bluuebunny/crossref_metadata_2025_split huggingface dataset:
Investigation of critical factors influencing the underestimation of hearing loss predicted by the ISO 1999 predicting model
Authors: Li Fei , Xie Hong-wei , Su Shi-biao , Zou Hua , ZHou Li-Fang , Xu Qiu-Liang , Wei Fang , Zhang Meibian 
Published: April 2023

Abstract
Objective To analyze factors influencing the underestimation of noise-induced permanent threshold shift (NIPTS) among manufacturing workers, providing baseline data for revising noise exposure standard.
Design A cross-sectional study was designed with 2702 noise-exposed workers from 35 enterprises from 10 industries. Personal noise exposure level(LAeq,8h) and noise kurtosis level were determined by a noise dosimeter. Questionnaires and hearing loss tests were performed for each subject. The predicted NIPTS was calculated using the ISO 1999:2013 model for each participant, and the actual measured NIPTS was corrected for age and sex. The factors influencing the underestimation of NIPTS were investigated.
Results The predicted NIPTS at each test frequency (0.5, 1, 2, 3, 4, or 6kHz) and mean NIPTS at 2, 3, 4, and 6kHz (NIPTS2346) using the ISO 1999:2013 model were significantly lower than their corresponding measured NIPTS, respectively (P<0.001). The ISO model significantly underestimated the NIPTS2346 by 12.36 dB HL. The multiple linear regression analysis showed that noise exposure level, exposure duration, age, and kurtosis could affect the degree of underestimation of NIPTS2346. The generalized additive model (GAM) with (penalized) spline components showed nonlinear relationships between critical factors (age, exposure duration, noise level, and kurtosis) and the underestimated NIPTS2346.The underestimated NIPTS2346 decreased with an increase in exposure duration (especially over ten years). There was no apparent trend in the underestimated NIPTS2346 with age. The underestimated NIPTS2346 decreased with the increased noise level [especially >90 dB(A)]. The underestimated NIPTS2346 increased with an increase in noise kurtosis after adjusting for the noise exposure level and exposure duration and ultimately exhibiting a linear regression relationship.
Conclusions The ISO 1999 predicting model significantly underestimated the noise-induced hearing loss among manufacturing workers. The degree of underestimation became more significant at the noise exposure condition of fewer than ten years, less than 90 dB(A) and higher kurtosis level. It is necessary to apply kurtosis to adjust the underestimation of hearing loss and consider the applying condition of noise energy metrics when using the ISO predicting model.
Ensuring financial sustainability of the health systems to achieve universal health coverage in the wake of an ageing population: the challenge of Mauritius
Authors: Nundoochan Ajoy 
Published: April 2023

Abstract

Public health achievements have contributed to people living longer and healthily. Countries pledged to achieve universal health coverage where all people have access to health services they need, of sufficient quality, without experiencing any financial distress by 2030. Changing population age-mix on the economy poses serious treats for a financially sustainable health sector. Mauritius, notwithstanding its long tradition of a welfare state with free health services, is no exception considering its rapid demographical and epidemiological shift. Based on Population ageing financial sustainability gap for health systems Simulator, developed by the European Observatory on Health Systems and Policies and World Health Organization Kobe Centre, and considering specific health expenditure profile scenario, an additional amount of USD 137 per person would be required by 2060 to cater for the health needs of an ageing population in Mauritius, representing 0.6% of the gross domestic product. Changes in tax rates and social contributions will influence revenues and alleviate the financing gaps for the health sector. An increase of 100 base points on taxes on goods and services, is expected to reduce the financing gap by USD 43 per person, representing a drop of 8.7 base points. The financial implications of an ageing population are exacerbated as the burden disease conditions among the elderly disproportionately affects mostly the poor and vulnerable population. The financing strategies for the health sector will have to be revisited to generate sustainable adequate financial resources. This is essential to promote efficiency, equity in the use of resources, and sustain financial risk protection against catastrophic health payments in pursuit of universal health coverage. Adopting the World Health Organization integrated care for older people approach would contribute towards mainstreaming the elderly health needs in primary health care, using a person-centred and integrated approach, and maximize both intrinsic capacity and functional ability.
Comparison of distal radius fracture plating surgery under wide-awake local anesthesia no tourniquet technique and general anesthesia: a retrospective cohort study
Authors: Chen Chih-Ting , Chou Shih-Hsiang , Huang Hsuan-Ti , Fu Yin-Chih , Jupiter Jesse , Liu Wen-Chih 
Published: April 2023

Abstract
Background
Distal radius fractures (DRF) are frequently treated with internal fixation under general anesthesia (GA) or a brachial plexus block. Recently, the wide-awake local anesthesia with no tourniquet (WALANT) technique has been suggested as a method that results in higher patient satisfaction. This study aimed to evaluate the functional outcomes, complications, and patient-reported outcomes of DRF plating surgery under both the WALANT and GA methods.
Methods
Ninety-three patients with DRFs who underwent open reduction and plating were included. Regarding the anesthetic technique, 38 patients received WALANT, while 55 received GA. The patient's overall satisfaction in both groups and the intraoperative numerical rating scale of pain and anxiety (0 to 10) in the WALANT group were recorded. The peri-operative radiographic parameters were measured; the clinical outcomes, including Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score, wrist mobility, and grip strength, were recorded in up to 1-year follow-up. Results presented with a mean difference and 95% confidence intervals (CIs).
Results
The mean age of patients in the WALANT group was higher than in the GA group (63 ± 17 vs. 54 ± 17, P < 0.01), and there were fewer intra-articular DRF fractures in the WALANT group than in the GA group (AO type A/B/C: 30/3/5 vs. 16/10/19, P < 0.01). The reduction and plating quality were similar in both groups. The clinical outcomes at follow-up were comparable between the two groups, except the WALANT group had worse postoperative 3-month pronation (88% vs. 96%; -8.0% [-15.7 to -0.2%]) and 6-month pronation (92% vs. 100%; -9.1% [-17.0 to -1.2%]), and better postoperative 1-year flexion (94% vs. 82%; 12.0% [2.0 to 22.1%]). The overall satisfaction was comparable in the WALANT and GA groups (8.7 vs. 8.5; 0.2 [-0.8 to 1.2]). Patients in the WALANT group reported an injection pain scale of 1.7 ± 2.0, an intraoperative pain scale of 1.2 ± 1.9, and an intraoperative anxiety scale of 2.3 ± 2.8.
Conclusion
The reduction quality, functional outcomes, and overall satisfaction were comparable between the WALANT and GA groups. With meticulous preoperative planning, the WALANT technique could be an alternative to GA for DRF plating surgery in selected patients.
External validation and comparison of distal pancreatectomy fistula risk score (D-FRS) and DISPAIR-FRS for predicting pancreatic fistula after distal pancreatectomy
Authors: Tang Bingjun , Wang Pengfei , Ma Jiming , Yu Fei , Shi Jun , Yang Shizhong , Feng Xiaobin , Zeng Jianping , Xiang Canhong , Wang Xuedong 
Published: April 2023

Abstract
Background Distal pancreatectomy fistula risk score (D-FRS) and DISPAIR-FRS has not been widely validated for predicting postoperative pancreatic fistula (POPF) after distal pancreatectomy (DP).Methods We retrospectively analyzed 104 patients undergoing DP. The predictive value of the D-FRS and DISPAIR were compared. Risk factors associated with POPF were investigated by multivariate analysis.Results Of the 104 patients, 23 (22.1%) were categorized into the POPF group (all grade B). The areas under the ROC (AUCs) of the D-FRS (preoperative), D-FRS (intraoperative), and DISPAIR-FRS were 0.737, 0.809, and 0.688, respectively. Stratified by the D-FRS (preoperative), the POPF rates in low-risk, intermediate-risk, and high-risk groups were 5%, 22.6%, and 36.4%, respectively. By the D-FRS (intraoperative), the POPF rates in low-risk, intermediate-risk, and high-risk groups were 8.8%, 47.1%, and 47.4%, respectively. By the DISPAIR-FRS, the POPF rates in low-risk, intermediate-risk, and extreme-high-risk groups were 14.8%, 23.8% and 62.5%, respectively. Body mass index and main pancreatic duct diameter were independent risk factors of POPF both in preoperative (P = 0.014 and P = 0.033, respectively) and intraoperative (P = 0.015 and P = 0.039) multivariate analyses.Conclusions Both the D-FRS (preoperative), D-FRS (intraoperative), and DISPAIR-FRS has good performance in POPF prediction after DP. The risk stratification was not satisfactory in current Asian cohort.
Lung Quantitative Computer Tomography Analysis for Non-HIV Associated Pneumocystis Pneumonia Assessment：An Observational Clinical Cohort Study
Authors: Wang HY , Zhao HL , Leng BL , Wang Y 
Published: April 2023

Abstract
Introduction
Pneumocystis pneumonia (PCP) is an opportunistic infection caused by Pneumocystis jirovecii. It always occurs secondary to HIV or tumors after chemotherapy or exposure to glucocorticoids. This infection can rapidly progress to respiratory failure, requiring ventilation support. CT is a significant tool for assessing the severity of PCP. Physicians commonly use descriptive features such as ground glass opacity (GGO), crazy paving, and consolidation in CT reports, but the relationship between these features and clinical physiopathological situations is unclear. In this study, we aim to investigate the association between quantitative CT features and clinical laboratory data for PCP.
Method
Between October 2018 and October 2022, 126 patients with PCP were enrolled in the study. 53 patients were included in the final cohort. Quantitative CT features, GGO, and consolidation were identified and marked using dedicated imaging software. Lung volume and percentage for each feature were estimated by 3D lung reconstruction. The Spearman correlation was used to illustrate the relationships among the CT features and laboratory items. Multiple linear regression, including the interaction of CT features, was performed to discuss the relationships between dedicated CT features and laboratory data. Finally, the ROC curve was used to determine the best cut-off value for predicting respiratory failure.
Results
GGO was the predominant finding (90%) in all CT slices, with 81.2% of CT slices demonstrating consolidation. Consolidation percentage was correlated with PaO2/FiO2, CRP, and NLR (r=-0.76, 0.66, and 0.59, respectively; all p=0.00). GGO percentage was also correlated with PaO2/FiO2, CRP, and NLR (r2=-0.35, 0.35, and 0.38, respectively; p=0.01, 0.005, and 0.009, respectively). The results of multiple linear regression indicated that consolidation percentage was associated with PaO2/FiO2(β=-26.69, 95%CI -42.93– -10.46, p=0.002) and NLR (β=1.38, 95%CI 0.02–2.75, p=0.04); the interaction of consolidation and GGO percentage was associated with CRP (β=0.28, 95%CI 0.04–0.52, p=0.03) when adjusted for time from onset to CT test. The best cut-off value of consolidation percentage for respiratory failure was 22.5% (sensitivity=0.452, specificity=0.955).
Conclusion
Although GGO is a common and typical pattern for PCP, the consolidation pattern is associated with a poor pathophysiological state. It could serve as a warning reminder for physicians in clinical practice.
Cost-effectiveness of a second opinion program on spine surgeries: an economic analysis
Authors: Antonioli Eliane , Malheiro Daniel Tavares , Teich Vanessa Damazio , Paiao Isabela Dias , Neto Miguel Cendoroglo , Lenza Mario 
Published: April 2023

Abstract
Background In this study we proposed a new strategy to measure cost-effectiveness of second opinion program on spine surgery, using as measure of effectiveness the minimal important change (MIC) in the quality of life reported by patients, including the satisfaction questionnaire regarding the treatment and direct medical costs.Methods Retrospective analysis of patients with prior indication for spine surgery included in a second opinion program during May 2011 to May 2019. Treatment costs and outcomes where compared considering each patients’ recommended treatment before and after the second opinion. Costs were measured under the perspective of the hospital, including hospital stay, surgical room, physician and staff fees and other costs related to hospitalization when surgery was performed and physiotherapy or infiltration costs when a conservative treatment was recommended. Reoperation costs were also included. For comparison analysis, we used data based on our clinical practice, using data from patients who underwent the same type of surgical procedure as indicated by the first referral. The measure of effectiveness was the percentage of patients who achieved the MIC in quality of life measured by the EQ-5D-3L 2 years after starting treatment. An incremental cost-effectiveness ratio (ICER) was calculated.Results Based upon the assessment of 1,088 patients that completed the entire second opinion process, conservative management was recommended for 662 (60.8%) patients; 49 (4.5%) were recommended to infiltration and 377 (34.7%) to surgery. Complex spine surgery, as arthrodesis, was recommended by second opinion in only 3.7% of cases. The program resulted in financial savings of -$6,705 per patient associated with appropriate treatment indication, with an incremental effectiveness of 0.077 patients achieving MIC when compared to the first referral, resulting in an ICER of $-87,066 per additional patient achieving the MIC, ranging between $-273,016 and $-41,832.Conclusion After 2 years of treatment, the second opinion program demonstrated the potential for cost-offsets associated with improved quality of life.
Low-Income and Elderly with Feed-in Tariffs Drive Solar Installation Rates for Energy Equity
Authors: Feng Kuishuang , Chang Rui-Dong , Wang Yuan , Zuo Jian , Yang Chenbo , Shan Mei , Gao Benhan , Goodsite Michael 
Published: April 2023

Abstract
Australian residents have the highest solar energy installation rate in the world. However, after experiencing rapid growth, the residential installation rate began to decline sharply starting in 2011. In this study, we examine installation data for small and medium-sized solar photovoltaic (PV) devices across 2,413 Australian postcode areas using regression analysis and coarsened exact matching (CEM). We reevaluate four primary factors influencing the residential solar energy installation rate: natural factors, energy policy factors, rooftop space factors, and socioeconomic factors. Our findings reveal that areas with higher proportions of elderly or low-income residents exhibit greater household solar PV installation rates. Additionally, increased feed-in tariff (FiT) subsidies further motivate these resident groups to install solar PV systems, resulting in higher installation rates within their neighborhoods. The results also suggest that if a subsidy policy with a feed-in tariff average expected return (FiT-AER) of more than 7 cents/kWh persists, elderly and low-income groups in Australia may continue to dominate home solar PV installations. This trend could potentially mitigate energy inequity during the energy transition process.
Amorphous Cis-1,4-Polybutadiene P-V-T properties from atomistic simulations
Authors: Shamsieva Aigul , Piyanzina Irina , Minisini Benoit 
Published: April 2023

Abstract
Context The experimental values of variation of glass transition temperature (Tg) with the pressure are relatively dispersed due to the diversity of microstructure encountered in Cis-1,4-Polybutadiene (PB) and the diversity of technics used for its measurement. Fortunately, atomistic simulations allow to get valuable information for very well controlled chemistry and structures using very well-defined protocol of acquisition. That’s why, atomistic modelling will be used to evaluate the variation of Tg with the pressure for a well-defined amorphous oligomer of cis-1,4 PB.Method Atomistic dilatometry was performed on model of amorphous cis-1,4 PB with a molecular weight of 5402 g.mol− 1. The analysis was carried out by reporting with respect to the temperature, the specific volume, the coefficient of thermal expansion, the total energy, and the constant volume heat capacity averaged over 7 independent configurations. Tait equation was used to fit the evolution of the specific volume for temperatures between 10 K and 700 K and pressure of 0, 60 and 100 MPa.Results The specific volume evolution with temperature and pressure of the melt is predicted to be within 2% of error with the experimental values extrapolated for a similar molecular weight with a very well reproduced coefficient of thermal expansion. The best predictions of Tgs are obtained using the Tait equation fit with a Tg predicted at 162 K at zero pressure and a linear dependence with pressure given a slope of 0.22 K/MPa. As recently observed for PEO and PS, the different calculated properties show hysteresis between the heating and cooling curves.
Measuring Small-scale Plasma Irregularities in the High-latitude E- and F-regions Simultaneously
Authors: Ivarsen Magnus F , St-Maurice Jean-Pierre , Hussey Glenn C , Spicher Andres , Jin Yaqi , Lozinsky Adam , Goodwin Lindsay V , Galeschuk Draven , Park Jaeheung , Clausen Lasse B N 
Published: April 2023

Abstract
The ionosphere, Earth’s space environment, exhibits widespread turbulent structuring, or plasma irregularities, visualized by the auroral displays seen in Earth’s polar regions. Such plasma irregularities have been studied for decades, but plasma turbulence remains an elusive phenomenon. We combine scale-dependent measurements from a ground-based radar with satellite observations to characterize small-scale irregularities simultaneously in the bottomside and topside ionosphere and perform a statistical analysis on an aggregate from both instruments over time. We demonstrate the clear mapping of information vertically along the ionospheric altitude column, for field-perpendicular wavelengths down to 1.5 km. Our results paint a picture of the northern hemisphere high-latitude ionosphere as a turbulent system that is in a constant state of growth and decay; energy is being constantly injected and dissipated as the system is continuously attempting an accelerated return to equilibrium. We connect the widespread irregularity dissipation to Pedersen conductance in the E-region, and discuss the similarities between irregularities found in the polar cap and in the auroral region in that context. Due to this intimate relationship between high-latitude irregularities and E-region ionization, we suggest that the electrodynamics of a conducting E-region should be considered when discussing plasma turbulence at high latitudes.
Engaging Adolescents and Young Adults in Decisions About Return of Genomic Research Results: a mixed-methods longitudinal clinical trial protocol
Authors: Blumling Amy , McGowan Michelle , Prows Cynthia , Childers-Buschle Kristin , Martin Lisa , Lynch John , Dufendach Kevin , Lipstein Ellen , Kovacic Melinda Butsch , Brinkman Bill , Myers Melanie 
Published: April 2023

Abstract
Background
To protect minors’ future autonomy, professional organizations have historically discouraged returning predictive adult-onset genetic test results and carrier status to children. Recent clinical guidance diverges from this norm, suggesting that when minors have genomic sequencing performed for clinical purposes, parents and children should have the opportunity to learn secondary findings, including for some adult-onset conditions. While parents can currently opt in or out of receiving their child’s secondary findings, the American Society of Human Genetics Workgroup on Pediatric Genetic and Genomic Testing suggests including adolescents in the decision-making process. However, it is not clear what factors young people consider when given the opportunity to learn genetic findings for themselves. We are examining adolescents’, young adults’, and parents’ (if applicable) decisions about learning genomic information for the adolescent.
Methods
We are enrolling assenting (ages 13–17) adolescents and consenting (ages 18–21) young adults in a prospective genomic screening study to assess the choices they make about receiving individual genomic results. Participants use an online tool to indicate whether they want to learn their personal genetic risk for specific preventable, treatable, and adult-onset conditions, as well as carrier status for autosomal recessive conditions. We are examining 1) how choices differ between adolescent and young adult cohorts (as well as between adolescents/young adults and parents) and 2) decisional conflict and stability across study timepoints. Results are returned based on participants’ choices. Qualitative interviews with a subset of participants explore decisional stability, adolescent/young adult engagement with parents in decision-making, and the impact of learning pathogenic/likely pathogenic and carrier results.
Discussion
This study explores decision making and decision stability between adolescents and parents (where applicable), as well as the ethical implications and impact of return of clinical-grade genetic research results to adolescents and young adults. The results of this study will contribute empirical evidence to support best practices and guidance on engaging young people in genetic research studies and clinical care that offer return of results.
Trial Registration:
ClinicalTrials.gov Identifier: NCT04481061. Registered 22 July 2020.