bluuebunny/crossref_metadata_2025_split huggingface dataset:
Subclinical hypothyroidism in Wales from 2000 to 2021: A descriptive cohort study based on electronic health records
Authors: Bauer Brenda S. , Azcoaga-Lorenzo Amaya , Agrawal Utkarsh , Fagbamigbe Adeniyi Francis , McCowan Colin 
Published: May 2024

Background
Subclinical hypothyroidism (SCH) is a biochemical thyroid disorder characterised by elevated levels of Thyroid Stimulating Hormone (TSH) together with normal levels of thyroid hormones. Evidence on the benefits of treatment is limited, resulting in persistent controversies relating to its clinical management.

Aim
This study describes the demographic and clinical characteristics of patients identified as having subclinical hypothyroidism in Wales between 2000 and 2021, the annual cumulative incidence during this period and the testing and treatment patterns associated with this disorder.

Methods
We used linked electronic health records from SAIL Databank. Eligible patients were identified using a combination of diagnostic codes and Thyroid Function Test results. Descriptive analyses were then performed.

Results
199,520 individuals (63.8% female) were identified as having SCH, 23.6% (n = 47,104) of whom received levothyroxine for treatment over the study period. The median study follow-up time was 5.75 person-years (IQR 2.65–9.65). Annual cumulative incidence was highest in 2012 at 502 cases per 100,000 people. 92.5% (n = 184,484) of the study population had TSH levels between the upper limit of normal and 10mIU/L on their first test. 61.9% (n = 5,071) of patients identified using Read v2 codes were in the treated group. 41.9% (n = 19,716) of treated patients had a history of a single abnormal test result before their first prescription.

Conclusion
In Wales, the number of incident cases of SCH has risen unevenly between 2000 and 2021. Most of the study population had mild SCH on their index test, but more than a third of the identified patients received levothyroxine after a single abnormal test result. Patients with clinically recorded diagnoses were more likely to be treated. Given the expectation of steadily increasing patient numbers, more evidence is required to support the clinical management of subclinical hypothyroidism.
Enhancing medication management in hemodialysis patients: Exploring the impact of patient-centered pharmacist care and motivational interviewing
Authors: Paneerselvam Ganesh Sritheran , Kenneth Lee Kwing Chin , Aftab Raja Ahsan , Sirisinghe Roland Gamini , Siew Mei Lai Pauline , Lim Soo Kun 
Published: May 2024

Background
Patients on hemodialysis (HD) often uses several medications, making them highly susceptible to medication-related problems (MRP) thereby leading to medication nonadherence. Therefore, an innovative pharmaceutical care strategy incorporating drug therapy optimization (DTO) and motivational interviewing (MI) can mitigate medication-related problems and optimize patient care.

Aims and objective
The objective of this study is to assess the efficacy of pharmacist led interventions in utilizing DTO and MI techniques in managing medication related problems among patients undergoing hemodialysis.

Method and design
A12-months, cross sectional prospective study was conducted among 63 End Stage Renal Disease (ESRD) patients on HD. DTO was conducted by the pharmacist to identify the MRP by reviewing complete medication list gathered from patient interview and medical records. All MRPs was classified using the PCNE classification version 9.00 and medication issues, that require patient involvement were categorized as patient-related, while those that necessitate physician intervention were classified as physician-related. The DTO was performed at the baseline, 6-month and at the final month of the study. Identified medication issues were communicated to the site nephrologist and was tracked during next follow up. Whereas MI was conducted physically at Month-3 and via telephone on month-6 and month-9 to address patient related medication issues.

Results
Mean age of the study population was 48.5±14 years. While the mean number of prescribed medications was 8.1±2 with 57% of the patients taking more than 5 types of medication. After 12 months of pharmacist intervention using DTO and MI, a mean reduction in MRP was observed for both patient-related and physician-related MRPs across three time series. However, further analysis using repeated measure ANOVA revealed that the reduction in patient-related MRPs was statistically significant [F(1.491, 92.412) = 60.921, p < 0.05], while no statistically significant difference was detected in physician-related MRPs [F(2, 124) = 2.216, P = 0.113].

Conclusion
Pharmaceutical care service through DTO and MI can effectively reduce and prevent drug-related issues to optimize medication therapy among HD patients.
An assessment of the direct and indirect costs of breast cancer treatment in leading cancer hospitals in Ghana
Authors: Okyere Asante Patience Gyamenah , Owusu Adobea Yaa , Oppong Joseph Ransford , Amegah Kingsley E. , Nketiah-Amponsah Edward 
Published: May 2024

Background
In Ghana, breast cancer remains the most common cancer and the leading cause of cancer deaths among women. The cost of treating cancer is huge and poses a great challenge for patients, their families, and health care systems. While comprehensive studies have been conducted on the economic burden of cancers in developed economies such as the EU and the US, there are limited studies in Africa, and Ghana, in particular. This study quantitatively assessed Ghana’s direct and indirect costs of breast cancer treatment.

Methods
Primary data were collected using a questionnaire administered to 217 breast cancer patients at the Korle-Bu and Komfo Anokye Teaching Hospitals, Ghana’s two leading hospitals, and Sweden Ghana Medical Centre. Direct and indirect costs were computed using the Cost-of-Illness Approach. Quantitative analysis was done using multivariate linear regression.

Results
The findings showed that the breast cancer patients studied paid a median amount of Ghana cedis (GHC) 31,021.0 (IQR; 25,262.5–42,147.0), approximating USD 5,500.2 (IQR: 4,477.0–7,469.2 USD) for their treatment within one year of active treatment in 2019. About 61.9% (95% CI: 61.8–62.0%) of this cost was direct cost, while the remaining 38.1% (95% CI: 38.0–38.1%) was indirect cost. Patients who sought care from public facilities for breast cancer paid a median amount of GHC 29,606.3 (USD 5,249.3), while those who sought care from private facilities paid GHC 55,071.2 (USD 9,744.4). Findings from the multivariate linear regression indicate that being married/cohabiting, divorced/separated and having tertiary level education predicted higher cost of breast cancer treatment while patients on retirement and patients in the middle stage (Stage II) of breast cancer diagnoses were associated with lower cost of breast cancer treatment.

Conclusions
The cost of breast cancer treatment poses a significant burden on patients and their families. There is a need for increased public funding for breast cancer treatment to reduce the huge economic burden its treatment poses for patients and their families.
Burnout among Chinese live streamers: Prevalence and correlates
Authors: Chen Shi , Wang Hanqin , Yang Shang , Zhang Fushen , Gao Xiao , Liu Ziwei 
Published: May 2024

Background
The prevalence of burnout among live streamers remains largely unknown. This study aims to investigate the prevalence and factors associated with burnout among Chinese live streamers.

Methods
A cross-sectional study recruited 343 full-time live streamers from 3 companies in Changsha city. Socio-demographic and occupational characteristics were collected using self-designed items. Job stress was assessed using the Job Content Questionnaire (JCQ-22), while supervisor and coworker support were evaluated using the last 8 items of the JCQ-22. Burnout was assessed using the 17-item Chinese version of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS).

Results
Our findings revealed that 30.6% of live streamers experienced burnout. Lower levels of education (OR = 2.65 and 3.37, p = 0,005 and 0.003), higher monthly income (OR = 10.56 and 11.25, both p = 0.003), being an entertainment-oriented streamer (OR = 2.13, p = 0.028), continuous walking during live streams (OR = 2.81, p = 0.006), significant drop in follower count (OR = 2.65, P = 0.006), live streaming during the daytime (OR = 3.75, p = 0.001), and higher support from supervisors and coworkers (OR = 3.66, p = 0.001) were positively associated with burnout. However, the effects of education and drop in followers on burnout were not significant in the multivariate logistic models (p = 0.321 and 0.988).

Conclusions
Burnout among Chinese live streamers is associated with income, being an entertainment streamer, engaging in continuous walking during live streams, conducting live streams during the daytime, and experiencing excessive support from supervisors and coworkers.
The use of artificial intelligence in induced pluripotent stem cell-based technology over 10-year period: A systematic scoping review
Authors: Vo Quan Duy , Saito Yukihiro , Ida Toshihiro , Nakamura Kazufumi , Yuasa Shinsuke 
Published: May 2024

Background
Stem cell research, particularly in the domain of induced pluripotent stem cell (iPSC) technology, has shown significant progress. The integration of artificial intelligence (AI), especially machine learning (ML) and deep learning (DL), has played a pivotal role in refining iPSC classification, monitoring cell functionality, and conducting genetic analysis. These enhancements are broadening the applications of iPSC technology in disease modelling, drug screening, and regenerative medicine. This review aims to explore the role of AI in the advancement of iPSC research.

Methods
In December 2023, data were collected from three electronic databases (PubMed, Web of Science, and Science Direct) to investigate the application of AI technology in iPSC processing.

Results
This systematic scoping review encompassed 79 studies that met the inclusion criteria. The number of research studies in this area has increased over time, with the United States emerging as a leading contributor in this field. AI technologies have been diversely applied in iPSC technology, encompassing the classification of cell types, assessment of disease-specific phenotypes in iPSC-derived cells, and the facilitation of drug screening using iPSC. The precision of AI methodologies has improved significantly in recent years, creating a foundation for future advancements in iPSC-based technologies.

Conclusions
Our review offers insights into the role of AI in regenerative and personalized medicine, highlighting both challenges and opportunities. Although still in its early stages, AI technologies show significant promise in advancing our understanding of disease progression and development, paving the way for future clinical applications.
Effectiveness of structured exercise program on insulin resistance and quality of life in type 2 diabetes mellitus–A randomized controlled trial
Authors: Amaravadi Sampath Kumar , Maiya G. Arun , K. Vaishali , Shastry B. A. 
Published: May 2024

Objective
Impaired glucose control & Insulin resistance are reported to be risk factors for the development of cardiovascular diseases. To find the effects of a structured exercise program on insulin resistance, glycaemic control, functional capacity, and quality of life in patients with Type 2 diabetes mellitus.

Design
Randomized, controlled trial.

Setting
Diabetic Foot Clinic, Department of Physiotherapy & Department of General Medicine, Kasturba Hospital in Manipal, Karnataka, India.

Participants
160 participants aged between 30–65 years with Type 2 diabetes mellitus.

Intervention
A set of structured exercise programs (aerobic, resistance, and combined) along with the standard hospital care was performed 3–5 times weekly for 12 weeks.

Measurements: Primary outcome measures
Fasting Insulin Level, Homa-IR, Six-minute walk test (6MWT), and WHOQOL-BREF questionnaire at baseline and 12th week.

Secondary outcome measures
Body composition analysis, Fasting Blood Sugar, Postprandial Blood Sugar, Glycated Haemoglobin (HbA1c), and GPAQ questionnaire at baseline and 12th week.

Results
Significant differences have been observed in Homeostasis model assessment for insulin resistance (Homa-IR) (F (1, 144) = 89.29, p < 0.001); Fasting insulin (FI) (F (1, 144) = 129.10, p < 0.001); Fasting blood sugar (FBS) (F (1, 144) = 12.193, p< 0.001); Post prandial blood sugar (PPBS) (F (1, 144) = 53.015, p< 0.001); glycated haemoglobin (HbA1c) (F (1, 144) = 80.050, p < 0.001); WHOQOL-Physical health (F (1, 144) = 20.008, p< 0.001), Psychological (F (1, 144) = 77.984, p< 0.001), Social relationship (F (1, 144) = 44.866, p< 0.001); Environmental (F (1, 144) = 69.974, p< 0.001); Six minute walk test (6MWT) (F (1, 144) = 84.135, p< 0.001) in the study group when compared with the control group from baseline to 12th week.

Conclusions
The study reveals that a 12-week structured exercise training program effectively reduces insulin resistance, improves quality of life, enhances functional capacity, and improves glycaemic control in type 2 diabetes mellitus.
Association between stringency of lockdown measures and emergency department visits during the COVID-19 pandemic: A Dutch multicentre study
Authors: Booij-Tromp F. Marlijn , van Groningen Nicole J. , Vervuurt Sebastian , Haagsma Juanita A. , de Groot Bas , Lameijer Heleen , Gaakeer Menno I. , Alsma Jelmer , Rood Pleunie P. M. , Verdonschot Rob J. C. G. , Bouwhuis Marna G. 
Published: May 2024

Introduction
The COVID-19 outbreak disrupted regular health care, including the Emergency Department (ED), and resulted in insufficient ICU capacity. Lockdown measures were taken to prevent disease spread and hospital overcrowding. Little is known about the relationship of stringency of lockdown measures on ED utilization.

Objective
This study aimed to compare the frequency and characteristics of ED visits during the COVID-19 outbreak in 2020 to 2019, and their relation to stringency of lockdown measures.

Material and methods
A retrospective multicentre study among five Dutch hospitals was performed. The primary outcome was the absolute number of ED visits (year 2018 and 2019 compared to 2020). Secondary outcomes were age, sex, triage category, way of transportation, referral, disposition, and treating medical specialty. The relation between stringency of lockdown measures, measured with the Oxford Stringency Index (OSI) and number and characteristics of ED visits was analysed.

Results
The total number of ED visits in the five hospitals in 2019 was 165,894, whereas the total number of visits in 2020 was 135,762, which was a decrease of 18.2% (range per hospital: 10.5%-30.7%). The reduction in ED visits was greater during periods of high stringency lockdown measures, as indicated by OSI.

Conclusion
The number of ED visits in the Netherlands has significantly dropped during the first year of the COVID-19 pandemic, with a clear association between decreasing ED visits and increasing lockdown measures. The OSI could be used as an indicator in the management of ED visits during a future pandemic.
Genetic diversity and distribution of noroviruses among all age groups of patients with diarrhea in Amhara National Regional State, Ethiopia
Authors: Tegegne Dessie , Gelaw Aschalew , Alemayehu Dawit Hailu , Seyoum Tamrayehu , Leta Dereje , Ferede Getachew , Mulu Andargachew , Gelaw Baye 
Published: May 2024

Background
Norovirus (NoV) is the leading cause of diarrheal disease worldwide and the impact is high in developing countries, including Ethiopia. Moreover, there is a significant and fluctuating global genetic diversity that varies across diverse environments over time. Nevertheless, there is a scarcity of data on the genetic diversity of NoV in Ethiopia.

Objective
This study was aimed to assess the genetic diversity and distribution of NoVs circulating in the Amhara National Regional State, Ethiopia, by considering all age groups.

Methods
A total of 519 fecal samples were collected from diarrheal patients from May 01/2021 to November 30/ 2021. The fecal samples were screened for the presence of NoVs using real-time RT-PCR by targeting a portion of the major capsid protein coding region. The positive samples were further amplified using conventional RT-PCR, and sequenced.

Results
The positivity rate of NoV was (8.9%; 46/519). The detection rate of NoV genogroup II (GII) and genogroup I (GI) was 38 (82.6%) and 8 (17.4%), respectively. Overall, five distinct GII (GII.3, GII.6, GII.10, GII.17, and GII.21) and two GI (GI.3 and GI.5) genotypes were detected. Within the GII types, GII.3 was the predominant (34.2%) followed by GII.21 (15.8%), GII.17 (10.5%), GII.6 and GII.10 each (2.6%). Norovirus GII.21 is reported for the first time in Ethiopia. The genetic diversity and distribution of NoVs were significantly different across the four sampling sits and age groups. The phylogenetic analysis revealed close relatedness of the current strains with published strains from Ethiopia and elsewhere.

Conclusion
The distribution and genetic diversity of NoV was considerably high, with predominance of non-GII.4 genotypes. The GII.21 genotype is a new add on the growing evidences on the genetic diversity of NoVs in Ethiopia. Future nationwide surveillance studies are necessary to gain comprehensive data in Ethiopia.
Uso del libro de texto en España: un estudio exploratorio con profesorado de Geografía, Historia e Historia del Arte
Authors: González González José-Manuel , Rivero Pilar , García Ceballos Silvia 
Published: May 2024

Este artículo pretende mostrar el uso que hace del libro de texto el profesorado español de Geografía, Historia e Historia del Arte que imparte clases en educación secundaria. Para ello se analizan los datos obtenidos mediante una encuesta enviada online a finales de 2021. El estudio exploratorio con metodología de tipo mixto y carácter transversal evalúa las respuestas de 998 personas, y establece la correlación entre los datos demográficos y las variables sobre el empleo del manual escolar, estableciendo que un 78,2 % tiene una opinión normal o buena sobre el libro de texto, y que el empleo en el aula, en el curso 2020-2021, es elevado en un 30,9 % de encuestados, y medio en el 27,4 %. Según las respuestas múltiples, las editoriales más usadas son Vicens Vives, Santillana y Anaya: 448 (24,2 %), 332 (18 %), y 225 (12,2 %) profesores las emplean al menos en uno de sus cursos, siendo también relevante los que usan apuntes o materiales propios, 321 (17,5 %), y los que no utilizan libro, 105 docentes (5,7 %). Es habitual el uso de varias editoriales. Seis de cada diez profesores estiman como aspectos positivos del libro de texto que viene con ilustraciones y figuras, cinco de cada diez que resume y explica bien los contenidos, y un 48,9 % que facilita una variedad amplia de actividades. Entre las características negativas: que es excesivamente caro, 54,3 %, que no fomenta el espíritu crítico, 48,1 %, y que tiene pocas actividades prácticas o que son poco variadas, 45,5 %. Se concluye que el uso del libro de texto sigue siendo predominante.
Criptococosis meníngea en personas que viven con VIH
Authors: Beloso Melina , Coduri Anthonioz Blanc Joaquín Ignacio , Martínez Agust´ín , Sadonio María José , Castro Maximiliano Gabriel 
Published: May 2024

La criptococosis meníngea es una infección oportunista que afecta a personas que viven con el virus de la inmunodeficiencia humana (PVVIH) con alto nivel de inmunosupresión. La misma se asocia a una elevada morbimortalidad. Debido a la limitada disponibilidad de estudios regionales publicados, se propone describir las principales características clínico-bioquímicas, conducta terapéutica y evolución de una serie de PVVIH con criptococosis meníngea en un hospital de referencia para la región centro-norte de la provincia de Santa Fe (Argentina). Se incluyeron 10 pacientes, con una edad de 44 (61-34) años y una mediana de 3 (30-0) años de evolución de la infección por VIH. Al realizar la primera consulta presentaban una mediana de 15 (40-2) días de evolución, siendo la fiebre el síntoma más común. Todos recibieron tratamiento con anfotericina B liposomal por 26,5 (44-2) días. El cultivo de líquido cefalorraquídeo (LCR) de control a los 14 días de iniciada la terapéutica fue positivo en 5 individuos. Cinco sujetos evolucionaron favorablemente con alta hospitalaria y seguimiento ambulatorio, mientras que cinco requirieron atención en Unidad de Cuidados Intensivos para asistencia respiratoria mecánica. Por otra parte, Cinco de las PVVIH incluidas fallecieron.
Finite element analysis of the thermal and thermo-mechanical coupling problems in the dry friction clutches using functionally graded material
Authors: Jabbar Nasr A. , Hussain Ihsan Y. , Abdullah Oday I. , Mohammed M. N. 
Published: May 2024

AbstractThe friction clutch is an important machine part in the torque transmission system, where it is responsible for gently transmitting the power from the engine to the gearbox and damping the tensional vibration. At the beginning of the engagement between the clutch’s elements, a large amount of heat is released due to frictional sliding between the elements of the clutch system, generating very high temperatures. In this work, the two- and three-dimensional finite element models were developed from scratch to explore the clutch disk’s temperature and contact pressure behaviors using an alternative frictional material such as functionally graded material (FGM). The two assumptions for the thermal loads were considered: uniform wear and uniform pressure assumptions. The thermal–structural problem for the new frictional material was solved numerically and then presented as the temperature distributions and the contact pressure at any instant of sliding time. Also, a comparison was made between the clutch system behaviors when using FGM with different frictional materials. The results showed that the FGM has superior results to the other available frictional materials.
Experimental investigation and thermodynamic analysis of TiC–Fe cermets with Mo additions
Authors: Pan Yafei , Huang Lei , Du Yong 
Published: May 2024

Abstract
In this study, the effects of Mo additions on the microstructure, hardness and bending strength of TiC–Fe cermets manufactured by spark plasma sintering were investigated by scanning electron microscopy, X-ray diffraction and mechanical properties tests. Thermodynamic calculations were utilized to analyze the evolution of the microstructure. The results show that the conventional core/rim structure was not formed during the solid-phase sintering of TiC–Fe cermets. The heat-treatment process and reasonable Mo addition can effectively enhance the overall performance of the alloys. With the addition of minor Mo, the hardness of the sintered cermets improved significantly, which was attributed to the solid solution strengthening mechanism of Mo in Fe binder. However, excessive Mo exceeded the solubility range of Fe binder and precipitated in the form of M
6C and Mo2C phases, which damaged the bending strength of the heat-treated cermets.
Weld interface metallurgy of dissimilar alloys welded by TIG technique
Authors: Teker Tanju , Günes Ahmet 
Published: May 2024

Abstract
TIG welding is an important joining technique for fabricating quality structural components with industrial capability. Dissimilar alloy plates were combined using double-sided tungsten inert gas (TIG) welding. Microstructure evaluation of joints were anayzed by using scanning electron microscopy, optical microscope, energy dispersion spectrometry, elemental mapping, electron back scatter diffraction. DSAW technique increased joint penetration and reduced distortion of joints. In the weld metal zone, austenite, delta ferrite and lath martensite were dominant. The weld pool had high density of Cr7C3 and Fe3C phases and low density of CrFe7C0.45, FeNi, martensite, and Fe3Ni2 phases.