bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nonsensus in the treatment of proximal humerus fractures: uncontrolled, blinded, comparative behavioural analysis between Homo chirurgicus accidentus and Macaca sylvanus
Authors: Razaeian Sam , Wiese Birgitt , Zhang Dafang , Harb Afif , Krettek Christian , Hawi Nael 
Published: December 2020

Abstract

Objective
To investigate the inter-rater reliability of Barbary macaques compared with an expert group of surgeons for the choice of treatment and predicted outcome of proximal humerus fractures.

Design
Uncontrolled, blinded, comparative behavioural analysis.

Setting
Germany and United States.

Participants

10 blinded experts in the field of orthopaedic trauma surgery (
Homo chirurgicus accidentus
), with special focus on upper extremity surgery from Germany and the US, and five Barbary macaques (
Macaca sylvanus
) from a semi-free range enclosure.

Main outcome measures
The reliability of agreement between raters assessed with Fleiss’ ĸ.

Results

Barbary macaques seem to have inferior inter-rater reliability in comparison with experts for choice of treatment (non-surgical
v
surgical), but for the geriatric age group most frequently affected by proximal humeral fractures, they performed similarly to the experts in their choices of treatment and choice of surgical procedure. Agreement about predicted outcome was poor among the macaques and slight among the experts. All experts almost always predicted the outcome incorrectly and tended to underestimate it. While only 4 (4.4%) of 90 experts’ predictions were correct, 13 (28.9%) of 45 macaques’ predictions were correct.

Conclusions
Consensus on treatment and expected outcomes of proximal humeral fractures is lacking even beyond the human species. Although Barbary macaques tend to predict the clinical outcome more accurately, their reliability to assist surgeons in making a consistent decision is limited. Future high quality research is needed to guide surgeons’ decision making on the optimal treatment of this common injury.
Cross-sectional study on the awareness, susceptibility and use of heated tobacco products among adolescents in Guatemala City, Guatemala
Authors: Gottschlich Anna , Mus Sophia , Monzon Jose Carlos , Thrasher James F , Barnoya Joaquin 
Published: December 2020

ObjectivesHeated tobacco products (HTPs) are increasingly marketed worldwide, yet limited research on HTPs has been conducted in low and middle-income countries (LMICs) or among adolescents. Guatemala is one of the few LMICs where HTPs are available. This study examined prevalence and correlates of HTP awareness, susceptibility and use among adolescents in Guatemala.Design, setting and participantsA cross-sectional survey on HTP awareness, susceptibility and use was conducted among 2870 students between the ages of 13 and 17 in private schools in Guatemala City, Guatemala.Primary and secondary outcome measuresThe primary outcome was susceptibility to future use of HTP among school-aged current and never smokers in Guatemala. We also explored awareness and use of HTPs. Multivariate binomial regression models were used to explore associations between these outcomes and both sociodemographic factors and established smoking correlates.ResultsOf all students (n=2870), about half were aware of HTPs (52.4%) and susceptible to future or continued use (52.4%). Whereas 8.4% of students had tried HTPs in the lifetime (but not in the last month), only 2.9% used HTPs in the past month. Independent correlates of HTP susceptibility and ever-use included: use of other tobacco products (current smoking: adjusted OR (AOR)=10.53 and 6.63, respectively; current e-cigarette use: AOR=21.87 and 10.40, respectively), moderate alcohol consumption (AOR=1.49 and 1.19, respectively), marijuana use in the past 30 days (AOR=3.49 and 2.29, respectively) and having friends who use HTPs (AOR=1.83 and 7.28, respectively).ConclusionsAmong this sample of adolescents in Guatemala City, where tobacco control is weak, the prevalence of HTP use was low but susceptibility to future use was high. Tobacco prevention and intervention strategies for cigarettes and e-cigarettes should now also include HTPs, which tend to be used by similar adolescent populations (ie, those who use other substances or are exposed to tobacco through family and friends).
Community health workers for non-communicable disease prevention and control in Nepal: a qualitative study
Authors: Rawal Lal B , Kharel Chandani , Yadav Uday Narayan , Kanda Kie , Biswas Tuhin , Vandelanotte Corneel , Baral Sushil , Abdullah Abu S 
Published: December 2020

Background/objectiveThe increasing burden of non-communicable diseases (NCDs) in Nepal underscores the importance of strengthening primary healthcare systems to deliver efficient care. In this study, we examined the barriers and facilitators to engaging community health workers (CHWs) for NCDs prevention and control in Nepal.DesignWe used multiple approaches including (a) review of relevant literature, (b) key personnel and stakeholders’ consultation meetings and (c) qualitative data collection using semistructured interviews. A grounded theory approach was used for qualitative data collection and the data were analysed thematically.SettingData were collected from health facilities across four districts in Nepal and two stakeholder consultative meetings were conducted at central level.ParticipantsWe conducted in-depth interviews with CHWs (Health Assistants, Auxiliary Health Workers, Auxiliary Nurse Midwife) (n=5); key informant interviews with health policymakers/managers (n=3) and focus group discussions (FGDs) with CHWs (four FGDs; total n=27). Participants in two stakeholder consultative meetings included members from the government (n=8), non-government organisations (n=7), private sector (n=3) and universities (n=6).ResultsThe CHWs were engaged in a wide range of public health programmes and they also deliver NCDs specific programmes such as common NCDs screening, provisional diagnosis, primary care, health education and counselling, basic medication and referral and so on. These NCD prevention and control services are concentrated in those districts, where the WHO, Package for prevention and control of NCDs) program is being implemented. Some challenges and barriers were identified, including inadequate NCD training, high workload, poor system-level support, inadequate remuneration, inadequate supply of logistics and drugs. The facilitating factors included government priority, formation of NCD-related policies, community support systems, social prestige and staff motivation.ConclusionEngaging CHWs has been considered as key driver to delivering NCDs related services in Nepal. Effective integration of CHWs within the primary care system is essential for CHW’s capacity buildings, necessary supervisory arrangements, supply of logistics and medications and setting up effective recording and reporting systems for prevention and control of NCDs in Nepal.
Population-based comparison of chronic kidney disease prevalence and risk factors among adults living in the Punjab, Northern India and the USA (2013–2015)
Authors: Bragg-Gresham Jennifer , Thakur JS , Jeet Gursimer , Jain Sanjay , Pal Arnab , Prasad Rajendra , Pennathur Subramaniam , Saran Rajiv 
Published: December 2020

ObjectivesIndia is witnessing a disturbing growth in non-communicable diseases (NCDs), including chronic kidney disease (CKD). Recently, a WHO STEPS survey was conducted in the state of Punjab, India to collect data from the adult population on NCD risk factors. We sought to compare the prevalence of CKD and its risk factors between this large state in northern India and the USA.SettingSamples were drawn from both locations, Punjab, India and the USA, using multistage stratified sampling designs to collect data representative of the general population.ParticipantsData from 2002 participants in the Punjab survey (2014–2015) and 5057 in the USA (National Health and Nutrition Examination Survey (NHANES; 2013–2014), between the ages of 18–69 years were examined.Primary and secondary outcome measuresModified Poisson regression was employed to compare prevalence between the two samples for markers of CKD and its risk factors. All analyses used sampling weights.ResultsThe average age in the Punjab sample was significantly lower than the USA (38.3 vs 42.5 years, p<0.0001). While smoking and obesity were higher in the USA, hypertension was much more common in Punjab (48.2% vs 33.4%, p<0.0001). Significant differences were seen in the prevalence of CKD, with lower prevalence of eGFR <60 mL/min/1.73 m2 (2.0% vs 3.8%, p<0.0001), but markedly higher prevalence of albuminuria (46.7% vs 8.9%, p<0.0001) in Punjab. These differences could not be explained by traditional risk factors such as diabetes and hypertension.ConclusionsWe report a strikingly high prevalence of albuminuria in Punjab, India, compared with the USA. This requires further study and may have enormous public health implications for future burden of progressive CKD, end-stage kidney disease, morbidity, mortality and specifically for elevated risk or presence of cardiovascular disease in the northern state of Punjab, India.Funding came from the National Health Mission, Punjab, India, JST and the Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Pilot cluster randomised trial of an evidence-based intervention to reduce avoidable hospital admissions in nursing home residents (Better Health in Residents of Care Homes with Nursing—BHiRCH-NH Study)
Authors: Sampson Elizabeth L , Feast Alexandra , Blighe Alan , Froggatt Katherine , Hunter Rachael , Marston Louise , McCormack Brendan , Nurock Shirley , Panca Monica , Powell Catherine , Rait Greta , Robinson Louise , Woodward-Carlton Barbara , Young John , Downs Murna 
Published: December 2020

ObjectivesTo pilot a complex intervention to support healthcare and improve early detection and treatment for common health conditions experienced by nursing home (NH) residents.DesignPilot cluster randomised controlled trial.Setting14 NHs (7 intervention, 7 control) in London and West Yorkshire.ParticipantsNH residents, their family carers and staff.InterventionComplex intervention to support healthcare and improve early detection and treatment of urinary tract and respiratory infections, chronic heart failure and dehydration, comprising: (1) ‘Stop and Watch (S&W)’ early warning tool for changes in physical health, (2) condition-specific care pathway and (3) Situation, Background, Assessment and Recommendation tool to enhance communication with primary care. Implementation was supported by Practice Development Champions, a Practice Development Support Group and regular telephone coaching with external facilitators.Outcome measuresData on NH (quality ratings, size, ownership), residents, family carers and staff demographics during the month prior to intervention and subsequently, numbers of admissions, accident and emergency visits, and unscheduled general practitioner visits monthly for 6 months during intervention. We collected data on how the intervention was used, healthcare resource use and quality of life data for economic evaluation. We assessed recruitment and retention, and whether a full trial was warranted.ResultsWe recruited 14 NHs, 148 staff, 95 family carers and 245 residents. We retained the majority of participants recruited (95%). 15% of residents had an unplanned hospital admission for one of the four study conditions. We were able to collect sufficient questionnaire data (all over 96% complete). No NH implemented intervention tools as planned. Only 16 S&W forms and 8 care pathways were completed. There was no evidence of harm.ConclusionsRecruitment, retention and data collection processes were effective but the intervention not implemented. A full trial is not warranted.Trial registration numberISRCTN74109734(https://doi.org/10.1186/ISRCTN74109734).Original protocolBMJ Open. 2019;9(5):e026510. doi:10.1136/bmjopen-2018-026510.
Use of guideline-recommended drug therapy in patients undergoing percutaneous coronary intervention for stable coronary heart disease in Germany: a multilevel analysis of nationwide routine data
Authors: Frank-Tewaag Julia , Bleek Julian , Horenkamp-Sonntag Dirk , Marschall Ursula , Zeymer Uwe , Donner-Banzhoff Norbert , Sundmacher Leonie 
Published: December 2020

ObjectivesTo determine the prescription of guideline recommended drug therapy in patients with stable coronary heart disease (sCHD) prior to percutaneous coronary intervention (PCI) in Germany and to examine the role of patient characteristics and features of regional healthcare supply in a multilevel model.DesignSecondary data analysis of factors associated with the prescription of guideline recommended drug therapy using a multilevel model to analyse regional-level effects, over and above the effects of patient-level demographic and health status.SettingOffice-based prescriptions in the year prior to the invasive procedure.ParticipantsA linked nationwide dataset from Germany’s three largest statutory health insurance funds of all patients receiving PCI in the year 2016.Main outcome measuresPatients’ odds of receiving optimal medical therapy and symptom-oriented therapy within 1 year prior to PCI.Results68.6% of patients received at least one lipid-lowering drug and one symptom-oriented therapy prior to PCI. 43.6% received at least two agents to control their symptoms. Patients who received treatment in accordance with the recommendations had a greater number of diagnosed risk factors, a more severe history of cardiac disease and used a higher volume of ambulatory office-based physician services. The prescriptions prevalence for the symptom-oriented therapies differed significantly between eastern and western Germany, with a higher prevalence in the eastern districts.ConclusionsGuidelines can only provide decision-making corridors, and the applicability of recommendations must always be assessed on a case by case basis. Nevertheless, our analysis indicates that the prevalence of prescriptions in routine practice is subject to substantial variation and that conservative therapy options are not fully exhausted prior to PCI. This suggests that there might be room for improvement in the care of patients with sCHD.
Analytic treatment of near-extremal charged black holes supporting non-minimally coupled massless scalar clouds
Authors: Hod Shahar 
Published: December 2020

AbstractIt has recently been revealed that massless scalar fields which are non-minimally coupled to the Maxwell electromagnetic tensor can be supported in the exterior spacetime regions of spherically symmetric charged black holes. The boundary between scalarized charged black-hole spacetimes and bald (scalarless) Reissner–Nordström black holes is determined by the presence of a critical existence-line which describes spatially regular linearized scalar ‘clouds’ that are supported in the black-hole spacetime. In the present paper we use analytical techniques in order to solve the Klein–Gordon wave equation for the non-minimally coupled linearized scalar fields in the spacetimes of near-extremal supporting black holes. In particular, we derive a remarkably compact analytical formula for the discrete resonant spectrum $$\{\alpha (l,Q/M;n)\}^{n=\infty }_{n=1}$$

{
α

(
l
,
Q
/
M
;
n
)

}

n
=
1

n
=
∞

which characterizes the dimensionless coupling parameter of the composed Reissner–Nordström-black-hole-nonminimally-coupled-massless-scalar-field configurations along the critical existence-line of the Einstein–Maxwell-scalar theory (here Q/M is the dimensionless charge-to-mass ratio of the central supporting black hole and l is the angular harmonic index of the supported scalar configurations).
Hybrid Energy Source Fed Fuzzy-Based SVPWM for 5-Level NPC Inverter with Grid Connected System
Authors: Palanisamy R. , Vijayakumar K. , Karthikeyan B. 
Published: December 2020

This paper presents the fuzzy-based Space Vector Pulse Width Modulation (SVPWM) for 5-level Neutral Point Clamped inverter with hybrid energy source fed grid connected system. The proposed scheme is energized using Photovoltaic and Wind energy system combination. The Neural Network-(NN) based Maximum Power Point Tracking algorithm (MPPT) has been implemented to track maximum power under different operating conditions. First, we proposed fuzzy-based SVPWM, which is developed for 5-level NPC inverter to provide voltage and current control, reduced THD, predetermined switching pattern, capacitor voltage unbalance minimization and maintain good control under nonlinearities and suspicions of PV-Wind energy connected hybrid system. Second, we proposed the inverter output voltage, which has been synchronized with grid connected system using split inductor (SI). The reference voltages for SVPWM implementation were obtained using feedback current control method. Third, we proposed different solar radiations, the proposed system has attained better performance by trailing maximum power from hybrid energy system. The simulation and experimental responses have been validated using Matlab/simulink and FPGA processor.
Improve Inter-day Hand Gesture Recognition Via Convolutional Neural Network-based Feature Fusion
Authors: Fang Yinfeng , Zhang Xuguang , Zhou Dalin , Liu Honghai 
Published: December 2020

The learning of inter-day representation of electromyographic (EMG) signals across multiple days remains a challenging topic and not fully accommodated yet. This study aims to improve the inter-day hand motion classification accuracy via convolutional neural network (CNN)-based data feature fusion. An EMG database (ISRMyo-I) was recorded from six subjects on 10 days via a low density electrode setting. This study investigated CNNs’ capability of feature learning, and found that the output of the first fully connected layer (CNNFeats) was a decent supplement feature set to the most prevalent Hudgins’ time domain features in combination with fourth-order autoregressive coefficients (TDAR). Through adding the automatically learned CNNFeats to the handcrafted TDAR feature set, both linear discriminant analysis (LDA) and support vector machine (SVM) classifiers received [Formula: see text]3% accuracy improvement. Similarly, taking TDAR as additional input to the CNN improved the accuracy by [Formula: see text]1% in the comparison with the basic CNN. Our results also demonstrated that the CNN approach outperformed conventional approaches when multiple subjects’ data were available for training, while traditional approaches were more adept at presenting motion patterns for single subject. A preliminary conclusion is drawn that substantial “common knowledge/features” can be learned by CNNs from the raw EMG signals across multiple days and multiple subjects, and thus it is believed that a pre-trained CNN model would contribute to higher accuracy as well as the reduction of learning burden.
Reduced Birth Weight, Decreased Early-Phase Insulin Secretion, and Increased Glucose Concentrations after Oral Glucose Tolerance Test in Japanese Women Aged 20 Years with Family History of Type 2 Diabetes
Authors: Honda Mari , Tsuboi Ayaka , Minato-Inokawa Satomi , Kitaoka Kaori , Takeuchi Mika , Yano Megumu , Kurata Miki , Wu Bin , Kazumi Tsutomu , Fukuo Keisuke 
Published: December 2020

Introduction. We tested the hypothesis that family history of type 2 diabetes (FHD) is associated with reduced birth weight and reduced insulin secretion later in life. Materials and Methods. Birth weight, body composition by whole-body dual-energy X-ray absorptiometry, and homeostasis model assessment-insulin resistance were compared between Japanese women aged 20 years with positive (

n
=
73

) and negative (

n
=
258

) FHD. A subsample of 153 women (57 with positive FHD) underwent a 75 g oral glucose tolerance test. Multivariate logistic regression analyses were used to identify the most important determinants of FHD. Results. Women with positive as compared with negative FHD had lower birth weight (

3132
±
364

vs.

3238
±
418

g

,

p
=
0.04

). However, the current fat mass index and trunk/leg fat ratio, sophisticated measures of general and abdominal fat accumulation, respectively, did not differ. Women with positive FHD had a lower insulinogenic index (

2.4
±
7.3

vs.

6.2
±
16

,

p
=
0.007

) and higher area under the glucose curve (

217
±
47

vs.

198
±
36

mg

/dL/2 h,

p
=
0.006

). However, fasting and postload insulinemia, homeostasis model assessment-insulin resistance, and Matsuda index did not differ. In multivariate logistic regression analysis, birth weight was marginally associated with FHD (odds ratio, 0.999; 95% confidential interval, 0.98-1.00000;

p
=
0.0509

). Conclusions. FHD was associated not only with reduced birth weight but also with decreased early-phase insulin secretion and increased postload glucose concentrations in Japanese women aged 20 years. These findings may be in keeping with the fetal insulin hypothesis and provide some evidence that FHD can alter size at birth, probably through genetic and shared environmental components, which consequently resulted in decreased early-phase insulin secretion and increased glucose excursion in the early twenties. FHD was not related to sophisticated measures of general and abdominal adiposity and insulin resistance/sensitivity.
Use of Endemic Date Palm (Phoenix dactylifera L.) Seeds as an Insoluble Dietary Fiber: Effect on Turkey Meat Quality
Authors: Bouaziz Mohamed Ali , Bchir Brahim , Ben Salah Tayssir , Mokni Abir , Ben Hlima Hajer , Smaoui Slim , Attia Hamadi , Besbes Souhail 
Published: December 2020

In order to enhance the quality of a meat product, turkey burgers with a low-fat and a high-fiber level were formulated by the incorporation of insoluble fibers from Tunisian Deglet Nour date seeds as insoluble fiber concentrate (IFC) at 3%, 5%, and 10% (w/w). Compared to Deglet Nour date seeds powder (DSP), physicochemical results revealed that IFC presented higher (

P

< 0.05) levels in carbohydrates at 88.85% and lower values of fat (5.94%), protein (3.81%), and ash (2.35%). For the technofunctional properties, IFC improved the oil-holding capacity (OHC) by 57.14% compared to DSP. IFC addition into turkey burgers was also instrumentally investigated by color (L

∗

, a

∗

, and b

∗

) and textural parameters (hardness, cohesiveness, adhesiveness, and elasticity) and sensory attributes using a 5-point hedonic scale. Furthermore, IFC changed significantly the color of the formulated products. In addition, hardness and adhesiveness values of all experiments increased significantly (

P

< 0.05) with the increase of the incorporation levels compared to the control sample. Regarding sensory analysis, formulated with 5 % IFC, turkey burger samples were most appreciated by the panel with higher (

P

< 0.05) overall acceptability. Additionally, two multivariate exploratory techniques, namely, Principal Component Analysis (PCA) and Hierarchical Cluster Analysis (HCA), were used to all obtained data describing the main characteristics attributed to refrigerated turkey meat samples. The applied chemometric approaches were useful in discriminating meat samples and therefore offer an approach to rely interrelationships between meat quality traits. Overall, the findings demonstrate the potential functional and economic utility of IFC as a promising ingredient for future healthy meat applications.