bluuebunny/crossref_metadata_2025_split huggingface dataset:
How to interpret patient-reported outcomes? - Stratified adjusted minimal important changes for the EQ-5D-3L in hip and knee replacement patients
Authors: Salvi Irene , Ehlig David , Vogel Justus , Bischof Anja , Geissler Alexander 
Published: November 2024

Abstract
Background
As one of the main goals of hip and knee replacements is to improve patients’ health-related quality of life, a meaningful evaluation can be achieved by calculating minimal important changes (MICs) for improvements in patient-reported outcome measures (PROMs). This study aims at providing MICs adjusted for patient characteristics for EQ-5D-3L index score improvements after hip and knee replacements. It adds to existing literature by relying on a large national sample and precise clustering algorithms, and by employing a state-of-the-art methodology for the calculation of improved adjusted MICs.

Methodology
A retrospective observational study was conducted using the publicly available National Health Service (NHS) PROMs dataset for primary hip and knee replacements. We used information on 252,331 hip replacements and 279,668 knee replacements from all NHS-funded providers in England between 2013 and 2020. Clusters of patients were created based on pre-operative EQ-VAS, depression status, and sex. Unstratified and stratified estimates for meaningful EQ-5D-3L improvements were obtained through anchor-based predictive MICs corrected for the proportion of improved patients and the reliability of transition ratings.

Results
Stratifying patients showed that MICs varied across subgroups based on pre-operative EQ-VAS, depression status, and sex. MICs were larger for patients with worse pre-operative EQ-VAS scores, while patients with better pre-operative scores required smaller MICs to achieve a meaningful change. We show how after stratification the percentage of patients achieving their stratified MIC was better in line with the actual share of improved patients. Larger MICs were found for patients with depression and for female patients. MICs calculated for knee replacements were consistently lower than those for hip replacements.

Conclusions
Our findings show the importance of adjusting MICs for patients’ characteristics and should be considered for quality-related choices and policy initiatives.
Combinatorial chance-constrained economic optimization of distributed energy resources
Authors: Sager Jens , Nieße Astrid 
Published: November 2024

AbstractThe transformation of the energy system towards sustainable energy sources is characterized by an increase in weather dependent distributed energy resources (DER). This adds a layer of uncertainty in energy generation on top of already uncertain load distribution. At the same time, many households are fitted with renewable generation units and storage systems. The increased intermittent generation in the distribution grid leads to new challenges for the commitment and economic dispatch of DER. The main challenge addressed in this work is to decide which available resources to select for a given task. To solve this, we introduce Stochastic Resource Optimization (SRO), a general purpose, combinatorial, chance-constrained optimization model for the short-term economic selection of stochastic DER. It incorporates correlations between stochastic resources are using copula theory. The contributions of this paper are twofold: First, we validate the applicability of the SRO formulation on a simplified congestion management use-case in a small neighbourhood grid comprised of prosumer households. Second, we provide an analysis of the performance of different solving algorithms for SRO problems and their run-times. Our results show that a fast metaheuristic algorithm can provide high quality solutions in acceptable time on the evaluated problem sets.
Knowledge, attitude, and use of electronic cigarettes among Cairo University medical students
Authors: Mostafa Ola A. , Taha Mahmoud A. 
Published: November 2024

Abstract
Background
Electronic cigarette use has increased exponentially in Egypt and all over the world. However, there is insufficient information about their use among Cairo University medical students. This study aimed to assess e-cigarette knowledge, attitude, and use among Cairo University medical students.

Methods
A cross-sectional study of 300 consenting Cairo University medical students in the period of 1st November 2023 to 15th December 2023 was conducted using a self-administered questionnaire. A multistage sampling technique was used to randomly select 300 students: 150 students from the third year and 150 from the fifth year of the Cairo University Medical School.

Results
The mean age was 22.12 ± 1.87 years and 69.3% were males and 30.7% were females. Most of them (88.3%) had heard about e-cigarettes, with higher knowledge for students in their clinical years. The main sources of information were the media and friends (41.8% and 37.5%). By type, 14%, 12.7%, and 7.3% were cigarette, shisha, and e-cigarette smokers. Smoking prevalence was higher among males and students in their clinical years (12% and 4.7% in clinical and preclinical years respectively, p = 0.02).
Among all, 39.3%, 10.2%, and 3.3% of the participants’ friends, siblings, and parents smoked e-cigarettes respectively; compared to 16.7%, 17.9%, and 33% among the subset of participants who were e-cigarette smokers. A significantly lower percentage of e-cigarette smokers believed that e-cigarettes are addictive or cause respiratory problems, and a higher percentage thought that e-cigarettes are less harmful, help in smoking cessation, and that their nicotine content is lower than traditional cigarettes. Predictors of e-cigarette smoking were being in clinical years, cigarette and shisha smoking, and having friends who are e-cigarette smokers.

Conclusion
The study revealed several students’ misconceptions and a wide variation in their attitudes about the harmful and addictive effects of e-cigarettes. This underscores the urgent need for the development of a medical school curriculum to provide accurate information about e-cigarettes to address the problem of its growing use in Egypt.
Preparation, characterization and application in environmental protection of low-molecular-weight chitosan: a review
Authors: Niu Yaolan , Hu Wei 
Published: November 2024

AbstractChitosan is a biopolymer derived from chitin, which is the second most abundant and renewable polymer in nature after cellulose. Low-molecular-weight chitosan (LMWC) is the degradation product of chitosan through depolymerization. Compared with conventional chitosan, LMWC is considered as one of the most promising functional materials due to its characteristics of lower polymerization degree, lower viscosity, good water solubility, reactivity and degradability. This review focused on the preparation and characterization methods as well as the application in environmental remediation of LMWC. The three main methods of LMWC preparation including chemical, physical and enzymatic methods were summarized and compared in this paper. The mechanism, advantages and disadvantages of various preparation methods were also discussed. In addition, the applications of LMWC in environmental fields such as water treatment, soil remediation and air purification were briefly reviewed. With the continuous progress of science and technology and the improvement of environmental awareness, it is believed that more efficient, economical and environmentally friendly chitosan degradation methods will be developed, providing strong support for the wide application of LMWC in the field of environmental protection.
Modifiable and non-modifiable risk factors affecting surgical failure after revision ACL reconstruction: a cohort study
Authors: Moon Hyun-Soo , Jung Min , Choi Chong-Hyuk , Chung Kwangho , Jung Se-Han , Byun Junwoo , Kim Jin-Gyu , Lee Seungmin , Kim Sung-Hwan 
Published: November 2024

Abstract
Background
Research on factors influencing the outcomes of revision anterior cruciate ligament (ACL) reconstruction is relatively scarce and mostly relies even on reports from a single group. Understanding the factors contributing to the failure of revision ACL reconstruction can provide valuable information for achieving better clinical outcomes and assist in patient counseling before surgery. Therefore, this study aimed to analyze the factors contributing to surgical failure after revision ACL reconstruction.

Methods
The medical records of consecutive patients who underwent single-bundle revision ACL reconstruction using the transportal technique between 2010 and 2020 and had a minimum follow-up of 2 years were retrospectively reviewed. Eligible patients were classified into two groups on the basis of the presence of surgical failure during the follow-up period (group NF, patients who did not experience surgical failure; group F, patients who experienced surgical failure). In this study, surgical failure after revision ACL reconstruction was defined as meeting any of the following conditions during follow-up: the presence of graft re-tear confirmed by magnetic resonance imaging (MRI), anterior–posterior laxity graded ≥ 2, or rotational laxity graded ≥ 2. A comparative analysis was conducted on demographic data, as well as peri-, intra-, and postoperative data between the groups. Additionally, a regression analysis was performed to investigate factors influencing surgical failure after revision ACL reconstruction.

Results
A total of 58 patients were included (group NF, 40 patients; group F, 18 patients). In between-group comparisons of demographic, peri-, and intra-operative data, group F exhibited a higher frequency of multiple revision surgeries (P = 0.001), increased preoperative osteoarthritis grade (P = 0.001), and shallower femoral tunnel depth (P = 0.002) compared with group NF. At the final follow-up, group F demonstrated relatively poor clinical outcomes, both subjectively and objectively. Multivariate regression analysis revealed that all variables that showed differences in the preceding comparisons were independent factors affecting surgical failure after revision ACL reconstruction.

Conclusions
Surgical failure after revision ACL reconstruction can occur in a substantial number of patients, influenced by non-modifiable factors, such as cases corresponding to multiple revision surgery and preoperative osteoarthritis grade, and modifiable factors, such as femoral tunnel depth.
STEM major’s decision to teach: examining teaching experiences in high-needs communities
Authors: Edwards Laura A. , Gerberry Carla 
Published: November 2024

AbstractA significant teacher shortage exists in the US, particularly in STEM teaching fields. Professionals in STEM fields make higher wages while teachers manage intense and challenging work conditions. Teacher dissatisfaction and shortage negatively impacts students’ learning outcomes. This paper examines how teacher self-efficacy developed for university science, technology, engineering, and mathematics (STEM) majors who participated in an internship and the shifts in their career path decisions to teaching STEM. Self-efficacy in potential teachers is key to future teachers’ perception of lowered levels of emotional exhaustion and higher job satisfaction influencing their transition to the teaching profession This study identifies how STEM major interns developed multiple sources of self-efficacy that transitioned half of the intern’s career choice to enter teaching STEM fields. Results reveal early exposure to teaching experiences and responsibilities influenced the decisions of the STEM majors to enter the teaching profession. This study contributes to teacher self- efficacy with insights into how early teaching experiences cultivate self-efficacy. Mastery teaching practice in authentic settings through the internships built self-efficacy. Additionally, relationships with peers as co-teaching assisted interns to develop their teaching self-efficacy. Findings point to lessons learned from curriculum and instruction in STEM teacher education that bridges research and practice for STEM education improvement and demonstrate teacher education programs benefit from early, authentic field-based experiences which motivate STEM majors’ desire to teach. It is crucial for future students to uncover how teacher-efficacy is developed for STEM teachers and their decisions to teach and persist in the teaching profession.
Clinico-epidemiological and treatment factors impact on survival in Egyptian patients with head and neck sarcoma: a retrospective case-series analysis
Authors: Kelany Mohamed Reda , Abd Eltawab Asmaa A. , Mohamed Mohamed Naguib , Bayomy Mohamed Fathy , Soliman Doaa Atef Mohamed 
Published: November 2024

Abstract
Background
Head and neck sarcomas are very rare accounting for about 1% of head and neck malignancies and 5% of sarcomas. Outcomes have historically been worse in this group compared to other sarcomas, due to anatomical constraints that make complete surgical removal difficult and increased local relapse rate. Surgery remains the main intervention although the data suggest the role of chemotherapy and irradiation as treatment options.

Methodology
and Design.
Data of patients diagnosed with head and neck sarcoma were retrospectively collected. Clinicopathologic characteristics and patients’ management were reviewed. Time to relapse (TTR) includes both time to local relapse (TTLR) and time to systemic relapse (TTSR). Overall survival (OS), TTLR and TTSR were calculated with Kaplan Mayer analysis using log rank test.

Results
Twenty-four patients were retrospectively identified. Mean age was 37.7 years (range 17–80) with female gender predominance (62.5%). Rhabdomyosarcoma and osteosarcoma were the most common types (16.7%). At presentation, 23 patients showed localized disease (95.8%), while one patient was metastatic to the bone. Surgery was the primary treatment in 83.3% patients with different surgical margin status (R0 in 6/20, R1 in 11/20 and R2 in 3/20 patients), while 4/24 patients were not operated. Radiotherapy was applied as adjuvant treatment in 9 patients, as definitive in 2 and as palliative in one patient. Chemotherapy was administered in neoadjuvant/ adjuvant settings in 8 patients. Median follow-up was 31 months. Mean TTR for all surgically resected population was 39.8 months. Locally relapsed patients were 35% with mean TTLR 43.2 months while 15% of patients developed systemic relapse with mean TTSR 55 months. Mean OS of all studied patients was 48 months.

Conclusion
Head and neck sarcomas are rare challenging malignancies due to anatomical constrain, with only 20% achieving R0 surgical resection and > 30% suffering of local relapse after complete surgical resection.
Development of a low-cost IoT-based e-health monitoring system for diabetic patients
Authors: Okubanjo Ayodeji Akinsoji , Alexander Okandeji , Olumide Odeyinka , Benjamin Akinloye , Oluwatoyin Oluyemi 
Published: November 2024

AbstractThe global need for diabetic patient self-care is increasing. The current global epidemiology of diabetes calls for an improved healthcare management system, particularly in poorer countries, to minimize the burden of diabetes complications and mortality. The main objective of this study seeks to increase diabetic patients’ access to healthcare by utilizing internet of things-based smart self-care high-tech devices. The proposed model was integrated with a Blynk software and hosted in NodeMCU, allowing user to access diabetic health metric from the smartphones or interconnected devices. The e-monitoring system has an inbuilt feedback mechanism that provides online access to healthcare provider for immediate insulin therapy. Furthermore, patients suffering from acute diabetic metabolic issues may have difficulty visiting the hospital. Therefore, they can use the proposed model to track and monitor their blood glucose levels, as well as communicate remotely with their doctor, so improving their health while saving money and time. Also, diabetic patients can use this system to record their health condition on their phone, decreasing the need for doctor visits and clinical medical procedure. The proposed system has several advantages, including speedy internet access and remote monitoring from anywhere in the world. This research also helps to achieve the United Nations’ Sustainable Development Goals, which include good health and well-being, equitable healthcare access, and sustainable cities and communities.
Influence of the degree of hearing impairment on central auditory processing in people with presbycusis
Authors: Veletić Marija , Đoković Sanja , Kovačević Tamara , Isaković Ljubica , Bjelić Marija 
Published: November 2024

Abstract
Background
Auditory processing involves decoding auditory impulses along auditory pathways in the central nervous system. Aging causes a decline in hearing and auditory processing abilities. Difficulties in auditory information processing include limitations in transferring, processing, organizing, transforming, analyzing, storing, recalling, and using auditory information. The aim of this research was to examine the influence of hearing impairment on auditory processing abilities in people with presbycusis. In addition, this research aimed to determine whether gender and age affect auditory processing in people with presbycusis.

Method
The research included 43 participants, 59–90 years of age. The PSP-1 Auditory Processing Disorder Test Battery was used to examine auditory processing abilities. We also used liminal tonal audiometry and the Short Portable Mental Status Questionnaire–SPMSQ.

Results
The participants achieved the worst results on the speech-in-noise test and the dichotic word test. A statistically significant difference was found in auditory processing abilities with regard to age (p < 0.001) and the degree of hearing impairment (p < 0.001). No statistically significant differences were determined in relation to gender. Regression analysis pointed out the degree of hearing impairment as a significant predictor of auditory processing abilities (p < 0.001).

Conclusion
Auditory processing abilities decline with age, and the degree of hearing impairment significantly affects these abilities.
Outcomes of primary stapedotomy using ionomeric cement at incus-prosthesis attachment versus nonuse of ionomeric cement: a prospective case–control study
Authors: Galal Ahmed , Saggaf Mashrab , Shewel Yasser , Elgarem Hani F. , Mina Amir 
Published: November 2024

Abstract
Background
Stapedotomy is the main stay management of otosclerosis till the present day. Other alternatives are hearing aids and medical treatment. Many complications arise at the step of crimping of the prosthesis. Bone cement is a material that has strong adhesive and osteointegration properties. The aim of the present study is to compare hearing results between bone cement-applied and non-bone cement-applied primary stapedotomy patients at the incus prosthesis attachment.

Methods
Thirty patients diagnosed with otosclerosis were randomly selected. Classical primary stapedotomy was performed for both groups, except for using GIC over the incus–prosthesis attachment in group A patients. The duration of follow-up was 2 months. Mean thresholds were measured at 0, 1, 2, and 4 kHz frequency levels and used to calculate the primary outcome measurements, which were ABG closure and hearing gain.

Results
The overall 30 patients’ mean age was 37.2 years. Bilateral disease occurred in 73.3%. Both groups showed significant ABG closure in relation to the preoperative values (P < 0.001). However, ABG closure in cement-used patients was significantly better (P 0.007). The mean for air conduction hearing gain was higher in group A (31.9 dB) than in group B (27.3 dB). However, this was statistically insignificant (P 0.313).

Conclusions
GIC can improve hearing outcomes in classical primary stapedotomy and potentially reduce postoperative complications and should be considered in routine practice.
Efficacy of human epididymis protein-IV as potential lung disease biomarker in comparison to Krebs von den Lungen-VI glycoprotein and apoprotein A2 among systemic sclerosis patients
Authors: El-Salawy Alaa Mohammad , El-Banna Hanaa Samy , Hussein Manal Shawky , Fouda Mohamed Hosny , Gaber Rasha Ahmad , Hagag Rasha Youssef , Gado Souzan Ezzat 
Published: November 2024

Abstract
Background
Systemic sclerosis is a connective tissue disease of unknown etiology, characterized by vasculopathy, fibrosis, inflammation, and immune dysregulation that lead to widespread internal organs fibrosis, chronic ischemia, and subsequent end-stage organ failure. Our purpose was to examine the role of human epididymis protein IV as a biomarker of interstitial lung disease severity in comparison to Krebs von den Lungen-VI glycoprotein and apoprotein A2 among systemic sclerosis patients.

Results
There was a highly significant elevation of serum human epididymis protein IV between systemic sclerosis patients (both with and without interstitial lung disease) and the control group (p < 0.001) with the highest value in patients having interstitial lung disease. Krebs von den Lungen-VI and apoprotein A2 also showed a significant difference in their values between the patients’ and control groups (p < 0.01 and = 0.02 respectively).

Conclusion
The level of human epididymis protein-IV was overexpressed in systemic sclerosis patients with interstitial lung disease in comparison to systemic sclerosis patients without interstitial lung disease indicating its high sensitivity as a potential biomarker in fibrotic activity diagnosis.
Fire behavior of composite steel truss bridge girders: numerical investigation and design strategies
Authors: Zhang Gang , Yuan Zhuoya , Ding Yuhang , Xu Feng , Tang Chenhao , Wang Shichao 
Published: November 2024

AbstractFire pose more severe threat to steel truss bridge girders as compared to common steel plate and box bridge girders. To deeply clarify failure mechanism of fire exposed steel truss bridge girders, this paper presents an investigation on fire performance of composite steel truss bridge girders simultaneously subjected to structural loadings and hydrocarbon fires. A numerical model, developed using the computer program ANSYS, is validated dependent on fire test to trace fire behavior of a typical through-type composite steel truss bridge girders under different hydrocarbon fire exposure conditions. The analysis is applied to evaluate influence of potential fire exposure scenarios occurred in bridge structures, including fire exposure lanes on bridge deck and fire exposure length beneath bridge, on temperature and structural response in steel truss bridge girders. The results shows that fire exposure lanes on bridge decks and fire exposure length beneath bridge has a significant influence on fire performance of steel truss bridge girders. Fire exposure on all lanes and side lanes can cut down fire resistance highly as compared to fire exposure on mid-lanes. The composite steel truss bridge girders exhibit special multi-hinge failure modes when fire exposure under bridge. Further, the composite steel truss bridge girders exposed to side-lane fire exhibit significant transverse torsional deformation. The established failure criteria dependent on structural deflection limit states, chord deformation and strength can be applied to evaluate fire resistance of actual composite steel truss bridge girders under realistic fire exposure scenarios. Limiting the minimum clearance of passage on bridge deck and increasing fire protection measures in upper portion of trusses can effectively improve fire resistance of through-type composite steel truss bridge girders. Some predominant design strategies closely related to oil tanker trucks traversing composite steel truss bridge girders are proposed to minimize probability of fire incidents on bridge and keep integrity of structure in the case of fire to the maximum extent possible.