bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ultrawide dynamic modulation of perfect absorption with a Friedrich–Wintgen BIC
Authors: Gao Enduo , Jin Rong , Fu Zhenchu , Cao Guangtao , Deng Yan , Chen Jian , Li Guanhai , Chen Xiaoshuang , Li Hongjian 
Published: January 2023

Dynamical control of perfect absorption plays an indispensable role in optical switch and modulators. However, it always suffers from the limited modulation range, small depth, and susceptible absorption efficiencies. Here, we propose a new strategy based on Friedrich–Wintgen bound states in the continuum (F–W BICs) to realize a tunable perfect absorber with large dynamic modulation range. For proof of concept, we demonstrate a pentaband ultrahigh absorption system consisting of graphene gratings and graphene sheets through elaborately tuning F–W BIC. The nature of the F–W BIC arises from the destructive interference between Fabry–Perot resonance and guided mode resonance modes in the coherent phase-matching condition. The radiation channels are avoided from crossing. The BIC can be dynamically modulated by engineering the Fermi level of graphene gratings, which breaks the traditional modulation methods with an incidence angle. Remarkably, the perfect absorber with this F–W BIC approach achieves the largest modulation range of up to 3.5 THz. We believe that this work provides a new way to dynamically engineer perfect absorption and stimulates the development of multiband ultracompact devices.
Reinforcing personalized persuasion in task-oriented virtual sales assistant
Authors: Raut Aritra , Tiwari Abhisek , Das Subrata , Saha Sriparna , Maitra Anutosh , Ramnani Roshni , Sengupta Shubhashis 
Published: January 2023

PurposeExisting task-oriented virtual agents can assist users with simple tasks like ticket booking, hotel reservations, etc. effectively and with high confidence. These virtual assistants, however, assume specific, predictable end-user behavior, such as predefined/servable objectives, which results in conversation failures in challenging situations, such as when goals are unavailable.MethodologyInspired by the practice and its efficacy, we propose an end-to-end framework for task-oriented persuasive dialogue generation that combines pre-training and reinforcement learning for generating context-aware persuasive responses. We utilize four novel rewards to improve consistency and repetitiveness in generated responses. Additionally, a meta-learning strategy has also been utilized to make the model parameters better for domain adaptation. Furthermore, we also curate a personalized persuasive dialogue (PPD) corpus, which contains utterance-level intent, slot, sentiment, and persuasion strategy annotation.FindingsThe obtained results and detailed analysis firmly establish the effectiveness of the proposed persuasive virtual assistant over traditional task-oriented virtual assistants. The proposed framework considerably increases the quality of dialogue generation in terms of consistency and repetitiveness. Additionally, our experiment with a few shot and zero-shot settings proves that our meta-learned model learns to quickly adopt new domains with a few or even zero no. of training epochs. It outperforms the non-meta-learning-based approaches keeping the base model constant.OriginalityTo the best of our knowledge, this is the first effort to improve a task-oriented virtual agent’s persuasiveness and domain adaptation.
Supporting care engagement in primary care; the development of a maturity matrix
Authors: Wolters René , Mokadem Ibtissam , Wensing Michel , Braspenning Jozé 
Published: January 2023

Background
Care engagement or active patient involvement in healthcare contributes to the quality of primary care, but organisational preconditions in routine practice need to be aligned. A Maturity Matrix for Care Engagement to assess and discuss these preconditions in the general practice team was developed and tested on feasibility and acceptability in general practice.

Methods and findings
A systematic user-centred approach was applied, starting with a scoping literature search to describe the domains on the horizontal axis of the maturity matrix. The domains and growing steps (vertical axis) were refined by patients (n = 16) and general practice staff (n = 11) in three focus group discussions and reviewed by six experts (local facilitators and scientists). Seven domains could be distinguished: Personalised Care, Shared Decision Making, Self-Management, Patient as Partner, Supportive Means, Patient Environment, and Teamwork among Healthcare Professionals. The growing steps described three to six activities per domain (n = 32 in total) that contribute to care engagement. Local facilitators implemented the tool in two general practice teams according to a user guide, starting with a two-hour kick-off meeting on care engagement. In the next step, practitioners, nurses and assistants in each practice indicated their score on the domains individually. The scores were discussed in the facilitated practice meeting which was aimed at SMART improvement plans. Feasibility and acceptability were assessed in interviews showing that the tool was well received by the pilot practices, although the practice assistants had difficulties scoring some of the activities as they did not always relate to their daily work. An assessment after three months showed changes in practice organisation towards increased care engagement.

Conclusions
The maturity matrix on care engagement is a tool to identify the organisational practice maturity for care engagement. Suggested adaptations must be implemented before large-scale testing.
Relationship of mental health and burnout with empathy among medical students in Thailand: A multicenter cross-sectional study
Authors: Pitanupong Jarurin , Sathaporn Katti , Ittasakul Pichai , Karawekpanyawong Nuntaporn 
Published: January 2023

Objectives
To explore mental health, burnout, and the factors associated with the level of empathy among Thai medical students.

Background
Empathy is an important component of a satisfactory physician-patient relationship. However, distress, including burnout and lack of personal well-being, are recognized to affect a lower level of empathy.

Material and methods
A cross-sectional study surveyed sixth-year medical students at three faculties of medicine in Thailand at the end of the 2020 academic year. The questionnaires utilized were: 1) Personal and demographic information questionnaire, 2) Thai Mental Health Indicator-15, 3) The Maslach Burnout Inventory-Thai version, and 4) The Toronto Empathy Questionnaire. All data were analyzed using descriptive statistics, and factors associated with empathy level were analyzed via the Chi-square test or Fisher’s exact test, logistic regression., and linear regression.

Results
There were 336 respondents with a response rate of 70.3%. The majority were female (61.9%). Most participants reported a below-average level of empathy (61%) with a median score (IQR) of 43 (39–40). Assessment of emotion comprehension in others and altruism had the highest median empathy subgroup scores, whereas behaviors engaging higher-order empathic responses had the lowest median empathy subgroup score. One-third of participants (32.1%) had poor mental health, and two-thirds (62.8%) reported a high level of emotional exhaustion even though most of them perceived having a high level of personal accomplishment (97%). The multivariate analysis indicated that mental health was statistically significantly associated with the level of empathy. The participants with higher levels of depersonalization had statistically lower scores of demonstrating appropriate sensitivity, altruism, and behaviors engaging higher-order empathic responding.

Conclusions
Most medical students had below-average empathy levels, and two-thirds of them had high emotional exhaustion levels, yet most of them reported having a high level of personal accomplishment and good mental health. There was an association between mental health and the level of empathy. Higher levels of depersonalization related to lower scores of demonstrating sensitivity, altruism, and behaviors responding. Therefore, medical educators should pay close attention to promoting good mental health among medical students.
Healthcare expenditure and its socio-demographic and clinical predictors in Australians with poorly controlled asthma
Authors: Lartey Stella T. , Lung Thomas , Serhal Sarah , Bereznicki Luke , Bereznicki Bonnie , Emmerton Lynne , Bosnic-Anticevich Sinthia , Saini Bandana , Billot Laurent , Krass Ines , Armour Carol , Jan Stephen 
Published: January 2023

Introduction
Asthma has substantial and increasing health and economic burden worldwide. This study aimed to estimate healthcare expenditure and determine the factors that increase expenditure in Australians with poorly controlled asthma.

Methods
Individuals ≥18 years of age with poorly controlled asthma, as determined by a score ≥1.5 on the Asthma Control Questionnaire, were included in the study. Healthcare utilization costs from medical services and medications were estimated over an average follow-up of 12 months from administratively linked data: the Medicare Benefits Schedule and Pharmaceutical Benefits Scheme. A generalized linear model with gamma distribution and log link was used to predict participants’ key baseline characteristics associated with variations in healthcare costs.

Results
A total of 341 participants recruited through community pharmacies were included. The mean (standard deviation, SD) age of participants was 56.6 (SD 17.6) years, and approximately 71% were females. The adjusted average monthly healthcare expenditure per participant was $AU386 (95% CI: 336, 436). On top of the average monthly costs, an incremental expenditure was found for each year increase in age ($AU4; 95% CI: 0.78, 7), being unemployed ($AU201; 95% CI: 91, 311), one unit change in worsening quality of life ($AU35; 95% CI: 9, 61) and being diagnosed with depression and anxiety ($AU171; 95% CI: 36, 306).

Conclusions
In a cohort of Australian patients, characterized by poor asthma control and co-morbidities individuals impose substantial economic burden in terms of Medicare funded medical services and medications. Programs addressing strategies to improve the quality of life and manage co-morbid anxiety and depression and encourage asthma patients’ engagement in clinically tolerable jobs, may result in significant cost savings to the health system.
Pyrotinib versus lapatinib therapy for HER2 positive metastatic breast cancer patients after first-line treatment failure: A meta-analysis and systematic review
Authors: Yuan Ye , Liu Xumei , Cai Yi , Li Wenyuan 
Published: January 2023

IntroductionIt is critical to select subsequent treatments for patients after the failure of trastuzumab therapy. Following the failure of standard trastuzumab therapy guidelines in the Chinese Society of Clinical Oncology, pyrotinib and capecitabine is a grade I recommended regimen for treating patients with HER2-positive metastatic breast cancer. Concurrently, in treating patients with HER2-positive metastatic breast cancer, lapatinib and capecitabine are also recommended regimens for those who have previously received taxanes, anthracyclines, and trastuzumab therapy. However, there is currently no systematic review and meta-analysis comparing pyrotinib with lapatinib among HER2+ MBC patients. Therefore, this study aims to perform a systematic review and meta-analysis and assess whether pyrotinib is superior to lapatinib in efficacy and safety.MethodsRelevant trials were searched in CNKI, Wanfang, VIP, PubMed, Embase, and Cochrane CENTRAL databases from inception until March 27th, 2022. The primary outcomes were PFS and OS, and the secondary outcomes were ORR and grade ≥3 AEs.ResultsFive relevant studies were included in this study, including 2 RCTs and 3 retrospective cohort studies. Pyrotinib combined with chemotherapy is superior to lapatinib combined with chemotherapy among HER2+ metastatic breast cancer patients, with a significant improvement in PFS (prior trastuzumab therapy) (HR: 0.47, 95% CI: 0.39–0.57,p<0.001, I2= 0%, FEM), PFS (trastuzumab resistance) (HR: 0.52, 95% CI: 0.39–0.68,p<0.001, I2= 40%, FEM) and ORR (RR: 1.45, 95% CI: 1.26–1.67,p<0.001, I2= 8%, FEM), but has higher grade ≥3 diarrhea incidence (RR: 2.68, 95% CI: 1.85–3.90,p<0.001, I2= 44%, FEM).ConclusionsThe efficacy of pyrotinib combined with chemotherapy is superior to lapatinib combined with chemotherapy but has more safety risks.
Impact of the period of the day on all-cause mortality and major cardiovascular complications after arterial vascular surgeries
Authors: Artioli Thiago , Gualandro Danielle Menosi , Cardozo Francisco Akira Malta , Rojas María Carmen Escalante , Calderaro Daniela , Yu Pai Ching , Casella Ivan Benaduce , Luccia Nelson de , Caramelli Bruno 
Published: January 2023

Background
Conflicting results are reported about daytime variation on mortality and cardiac outcomes after non-cardiac surgeries. In this cohort study, we evaluate whether the period of the day in which surgeries are performed may influence all-cause mortality and cardiovascular outcomes in patients undergoing non-cardiac arterial vascular procedures.

Methods
1,267 patients who underwent non-cardiac arterial vascular surgeries between 2012 and 2018 were prospectively included in our cohort and categorized into two groups: morning (7 a.m. to 12 a.m., 79%) and afternoon/night (12:01 p.m. to 6:59 a.m. in the next day, 21%) surgeries. Primary endpoint was all-cause mortality within 30 days and one year. Secondary endpoints were the incidence of perioperative myocardial injury/infarction (PMI), and the incidence of major adverse cardiac events (MACE, including acute myocardial infarction, acute heart failure, arrhythmias, cardiovascular death) at hospital discharge.

Results
After adjusting for confounders in the multivariable Cox proportional regression, all-cause mortality rates at 30 days and one year were higher among those who underwent surgery in the afternoon/night (aHR 1.6 [95%CI 1.1–2.3], P = 0.015 and aHR 1.7 [95%CI 1.3–2.2], P < 0.001, respectively). Afternoon/night patients had higher incidence of PMI (aHR 1.4 [95%CI 1.1–1.7], P < 0.001). There was no significant difference in the incidence of MACE (aHR 1.3 [95%CI 0.9–1.7], P = 0.074).

Conclusions
In patients undergoing arterial vascular surgery, being operated in the afternoon/night was independently associated with increased all-cause mortality rates and incidence of perioperative myocardial injury/infarction.
Validation of the motion sickness severity scale: Secondary analysis of a randomized, double-blind, placebo-controlled study of a treatment for motion sickness
Authors: Czeisler Mark É. , Pruski Justina M. , Wang Pan , Wang Jingyuan , Xiao Changfu , Polymeropoulos Mihael H. , Polymeropoulos Vasilios M. 
Published: January 2023

Background
Motion sickness is characterized by nausea and vomiting among a constellation of symptoms. Symptom severity is dynamic and distressing. Most validated motion sickness scales are time-intensive and effortful, with alternative scales having uncertain performance or non-specific measures. A validated instrument allowing for facile, rapid assessment of core motion sickness symptom severity would therefore be valuable. We assessed the performance of the Motion Sickness Severity Scale (MSSS), a six-item questionnaire designed to measure real-time motion sickness symptoms.

Methods
MSSS construct validity was assessed as a secondary analysis of data from 63 healthy participants without antiemetic treatment in a clinical trial (Unique Identifier = NCT03772340) conducted to evaluate the safety and efficacy of Tradipitant—a novel neurokinin-1 receptor antagonist—in the treatment of motion sickness. Clinical outcome assessments included the MSSS, the Patient Global Impression of Severity (PGI-S), and the Motion Sickness Assessment Questionnaire (MSAQ). The performance of the MSSS through Pearson correlation coefficients, within-group analysis of variance, empirical cumulative distribution functions, and Kolmogorov-Smirnov tests.

Results
The MSSS correlated very highly with the PGI-S (r = 0.93, p-value<0.0001) and highly with the MSAQ (r = 0.83, p-value<0.0001). Mean MSSS scores between increasing PGI-S severity levels increased significantly in all four increments (None-to-Mild: p-value = 0.006, Mild-to-Moderate: p-value<0.0001, Moderate-to-Severe: p-value = 0.006, Severe-to-Very-Severe: p-value = 0.002). There were statistically significant differences in MSSS score distributions stratified by PGI-S severity level, with higher MSSS scores associated with higher PGI-S severity levels and lower MSSS scores associated with lower PGI-S severity levels.

Discussion
The MSSS is a valid instrument for the assessment of the core motion sickness symptoms and is reflective of global disease severity. Implementation of the MSSS and comparable simplified, short questionnaires in motion sickness research will provide rapid and accurate measures of disease severity. These measures will enable further elucidation of motion sickness as an illness and inform the development and evaluation of motion sickness therapies.
Monitoring SARS-CoV-2 seroprevalence over time among pregnant women admitted to delivery units: Suitability for surveillance
Authors: Miyadahira Mariana Yumi , Brizot Maria de Lourdes , Alexander Neal , Cerdeira Sabino Ester , Campos de Oliveira da Silva Lea , Hoshida Mara Sandra , da Silva Sousa Oliveira Ana Maria , Silva Farche Ana Claudia , Pulcineli Vieira Francisco Rossana , Mayaud Philippe 
Published: January 2023

Objectives
To determine SARS-CoV-2 seroprevalence over time and risk factors among pregnant women at delivery in São Paulo, Brazil; and to evaluate the suitability of pregnant women as a sentinel population for SARS-CoV-2 serosurveillance.

Methods
Unselected consecutive pregnant women presenting at the labor ward of a single large hospital between July 20th 2020 to February 21st 2021 were enrolled and tested for SARS-CoV-2 serology using two assays: the rapid chromatic Wondfo One Step (for total IgA and IgG detection) and Roche Elecsys assay (detecting anti-nucleoprotein [N] IgG). SARS-CoV-2 seroprevalence was computed as smooth spline function over time with 95% confidence intervals (CI). Risk factors were evaluated for positivity by each assay. We compared timepoint seroprevalence by the two assays with four concomitant community household surveys (HHS), in which the Roche assay was used, to determine the sensitivity and relevance of the pregnant women population as sentinel population.

Results
Overall SARS-CoV-2 seroprevalence was 28.9% (221/763) by Roche and 17.9% (137/763) by Wondfo. Reported symptoms experienced during pregnancy were all significantly correlated with being SARS-CoV-2 seropositive at delivery with any assay (with odds-ratios ranging from 3.0 [95% CI: 2.1–4.3] for coryza to 22.8 [95% CI: 12.3–46.6] for ageusia). Seropositivity by either assay was high in women at delivery in the early period of the pandemic (June 2020), compared with seropositivity in women from the concomitant HHS: 44.1% (95% CI: 21.8–66.4) for Roche, 54.1% (30.9–78.5) for Wondfo, versus 11.4% (95% CI: 9.2–13.6) for HHS. For later periods (October 2020 and January 2021), the seropositivity in women at delivery measured by Roche corresponded well with the prevalence found among women in the HHS using the same assay, whilst prevalence measured by Wondfo dropped.

Conclusions
Women at delivery represent a highly exposed and readily accessible population for sentinel surveillance of emerging infections such as SARS-CoV-2.
Epicardial conduction abnormalities in patients with Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) and mutation positive healthy family members – A study using electrocardiographic imaging
Authors: Kommata Varvara , Sciaraffia Elena , Blomström-Lundqvist Carina 
Published: January 2023

Background
The diagnosis of arrhythmogenic right ventricular cardiomyopathy (ARVC) in early stages is challenging. The aim of this study was therefore to investigate whether electrocardiographic imaging (ECGI) can detect epicardial conduction changes in ARVC patients and healthy mutation-carriers (M-carriers).

Method
Twelve ARVC patients, 20 M-carriers and 8 controls underwent 12-lead ECG, signal-averaged ECG, 2-dimensional echocardiography, 24-hours Holter monitoring and ECGI (body surface mapping and computer tomography with offline analysis of reconstructed epicardial signals). Total and Right Ventricular Activation Time (tVAT and RVAT respectively), area of Ventricular Activation during the terminal 20 milliseconds (aVAte20) and the activation patterns were compared between groups.

Results
In ARVC patients the locations of aVAte20 were scattered or limited to smaller parts of the right ventricle (RV) versus in controls, in whom aVAte20 was confined to right ventricular outflow tract (RVOT) and left ventricle (LV) base (+/- RV base). ARVC patients had smaller aVAte20 (35cm2 vs 87cm2, p<0.05), longer tVAT (99msec vs 58msec, p<0.05) and longer RVAT (66msec vs 43msec, p<0.05) versus controls. In 10 M-carriers (50%), the locations of aVAte20 were also eccentric. This sub-group presented smaller aVAte20 (53cm2 vs 87cm2, p = 0.009), longer RVAT (55msec vs 48msec, p = 0.043), but similar tVAT (65msec vs 60msec, p = 0.529) compared with the M-carriers with normal activation pattern.

Conclusions
ECGI can detect epicardial conduction abnormalities in ARVC patients. Moreover, the observation of localized delayed RV epicardial conduction in M-carriers suggests an early stage of ARVC and may be a useful diagnostic marker enhancing an early detection of the disease.
ANALYSIS OF THE QUERIES RECEIVED AT THE DRUG INFORMATION CENTER OF PARAGUAY: A CONTRIBUTION TO THE RATIONAL USE OF MEDICINES
Authors: Maidana de Larroza Gladys Mabel , Acosta Patricia Guadalupe , Maciel Olga Yolanda , Samaniego Lourdes Raquel , Vera Zully Concepción , Lugo Gladys Beatriz 
Published: January 2023

Los Centros de Información de Medicamentos (CIM) son defi nidos como unidades operacionales que proporcionan información científi ca y técnica sobre medicamentos de forma objetiva y oportuna, constituyendo una óptima estrategia para atender necesidades particulares de información, con el fin de promover el uso correcto y seguro de los mismos. El propósito de este estudio es describir las consultas recibidas en el CIM de |UNA durante el periodo 2015 -2019 y su rol en la contribución al uso racional de medicamentos, para lo cual se llevó a cabo un estudio observacional descriptivo de corte transversal con recolección retrospectiva de la información. Se tomaron todas las fichas de consultas ingresadas a la base de datos del CIM durante el periodo en estudio. En el periodo de estudio se han realizado un total de 254 consultas, con un promedio de 51 consultas por año, en su mayoría se hicieron a nivel nacional y en un 13% de las mismas involucraban a pacientes. Los principales temas solicitados al CIM fueron aquellos relacionados a legislación farmacéutica (Registro y disponibilidad de medicamentos en el país), seguido de temas relacionados al uso racional, Farmacovigilancia entre otros. El análisis y caracterización permitió conocer las necesidades de información respecto a los medicamentos, brindar la información objetiva, dirigida y de calidad cumpliendo con el objetivo de promover el uso racional de medicamentos.