section 3 also assumes that the reader is familiar with the concept of Fréchet differentiability.
Modelling optimal vaccination strategy for SARS-CoV-2 in the UK
Authors: Moore Sam , Hill Edward M. , Dyson Louise , Tildesley Michael J. , Keeling Matt J. 
Published: May 2021

The COVID-19 outbreak has highlighted our vulnerability to novel infections.
Faced with this threat and no effective treatment, in line with many other countries, the UK adopted enforced social distancing (lockdown) to reduce transmission—successfully reducing the reproductive number R below one. However, given the large pool of susceptible individuals that remain, complete relaxation of controls is likely to generate a substantial further outbreak. Vaccination remains the only foreseeable means of both containing the infection and returning to normal interactions and behaviour. Here, we consider the optimal targeting of vaccination within the UK, with the aim of minimising future deaths or quality adjusted life year (QALY) losses. We show that, for a range of assumptions on the action and efficacy of the vaccine, targeting older age groups first is optimal and may be sufficient to stem the epidemic if the vaccine prevents transmission as well as disease.
Combining Global Positioning System (GPS) with saliva collection among sexual minority adults: A feasibility study
Authors: Chen Tzuan A. , Smith Nathan Grant , Regan Seann D. , Obasi Ezemenari M. , Anderson Kathryn Freeman , Reitzel Lorraine R. 
Published: May 2021

Background
This is the first study, of which we are aware, to evaluate the feasibility and accessibility of simultaneous use of Global Positioning System (GPS) and saliva collection for biomarker assessment as an objective measure of stress physiology among sexual minority (lesbian, gay, bisexual, queer, and other non-heterosexual identities) individuals. The principal motivation for pairing GPS and saliva collection was to investigate how characteristics of the built and social environments along with participants’ daily activity paths affect stress. This can contribute to a better understanding of health and health behaviors in the sexual minority community.

Methods
A convenience sample of enrolled participants (N = 124) from Houston, Texas was asked to complete questionnaires, carry with them a GPS unit daily, and collect and store 6 samples of saliva at specific times across the span of a day prior to a second visit around one week later.

Results
Of 124 participants, 16 participants (12.90%) provided no useable GPS data and 98 (79.03%) provided at least 4 days of data. More than three-fourths (n = 98, 79.03%) also provided complete saliva samples.

Conclusions
Our results show that the simultaneous use of GPS and saliva collection to assess sexual minority individuals’ activity paths and stress level is feasible.
Web-based survey among animal researchers on publication practices and incentives for increasing publication rates
Authors: Deutsch Susanne , Heider Miriam , Glage Silke , Bleich André , Tolba René , Strech Daniel , Wieschowski Susanne 
Published: May 2021

Objectives
Publication bias, non-publication, and selective reporting of animal studies limit progress toward the 3Rs (Replacement, Reduction, and Refinement) that guide ethical animal testing, waste public resources, and result in redundant research, which collectively undermine the public’s trust in scientific reliability. In this study, we aimed to 1) validate findings from a previous follow-up study by our team that examined the publication rates of animal studies from protocol to publication and 2) identify incentives for improving publication rates in animal research.

Methods
The researchers responsible for the animal proposals (n = 210) from our previous study were contacted as participants for a Web-based survey between October 2019 and April 2020. Question types varied between free text questions, answer options based on a 5-point Likert scale and closed yes/no questions.

Results
In total, 78 researchers responsible for 101 of 210 animal study proposals participated, yielding a response rate of 48.1%. Results showed that the publication rate increased from 67% in our follow-up study to 70%. According to a 5-point Likert scale (from 1 = “not relevant” to 5 = “extremely relevant”), the most widely accepted suggestions for increasing publication rates were “Publication costs for open access journals are fully covered by funders or universities” (mean 4.02, SD 1.01), “Performance-based allocation of intramural funds for results reporting of animal research not supporting the initial hypothesis (including preprints and repositories)” (mean 3.37, SD 1.05), and “Researchers receive more information from scientific journals that also publish non-significant results” (mean 3.30, SD 1.02).

Conclusion
While the extent of publication and publication practices have been thoroughly investigated for clinical trials, less data is available for animal research to date. Therefore, the study contributes in complementing the picture of publication practice in animal research. Suggestions from our survey may help improve the publication rates of animal studies.
Clinical factors associated with rapid treatment of sepsis
Authors: Song Xing , Liu Mei , Waitman Lemuel R. , Patel Anurag , Simpson Steven Q. 
Published: May 2021

PurposeTo understand what clinical presenting features of sepsis patients are historically associated with rapid treatment involving antibiotics and fluids, as appropriate.DesignThis was a retrospective, observational cohort study using a machine-learning model with an embedded feature selection mechanism (gradient boosting machine).MethodsFor adult patients (age ≥ 18 years) who were admitted through Emergency Department (ED) meeting clinical criteria of severe sepsis from 11/2007 to 05/2018 at an urban tertiary academic medical center, we developed gradient boosting models (GBMs) using a total of 760 original and derived variables, including demographic variables, laboratory values, vital signs, infection diagnosis present on admission, and historical comorbidities. We identified the most impactful factors having strong association with rapid treatment, and further applied the Shapley Additive exPlanation (SHAP) values to examine the marginal effects for each factor.ResultsFor the subgroups with or without fluid bolus treatment component, the models achieved high accuracy of area-under-receiver-operating-curve of 0.91 [95% CI, 0.86–0.95] and 0.84 [95% CI, 0.81–0.86], and sensitivity of 0.81[95% CI, 0.72–0.87] and 0.91 [95% CI, 0.81–0.97], respectively. We identified the 20 most impactful factors associated with rapid treatment for each subgroup. In the non-hypotensive subgroup, initial physiological values were the most impactful to the model, while in the fluid bolus subgroup, value minima and maxima tended to be the most impactful.ConclusionThese machine learning methods identified factors associated with rapid treatment of severe sepsis patients from a large volume of high-dimensional clinical data. The results provide insight into differences in the rapid provision of treatment among patients with sepsis.
Ocular biometric parameters changes and choroidal vascular abnormalities in patients with neurofibromatosis type 1 evaluated by OCT-A
Authors: Vagge Aldo , Corazza Paolo , Ferro Desideri Lorenzo , Camicione Paola , Agosto Giulia , Vagge Roberta , Maria Grazia Calevo , Carnevali Adriano , Giannaccare Giuseppe , Nicolò Massimo , Traverso Carlo Enrico 
Published: May 2021

Purpose
To analyze ocular biometric parameters alterations of the posterior pole and choroidal abnormalities in patients with neurofibromatosis type 1 (NF1) by adopting multimodal imaging, especially focusing on the role of novel diagnostic devices like swept-source optical coherence tomography angiography (SS-OCTA).

Methods
In this prospective, case-controlled study, patients with NF1 and age-matched control subjects were quantitatively analyzed by using multimodal imaging. All the subjects underwent confocal scanning laser ophthalmoscopy (SLO), SS-OCT and SS-OCTA examinations.

Results
SS-OCT analysis revealed a lower macular retinal nerve fiber layer (RNFL) thickness in patients with NF1 compared with those with suspected NF1 (95.0±15.9 vs 109.7±11.3 μm; P = 0.001) and control subjects (106.8±14.4 μm, P = 0.003). Retinal thickness was significantly lower in NF1 patients compared to those with suspected NF1 (280.7±23.0 vs 304.2±15.3 μm; P < 0.001) and control subjects (298.7±23.8 μm, P = 0.003). The mean vascular flow area of the SCP was significantly higher in patients with NF1 (42.6±2.2%) and suspected NF1 (43.1±2.5%) compared to control subjects (41.0±2.0%; respectively, P = 0.017 and P = 0.002). In the second choroidal layer, the flow area was significantly lower in patients with NF1 compared to control subjects (45.4±4.8 vs 49.0±4.0%,; P = 0.011).

Conclusions
Retinal thicknesses alterations and choroidal nodules are described as ocular manifestations in patients with NF1. In addition, OCTA could represent an important novel advanced imaging technique, capable of detecting early altered retinal and choroidal vascular flow area in patients with NF1.
The Healthy Taiwanese Eating Approach is inversely associated with all-cause and cause-specific mortality: A prospective study on the Nutrition and Health Survey in Taiwan, 1993-1996
Authors: Chuang Shao-Yuan , Chang Hsing-Yi , Fang Hsin-Ling , Lee Shu-Chen , Hsu Yueh-Ying , Yeh Wen-Ting , Liu Wen-Ling , Pan Wen-Harn 
Published: May 2021

Background
Few longitudinal studies have investigated the association between foods/dietary pattern and mortality risk in the Asian population. We investigated the prospective association between foods/dietary pattern and risk of death among ethnic Chinese adults in Taiwan.

Methods
The study population included 2475 young and middle-aged adults (aged 18–65 years at baseline) who completed the questionnaires and physical examinations in the Nutrition and Health Survey in Taiwan from 1993 to 1996. A food frequency questionnaire was administered to assess food consumption habits in a face-to-face interview. With survey data linked to the Taiwanese Death Registry, Cox proportional hazard model was used to identify the foods associated with all-cause mortality(followed until 2012), which were then tallied to calculate a dietary pattern score called Taiwanese Eating Approach(TEA) score. The TEA scores were then associated with various kinds of mortality outcomes. In addition, data from 431 elders (aged≥65 yrs) with 288 death endpoints were used to conduct a sensitivity analysis.

Results
A total of 385(15.6%) participants died (111 cardiovascular related deaths and 122 cancer related deaths) during the 17.8-year follow-up period(41274 person-years). Twelve foods (9 inverse [vegetables/fish/milk/tea](+1) and 3 positive[fatty meats/fermented vegetables/sweet drinks](-1)) were significantly associated with all-cause mortality risk. All adults were grouped by their cumulative food score into three diet groups: poor diet(29.3% of all subjects), average diet(44.0%), and healthy diet(26.70%). The better the diet, the lower the total, cardiovascular, and other cause mortality outcomes (trend-p < .001). The hazard ratio for the healthy diet was 0.64 (95% confidence interval:0.47–0.87) for total mortality, and 0.52(0.28–0.95) for cardiovascular death, compared with the poor diet in the multivariable models. This phenomenon was also seen in older adults for all-cause, cancer, and other cause mortalities.

Conclusion
Consuming a healthy Taiwanese Eating Approach (TEA) diet is negatively associated with all-cause, cardiovascular, and other-cause mortalities in Taiwan.
Intraobserver and interobserver agreement among anterior chamber angle evaluations using automated 360-degree gonio-photos
Authors: Matsuo Masato , Mizoue Shiro , Nitta Koji , Takai Yasuyuki , Sugihara Kazunobu , Tanito Masaki 
Published: May 2021

Purpose
To investigate the reproducibility for the iridocorneal angle evaluations using the pictures obtained by a gonioscopic camera, Gonioscope GS-1 (Nidek Co., Gamagori, Japan).

Methods
The pragmatic within-patient comparative diagnostic evaluations for 140 GS-1 gonio-images obtained from 35 eyes of 35 patients at four ocular sectors (superior, temporal, inferior, and nasal angles) were conducted by five independent ophthalmologists including three glaucoma specialists in a masked fashion twice, 1 week apart. We undertook the observer agreement and correlation analyses of Scheie’s angle width and pigmentation gradings and detection of peripheral anterior synechia and Sampaolesi line.

Results
The respective Fleiss’ kappa values for the four elements between manual gonioscopy and automated gonioscope by the glaucoma specialist were 0.22, 0.40, 0.32 and 0.58. Additionally, the respective intraobserver agreements for the four elements by the glaucoma specialist each were 0.32 to 0.65, 0.24 to 0.71, 0.35 to 0.70, and 0.20 to 0.76; the Fleiss’ kappa coefficients for the four elements among the three glaucoma specialists were, respectively, 0.31, 0.38, 0.31, and 0.17; the Fleiss’ kappa coefficients for the angle width and pigmentation gradings between the two glaucoma specialists each were 0.30 to 0.35, and 0.29 to 0.43, respectively. Overall, the Kendall’s tau coefficients for the angle gradings reflected the positive correlations in the evaluations.

Conclusion
Our findings suggested slight-to-substantial intraobserver agreement and slight-to-fair (among the three) or fair-to-moderate (between the two each) interobserver agreement for the angle assessments using GS-1 gonio-photos even by glaucoma specialists. Sufficient training and a solid consensus should allow us to perform more reliable angle assessments using gonio-photos with high reproducibility.