bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impaired Sensitivity to Thyroid Hormones Is Associated With Elevated Homocysteine Levels in the Euthyroid Population
Authors: Ding Xiaoyu , Wang Ying , Liu Jia , Wang Guang 
Published: June 2022

Abstract

Context
Homocysteine (Hcy), a known risk factor for cardiovascular disease, has been reported to be linked with thyroid dysfunction. However, the association of thyroid hormones sensitivity with Hcy levels remains unknown.

Objective
We aimed to investigate the relationship between thyroid hormone sensitivity and elevated Hcy levels in the euthyroid population.

Methods
A total of 8957 euthyroid adults were included in this study. Free triiodothyronine (FT3), free thyroxine (FT4), thyrotropin (TSH), Hcy levels, and other clinical parameters were measured. Hyperhomocysteinemia (HHcy) was defined as serum Hcy level &gt; 15 μmol/L. Thyroid hormone sensitivity indices were calculated by thyroid feedback quantile-based index (TFQI), Chinese-referenced parametric TFQI (PTFQI), TSH index (TSHI) and thyrotropin thyroxine resistance index (TT4RI).

Results
Subjects with decreased sensitivity to thyroid hormones had higher Hcy levels (P for trend &lt; 0.001). Logistic regression analysis revealed the higher quartiles of TFQI, PTFQI, TSHI, and TT4RI were significantly associated with elevated Hcy levels, and these associations remained significant even after adjustment for multiple risk factors. After adjusting for age, sex, body mass index, dyslipidemia, fatty liver, diabetes, and hypertension, the odds ratio (95% CI) for having HHcy of the TFQI in the highest quartile was 1.393 (1.210, 1.603), the PTFQI in the highest quartile was 1.409 (1.225, 1.621), the TSHI in the highest quartile was 1.372 (1.190, 1.583), and the TT4RI in the highest quartile was 1.315 (1.141, 1.515) (all P &lt; 0.001).

Conclusion
In euthyroid subjects, impaired sensitivity to thyroid hormones was associated with elevated Hcy levels.
Dual-Layer Rotation: A Versatile Therapeutic Mammoplasty Technique
Authors: Joukainen Sarianna , Laaksonen Elina , Vanninen Ritva , Kaarela Outi , Sudah Mazen 
Published: June 2022

Abstract
Background
Multifocal or complex breast lesions are a challenge for breast-conserving surgery, particularly surgery in small breasts or those located in the upper inner quadrant. The dual-layer rotation technique exploits the idea of manipulating the skin and glandular tissue in separate layers to fill the resection cavity via vertical mammoplasty if skin excision is not required, except in the central area.

Methods
The authors performed a retrospective review of consecutive breast cancer patients who underwent DLR mammoplasty between 2017 and 2019 at a single institution. Clinical data, reoperations, surgical complications, delays in adjuvant treatments, and the need for late revisional surgery were evaluated. Aesthetic outcomes were evaluated objectively and subjectively from photographs.

Results
The study included 46 breasts of 40 patients. Tumors were located in the UIQ (30%, 14/46) or in multiple quadrants (22%, 10/46). One third (33%, 13/40) of the patients had a small breast cup size (A–B). Negative margins were primarily achieved in 45 of the 46 breasts. Major complications occurred in three patients, who needed reoperation, and adjuvant therapy was delayed for one of these patients. Late refinement surgery was needed for two patients. The objective and subjective aesthetic outcomes were good or excellent regardless of the tumor position.

Conclusion
As a novel oncoplastic approach, DLR mammoplasty offers a one-step procedure to treat selected breast cancer patients with challenging resection defects due to different breast sizes or lesion locations. The technique preserves the breast’s natural appearance.
Performance measurement of university-industry collaboration in the technology transfer process: A systematic literature review
Authors: Pujotomo Darminto , Helmi Syed Hassan Syed Ahmad , Ma’aram Azanizawati , Sutopo Wahyudi 
Published: June 2022

BackgroundTo fostering organizational improvement, the performance must be assessed. In the context of university-industry collaboration (UIC) in the technology transfer process, the performance of also must be assessed. However, the performance covers complex aspects which makes it difficult to be measured. This indicates the need to have a better understanding of the methods used. Therefore, this study presents a systematic literature review on the performance measurement of UIC in the technology transfer process that can give to the researchers an easy and quick overview of the literature about (mainly) the methods used for the performance measurement.MethodsWe used two major scientific databases, i.e., Scopus and Web of Science. We defined four groups of keywords to restrict the search criteria. We only consider articles published in the last decade, during 2010 to November 2021. The search procedure contains four phases following the PRISMA framework: (i) identification, (ii) screening, (iii) eligibility, and (iv) inclusion.ResultsThe final screening process resulted in 24 articles that satisfied the criteria for inclusion in this review. The collected articles are categorized according to two classifications. The first is about type of the collaboration, while the second is about the methods used. We investigated three types of collaboration, i.e., at the level of technology transfer office (TTO), the academic (university) spin-offs, and joint-research. There are several methods for assessing performance, ranging from qualitative, quantitative, to mixed methods.ConclusionThe literature review leads us to the following conclusions. First, most studies are conducted at the TTO level, in which it is anticipated since it is the most common form UIC. Second, the application of data envelopment analysis is still preferable than other method in measuring the performance. This study also provides possible research directions that can facilitate scholars to uncover gaps in the literature.
Analysis of football referees injuries - literature review
Authors: Mańko Aleksandra 
Published: June 2022

Introduction and purpose: According to the literature, injuries are defined as the result of the action of significant energy, causing dysfunction and anatomical-physiological changes. In the case of football referees, sports injuries occur during physical exertion in the form of matches and training sessions. As a result, various injuries occur, both on the pitch and during arduous training. They often take place as the aftermath of summed micro-injuries. Properly early detection and analysis of these signals helps to heal the damage and to avoid a longer break from activity, which would inevitably result in a serious injury. The aim of this study is to analyze the most common injuries and their risk factors in football referees on the basis of the current literature.
Description of the state of knowledge: 9 research papers from the last twelve years (2009-2021) containing the above-mentioned keywords have been qualified for this review. Based on the above works, it is possible to determine when and how often injuries occur among referees, and what areas of the body are injured. Due to the multifactorial etiology of injuries and heterogeneous diagnostic systems, which would constitute a standardized research tool, it is difficult to say unequivocally what is the greatest cause of an injury.
Conclusions: 1) Injuries among referees at different levels of the game occur more often due to the match load than the training load. 2) Muscle injuries were the most common, but there was no indication of a tendency towards the exact location of the injury, which requires further research.
The Hidden Costs of Securing Innovation: The Manifold Impacts of Compulsory Invention Secrecy
Authors: Gross Daniel P. 
Published: June 2022

One of the most commanding powers of the U.S. Patent and Trademark Office (USPTO) is to compel inventions into secrecy, withholding patent rights and prohibiting disclosure, to prevent technology from leaking to foreign competitors. This paper studies the impacts of compulsory secrecy on firm invention and the wider innovation system. In World War II, USPTO issued secrecy orders to more than 11,000 patent applications, which it rescinded en masse at the end of the war. Compulsory secrecy caused implicated firms to shift their patenting away from treated classes, with effects persisting through at least 1960. It also restricted commercialization and impeded follow-on innovation. Yet it appears it was effective at keeping sensitive technology out of public view. The results provide insight into the effectiveness of compulsory secrecy as a regulatory strategy and into the roles, and impacts, of formal intellectual property in the innovation system. This paper was accepted by Toby Stuart, entrepreneurship and innovation. Funding: This work was supported by Harvard Business School (Division of Research and Faculty Development) and the National Bureau of Economic Research (Innovation Policy Grant). This material is based upon work supported by the National Science Foundation [Grant 1951470]. Supplemental Material: Data and the online appendices are available at https://doi.org/10.1287/mnsc.2022.4457 .
67  GHz light-trapping-structure germanium photodetector supporting 240  Gb/s PAM-4 transmission
Authors: Chen Daigao , Zhang Hongguang , Liu Min , Hu Xiao , Zhang Yuguang , Wu Dingyi , Zhou Peiqi , Chang Siyao , Wang Lei , Xiao Xi 
Published: June 2022

A light-trapping-structure vertical Ge photodetector (PD) is demonstrated. In the scheme, a 3 μm radius Ge mesa is fabricated to constrain the optical signal in the circular absorption area. Benefiting from the light-trapping structure, the trade-off between bandwidth and responsivity can be relaxed, and high opto-electrical bandwidth and high responsivity are achieved simultaneously. The measured 3 dB bandwidth of the proposed PD is around 67 GHz, and the responsivity is around 1.05 A/W at wavelengths between 1520 and 1560 nm. At 1580 nm, the responsivity is still over 0.78 A/W. A low dark current of 6.4 nA is also achieved at

−
2

V

bias voltage. Based on this PD, a clear eye diagram of 100 GBaud four-level pulse amplitude modulation (PAM-4) is obtained. With the aid of digital signal processing, 240 Gb/s PAM-4 signal back-to-back transmission is achieved with a bit error ratio of

1.6
×

10

−
2

. After 1 km and 2 km fiber transmission, the highest bit rates are 230 and 220 Gb/s, respectively.
Comparative assessment of cognitive impairment and oxidative stress markers among vitamin D insufficient elderly patients with and without type 2 diabetes mellitus (T2DM)
Authors: R. Rajalakshmi , Uthaiah Chinnappa A. , C. M. Ramya , Madhunapantula SubbaRao V. , Salimath Paramahans V. , K. Praveen , M. Srinath K. , M. R. Kishor 
Published: June 2022

Background
Disorders of mental health are known to affect cognitive functions, hence called as cognitive disorders. Impaired glucose metabolism, insulin resistance, vitamin-D deficiency and oxidative stress are some of the key early events reported to be involved in the pathogenesis of most common cognitive disorders, which include Alzheimer’s disease. Type-2 diabetes mellitus (T2DM) is one of the known contributing factors of cognitive impairment and dementia.

Methods
A cross sectional study was carried out in 145 subjects, who were assessed for cognitive function by modified mini mental status examination (3MS). In addition, measurement of fasting blood sugar (FBS), fasting insulin, HbA1c, lipid profile, vitamin D and oxidative markers was performed. Participants were divided into different groups based on (a) vitamin D insufficiency and sufficiency; (b) diabetic and non-diabetic with and without cognitive impairment.

Results
The study included a total of 145 subjects; 51 males and 94 females and the mean age was 68.24±9.70 years. Among diabetics with vitamin D insufficiency, 35 subjects (71.43%) had cognitive impairment, but, among non-diabetics with vitamin D insufficiency, 27 subjects (62.79%) had cognitive impairment. Chi square test showed no significant association between diabetes, vitamin D insufficiency and cognitive impairment. Glutathione peroxidase (GPx) and superoxide dismutase (SOD) levels were non-significantly lower in cognition-impaired subjects, when compared to cognition normal subjects in diabetics with vitamin D insufficiency.

Conclusion
Our study showed that cognitive impairment is more predominant in individuals with diabetes. However, our study did not find any significant relationship between T2DM, vitamin D deficiency, cognitive impairment, and oxidative stress. A significant association was found only with GPx and 3MSE score in vitamin D insufficient non-diabetics.
Economic burden of sickle cell disease in Brazil
Authors: Silva-Pinto Ana Cristina , Costa Fernando F. , Gualandro Sandra Fatima Menosi , Fonseca Patricia Belintani Blum , Grindler Carmela Maggiuzzu , Souza Filho Homero C. R. , Bueno Carolina Tosin , Cançado Rodolfo D. 
Published: June 2022

Background
Sickle cell disease (SCD) may cause several impacts to patients and the whole society. About 4% of the population has the sickle cell trait in Brazil, and 60,000 to 100,000 have SCD. However, despite recognizing the significant burden of disease, little is known about SCD costs.

Objective
To estimate SCD societal costs based on disease burden modelling, under Brazilian societal perspective.

Methods
A disease burden model was built considering the societal perspective and a one-year time horizon, including direct medical and indirect costs (morbidity and mortality). The sum of life lost and disability years was considered to estimate disability-adjusted life years (DALYs). Data from a public database (DATASUS) and the prevalence obtained from literature or medical experts were used to define complications prevalence and duration. Costs were defined using data from the Brazilian public healthcare system table of procedures and medications (SIGTAP) and the human capital method.

Results
Annual SCD cost was 413,639,180 USD. Indirect cost accounted for the majority of burden (70.1% of the total; 290,158,365 USD vs 123,480,816 USD). Standard of care and chronic complications were the main source of direct costs among adults, while acute conditions were the main source among children. Vaso-occlusive crisis represented the complication with the highest total cost per year in both populations, 11,400,410 USD among adults and 11,510,960 USD among children.

Conclusions
SCD management may impose an important economic burden on Brazilian society that may reach more than 400 million USD per year.
Factors associated with delay in treatment-seeking behaviour for fever cases among caregivers of under-five children in India: Evidence from the National Family Health Survey-4, 2015–16
Authors: Debsarma Dhiman , Saha Jayanti , Ghosh Sagar 
Published: June 2022

Background
Fever is one of the common clinical symptoms found among children suffering from various illnesses. India carries a substantial burden of febrile illness among under-five children which heighten the risk of malnutrition, mortality and morbidity. This study aims to determine the factors associated with delay in treatment-seeking for fever among under-five children in India.

Methods
A cross-sectional study was carried out using the large-scale nationally representative data from the National Family Health Survey (NFHS-4), conducted in 2015–2016. The data were collected by using four survey questionnaires i.e., Household Questionnaire, Woman’s Questionnaire, Man’s Questionnaire, and Biomarker Questionnaire. Delay in treatment-seeking was defined as taking a child for treatment after 24 hours of fever onset. Bivariate and multivariate logistic regression models were performed to assess the factors associated with delay in treatment-seeking behaviour for fever in under-five children.

Results
In India, 31.12% (n = 7229) of the caregivers sought treatment for children after 24 hours of the onset of fever. Findings show no significant differences in delay in treatment-seeking behaviour by age groups and sex of children. Multivariate analysis revealed that the odds of delay in treatment-seeking behaviour of fever were higher among children from the poorest wealth quintile (AOR: 2.06; 95% CI: 1.85, 2.31), belonging to the scheduled tribe (AOR: 1.35; 95% CI: 1.24, 1.48), children who resided in rural areas (AOR: 1.14; 95% CI: 1.07, 1.22), children from the northeast region (AOR: 1.29; 95% CI: 1.14, 1.46), and children of caregivers who perceived distance to health facilities as a ‘big problem’ (AOR: 1.16; 95% CI: 1.09, 1.23).

Conclusion
The study shows a high prevalence of delay in seeking treatment for fever among caregivers of under-five children in India. Delay in seeking treatment is associated with socio-demographic and socio-economic factors. Therefore, there is a need for intensified health promotion programs to sensitize caregivers on the importance of early health-seeking behaviour.
Acute clinical deterioration and consumer escalation: The understanding and perceptions of hospital staff
Authors: Thiele Lisa , Flabouris Arthas , Thompson Campbell 
Published: June 2022

Introduction
Consumer escalation systems allow patients and families to escalate concerns about acute clinical deterioration. Hospital staff can impact upon the success of this process. As part of evaluation processes within a Local Health Network, where a consumer escalation system was introduced in accordance with National requirements, we sought to explore clinicians’ understanding and perceptions of consumer escalation.

Methods
Voluntary and anonymous staff surveys pre, and post, system introduction. Quantitative data was analysed using descriptive statistics, chi-square independence, and non-parametric independent samples median tests. Qualitative data was evaluated using content analysis and cross-referenced with quantitative responses.

Results
Respondent’s (pre: 215; post: 89) area of work varied significantly between survey periods. Most agreed that patients/families have a sound knowledge of a patient’s typical health status (pre: 192/215 (89.3%); post 82/88 (93.2%)) and that patients/families should be encouraged to escalate concerns of deterioration to ward staff (pre: 209/212 (98.6%); post: 85/89 (95.5%)). Respondent perceptions of patient/family ability to recognise clinical deterioration varied. Staff agreement towards local response expectations decreased as the degree of clinical requirement increased. Staff concerns of increased workloads (pre: 90/214 (42.1%); post 12/72 (16.7%), p<0.001) and conflict generation (pre: 71/213 (33.3%); post: 7/71 (9.9%), p = 0.001) decreased significantly following system introduction. However, clinician perceptions of positive system effects also decreased (patient-staff rapport pre: 163/213 (76.5%); post: 38/72 (52.8%), p = 0.001; patient centred care pre: 188/214 (87.9%); post: 53/72 (73.6%), p = 0.012; patient safety pre: 173/214 (80.8%); post: 49/72 (68.1%), p = 0.077). Only 53% of respondents (pre: 112/213 (52.6%); post: 48/88 (54.5%)) perceived that patient/family have sufficient confidence to escalate concerns.

Conclusion
Consumer escalation systems require staff support. Staff perceptions may indicate, and act as, barriers to the operation of consumer escalation processes. Further exploration in identifying and managing staff barriers is crucial to the success of consumer escalation.
The correlation between serum albumin and diabetic retinopathy among people with type 2 diabetes mellitus: NHANES 2011–2020
Authors: Wang Gao-Xiang , Fang Ze-Bin , Li Jun-Tong , Huang Bao-Li , Liu De-Liang , Chu Shu-Fang , Li Hui-Lin 
Published: June 2022

Objectives
The objective of this research aimed to investigate the correlation involving serum albumin with diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM).

Methods
From 2011 to 2020, the National Health and Nutrition Examination Survey (NHANES) surveyed 45462 participants. We used the relevant data to conduct descriptive statistics, linear regression, and Logistic regression analysis.

Results
After adjusting for age, sex, and race, as well as all other variables, serum albumin was significantly negatively related to DR (P<0.001). Furthermore, after controlling for confounding factors, the third quartile (Q3) and the fourth quartile (Q4) had quite a negative significant relationship with the incidence of DR (P<0.01). The second quartile had a significant positive correlation with DR, whereas the observed negative correlations were not statistically meaningful (P>0.05).

Conclusion
Albumin levels in the serum have a quantitatively significant negative correlation with DR. Serum albumin levels in the blood can be used as a reference point for protracted follow-up of people with T2DM.
Undergraduate dental students’ perspective of online learning and their physical and mental health during COVID-19 pandemic
Authors: Etajuri Enas Abdalla , Mohd Noorhayati Raja , Naimie Zahra , Ahmad Norasmatul Akma 
Published: June 2022

Background and objectiveCOVID-19 pandemic continuously spread exacerbating global concerns. It had impacted all life aspects such as social, cultural, economic and education. This study assess the impact of COVID-19 pandemic on undergraduate dental students at Faculty of Dentistry, University of Malaya. The objective of this study is to evaluate the impact of the pandemic on physical and mental health of undergraduate dental students.MethodsThis is a cross-sectional study. An online questionnaire was administrated to 150 undergraduate dental students. The questionnaire included questions related to students’ demographic data, their concerns on academic achievement, their opinion on institution response, and the impact of the crisis on their mental and physical health. SPSS software v26.0 was used to analyse the collected data.ResultsA total of 147 respondents participated in the study. About 66% of the students felt comfortable in adapting to the new technology while 85.7% were concerned about the quality of online learning. Almost all students 98.6% expressed their doubts on the ability to pass the competency exams and to graduate on time, with only 49.7% agreed that clinical experience was effectively delivered through online classes. Most students were also concerned on the impact of the pandemic on their physical and emotional health 85.8% and 76.9% respectively.ConclusionsThe findings of our study highlight the positive adaptation of the students to online learning and using technology. On the other hand, the study indicates that the COVID-19 pandemic brings negative impacts on our students’ physical and mental health.