bluuebunny/crossref_metadata_2025_split huggingface dataset:
Back Pain During Pregnancy in Indonesia: Characteristics, Prevalence, and Impact on Quality of Life
Authors: Djawas Faizah Abdullah , Noviana Mita , Pahlawi Riza , Pratama Aditya Denny , Roa-Alcaino Sonia 
Published: October 2023

AbstractBackground:Back pain is one of the most common musculoskeletal disorders experienced during certain periods of pregnancy. Though not life-threatening, pregnancy-related LBP and PGP may affect daily activities and impact quality of life. Our study aims to identify the risk factors linked with LBP and PGP and gauge the level of disability experienced by expectant mothers.Methods:A cross-sectional study was conducted throughout Indonesia. Data for this study were collected through self-administered questionnaires, with 341 women participating. The study required participants to answer a series of questionnaires that covered socio-demographics, medical information, characteristics of back pain, and quality of life. To evaluate the severity of pain and physical limitations, the study utilized the VAS and Indonesian versions of the Oswestry Disability Index (ODI), respectively.Results:There is no significant difference in the incidence of back pain among individuals with varying backgrounds in education and occupation. The odds ratio value of the age variable is 0.932, indicating that with each year's increase in age, there is a 6.8% decrease in the probability of developing back pain. A person who has had three pregnancies has a 0.2084 chance of experiencing back pain compared to those who are pregnant more than three times. Pregnant women who experience back pain have a disability level of 0.190645 (19.0645%), while those who do not experience back pain have an average of 0.013139 (1.3139%). This suggests that expectant mothers who experience back pain have a lower quality of life than those who do not.Conclusion:Pregnant women in Indonesia experience a high occurrence of back pain, which can significantly reduce their quality of life. Younger age and number of pregnancy is associated with the incidence of back pain.
Diagnostic Utility of Capnography in Emergency Department Triage for Screening Acidemia: A Pilot Study
Authors: Peng Paul , Manini Alex F. 
Published: October 2023

Abstract

Background: Capnography is a quantitative and reliable method of determining the ventilatory status of patients. We describe the test characteristics of capnography obtained during Emergency Department triage for screening acidemia.
Results: We performed an observational, pilot study of adult patients presenting to Emergency Department (ED) triage. The primary outcome was acidemia, as determined by the basic metabolic panel and/or blood gas during the ED visit. Secondary outcomes include comparison of estimated and measured respiratory rates (RR), relationships between end-tidal CO2 (EtCO2) and venous partial pressure of CO2, admission disposition, in-hospital mortality during admission, and capnogram waveform analysis.
A total of 100 adult ED encounters were included in the study and acidemia ([HCO3- ]≤22 "mEq/L" or pH< 7.35) was identified in 28 patients. The measured respiratory rate (20.3±6.4 breaths/min) was significantly different from the estimated rate (18.4 ±1.6 breaths/min), and its area under the receiver operating curve (c-statistic) to predict acidemia was only 0.60 (95% CI 0.51-0.75, p = 0.03). A low end-tidal CO2 (EtCO2 < 32 mmHg) had positive (LR+) and negative (LR-) likelihood ratios of 4.68 (95% CI 2.59-8.45) and 0.34 (95% CI 0.19-0.61) for acidemia, respectively—corresponding to sensitivity 71.4% (95% CI 51.3-86.8) and specificity 84.7% (95% CI 74.3-92.1). The c-statistic for EtCO2 was 0.849 (95% CI 0.76-0.94, p = 0.00). Waveform analysis further revealed characteristically abnormal capnograms that were associated with underlying pathophysiology.
Conclusions: Capnography is a quantitative method of screening acidemia in patients and can be implemented feasibly in Emergency Department triage as an adjunct to vital signs. While it was shown to have only modest ability to predict acidemia, triage capnography has wide generalizability to screen other life-threatening disease processes such as sepsis or can serve as an early indicator of clinical deterioration.
Is Remnant Preservation in Anterior Cruciate Ligament Reconstruction Superior to the Standard Technique? An overview of systematic reviews
Authors: Zhang Yunsong , Xiao Xiangyu , Deng Wei , Wang Jianyu , Han Jicheng , Gao Hongwei 
Published: October 2023

Abstract
Background: Anterior cruciate ligament injury is a common knee joint injury. Anterior cruciate ligament reconstruction is the best way to treat anterior cruciate ligament injury. It may have certain advantages to retain the ligament stump during the operation, but the results of systematic evaluation on whether to retain the ligament stump are different. The conclusion is still controversial, and the quality needs to be strictly evaluated.
Objective: To evaluate the methodological quality, risk of bias, reporting quality and evidence quality of the systematic review of remnant preservation in anterior cruciate ligament reconstruction, and to provide reference for clinical work.
Methods: We systematically searched the system evaluations in 8 electronic databases, the languages were limited to Chinese and English, and the time limit was from the establishment of the database to June 2023. Two reviewers independently screened literature and extracted data. The methodological quality, risk of bias, reporting quality and quality of evidence were evaluated by AMSTAR-2, ROBIS, PRISMA and GRADE tools.
Results: A total of 14 systematic reviews were included. The evaluation results showed that the methodological quality of the included systematic reviews was relatively low, of which 5 were low quality and 9 were critically low quality. A small number of systematic reviews were low risk of bias. The system evaluation reports are relatively complete, but the lack of program registration is a common problem. A total of 111 clinical evidence were extracted from the included systematic reviews. The quality of evidence was generally low, with only 7 high-quality evidence, 45 medium-quality evidence, and the rest were low and very low-quality evidence. Among the reasons for relegation, imprecision is the most common, followed by inconsistency and indirectness.
Conclusion: The existing evidence shows that patients after anterior cruciate ligament reconstruction with remnant preservation have certain advantages in knee joint function, joint stability and proprioception recovery, which may be a more effective surgical method. At the same time, it may increase the incidence of postoperative complications and adverse reactions. The disadvantage should also be taken seriously. However, at present, the quality of evidence is generally low, and the reliability of the conclusion is insufficient. It still needs to be verified and further in-depth research is needed.
BERT-based model to predict cardiovascular disease by analyzing healthcare utilization behavior of patients newly diagnosed with metabolic diseases
Authors: Chang Hyuk-Jae , Song Shinjeong , Kim Gaeun , Kim Taeyoung , Shin Dongyup , Kim Sunhee , Park Jeongho , Bae Jaehyung , Kong Junsik , Sung Jimin 
Published: October 2023

Abstract
Background
The rise in cardiovascular disease (CVD) worldwide is causing enormous social and economic costs. Accordingly, the field of precision medicine aims to improve care through personalized prediction and prevention. In South Korea, we have health insurance claims data (HIRA) covering almost every citizen, which provides all the information about healthcare utilization behavior. Health insurance users can access their data through a simple authentication process. This data can be used to predict their personalized risk factors. Recently, bidirectional encoder representations from transformers (BERT) and related models have achieved tremendous success in the natural language processing domain. We adapt the BERT framework originally developed for the text domain to the structured HIRA data. The study aimed to predict secondary cardiovascular diseases in patients with newly diagnosed metabolic diseases (hypertension, diabetes, hyperlipidemia) using HIRA claims data and BERT.
Methods
Each disease was assigned to the training, validation, and test sets in the ratio of 7:2:1 through data augmentation. Patients' diagnoses and prescribed medications were embedded as input sequences, and age was used for positional encoding to distinguish visits. The predictive ability of the model was evaluated by measuring the area under curve(AUC).
Result
In each group of patients diagnosed with hypertension, diabetes, and dyslipidemia, BERT achieved mean receiver operating characteristic curve (AUC) areas of 97.9%, 97.8%, and 97.8%, respectively.
We found that the top-ranked conditions for self-attendance were hypertension, diabetes, dyslipidemia, and diagnoses and medications that are more common in older adults.
Conclusion
BERT performs good cardiovascular disease prediction using only diagnosis names and medication prescriptions on a relatively small training dataset. This study suggests that BERT can be used to advance personalized predictive healthcare models and patient care.
A digital twin for parallel NMR spectroscopy
Authors: Korvink Jan , He Mengjia , MacKinnon Neil , Cheng Yen-Tse , Jouda Mazin , Luy Burkhard 
Published: October 2023

Abstract

One approach to increasing NMR measurement sample throughput is to implement multiple, independent NMR detection sites. However, the presence of radio frequency interference poses a significant challenge in multi-detector NMR systems, particularly in unshielded coil arrays lacking sufficient electrical isolation. This issue can lead to unwanted coupling of inductive coils, resulting in excitation pulse interference and signal transfer among multiple detection sites. To address this problem, we propose a theoretical framework that combines electromagnetic simulation with spin-dynamic calculations. This framework enables the evaluation of coil coupling effects, the design of parallel pulse sequences to mitigate inter-channel coupling, and the separation of composite Free Induction Decays (FIDs) obtained from multiple detectors. These results provide valuable insights for the design of parallel NMR hardware and for exploring the limits of parallelization capacity within a fixed magnet system.
Prophylactic mastectomies and bilateral salpingo-oophorectomies in patients with breast cancer and BRCA mutation: an Austrian registry
Authors: Leser Carmen , Deutschmann Christine , Dorffner Georg , Gschwantler-Kaulich Daphne , Abayev Sara , Stübler Madeleine , Reitsamer Roland , Singer Christian 
Published: October 2023

Abstract
Objectives
Risk-reducing surgeries are common in patients with breast cancer gene (BRCA) mutations. Certain patients develop breast cancer before they opt for these surgeries. We examined the frequency of risk-reducing mastectomies and salpingo-oophorectomy among Austrian patients with breast cancer and BRCA mutations.
Methods
In 2014, we established an Austrian registry of BRCA1 and BRCA2 mutation carriers. From onset until 2018, 111 patients were recruited from four breast cancer centers. Data on the type of mastectomy, reconstructions, and complications were collected.
Results
A small proportion of patients (13.5%) had bilateral breast cancer. Among patients with unilateral breast cancer, the majority (86.8%) opted for prophylactic mastectomy on the contralateral side. Those who underwent modified radical mastectomy were more likely to choose prophylactic surgery (p = 0.001). A total of 19.4% of patients experienced cancer relapse postoperatively. Immediate reconstructions were recorded (71.3%). In addition, patients undergoing immediate reconstruction were more likely to undergo a prophylactic operation on the contralateral side than those with delayed reconstruction (p = 0.001). A mesh was used in only 47.8% of all reconstructions. The subpectoral implant position was present in 75.6% of patients and the pre-pectoral position in 13.3%. A mesh was inserted in all patients with a the pre-pectoral implant position.
Conclusion
The results indicate that the patients understood the procedures considering their willingness for risk-reducing surgeries and the expectation of good cosmetic outcomes in immediate reconstructions.
Attitudes, Practices and Understanding of health workers and caregivers regarding the relationship between severe pneumonia and malnutrition in children: A Qualitative Study
Authors: Nalwanga Damalie , Opoka Robert Opika , Ssemata Andrew Sentoogo , Kakooza Lawrence , Kiggwe Andrew , Musiime Victor , Kiguli Sarah 
Published: October 2023

Abstract
Background Severe Pneumonia is still the leading cause of morbidity and mortality among children worldwide. Many children with severe pneumonia are reported to die in hospital as well as following discharge due to malnutrition. Severe pneumonia is a catabolic illness, which predisposes to severe malnutrition. WHO and United Nations Children’s Fund (UNICEF), recommend ‘continued’ feeding but do not give any specific recommendations for nutritional support. This could influence health workers’ and caregivers’ attitudes, practices and understanding regarding the topic. This study aimed to explore the attitudes, practices and understanding of health workers regarding the relationship between severe pneumonia and malnutrition.Methods We conducted an exploratory qualitative study among health workers and caregivers of children hospitalized with severe pneumonia at Mulago National Referral Hospital in Uganda. Data were collected using focus-groups involving caregivers and key informant interviews with health workers and analysed using the content-thematic analysis approach. Both manual coding and Atlas Ti software were used to support the analysis.Results Some of the health workers and caregivers were aware of the relationship between severe pneumonia and malnutrition to various degrees, citing reduced appetite, difficulty in breathing and persistent vomiting as pathways to malnutrition in patients with severe pneumonia, which called for a balanced diet and more frequent breastfeeding. Suppressed immunity in malnourished children was mentioned as the pathway to severe pneumonia. Some caregivers confessed not knowing anything about the relationship between the two conditions.Conclusion Attitudes, practices and understanding regarding the deadly relationship between severe pneumonia and malnutrition among care givers could further be improved by health education and mass sensitization. Clarifying practice guidelines could further enhance attitudes and practices of health workers to reduce preventable pneumonia deaths.
Early versus delayed enteral nutrition in ICU patients with sepsis: a propensity score- matched analysis based on the MIMIC-IV database
Authors: Xu Fuchao , Xu Jianxin , Ma Jinjin , Xu Wenbo , Gu Shuangshuang , Lu Geng , Wang Jun 
Published: October 2023

Abstract
Background
Nutrition therapy is an integral part of the management of patients with sepsis. Recently, published guidelines recommend early initiation of enteral nutrition in adults with sepsis who can be fed enterally. However, early enteral nutrition's optimal timing and clinical benefits are still unclear. This study aimed to evaluate whether early enteral nutrition improves clinical outcomes in patients with sepsis compared with delayed enteral nutrition.
Methods
We utilized data from septic patients in the Medical Information Mart for Intensive Care (MIMIC)-IV 2.2 database and categorized those who began enteral nutrition (EN) within 3 days of admission to the ICU as the early enteral nutrition (EEN) group and those who began EN between 3–7 days after ICU admission as the delayed enteral nutrition (DEN) group. The main outcome was 28-day mortality. We conducted propensity score-matched analyses to compare outcomes between the two groups. Subgroup analyses were performed to determine whether different groups of septic patients had better outcomes with early enteral nutrition.
Results
We identified 2267 eligible patients, including 1594 patients (70.3%) in the early EN group and 673 (29.7%) in the delayed EN group. Before propensity matching, we found that the EEN group had lower 28-day mortality than the DEN group (crude OR = 0.789 (0.637–0.977); p = 0.030), fewer ICU stays (8.36 (5.00-12.99) vs. 10.42 (7.83-15.00); p < 0.001), and a lower incidence of stage 3 AKI (35.1% vs. 50.2%; p < 0.001). After propensity score matching, there was no significant difference in 28-day mortality (OR = 0.808 (0.622–1.050); p = 0.111). However, the duration of ICU stay in the early EN group was still lower than that in the delayed EN group (8.83 (5.03-13.00) vs. 10.41 (7.83–14.89); p < 0.001), and the incidence of stage 3 AKI was lower (39.6% vs. 49.3%; p < 0.001). Subgroup analysis showed that the MICU group (adjusted OR = 0,631 (0,428-0,930); p = 0.020) and the male group (adjusted OR = 0,668 (0,455-0,981), p = 0,040) were associated with reduced 28-day mortality with early enteral nutrition.
Conclusions
For septic patients, early enteral nutrition may not reduce mortality. However, early enteral nutrition reduced the ICU length of stay and incidence of stage 3 AKI in sepsis patients. We also found that patients with sepsis in the MICU and males may benefit more from early enteral nutrition through subgroup analysis. Which patients with sepsis may benefit from early enteral nutrition needs to be further investigated.
Fabrication of Superhydrophobic, Permeable, and Anti-Reflective Porous Steel Surfaces using Laser Ablation and Heat Treatment for Multifunctional Applications
Authors: Zhu Duanyi , Liu Qiang , Li Qiang 
Published: October 2023

Abstract

Achieving high water resistance, good permeability, and anti-reflectivity on metal surfaces in a cost-effective and efficient manner has always been a major challenge. This study addresses these challenges by utilizing laser ablation and heat treatment to achieve high water resistance, breathability, and anti-reflection properties in porous steel. The laser ablation and heat treatment process generated a unique porous nested structure on the surface and imparted excellent hydrophobicity and low adhesion properties on the porous steel surface. The size and density of the porous nested structure can be adjusted by changing the laser parameters. Notably, hydrophobicity of the surface is demonstrated to be closely related to the complexity of the surface microstructure, which follows the same trend as the permeability and anti-reflectivity. Specifically, higher laser power and smaller laser spacing generate structures with greater aspect ratios and higher porosity, resulting in a rough surface with an increased air contact area and, consequently, an increase in the viscous permeability coefficient (B). Moreover, the intricate porous nested structure acts as a complex "light trap," whereby the reflectivity of the superhydrophobic porous steel surface ( laser power of 25.4 W and scanning interval of 100 µm) can be less than 15% across a wide wavelength range (200 nm-1800 nm). This study presents a method for fabricating multifunctional surfaces with superhydrophobicity, permeability and anti-reflectivity on permeable steel. The method provides an efficient and cost-effective solution to improve the performance of existing materials and has great potential for a wide range of applications such as solar cells, military stealth, and reduced navigation resistance.
Analysis of the application and efficacy of Tocilizumab in the treatment of COVID-19 in China: A real-world investigational study
Authors: Sun Kin-Weng , Guo Su-Juan , Yang Zhi-Cheng 
Published: October 2023

Abstract
Backgrounds:
The criteria for the clinical application of tocilizumab in COVID-19 treatment still remain unclarified. This study aims to retrospectively analyze the clinical application of Tocilizumab in the treatment of patients with COVID-19 in our hospital, identify existing issues during clinical use, and provide reference and recommendations for the rational use of Tocilizumab in the treatment of COVID-19.
Methods
The medical records and prescription information of patients who received Tocilizumab for COVID-19 in our hospital from December 1, 2022 to June 30, 2023 was reviewed and analyzed. By reviewing the prescription information of tocilizumab, combined with the clinical efficacy, the problems existing in the current clinical application of tocilizumab in treating COVID-19 were identified and summarized.
Results
A total of 30 patients were included in this study. (1) Two dosage regimens were provided, 17 patients received a dose of 400mg per administration, and 13 patients received a dose of 4–8 mg/kg per administration based on actual body weight. (2) Out of the 30 patients, 20 received only one dose, 9 received a second dose, and one received a third dose. (3) All patients received combination therapy, including glucocorticoids, proton pump inhibitors, and antiviral drugs. (4) Regarding clinical efficacy, 8 patients died after 28 days, while 17 patients were discharged. Among the 14 mechanically ventilated patients, 5 were successfully weaned off ventilation. CRP and IL-6 levels showed significant differences before and after administration (34.72% decrease and 222.88% increase respectively). Adverse reactions occurred in 19 patients, mainly anemia, hypertension, and thrombocytopenia.
Conclusions
Our retrospective analysis revealed several problems associated with the current clinical application of tocilizumab, such as undefined indications, inconsistent dosage regimens, discrepancies between contraindications and drug instructions, and lack of consideration for drug interactions in combination therapy. Furthermore, we found that the real-world treatment efficacy of Tocilizumab in COVID-19 is similar to that observed in major clinical trials. The use of Tocilizumab in the treatment of COVID-19 still faces numerous challenges and issues. Further optimization of treatment protocols is necessary to ensure the health and safety of the patients.
The Use of an Audience Response System in a Dental Gross Anatomy Practical Exam
Authors: Ahmad Maha , Hanna Fadia , Sleiman Naama , MacDonald Douglas A. 
Published: October 2023

AbstractPurpose: Traditional methods for the administration and scoring of gross anatomy practical laboratory examinations are time and resource intensive and can be susceptible to errors in grading. Alternative approaches, such as the use of audience response systems (e.g., clickers) and computerized scoring appear to hold promise to improve the examination experience for students and to improve the efficiency and accuracy of grading.Method: To assess perceptions of the use of such systems, two cohorts of students who completed the gross anatomy practical examination using clicker technology at the University of Detroit Mercy School of Dentistry were invited to complete the survey.Results: A total of 155 students completed the survey. Responses reflect a mostly positive appraisal of the use of clicker technology by the majority of students. In particular, students reported that the submission of responses was easier and that the speed of grading and feedback on examination performance was considerably improved.Conclusion: Based upon the survey results, it is concluded that the use of audience response systems appears to have more benefits than liability and seems to be a worthwhile technology to use for practical laboratory examinations.