bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of a nutrition education programme on the metabolic syndrome in type 2 diabetes mellitus patients at a level 5 Hospital in Kenya: “a randomized controlled trial”
Authors: Thuita Ann Watetu. , Kiage Beatrice Nyanchama , Onyango Arnold N. , Makokha Anselimo O. 
Published: August 2020

Abstract
Background
Type 2 diabetes mellitus (T2D), is a life-threatening condition of global public health concern. It worsens in the presence of the metabolic syndrome (MetS), a complex disorder characterized by co-occurrence of at least three of such factors as hypertension, obesity, dyslipidemia and insulin resistance. However, lifestyle interventions reduce the risk of both MetS and T2D, and nutrition education can empower individuals on the appropriate, lifestyle changes. The aim of the current study was to evaluate the effect of a nutrition education programme, with and without inclusion of peer to peer support, on MetS in T2D patients.

Methods
This was a randomized controlled trial with two intervention groups and one control. One of the intervention groups involved a nutrition education programme with peer-to-peer support (NEP); the other involved only the education program, while the control received standard care. Each group had 51 participants. The nutrition education programme was conducted for 2 h per week for 8 weeks. In addition, the NEP had weekly peer-to-peer interactions for 8 weeks. All groups had follow-up sessions for 6 months. Data on MetS risk factors as well as food intake patterns and physical activity levels were taken at baseline and at different time points during the study. Analysis of Co-variance and regression were used in the analysis.

Results
The MetS prevalence improved in the NEP (90 to 52%) and NE (86 to 69%), while it worsened in C (88 to 91%). There was improvement in the mean values of the anthropometric parameters in the NEP and NE which worsened in the control group. There was a general improvement in mean values of blood lipids, fasting blood glucose and HbA1c in all the groups, with NEP showing the greatest improvements, followed by NE, except for triglycerides and HDL where the control group had better improvement than the NE. Changes in the anthropometric and metabolic indicators mirrored the changes in food intake patterns and physical activity, where the greatest improvements occurred in the NEP.

Conclusions
Nutrition education with inclusion of peer to peer support was of clinical benefit in improving metabolic outcomes and reducing MetS in T2DM patients.

Trial registration
The study has been registered retrospectively by Pan African Clinical Trial Registry; Registration No: PACTR201910518676391.
Reliability of a Robotic Knee Testing Tool to Assess Rotational Stability of the Knee Joint in Healthy Female and Male Volunteers
Authors: Beckley Samantha , Stinton Shaun , Lesosky Maia , September Alison , Collins Malcolm , Branch Thomas , Posthumus Mike 
Published: August 2020

Abstract
Background
Several clinical tests exist to assess knee laxity. Although these assessments are the predominant tools of diagnosis, they are subjective and rely on the experience of the clinician. The robotic knee testing (RKT) device has been developed to quantitatively and objectively measure rotational knee laxity. The purpose of this study was primarily to determine the intra-tester reliability of rotational knee laxity and slack, the amount of rotation occurring between the two turning points of the load deformation curve, measured by the RKT device and investigate the differences between female and male measurements.

Methods
Ninety-one healthy and moderately active volunteers took part in the study, of which twenty-five participated in the reliability study. Tibial rotation was performed using a servomotor to a torque of 6 N m, while measurements of motion in all 6° of freedom were collected. Reliability measurements were collected over 5 days at similar times of the day. Intra-class correlation coefficient (ICC) values and standard error of measurement (SEM) were determined across the load deformation curves. Linear mixed effects modelling was used to further assess the reliability of the measurement of external and internal tibial rotation using features of the curve (internal/external rotational laxity and slack). Measurements of internal/external rotational laxity and slack were compared between the sexes using the Student t test.

Results
Pointwise axial rotation measurements of the tibia had good reliability [ICC (2,1) 0.83–0.89], while reliability of the secondary motions ranged between poor and good [ICC (2,1) 0.31–0.89]. All SEMs were less than 0.3°. Most of the variation of the curve features were accounted for by inter-subject differences (56.2–77.8%) and showed moderate to good reliability. Comparison of the right legs of the sexes revealed that females had significantly larger amounts of internal rotation laxity (females 6.1 ± 1.3° vs males 5.6 ± 0.9°, p = 0.037), external rotation laxity (females 6.0 ± 1.6° vs males 5.0 ± 1.2°, p = 0.002) and slack (females 19.2 ± 4.2° vs males 16.6 ± 2.9°, p = 0.003). Similar results were seen within the left legs.

Conclusions
Overall, the RKT is a reliable and precise tool to assess the rotational laxity of the knee joint in healthy individuals. Finally, greater amounts of laxity and slack were also reported for females.
The actual implementation status of self-isolation among Japanese workers during the COVID-19 outbreak
Authors: Machida Masaki , Nakamura Itaru , Saito Reiko , Nakaya Tomoki , Hanibuchi Tomoya , Takamiya Tomoko , Odagiri Yuko , Fukushima Noritoshi , Kikuchi Hiroyuki , Amagasa Shiho , Kojima Takako , Watanabe Hidehiro , Inoue Shigeru 
Published: August 2020

Abstract
Background
Self-isolation is an important personal protective measure in inhibiting the transmission of coronavirus disease 2019 (COVID-19) as people carry out economic and social activities amid its spread. Yet few studies have clarified the actual implementation status of self-isolation during an outbreak. This study aimed to reveal the actual implementation of self-isolation among Japanese workers during the COVID-19 outbreak and the factors inhibiting this measure.

Methods
This was a cross-sectional study based on an internet survey completed by 1,226 workers (60.0% men) living in 7 prefectures (i.e., Tokyo, Kanagawa, Saitama, Chiba, Ibaraki, Tochigi, and Gunma) who were selected among registrants of an Internet research company, between May 12 and 17, 2020. Participants were asked whether they had experienced fever or other cold symptoms between February 17, 2020 and the date of the survey. Those who responded affirmatively were asked where they had visited (e.g., hospital, work, and shopping for groceries or necessities) to clarify whether they had left the house within 7 days after symptom onset. We performed multivariate logistic regression analysis to clarify the relationship between going to work within 7 days after symptom onset and both sociodemographic factors and employment-related constraints.

Results
Of the survey participants, 82 had experienced fever or other cold symptoms (6.7%). Among these participants, 51 (62.2%) went to work within 7 days after symptom onset. A mere 17.1% practiced strict self-isolation. Multivariate logistic regression analysis revealed that those living outside the metropolitan area (i.e., Ibaraki, Tochigi, and Gunma), working as a company employee, and being unable to work from home were associated with going to work within 7 days after symptom onset.

Conclusions
The prevalence of strict self-isolation among participants who experienced cold-like symptoms during the COVID-19 outbreak was extremely low, and 62.2% of these participants went to work within 7 days after symptom onset. This study highlights the need for further public awareness regarding self-isolation and countermeasures against factors that obstruct it.
Digital technology applications for contact tracing: the new promise for COVID-19 and beyond?
Authors: Owusu Priscilla N. 
Published: August 2020

AbstractAmong the most critical strategies in the fight against the Corona Virus Disease (COVID-19) is the rapid tracing and notification of potentially infected persons. Several nations have implemented mobile software applications (“apps”) to alert persons exposed to the coronavirus. The expected advantages of this new technology over the traditional method of contact tracing include speed, specificity, and mass reach. Beyond its use for mitigating and containing COVID-19, digital technology can complement or even augment the traditional approach to global health program implementation. However, as with any new system, strong regulatory frameworks are necessary to ensure that individual information is not used for surveillance purposes, and user privacy will be maintained. Having safeguarded this, perhaps the global health community will witness the beginning of a new era of implementing mass health programs through the medium of digital technology.
Symptoms and probabilistic anatomical mapping of lacunar infarcts
Authors: Barow Ewgenia , Pinnschmidt Hans , Boutitie Florent , Königsberg Alina , Ebinger Martin , Endres Matthias , Fiebach Jochen B. , Fiehler Jens , Thijs Vincent , Lemmens Robin , Muir Keith W. , Nighoghossian Norbert , Pedraza Salvador , Simonsen Claus Z. , Gerloff Christian , Thomalla Götz , Cheng Bastian ,   on behalf of the WAKE-UP investigators
Published: August 2020

Abstract
Background
The anatomical distribution of acute lacunar infarcts has mainly been studied for supratentorial lesions. In addition, little is known about the association with distinct stroke symptoms, not summarized as classical lacunar syndromes. We aimed to describe the spatial lesion distribution of acute supra- and infratentorial lacunar infarcts and their association with stroke symptoms in patients eligible for thrombolysis.

Methods
All patients enrolled in the WAKE-UP trial (efficacy and safety of magnetic resonance imaging [MRI]-based thrombolysis in wake-up stroke) were screened for lacunar infarcts on diffusion-weighted imaging (DWI). The relationship between the anatomical distribution of supra- and infratentorial lacunar infarcts, their demographic characteristics and acute stroke symptoms, defined by the National Institutes of Health Stroke Scale (NIHSS) score, were correlated and compared.

Results
Maps of lesion distribution from 224 lacunar infarct patients (76 [33.9%] females, mean age [standard deviation] of 63.4 [11.5] years) were generated using computational image mapping methods. Median infarct volume was 0.73 ml (interquartile range [IQR] 0.37–1.15 ml). Median NIHSS sum score on hospital arrival was 4 (IQR 3–6). 165 (73.7%) patients had lacunar infarcts in the supratentorial deep white or grey matter, while 59 (26.3%) patients had infratentorial lacunar infarcts. Patients with supratentorial lacunar infarcts presented with a significantly lower occurrence of deficits in the NIHSS items gaze (p < 0.001) and dysarthria (p = 0.008), but had more often a paresis of the left arm (p = 0.009) and left leg (p = 0.068) compared to patients with infratentorial infarcts.

Conclusions
The anatomical lesion distribution of lacunar infarcts reveals a distinct pattern and supports an association of localization with different stroke symptoms.

Trial registration
NCT01525290.
Highly selective and sensitive colorimetric chemosensor based on tricarboyanine for detection of Ag+ in industrial wastewater
Authors: Zeng Xiaolong , Li Xuezhao , Sun Wen 
Published: August 2020

Abstract
An efficient fluorescent probe 1 based on tricarbocyanine derivative was designed and synthesized, which can detect Ag+ in real industrial wastewater. UV-Vis absorption and fluorescent emission spectra of probe 1 were carried out and indicated this probe can bind Ag+ via complexation reaction, then leading to a remarkable color change from blue to light red. Furthermore, probe 1 showed high sensitive performance and excellent selectivity toward Ag+ over other common metal ions in neutral pH. The sensing mechanism was proposed and further confirmed by 1H NMR, which demonstrate analyte-induced destruction of the π-electron system could be shorten by the disruption of the pull-push π-conjugation system in probe 1. Moreover, a test strip was prepared by filter paper immersing in probe 1 solution, which further provide its potential application for trace Ag+ detection in real industrial wastewater.

Graphical abstract
Effects of intravenous iron monotherapy for patients with iron deficient anemia undergoing total knee arthroplasty
Authors: Shin Kyun-Ho , Park Jong-Hoon , Jang Ki-Mo , Hong Seok-Ha , Han Seung-Beom 
Published: August 2020

Abstract
Background
Unnecessary costs and complications can be reduced by increasing hemoglobin (Hb) levels and minimizing blood transfusions in patients who underwent total knee arthroplasty (TKA). This study aimed to determine the effects of intravenous iron monotherapy before TKA on preoperative iron deficient anemia and postoperative transfusion rates.

Methods
This prospective cohort study included 45 patients scheduled for TKA in the experimental group (Group I) and 221 patients who underwent TKA in 2015 and 2018 in the control group (Group C). One thousand milligrams of ferric carboxymaltose was administrated 1 month before TKA in group I. Intergroup comparison of the rate and total volume of transfusion, perioperative changes in Hb and analysis of iron metabolism variables in group I were performed. Subgroup analysis of Group I was conducted according to the response to iron monotherapy.

Results
Although Hb levels increased after intravenous iron monotherapy in Group I, postoperative transfusion rates in Groups I and C were 17.8% and 18.6%, respectively, without significant intergroup differences in the rate and total units of transfusion. Ferritin level and transferrin saturation were corrected in both subgroups of Group I. Only 17 patients (37.78%) showed response to iron monotherapy, with an Hb increase of 1.0 g/dL or more. Subgroup analysis showed lower proportions of coexisting chronic diseases, including chronic kidney disease in responders.

Conclusion
IV iron monotherapy was shown to be insufficient in successfully treating preoperative iron-deficient anemia to reduce postoperative allogenic blood transfusion in patients who underwent TKA. As preoperative anemia should be managed due to the high rates of postoperative transfusion for this surgery, clinicians should consider the complex interplay among the causal factors of anemia, apart from ID, in patients with preoperative anemia who are scheduled for TKA.
Beliefs about students’ mental health issues among teachers at elementary and high schools, Hail Governorate, Saudi Arabia
Authors: Kamel Ahmed , Haridi Hassan Kasim , Alblowi Thikra Mohammed , Albasher Asmaa Saleh , Alnazhah Nwayer Abdulaziz 
Published: August 2020

AbstractBackgroundTeachers’ awareness about and attitude towards students’ with mental health issues are often affecting their practical role in proper care of students with mental health problems. This is a cross-sectional study carried out among teachers in elementary (primary and middle) and secondary schools in Hail Governorate, Kingdom of Saudi Arabia (KSA). The objective of the study was to assess teachers’ awareness about and attitude towards student’s mental health issues through a response to a pretested constructed, semi-structured, anonymous self-administered questionnaire included 38 items.ResultsConsenting teachers returned 2398 completed questionnaires with response rate of 60.0%. Majority of respondents possessed favorable attitudes towards students with mental health issues attained 74.7% attitude score on a scale of maximum 55 points but revealed less awareness with students’ mental health issues; they just attained 55.1% awareness score.Teachers acknowledged the importance of providing training programs regarding mental health issues for teachers (73.7%) and for other school staff (76.2%), availability of psychologist in schools (81.1%), providing schools with educational materials regarding students’ mental health (78.1%), providing telephone hotline to support dealing with students’ with mental health issues (78.5%), and promoting general media to increase community awareness with mental health (84.4%).ConclusionThe current study gives insight to policy makers about teachers’ awareness and attitude they have towards mental health issues in schools. Training programs in mental health appear to be crucial for teachers. Providing enough resources for schools to support their roles in mental health will advance healthy development in children.
Ethnic variations in referrals to the Leicester memory and dementia assessment service, 2010 to 2017
Authors: Wilson Andrew , Bankart John , Regen Emma , Phelps Kay , Agarwal Shona , Johnson Mark , Raghavan Raghu , Sitaram Bina , Subramaniam Hari 
Published: August 2020

Background
The incidence of dementia in Black, Asian and minority ethnic (BAME) groups is increasing in the UK, with concern about underdiagnosis and late presentation.

Aims
By reviewing referrals to memory clinics from Leicester City we examined whether the following differed by ethnicity: the proportion with a diagnosis of dementia, type of dementia and severity at presentation.

Method
We examined referrals between 2010 and 2017: all those whose ethnicity was recorded as Black (n = 131) and a random sample of 260 Asian and 259 White British referrals. Severity of dementia was assessed by record review. Odds ratios (ORs) were adjusted for general practice, age, gender and year of referral.

Results
A diagnosis of dementia was recorded in 193 (74.5%) White British, 96 (73.3%) Black and 160 (61.5%) Asian referrals. Compared with Asians, White British had twice the adjusted odds of a dementia diagnosis (OR = 1.99 (1.23–3.22). Of those with dementia, Alzheimer's disease was more common in White British (57.0%) than in Asian (43.8%) and Black referrals (51.0%): adjusted OR White British versus Asian 1.76 (1.11–2.77). Of those with dementia, the proportion with moderate/severe disease was highest in White British (66.8%), compared with 61.9% in Asian and 45.8% in Black groups. The adjusted OR for the White versus Black groups was 2.03 (1.10–3.72), with no significant difference between Asian and White British groups.

Conclusions
Differences in confirmed dementia suggest general practitioners have a lower threshold for referral for possible dementia in some BAME groups. Unlike other centres, we found no evidence of greater severity at presentation in Asian and Black groups.
Design and Evaluation of a Multiplexed Assay to Assess Human Immunogenicity Against Humira®
Authors: Alleyn Matthew , Closson Kristin , Gentile Adam , Gulbis Nathan , Taylor Christopher , Rhyne Paul 
Published: August 2020

AbstractThe use of biologic-based therapeutics has revolutionized our ability to treat complex diseases such as cancer- and autoimmune-related disorders. Biologic-based therapeutics are known to generate anti-drug immune responses or immunogenicity in clinical patients which can lead to altered pharmacokinetics, decreased drug efficacy, and unwanted adverse clinical events. Assays designed to detect and assess anti-drug immune responses are used to help monitor patients and improve drug safety. Utilizing a tiered approach, screening assays are developed first to identify patients that are potentially positive for anti-drug-specific antibodies. Patients that screen positive are subjected to additional tiers of testing that include a confirmation assay to confirm the presence of expected anti-drug-specific antibodies, a titer assay to assess relative levels of anti-drug-specific antibodies, and, depending on the drug’s mechanism of action or concerns of adverse clinical reactions, further characterization such as drug neutralization and anti-drug antibody isotyping. This tiered approach can prove to be detrimental to clinical samples from exposure to multiple cycles of testing, freeze thaws, and repeated handling by lab personnel. Multiplexing some of these assays together may streamline the characterization of anti-drug immune responses and help reduce the repeated usage of clinical samples. In this study, we combined a screening assay and anti-drug isotyping assays into one multiplexed assay using the Luminex® xMAP® Technology. The multiplexed assay was developed and validated to meet the FDA recommended guidelines for immunogenicity assessments. These results show that multiplexed assays perform comparably to industry standards. This study should encourage labs to explore the use of multiplexing immunogenicity assays to characterize anti-drug antibody responses quickly, with less repeat testing and reduced sample handling.
Ontologies relevant to behaviour change interventions: a method for their development
Authors: Wright Alison J. , Norris Emma , Finnerty Ailbhe N. , Marques Marta M. , Johnston Marie , Kelly Michael P. , Hastings Janna , West Robert , Michie Susan 
Published: August 2020

Background: Behaviour and behaviour change are integral to many aspects of wellbeing and sustainability. However, reporting behaviour change interventions accurately and synthesising evidence about effective interventions is hindered by lacking a shared, scientific terminology to describe intervention characteristics. Ontologies are knowledge structures that provide controlled vocabularies to help unify and connect scientific fields. To date, there is no published guidance on the specific methods required to develop ontologies relevant to behaviour change. We report the creation and refinement of a method for developing ontologies that make up the Behaviour Change Intervention Ontology (BCIO). Aims: (1) To describe the development method of the BCIO and explain its rationale; (2) To provide guidance on implementing the activities within the development method. Method and results: The method for developing ontologies relevant to behaviour change interventions was constructed by considering principles of good practice in ontology development and identifying key activities required to follow those principles. The method’s details were refined through application to developing two ontologies. The resulting ontology development method involved: (1) defining the ontology’s scope; (2) identifying key entities; (3) refining the ontology through an iterative process of literature annotation, discussion and revision; (4) expert stakeholder review; (5) testing inter-rater reliability; (6) specifying relationships between entities, and; (7) disseminating and maintaining the ontology. Guidance is provided for conducting relevant activities for each step. Conclusions: We have developed a detailed method for creating ontologies relevant to behaviour change interventions, together with practical guidance for each step, reflecting principles of good practice in ontology development. The most novel aspects of the method are the use of formal mechanisms for literature annotation and expert stakeholder review to develop and improve the ontology content. We suggest the mnemonic SELAR3, representing the method’s first six steps as Scope, Entities, Literature Annotation, Review, Reliability, Relationships.