bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neuromusculoskeletal model-informed machine learning-based control of a knee exoskeleton with uncertainties quantification
Authors: Zhang Longbin , Zhang Xiaochen , Zhu Xueyu , Wang Ruoli , Gutierrez-Farewik Elena M. 
Published: August 2023

IntroductionResearch interest in exoskeleton assistance strategies that incorporate the user's torque capacity is growing rapidly. However, the predicted torque capacity from users often includes uncertainty from various sources, which can have a significant impact on the safety of the exoskeleton-user interface.MethodsTo address this challenge, this paper proposes an adaptive control framework for a knee exoskeleton that uses muscle electromyography (EMG) signals and joint kinematics. The framework predicted the user's knee flexion/extension torque with confidence bounds to quantify the uncertainty based on a neuromusculoskeletal (NMS) solver-informed Bayesian Neural Network (NMS-BNN). The predicted torque, with a specified confidence level, controlled the assistive torque provided by the exoskeleton through a TCP/IP stream. The performance of the NMS-BNN model was also compared to that of the Gaussian process (NMS-GP) model.ResultsOur findings showed that both the NMS-BNN and NMS-GP models accurately predicted knee joint torque with low error, surpassing traditional NMS models. High uncertainties were observed at the beginning of each movement, and at terminal stance and terminal swing in self-selected speed walking in both NMS-BNN and NMS-GP models. The knee exoskeleton provided the desired assistive torque with a low error, although lower torque was observed during terminal stance of fast walking compared to self-selected walking speed.DiscussionThe framework developed in this study was able to predict knee flexion/extension torque with quantifiable uncertainty and to provide adaptive assistive torque to the user. This holds significant potential for the development of exoskeletons that provide assistance as needed, with a focus on the safety of the exoskeleton-user interface.
Impact on health outcomes of hemodialysis patients based on the experience level of registered nurses in the hemodialysis department: a cross-sectional analysis
Authors: Jeong EunYoung 
Published: August 2023

BackgroundThe aim of the study is to improve the policy of health authorities regarding registered nurses (RNs) staffing by understanding how the health outcomes of hemodialysis (HD) patients vary depending on the level of HD nursing experience of at least 2 years.MethodsThe study included 21,839 patients who started maintenance HD for 3 months in early 2013 in the same medical institutions. Demographic variables such as sex, age, and causes of HD; institutional variables such as type of institution and number of RNs; and health outcomes such as HD adequacy, systolic and diastolic blood pressure (SBP, DBP), hemoglobin (Hb), and serum albumin were collected through web-based questionnaires. To determine the relationship between variables, t-test, chi-square test, and ANOVA were employed. Binary logistic regression was used to examine the odds ratio.ResultsInstitutions with 100% of experienced RNs with at least 2 years of experience in HD units were found to have higher NKF K-DOQI criteria satisfaction rate than Institutions with &lt;50% of experienced RNs with at least 2 years of experience in HD units for all health outcomes, except DBP (42.9% vs. 38.8%, p &lt; .001) and Hb (27.8% vs. 24.4%, p &lt; .001). Four of the six health-related variables—HD adequacy (Kt/v, urea reduction rate, URR), SBP, and serum albumin—were higher in institutions with 100% of experienced RNs than those with less than 50%.ConclusionsIn order to improve HD patients' health outcomes, HD institutions should prioritize recruiting RNs who are proficient in HD care. A higher proportion of skilled RNs results in a higher ability to prepare for emergencies and early detection of patient complications. RNs with extensive experience in HD nursing, therefore, promote quality management of HD patients.
Hyperhomocysteinemia in hypofertile male patients can be alleviated by supplementation with 5MTHF associated with one carbon cycle support
Authors: Clement Arthur , Amar Edouard , Clement Patrice , Sedbon Éric , Brami Charles , Alvarez Silvia , Menezo Yves 
Published: August 2023

IntroductionHomocysteine (Hcy) is a cellular poison, side product of the hydrolysis of S-Adenosyl Homocysteine, produced after the universal methylation effector S -Adenosylmethionine liberates a methyl group to recipient targets. It inhibits the methylation processes and its rising is associated with multiple disease states and ultimately is both a cause and a consequence of oxidative stress, affecting male gametogenesis. We have determined hyper homocysteinhemia (HHcy) levels can be reliably reduced in hypofertile patients in order to decrease/avoid associated epigenetic problems and protect the health of future children, in consideration of the fact that treatment with high doses of folic acid is inappropriate.MethodsHomocysteine levels were screened in male patients consulting for long-standing infertility associated with at least three failed Assisted Reproductive Technology (ART) attempts and/or repeat miscarriages. Seventy-seven patients with Hcy levels &gt; 15 µM were treated for three months with a combination of micronutrients including 5- MethylTetraHydroFolate (5-MTHF), the compound downstream to the MTHFR enzyme, to support the one carbon cycle; re-testing was performed at the end of a 3 months treatment period. Genetic status for Methylenetetrahydrofolate Reductase (MTHFR) Single nucleotide polymorphisms (SNPs) 677CT (c.6777C &gt; T) and 1298AC (c.1298A &gt; C) was determined.ResultsMicronutrients/5-MTHF were highly efficient in decreasing circulating Hcy, from averages 27.4 to 10.7 µM, with a mean observed decrease of 16.7 µM. The MTHFR SNP 677TT (homozygous form) and combined heterozygous 677CT/1298AC status represent 77.9% of the patients with elevated Hcy.DiscussionEstimation HHcy should not be overlooked in men suffering infertility of long duration. MTHFR SNPs, especially 677TT, are a major cause of high homocysteinhemia (HHcy). In these hypofertile patients, treatment with micronutrients including 5-MTHF reduces Hcy and even allows spontaneous pregnancies post treatment. This type of therapy should be considered in order to ensure these patients' quality of life and avoid future epigenetic problems in their descendants.
Quality of Life and Needs in Caregivers: Results From the Prospective Multicentric Open-Label Randomized Study of Informal Caregivers of Elderly Patients
Authors: Pozet Astrid , Darnis Sophie , Bonnet Magalie , Meurisse Aurélia , Dabakuyo-Yonli Tienhan Sandrine , Lejeune Catherine , Fagnoni Philippe , Gaimard Maryse , Manckoundia Patrick , Quibel Clémence , Marchand Mélanie , Anota Amélie , Nerich Virginie 
Published: August 2023

Objectives: To assess health-related quality of life (QoL) in caregivers of elderly patients with chronic disabilities receiving, or not receiving, social worker support.Methods: This multicenter open-label randomized study assigned caregivers to receive an information booklet, exclusively, or with social worker support. Caregivers completed Short Form-36 (SF-36) and Hospital Anxiety Depression Scale quarterly, and Zarit Burden Interview each semester, for 24 months. We reported caregiver QoL mean changes at 12 and 24 months (M12, M24). Longitudinal QoL analysis up to M24 used mixed models for repeated measures (MMRM).Results: Among the 179 caregivers randomized from 2015 to 2019, the SF-36 physical and mental component summary showed no significant changes at M12 and M24, in terms of neither anxiety nor burden. However, depression significantly increased (M12: 1.4 ± 4.0; M24: 1.7 ± 4.1) with significant adjusted mean increase using MMRM at M24: 3.4 [0.6–2.5] in the control group, exclusively.Conclusion: These findings call for better recognition of the social support to prevent caregiver QoL deterioration and alleviate their depression early in the course of the disease.Clinical Trial Registration:ClinicalTrials.gov, identifier NCT02626377.
Healthcare Professionals’ Experiences During the COVID-19 Pandemic in Sudan: A Cross-Sectional Survey Assessing Quality of Life, Mental Health, and Work-Life-Balance
Authors: Mahfouz Mohamed Salih , Osman Sara Amir , Mohamed Badreldin Abdelrhman , Saeed Esra Ali Mahjoub , Ismaeil Mohajer Ibrahim Hassan , Elkhider Rafiaa Ali Abdalla , Orsud Merdi Ahmed 
Published: August 2023

Objectives: The main objective of this research was to investigate the Work-life balance (WLB), mental health, and quality of life and their associated factors among Healthcare Professionals (HCPs) in Sudan during the peak of the COVID-19 pandemic during 2021.Methods: An observational cross-sectional web-based survey was conducted during August-December 2021 among a sample of 430 HCPs working in the hospitals of four Sudanese states. The study used the WHOQoLBREF scale, Work-Life Balance Scale, and General Anxiety Disorder (GAD-7).Results: HCPs reporting a poor quality of life made up 33.5% (95% CI 29.1–38.0), while those reporting worse WLB made up 52.6% (95% CI 47.8–57.2). HCPs reporting moderate to severe anxiety symptoms accounted for 35.8% (95% CI 31.4–40.5). The Multiple Regression model indicated that an increase in the anxiety scores is associated with a decrease in Health-related Quality of Life (HRQoL) (β= 0.831, p &lt; 0.05). Female HCPs exhibited 4.53-fold lower HRQoL scores than their male colleagues (p &lt; 0.05).Conclusion: Approximately one-third of the HCPs in Sudan reported low HRQoL and suffered from moderate to severe anxiety, while a large portion of them had an unequal work-life balance during COVID-19. Health policies addressing these factors are needed to improve the quality of health of HCPs.
Portrait of a Stranger: on the History of the Fight Against Prostitution in Russia (XV Century – 1917)
Authors: Заславский Д.В. , Белова Л.В. 
Published: August 2023

Цель. Проанализировать вопросы борьбы с проституцией в России (ХV в. – 1917 г.). Материалы и методы. Изучение научных трудов и докладов, изданий периодической печати, воспоминаний современников. Представлены редкие фотографии. Обсуждение. Восполнен пробел в историко-медицинской литературе. Проституция в России была под запретом вплоть до царствования императора Николая I. Борьба с ней велась постоянно, но попытки государства особого успеха не имели, и власть изменила тактику. Николай I признал проституцию терпимой в Российской империи, легализовал ее, узаконив указом (1843). Была поставлена задача взять проституцию под контроль, в первую очередь для того, чтобы остановить распространение сифилиса. Заключение. В России (ХV в. – 1917 г.) разными способами пытались бороться с проституцией как главной причиной распространения сифилиса. Однако жизнь показала, что представления правительства о способности легализации проституции и надзора врачебно-полицейских комитетов снизить заболеваемость сифилисом оказались иллюзорными. Официально проституция была запрещена в России только после Октябрьской революции (1917 г.).
Purpose. To analyze the issues of combating prostitution in Russia (XV century – 1917). Materials and methods. The study of scientific papers and reports, periodicals, memoirs of contemporaries. Rare photographs are shown. Discussion. A gap in the historical and medical literature has been filled. Prostitution in Russia was banned until the reign of Emperor Nicholas I. The fight against it was constantly fought, but the state’s attempts were not particularly successful, and the authorities changed tactics. Nicholas I recognized prostitution as tolerable in the Russian Empire, legalized it by legalizing it by decree (1843). The task was to bring prostitution under control, primarily in order to stop the spread of syphilis. Conclusions. In Russia (XV century – 1917) they tried in various ways to fight prostitution as the main cause of the spread of syphilis. However, life has shown that the government’s ideas about the ability of the legalization of prostitution and the supervision of medical and police committees to reduce the incidence of syphilis turned out to be illusory. Officially, prostitution was banned in Russia only after the October Revolution (1917).
Clinical Predictive Factors Affecting Laparoscopic Approach in the Management of Ectopic Pregnancy: A Retrospective Cross-Sectional Study
Authors: Al-Husban Naser , Thekrallah Fida , Qatawneh Aymen , Al-Ramahi Dania , Al-Ashqar Rama , Faraj Balqees , Asfour Mirona , Khreisat Farah 
Published: August 2023

Introduction: Ectopic pregnancy accounts for approximately 2% of all pregnancies and is the most common cause of pregnancy-related mortality in the first trimester. Our aim was to study the preoperative clinical factors affecting the choice of laparoscopic approach to tubal ectopic pregnancy.
Materials and methods: This was a retrospective cross-sectional study of tubal ectopic pregnancy cases that were managed by laparoscopy at an academic university hospital in the period January 2010 to December 2018. Cases that were managed medically or conservatively and laparoscopic cases that were converted to laparotomy were excluded. Cases where the surgical approach of laparoscopy or laparotomy were determined by the patients’ choice were also excluded.
Results: The laparoscopy rate was 49.4%. The mean age was 32.04 years. Compared with laparotomy, laparoscopy was significantly associated with low parity (less than 3) (p=0.008), a low level of initial beta-human chorionic gonadotrophin (p=0.032), fewer cases of adnexal mass (p=0.000451), hemoperitoneum (p=0.000072), ruptured ectopic (p=0.000261), and more cases of bowel adhesions (p=0.0095). There was no significant difference between laparoscopy and laparotomy regarding the risk factors of ectopic pregnancy. Salpingectomy and salpingostomy were not significantly different between the two surgical approaches (p=0.643). Twenty-eight laparoscopic cases were converted to laparotomy.
Conclusion: The laparoscopic approach to ectopic pregnancy was affected by parity, presenting symptoms of pain and vomiting, mean initial beta-human chorionic gonadotrophin, the presence of adnexal mass, the presence of hemoperitoneum, and the rupture of the ectopic. Bowel adhesions were seen more frequently in laparoscopy than laparotomy. Salpingectomy and salpingostomy were no different between laparoscopy and laparotomy.
Do We Need to Change Hip Spica Halfway Through Immobilization Following Closed Reduction for Developmental Dysplasia of the Hip
Authors: Al-Naser Saeed , Altamimi Anas , Gharaibeh Monther 
Published: August 2023

Objectives: Closed reduction (CR) is a well-established method for treating developmental dysplasia of the hip (DDH). Traditionally, the child is placed in a spica cast after DDH CR for three to four months and it is common practice to change the spica under general anesthesia after 6–8 weeks. To our knowledge, no previous studies have shown that changing the spica is necessary. We hypothesize that there is no need to change the spica and that it can be safely retained for three months without any significant complications.
Methods: We used our department database to find all children who had DDH CR and a spica cast for a minimum of 90 days over a one-year period (March 2018 to March 2019) and who had at least a one year follow up after removal of the cast. We retrospectively reviewed the medical notes and radiographs, looking at complications that may be attributed to prolonged use of spica.
Results: Thirty-nine patients (48 hips) met our criteria. None of the patients developed any cast-related complications during or after removal of the spica cast. No abdominal, joint or skin complications were reported throughout treatment. At one year follow up, there were no complications that could be attributed to using the spica for three months.
Conclusion: Changing the spica every 6–8 weeks after DDH CR is of no benefit and exposes the infant to an unnecessary general anesthesia, with the risk of losing the hip reduction. We conclude that it is very safe to keep the spica cast on for three months without changing after DDH CR. We recommend changing practice to reflect our findings.
COVID-19 Knowledge, Awareness and Perceived Stress among Jordanian Healthcare Providers
Authors: Aborajooh Emad , Mafrachi Baraa , Yassin Muhammad , Alhalaseh Lana , Dwairi Rami , Abu- Yaghi Nakhleh , AL-Khazraji Yahya , Abufaraj Mohammad 
Published: August 2023

Background: Healthcare providers (HCPs) are frontline workers during the COVID-19 pandemic. They are prone to increased risk of infection and psychological stress.
Aims: To measure levels of knowledge, awareness, and stress about COVID-19 among HCPs.
Methods: This cross-sectional study of 397 HCPs utilized an internet-based validated questionnaire to evaluate knowledge about COVID-19, the availability of personal protective equipment (PPE), future perceptions, and psychological distress. Univariate and multivariate ordinal logistic regression analyses were used to evaluate factors associated with the degree of knowledge and psychological stress.
Results: Overall, 24.4% showed excellent knowledge, while 54.4% and 21.2% demonstrated good and poor knowledge, respectively. Social media (61.7%) and medical papers (57.7%) were the most commonly used sources of information. Being a female (β=0.521, 95% CI 0.049–0.992), a physician (β=1.421, 95% CI 0.849–1.992), or using published literature to gain knowledge (β=1.161, 95% CI 0.657–1.664) were positive predictors of higher knowledge levels, whereas having higher levels of stress (β= -0.854, 95% CI -1.488 to -0.221) and using social media (β= -0.434, 95% CI -0.865 to -0.003) to gain information were negative predictors of knowledge levels. The availability of PPE was significantly associated with lower psychological stress (p=.01).
Conclusion: Institutions have to provide free evidence-based resources for HCPs about COVID-19, and PPE should be secured to reduce the amount of psychological stress associated with treating COVID-19 patients, as well as to improve their knowledge and the subsequent care provided
Prevalence and Risk Factors of Tinnitus Among University Students
Authors: Mahafza Nadeem , Mahafza Tareq , Mahafza Marina , AlOmari Hala 
Published: August 2023

Objective: The purpose of this study was to investigate the prevalence of tinnitus and other associated risk factors among students from the University of Jordan.
Methods and Design: This cross-sectional study included 1,302 students (785 females and 517 males; aged 17–30 years old) attending the University of Jordan. All participants completed a tinnitus survey that included questions concerning the presence of tinnitus and its characteristics, exposure to recreational noise, and smoking habits. Tinnitus discomfort was measured using an Arabic Visual Analogue Scale (VAS). Descriptive and inferential statistics were used to analyze the data.
Results: The overall prevalence of tinnitus (continuous or intermittent) was 21.2% among participants, with females having 13.9% prevalence and males having 7.3%. Pearson’s Chi-square test revealed a significant association between tinnitus and the influence of the various risk factors (x2=102.09, df=4, p<0.001). In addition, tinnitus was more likely to be associated with noise exposure (29%) and smoking (15%), and less likely to be related to seasonal allergies and gender. The results of the VAS indicated that only 5% of the students reported that their tinnitus was extremely uncomfortable.
Conclusion: According to the findings of this study, the prevalence of tinnitus among university students who participated in this study was 21.2%. Furthermore, our results showed that exposure to recreational noise and smoking were associated with the presence of tinnitus.
Pengaruh Diversifikasi Usaha dan Volume Perdagangan Saham terhadap Return Saham pada Perusahaan Sub Sektor Farmasi (Bursa Efek Indonesia 2018-2022)
Authors: Maharani Septia Putri 
Published: August 2023

Provision of drugs and medical devices to the public is the focus of the pharmaceutical industry. The pharmaceutical industry has been badly affected by the COVID-19 pandemic due to its relationship with health. The purpose of this study was to find out how business diversification and trading volume activity impacted stock returns for pharmaceutical companies listed on the IDX from 2018 to 2022. 40 data were collected using a purposive sampling technique and an observation period of 5 years. Descriptive and verification analyzes were performed, including classical assumptions (normality, heteroscedasticity, autocorrelation and multicollinearity), multiple linear regression analysis, t-test and f-test. Data processing was carried out using SPSS 26 statistics. The results of testing the data show that Business Diversification (X1) does not partially affect Stock Returns, and Trading Volume Activity (X2) partially affects Stock Returns. Furthermore, business diversification (X1) and trading volume activity (X2) affect stock returns simultaneously.
Keywords: Pharmaceutical Industry, Business Diversification (X1), Trading Volume Activity (X2), Stock Returns.
Sosialisasi Pernikahan Dini sebagai Upaya Penanggulangan Stunting di Desa Tammerodo Utara
Authors: Aco Nisya Auliyah , Arrun Rastia , Nurhatinah Nurhatinah , Rusli Magfirah , Nurfiana Nurfiana , Wahyuddin Wahyuddin , Dermawan Dermawan , Yana Muhhammad Saiful 
Published: August 2023

<p style="text-align: left;">Stunting dan pernikahan usia dini merupakan salah satu masalah yang cukup krusial di Indonesia seperti yang terjadi di desa Tammerodo Utara. Stunting dan pernikahan dini merupakan masalah yang harus segera ditangani oleh berbagai elemen masyarakat, karena akan berakibat pada sumber daya manusia yang tidak unggul. Oleh karena itu, sangat diperlukan kesadaran masyarakat mengenai untuk menanggulagi masalah stunting dan pernikahan dini melalui program kerja sosialisasi pernikahan dini yang diadakan oleh mahasiswa KKN STAIN Majene. Tujuan Kegiatan Kegiatan ini dilakukan untuk melaksanakan program pengabdian terhadap masyarakat, yakni menjadi penyelenggara untuk memfasilitasi masyarakat terutama remaja mengenai pernikahan dini. Adapun metode pengabdian yang digunakan yaitu 1) melakukan observasi, 2) Pemgamatan, 3) Pendekatan, 4) Analisis masalah yang ditemukan, kemudian membuat program kerja yang sesuai dengan kebutuhan masyarakat seperti sosialsasi perniakahan usia dini. Hal yang perlu kita pahami bahwa pernikahan dini adalah pernikahan di bawah usia 21 tahun bagi perempuan dan di bawah 25 tahun bagi laki-laki. penyebab pernikahan dini adalah ekonomi, pendidikan, orang tua, pergaulan bebas, internet, Hamil di luar nikah. Dampak pernikahan dini adalah perceraian, kerusakan rahim, bayi berisiko terhambatnya pertumbuhan, kematian ibu dan anak, bayi lahir prematur. Pernikahan usia dini merupakan hal yang sangat mendesak untuk diselesaikan supaya dapat menanggulagi masalah stunting.</p>