bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimization of sound absorbing material by using Taguchi and ANOVA
Authors: Bhingare Nirmala H , Subramaniam Prakash 
Published: March 2023

At present, target on eco-friendly acoustic material is decorated to diminish impact on environment due to adoption of synthetic material in acoustic application. In this paper, Taguchi method is enforced to find optimum parameters for sound absorbing coefficient of coconut fiber-based sound absorbing material. The influence of the various process parameters, i.e. Thickness, density, air gap and fiber percentage (%) on sound absorption coefficient (SAC) was studied. The settings of the parameters were determined by using Taguchi’s experimental design method. Orthogonal arrays (L25) of Taguchi, the signal-to-noise (S/N) ratio, the analysis of variance (ANOVA), and regression analyses were employed to find the optimal process parameter levels and to analyze the effect of these parameters on sound absorption coefficient values. Confirmation test with the optimal levels of parameters was carried out in order to illustrate the effectiveness of the Taguchi optimization method. Optimum parameters were found by using Taguchi method are which have 50 mm thickness, 0.0002539 g/mm3 density, 70% fiber percentage and 0 mm air gap. Also significant parameters are found which are thickness and density having p-value less than 0.05 and followed by fiber percentage and air gap. By using optimum parameters sound absorption coefficient is increased to 0.98 at frequency 2800–3500 Hz.
Medication Decision Making in Low-Income Families of Black Children With ADHD: A Mixed Methods Study
Authors: Glasofer Amy , Dingley Catherine , Kim Jinyoung , Colosimo Roseann , Gordon Howard R. D. 
Published: March 2023

Objectives: The purpose of this study was to explore how and why some low-income Black caregivers seek medication treatment for their children with ADHD. Methods: Using a sequential exploratory mixed method design, Phase 1 comprised an indepth case study design of seven low-income Black caregivers of children receiving medication for ADHD. Based on findings from Phase 1, the second phase involved a secondary analysis of data on Black uninsured or publicly insured children age 6 to 17 with ADHD ( n = 450). Results: Factors influencing medication decision-making included child safety and volatility, caregiver mental health, caregiver aggravation, family centered care (FCC), shared decision making (SDM), sole caregiver status, and school involvement. After adjusting for ADHD severity, previous receipt of special education services and experiences of FCC and SDM were independently associated with receipt of a medication for ADHD. Conclusions: Clinicians and school personnel can intervene to decrease disparities in the treatment of ADHD.
Clinical Accuracy of a Glucose Oxidase–Based Blood Glucose Test-Strip Across Extremes of Oxygen Partial Pressure
Authors: Setford Steven , Phillips Stuart , Cameron Hilary , Grady Mike 
Published: March 2023

Background: Glucose oxidase (GOx)-based blood glucose monitors (BGMs) are influenced by the partial pressure of oxygen (Po2) within the applied sample. Limited in-clinic data exists regarding the quantitative effect of Po2 in unmanipulated capillary fingertip blood samples across physiologically representative glucose and Po2 ranges. Method: Clinical accuracy data were collected as part of a BGM manufacturer’s ongoing post-market surveillance program for a commercially available GOx-based BGM test-strip. The data set comprised 29 901 paired BGM-comparator readings and corresponding Po2 values from 5 428 blood samples from a panel of 975 subjects. Results: A linear regression-calculated bias range of 5.22% (+0.72% [low Po2: 45 mm Hg] to −4.5% [high Po2: 105 mm Hg]); biases calculated as absolute at <100 mg/dL glucose was found. Below the nominal Po2 of 75 mm Hg, a linear regression bias of +3.14% was calculated at low Po2, while negligible impact on bias (regression slope: +0.002%) was observed at higher than nominal levels (>75 mm Hg). When evaluating BGM performance under corner conditions of low (<70 mg/dL) and high (>180 mg/dL) glucose, combined with low and high Po2, linear regression biases ranged from +1.52% to −5.32% within this small group of subjects and with no readings recorded at <70 mg/dL glucose at low and high Po2. Conclusions: Data from this large-scale clinical study, performed on unmanipulated fingertip capillary bloods from a diverse diabetes population, indicate Po2 sensitivity of the BGM to be markedly lower than published studies, which are mainly laboratory-based, requiring artificial manipulation of oxygen levels in aliquots of venous blood.
Comparison of clinical safety and efficacy of ultrasound-guided local lauromacrogol injection versus uterine artery embolization in the treatment of caesarean scar pregnancy: a systematic review and meta-analysis
Authors: Du Ziwei , Xu Wenjian , Lu Jingyuan , Li Cheng 
Published: March 2023

Abstract
Background
The aim of this systematic review and meta-analysis was to introduce the relatively novel method of ultrasound-guided local lauromacrogol injection (USG-LLI) followed by dilatation and curettage for caesarean scar pregnancy (CSP) and to investigate the clinical safety and efficacy between uterine artery embolization (UAE) and USG-LLI in the treatment of CSP.

Methods
The relevant literature and articles about USG-LLI, UAE and CSP published in eight electronic databases were searched to extract the primary outcomes for the selected articles. Review Manager Software(RevMan) V.5.2 was used for quantitative data synthesis and data analysis. Forest plots, sensitivity analysis and bias analysis were also performed on the included articles.

Results
Of 10 studies included in our search, 623 patients were in the USG-LLI group and 627 patients were in the UAE groups. There were no significant differences between the two groups in terms of success rate, blood loss and time to human chorionic gonadotropin (hCG) normalization. However, USG-LLI group patients than UAE group patients had a shorter duration of hospital stay (mean difference [MD] = -1.97; 95% confidence intervals [CI] -2.63 to -1.31; P < 0.05; I2 = 95%), shorter restored menses (MD = -4.84; 95%CI -5.78 to -3.90; P < 0.05; I2 = 95%), and lower complication rates [odds ratio(OR) = 0.21; 95%CI:0.15 to 0.30; P < 0.05]; and cheaper on expenses of hospitalization (MD = -8028.29; 95%CI -10,311.18 to -5745.40; P < 0.05; I2 = 100%).

Conclusions
The results demonstrate that USG-LLI is comparable in curative effect and success rates with UAE in the therapy of CSP, but patients in the USG-LLI group seem to have fewer complications rates, shorter duration of hospital stays and lower costs.
Undiagnosed hypertension and its determinants among hypertensive patients in rural districts of northwest Ethiopia: a mediation analysis
Authors: Teshome Destaw Fetene , Balcha Shitaye Alemu , Ayele Tadesse Awoke , Atnafu Asmamaw , Gelaye Kassahun Alemu 
Published: March 2023

AbstractBackgroundEarly detection of hypertension is associated with improved blood pressure control and a reduced risk of cardiovascular diseases. However, in rural areas of Ethiopia, evidence is scarce where access to healthcare services is low. This study aimed to estimate the proportion of undiagnosed hypertension and identify its determinants and mediators among patients with hypertension in rural northwest Ethiopia.MethodsA community-based cross-sectional study was conducted from September to November 2020. A three-stage sampling technique was used to select a total of 2436 study participants. Blood pressure was measured using an aneroid sphygmomanometer two times, 30 min apart. A validated tool was used to assess participants’ beliefs and knowledge of hypertension. The proportion, determinants, and mediators of undiagnosed hypertension were determined among patients with hypertension. The regression-based approach used to calculate the direct and indirect effects of determinants of undiagnosed hypertension. Joint significance testing was used to determine the significance of the indirect effect.ResultsThe proportion of undiagnosed hypertension was 84.0% (95% CI: 81.4–86.7%). Participants aged 25–34 years (AOR = 6.03; 95% CI: 2.11, 17.29), who drank alcohol (AOR = 2.40; 95% CI: 1.37, 4.20), were overweight (AOR = 0.41; 95% CI: 0.18, 0.98), had a family history of hypertension (AOR = 0.32; 95% CI: 0.20, 0.53), and had comorbidities (AOR = 0.28; 95% CI: 0.15, 0.54) were significantly associated with undiagnosed hypertension. The mediation analysis revealed that hypertension health information mediated 64.1% and 68.2% of the effect of family history of hypertension and comorbidities on undiagnosed hypertension, respectively. Perceived susceptibility to hypertensive disease mediated 33.3% of the total effect of age on undiagnosed hypertension. Health facility visits also mediated the effect of alcohol drinking (14.2%) and comorbidities (12.3%) on undiagnosed hypertension.ConclusionA higher proportion of hypertensive patients remain undiagnosed. Being young, drinking alcohol, being overweight, having a family history of hypertension, and having comorbidities were significant factors. Hypertension health information, knowledge of hypertensive symptoms, and perceived susceptibility to hypertension were identified as important mediators. Public health interventions aimed at providing adequate hypertension health information, particularly to young adults and drinkers, could improve knowledge and perceived susceptibility to hypertensive disease and reduce the burden of undiagnosed hypertension.
Comparative treatment outcomes after bilateral extractions of maxillary second molars or first premolars in patients with class II malocclusion: a retrospective study
Authors: Paddenberg Eva , Braun Maria Christina , Proff Peter , Lippold Carsten , Kirschneck Christian 
Published: March 2023

Abstract
Background
This retrospective cohort study aimed to compare treatment results between bilateral extraction of upper second molars (M2) and first premolars (P1) in terms of treatment timing, cephalometry, upper third molar alignment and relapse in the long-term.

Methods
Fifty-three consecutively treated Caucasian patients with a brachyfacial pattern, skeletal class I and dental class II requiring extraction in the maxilla due to crowding were retrospectively divided into group I (M2 extracted; N = 31) and II (P1 extracted; N = 22). Fixed appliances were inserted after extraction and after distalisation of the first molars in group I. Post-treatment lateral cephalograms were digitally analysed and compared between groups. Six to seven years later relapse and success of upper third molar alignment were clinically evaluated as well as orthodontic treatment duration, pre-treatment age and gender recorded.

Results
After debonding patients with second molar extraction showed significantly smaller values for the Wits-appraisal, but higher values for index and facial axis. Extracting first premolars caused significantly more retroinclination/−position of anterior teeth and an increased profile concavity, more relapse and less successful alignment of upper third molars. Orthodontic treatment duration, pre-treatment age and gender were not significantly different between groups.

Conclusions
Bilateral extraction of upper first premolars or second molars may solve dental crowding in skeletal class I dental class II patients with a brachyfacial growth pattern. Upper second molar extraction seems to affect maxillary third molar alignment, long-term stability and dental and soft-tissue cephalometric parameters positively, but no intervention proved to be clearly superior.
Effect of posterior cruciate ligament on knee pressure and gap measured by an electronic sensor during total knee arthroplasty
Authors: Zhao Ran , Liu Yanqing , Tian Hua 
Published: March 2023

Abstract
Purpose
The purpose of this study was to evaluate the change in posterior cruciate ligament (PCL) tension by directly measuring the pressure changes in the knee joint when the ligament was released or resected during total knee arthroplasty.

Methods
We prospectively analyzed 54 patients who underwent primary total knee arthroplasty (67 knees) from October 2019 to January 2022. An electronic pressure sensor was used to measure the pressure changes in the medial and lateral chambers on PCL retention, recession or resection.

Results
At 0°, 45°, 90° and 120° of flexion, the total pressure in the knee joint of PCL retention was significantly higher than with PCL recession, and even higher than PCL resection. PCL recession or resection affected knee joint extension, and the medial/lateral pressure in the knee joint decreased. Pressure in the lateral compartment showed no significant change during knee flexion, whereas pressure in the medial compartment was significantly decreased, which also led to a change in the ratios of the medial and lateral pressures in the knee joint. After PCL resection, the flexion gap (90°) increased significantly more than the extension (0°) gap, while 46 cases displayed the same change in the flexion and extension gaps after PCL resection of the 67 cases.

Conclusion
The PCL retained partial function after tibial recession. PCL resection affected both the flexion and extension gaps; although the average flexion gap increased more than the extension gap, the change in most cases of these two gaps was the same.
The impact of online design thinking-based learning on entrepreneurial intention: the case of vocational college
Authors: Woraphiphat Issariya , Roopsuwankun Pattama 
Published: March 2023

AbstractEntrepreneurial intention is fundamental to decision-making and the behaviors needed to become entrepreneurs, with subsequent effects on economic development. However, the COVID-19 pandemic calls for a novel approach to teaching entrepreneurship owing to the shift to online learning. The current study explores entrepreneurial intention and the satisfaction derived from the entrepreneurship education program. In particular, we offer a framework that explains students’ satisfaction and entrepreneurial intention by integrating the theory of planned behavior with design thinking-based entrepreneurship courses, peer interactions, and speaker interactions. The entrepreneurship education program was for vocational college students located in Southeast Asia. The online questionnaire was distributed to participants (N = 263, MAGE = 18.64) at the end of the online entrepreneurship education program. The model was tested using a structural equation model analysis. Attitude, subject norm, and satisfaction were found to predict higher entrepreneurial intention among vocational college students. Moreover, design thinking-based entrepreneurship courses, peer interaction, and speaker interaction indirectly affect entrepreneurial intention through satisfaction. This research extends the literature on entrepreneurship education by proposing a novel learning approach, that is, the online design thinking-based learning approach, which could be applied to entrepreneurship education programs to enhance students’ entrepreneurial intention.
Specific TCR profiles predict clinical outcome of adjuvant EGFR-TKIs for resected EGFR-mutant non-small cell lung cancer
Authors: Liu Si-Yang Maggie , Chen Cunte , Zhang Yi-Kai , Zhong Wen-Zhao , Wu Yi-Long , Liu Si-Yang , Li Yangqiu 
Published: March 2023

Abstract
Background
ADJUVANT-CTONG1104 reported a favorable survival outcome from adjuvant gefitinib treatment over chemotherapy in EGFR-mutant non-small cell lung cancer (NSCLC) patients. However, heterogeneous benefit from EGFR-TKIs and chemotherapy demands further biomarker exploration for patient selection. Previously, we identified certain TCR sequences with predictive value for adjuvant therapies from the CTONG1104 trial and found a relationship between the TCR repertoire and genetic variations. It remains unknown which TCR sequences could further enhance the prediction for only adjuvant EGFR-TKI.

Methods
In this study, 57 tumor and 12 tumor-adjacent samples, respectively, from gefitinib-treated patients in the CTONG1104 were collected for TCR β gene sequencing. We attempted to constitute a predictive model for prognosis and favorable adjuvant EGFR-TKI outcome for patients with early-stage NSCLC and EGFR mutations.

Results
The TCR rearrangements demonstrated significant prediction for overall survival (OS). A combined model of high frequent Vβ7-3Jβ2-5 and Vβ24-1Jβ2-1 with lower frequent Vβ5-6Jβ2-7 and Vβ28Jβ2-2 constituted the best value for predicting OS (P < 0.001; Hazard Ratio [HR] = 9.65, 95% confidence interval [CI]: 2.27 to 41.12) or DFS (P = 0.02; HR = 2.61, 95% CI: 1.13 to 6.03). In Cox regression analyses, when multiple clinical data were included, the risk score remained an independent prognostic predictor for OS (P = 0.003; HR = 9.49; 95% CI: 2.21 to 40.92) and DFS (P = 0.015; HR = 3.13; 95% CI: 1.25 to 7.87).

Conclusions
In this study, a predictive model was constituted with specific TCR sequences for prognosis prediction and gefitinib benefit in the ADJUVANT-CTONG1104 trial. We provide a potential immune biomarker for EGFR-mutant NSCLC patients who might benefit from an adjuvant EGFR-TKI.
Medical professionals’ job satisfaction and telemedicine readiness during the COVID-19 pandemic: solutions to improve medical practice in Egypt
Authors: El-Mazahy Hanan , Mekky Jaidaa , Elshaer Noha 
Published: March 2023

Abstract
Background
The COVID-19 pandemic has impacted medical professionals’ job satisfaction and was a call to adopt telemedicine. Finding out how far medical professionals are satisfied and ready to use telemedicine would be important to improve medical practice.

Methods
Data was collected from 959 medical professionals from both the governmental and private health sectors in Egypt in 2021 using a specifically designed online questionnaire, to evaluate job satisfaction, perception of telemedicine, and propose solutions to improve medical practice.

Results
The study revealed low to moderate job satisfaction at governmental (27.2%) and private (58.7%) sectors. Underpayment was the most reported challenge at both sectors (37.8% and 28.3%, respectively). Dissatisfaction with government salary was independently predicted by working at the Ministry of Health and Population (OR = 5.54, 95%CI = 2.39,12.8; p < 0.001). Wage increase (46.10%), medical training of professionals (18.1%), and management of non-human resources (14.4%) were the most proposed solutions to improve medical practice in Egypt. During the COVID-19 pandemic, 90.7% of medical professionals had practiced telemedicine with moderate level of perception of its benefits (56%).

Conclusions
During the COVID-19 pandemic, medical professionals reported low to moderate job satisfaction and a moderate level of perception of telemedicine. It is recommended to analyze the healthcare financing system and provide continuous training of medical professionals to improve medical practice in Egypt.
A Case of Bilateral Hyperglycemic Nonketotic Chorea in an 83-year-old Woman With Normal Brain Imaging
Authors: Khan Fahad , Matta Siddharth , Malik Komal , Shayuk Maryna 
Published: March 2023

Abstract
Bilateral hyperglycemic nonketotic chorea is a rare complication of hyperglycemia. In most cases, the literature illustrates patients presenting with unilateral chorea with image findings significant for hyperintense lesions in the basal ganglia on magnetic resonance imaging (MRI) or hyperdensities on computerized tomography (CT). Here, we present a case of an 83-year-old patient who was admitted to the hospital due to acute onset of orofacial and bilateral upper extremity chorea. She had no previous history of infection, genetic mutation, neoplasms, neurodegeneration, stroke, metabolic disease, drug exposure, or autoimmune disease. Surprisingly, her MRI showed only chronic microvascular changes in periventricular white matter without basal ganglia abnormalities. However, she was noted to have marked worsening of her glycemic control over the preceding 12 months based on worsening glycated hemoglobin (HbA1c) levels and elevated serum glucose on presentation. A literature review indicates that chorea caused by hyperglycemia is at times reversible with glycemic control, but as demonstrated in our patient, this is not always necessarily the case. A similar course has only been elaborated in a few other cases in the literature. We will also review the pathogenesis, the usual disease clinical course and standard treatment from the literature.
Labor Neuraxial Analgesia and Its Association With Perinatal Outcomes in China in 2015–2016: A Propensity Score–Matched Analysis
Authors: Meng Xi , Ye Jiangfeng , Qiao Ping , Ren Tai , Luo Qing , Hu Ling-qun , Zhang Jun 
Published: March 2023

BACKGROUND:
The use of labor neuraxial analgesia (NA) in China has increased significantly in the past decade, and the current rate of use is unknown. This study aimed to describe the epidemiology of NA based on a large multicenter cross-sectional survey, the China Labor and Delivery Survey (CLDS) (2015–2016), and to evaluate the association between NA and intrapartum caesarean delivery (CD) and maternal and neonatal outcomes.

METHODS:
The CLDS was a facility-based cross-sectional investigation with a cluster random sampling scheme conducted from 2015 to 2016. A specific weight was assigned to each individual based on the sampling frame. Logistic regression was adopted to analyze the factors associated with the use of NA. A propensity score matching scheme was used to analyze the associations between NA and intrapartum CD and perinatal outcomes.

RESULTS:
A total of 51,488 vaginal deliveries or intrapartum CD were included in our study, excluding prelabor CDs. The weighted NA rate was 17.3% (95% confidence interval [CI], 16.6–18.0) in this survey population. Nulliparous, previous CD, hypertensive disorders, and labor augmentation were associated with higher use of NA. In the propensity score–matched analysis, NA was associated with reduced risks of intrapartum CD, especially intrapartum CD by maternal request (adjusted odds ratio [aOR], 0.68; 95% CI, 0.60–0.78 and aOR, 0.48; 95% CI, 0.30–0.76, respectively), 3rd or 4th degree perineal laceration (aOR, 0.36; 95% CI, 0.15–0.89), and 5-minute Apgar score ≤3 (aOR, 0.15; 95% CI, 0.03–0.66).

CONCLUSIONS:
The use of NA may be associated with improved obstetric outcomes, including fewer intrapartum CD, less birth canal trauma, and better neonatal outcomes in China.