bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring the influencing factors of quality of life among the empty nesters in Shanxi, China: a structural equation model
Authors: Zhang Chichen , Cai Yuan , Xue Yaqing , Zheng Xiao , Yang Xiaozhao , Lu Jiao , Hou Lihong , Li Mimi 
Published: May 2021

Abstract
Background
As China’s aging trend intensifies and the proportion of empty nests increases, the health-related quality of life of the elderly is the focus of social attention. Previous studies focused on the quality of life of the elderly, rather than empty nesters, and lacked the discussion of the mechanism of influencing factors. Thus, this study aimed to explore the influencing factors of the quality of life (QOL) and interaction mechanisms among empty nesters in Shanxi Province, China, so as to provide practical reference for improving the QOL of empty nesters.

Methods
A total of 4901 empty nesters in Shanxi Province, China, were selected using multi-stage random cluster sampling method in this cross-sectional study. The quality of life was assessed with the Short Form 36 Health Survey (SF-36). Multiple linear regression analysis (stepwise) was performed to examine the factor associated with QOL. Structural equation model (SEM) approach was conducted to test the direct and indirect association between QOL influencing factors with QOL.

Results
The average QOL score of empty nesters was 63.34 (SD = 17.23). The multiple linear regression revealed that gender, age, education, monthly income, drinking status, exercise frequency, physical examination frequency, attention to daily nutritional health, relationship with a spouse and relationship with children were significant predictors of the empty nester’s QOL (P < 0.05) (R2 = 0.128). SEM showed that behavioral lifestyle had a direct effect on QOL (β = 0.446, P < 0.001). Socio-economic status had an indirect effect (β = 0.288, P < 0.001) on QOL through behavioral lifestyle. The family relationship had an indirect effect (β = 0.115, P < 0.001) on QOL.

Conclusion
Behavioral lifestyle was the strongest influencing factor in the quality of life among empty nesters, followed by socio-economic status and family relationships. Thus, maintaining a healthy behavioral lifestyle was important to improve the QOL of the empty nesters. Our findings provide a concrete and strong reference for the formulation of targeted intervention strategies.
An investigation on chemical/mineral compositions, ruminal microbial fermentation, and feeding value of some leaves as alternative forages for finishing goats during the dry season
Authors: Kazemi Mohsen 
Published: May 2021

AbstractFinding new fodder resources with moderate to high nutritional value that are cheaper and available is one of the most challenges in livestock industries. Hence, the nutritive value of some tree leaves (quince, pear, olive, mirabelle plum, greengage, sour cherry, and persimmon) was investigated by different laboratories and in vitro methods. Also, partial substitution of alfalfa and corn silage (50%) with these leaves was investigated using forty-eight goats in a randomized complete block design in vivo. Highest total phenol and tannin contents were obtained in quince (p < 0.001). Greengage (146.37 g/kg DM) and persimmon (136.96 g/kg DM) exhibited the highest crude protein, respectively (p < 0.001). Calcium content (19.82 g/kg DM) was highest in persimmon leaves (p < 0.001). Greengage (66.07 mmol/L) and mirabelle plum (65.58 mmol/L) produced more total volatile fatty acids in the culture medium, respectively (p < 0.001). Potential gas production ranged from 39.65 mL for pear to 55.32 mL mirabelle plum. Sour cherry had the highest acid–base buffering capacity (183.73 mEq × 10–3,p < 0.001). Highest dry matter intake (1087 g/day) and crude protein digestibility (70.80 %) were observed in diets containing greengage (p < 0.001). Total antioxidant capacity of serum increased when olive, quince, and persimmon were considered in goats feeding (p < 0.001). Although all studied leaves can be fed in diets of goats without deleterious effects on performance, serum, and hematology parameters, in vivo and in vitro results indicated that greengage in terms of nutritive value was superior to other studied leaves.
Evidence on collaboration of traditional and biomedical practitioners in the management of antimicrobial resistance in sub-Saharan Africa over 15 years: a systematic review protocol
Authors: Mushebenge Aganze Gloire-Aimé , Kadima Mukanda Gedeon , Mashamba-Thompson Tivani , Nlooto Manimbulu 
Published: May 2021

Abstract
Background
The overuse of prescribed antimicrobials, concurrent use of traditional medicine, and prescribed antimicrobials have led to antimicrobial resistance. The absence of collaboration between traditional health practitioners and biomedically trained healthcare professionals can contribute to antimicrobial resistance, treatment failure, overdose, toxicity, and misadministration. This scoping review explores the evidence on collaboration between traditional health practitioners and biomedically trained healthcare professionals to reduce antimicrobial resistance and treatment failure in bacterial and viral diseases.

Methods
We will search for electronic databases such as Science Direct, Google Scholar, PubMed, and MEDLINE via EBSCOhost. We will also search reference lists of included studies. A two-stage mapping procedure will be carried out. Stage one (1) will consist of the title, abstracts, and full article screening, respectively. A pilot screening form guided by the defined eligibility criteria will be used. In stage two (2), data will be extracted from the included studies. Two reviewers will conduct parallel screening and data extraction. Mixed methods appraisal tool (MMAT) will be used to assess the quality of the included studies. NVIVO version 11 will be employed to aid pertinent thematic analysis. The outcomes of interest will be as follows: Primary outcome will be preventing and reducing antimicrobial resistance. The secondary effect is the effective collaboration between traditional healthcare practitioners and biomedically healthcare professionals.

Discussion
This review anticipates uncovering pertinent publications reporting the evidence of collaboration between traditional health practitioners and biomedically trained healthcare professionals to reduce antimicrobial resistance in sub-Saharan Africa. The sum-up of evidence acquired from the included studies will help guide future research. The result of the study will be print and electronically exposed.

Systematic review registration
PROSPERO, CRD42017072952
Colors and dyes of archaeological textiles from Tarapacá in the Atacama Desert (South Central Andes)
Authors: Sepúlveda Marcela , Lemp Urzúa Cecilia , Cárcamo-Vega José , Casanova-Gónzalez Edgar , Gutiérrez Sebastián , Maynez-Rojas Miguel Ángel , Ballester Benjamín , Ruvalcaba-Sil José Luis 
Published: May 2021

Abstract
This work concerns the study of colors and dyes identified on archaeological textiles from the Atacama Desert. The different garments and ornaments come from the excavation of two important pre-Columbian cemeteries of the Tarapacá region: Tarapacá-40 attributed to the Formative period (1100 BC–660 AD) and Pica-8 to the Late Intermediate period (900–1450 AD). For the first time, a multi-analytical approach with non-invasive techniques using FORS and SERS was applied on samples of less than 2 cm of length for physicochemical characterization of the raw materials and the dyes employed in the textile production of northern Chile. The fibers are from animal origin. Blue, green, and yellow are identified as indigo, but we cannot discard a mixture with other dyes to vary hue and shade; while carminic acid and alizarin—to a lesser extent—are found on red, orange, and brown samples. This research provides new elements for the discussion about the textile technology developed in this desertic region, its changes, and continuities along the history. Our results are compared to recent findings on neighboring regions from South-Central Andes, to improve the current knowledge and discuss the existence of dyeing textile cultural traditions.
The dark-ventral-patch of male red deer, a sexual signal that conveys the degree of involvement in rutting behavior
Authors: de la Peña Eva , Pérez-González Javier , Martín José , Vedel Giovanni , Carranza Juan 
Published: May 2021

AbstractBackgroundIn polygynous mammals, signalling may play a decisive role in mating behavior, mediating the intensity of male fights and female mate choice. During the rutting season, male red deer may show a visible dark patch in their ventral fur. Recently, this patch has been suggested to act as a flexible sexual signal, due to its relationships with other variables such as age, body size, antler development, volatile compounds, or the competitive environment. The analysis of fur pigmentation at the ventral patch suggests that this might also visually indicate the male intrinsic predisposition to take part in mating competition.ResultsTo assess the possible role of this trait as a communicative signal related to mate competition, we used red deer behavioral observations during the rut in Doñana National Park (Spain) to examine the link between the degree of expression of the dark ventral patch and the rutting activity (assessed from both intra-and-inter-sexual behaviors). Consistent with our predictions, we found in a field study that males with large dark patches showed a higher frequency of rutting behaviors (mainly roaring and flehmen), more interactions with females, and attained larger harem sizes.ConclusionsThe dark ventral patch was a better predictor of male behavior than antler tines or territory holding, thus standing as a short-term indicator of male willingness to invest in mating competition.
The effect of two educational technology tools on student engagement in Chinese EFL courses
Authors: Teng Yilian , Wang Xia 
Published: May 2021

AbstractEducational technology has become an indispensable aspect of higher education, playing a crucial role in affecting student engagement, in particular. The application, advantages and disadvantages of learning management systems (LMS) and social networking systems in Chinese EFL courses, represented by Superstar—Xuexitong and WeChat, are introduced. The study aims to explore the relationship between the two educational technology tools and three dimensions of student engagement. Using an adopted and revised questionnaire from previous researches, the study measures the extent of impact of the specified educational technology tools on student engagement with the help of SPSS. Through the independent sample T tests, analysis of variance, correlation and regression, the study found that emotional engagement has the strongest positive effect on educational technology engagement. In addition, analysis of the four principal factors indicates that using LMS could engage students more than adopting social networking systems. There are significant differences in cognitive engagement between different genders, with that of males surpassing females. This article provides some empirical evidence for exploration into the use of educational technology in a specific discipline to foster better student engagement.
Material decomposition using iodine quantification on spectral CT for characterising nodules in the cirrhotic liver: a retrospective study
Authors: Laroia Shalini Thapar , Yadav Komal , Kumar Senthil , Rastogi Archana , Kumar Guresh , Sarin Shiv Kumar 
Published: May 2021

Abstract
Background
There is limited scientific evidence on the potential of spectral computed tomography (SCT) for differentiation of nodules in the cirrhotic liver. We aimed to assess SCT-generated material density (MD) parameters for nodule characterisation in cirrhosis.

Methods
Dynamic dual-energy SCT scans of cirrhotic patients performed over 3 years were retrospectively reviewed. They were classified as hepatocellular carcinoma (HCC), regenerative or indeterminate, according to the European Association for the Study of the Liver criteria. MD maps were generated to calculate the area under the curve (AUC) and cutoff values to discriminate these nodules in the hepatic arterial phase (HAP) and portal venous phase (PVP). MD maps included iodine concentration density (ICD) of the liver and nodule, lesion-to-normal liver ICD ratio (LNR) and difference in nodule ICD between HAP and PVP.

Results
Three hundred thirty nodules belonging to 300 patients (age 53.0 ± 12.7 years, mean ± standard deviation) were analysed at SCT (size 2.3 ± 0.8 cm, mean ± SD). One hundred thirty-three (40.3%) nodules were classified as HCC, 147 (44.5%) as regenerative and 50 (15.2%) as indeterminate. On histopathology, 136 (41.2%) nodules were classified as HCC, 183 (55.5%) as regenerative and 11 (3.3%) as dysplastic. All MD parameters on HAP and the nodule difference in ICD could discriminate pathologically proven HCC or potentially malignant nodules from regenerative nodules (p < 0.001). The AUC was 82.4% with a cutoff > 15.5 mg/mL for nodule ICD, 81.3% > 1.8 for LNR-HAP and 81.3% for difference in ICD > 3.5 mg/mL.

Conclusion
SCT-generated MD parameters are viable diagnostic tools for differentiating malignant or potentially malignant from benign nodules in the cirrhotic liver.
Effect of the combination of Leptadenia hastata (pers) decne and Momordica balsamina linn leaf extracts on lipid profile of streptozotocin-induced diabetic rats
Authors: Kabir Nafisatu , Alhaji Umar Ismail , James Dorcas Bolanle , Inuwa Hajia Mairo , Atiku Muhammad Kano 
Published: May 2021

Abstract
Background
Changes in blood lipid level (dyslipidemia) play a central role in the onset and pathogenesis of macrovascular complications of diabetes mellitus. Traditional herbal healers commonly use anti-diabetic polyherbal formulations to provide a multi-therapeutic approach for the treatment of diabetes mellitus and its associated complications. The effect of the aqueous leaf extracts of Leptadenia hastata (pers) Decne, Momordica balsamina Linn and their combination on lipid profile of streptozotocin (STZ)-induced diabetic rats was therefore evaluated in the present study.

Results
We evaluated the serum lipid profile and blood glucose level of STZ-induced diabetic rats (60 mg/kg body weight) treated with the aqueous leaf extracts of L. hastata (400 mg/kg) and M. balsamina (200 mg/kg) alone and in combination (400 + 200 mg/kg) after a period of 4 weeks. A significantly decreased (p < 0.05) level of total cholesterol (TC), triglyceride (TG), very low-density lipoprotein (VLDL) and low-density lipoprotein (LDL) cholesterol levels and increased (p < 0.05) level of high-density lipoprotein (HDL) cholesterol was observed in all the treated groups when compared to the untreated diabetic rats. Furthermore, the combination treatment was potentially a more effective blood lipid-lowering (p < 0.05) agent when compared to the single treatments.

Conclusion
Results from this study demonstrated the blood lipid-lowering potential of the aqueous leaf extracts of L. hastata, M. balsamina, and their combination. However, the polyherbal combination could be more potent in controlling diabetes mellitus, associated dyslipidemia, and its complications.
Awareness about FDA announcement on voluntary recall of ranitidine among physicians and pharmacists in and around Chennai, India: a cross-sectional study
Authors: Begam Rukaiah Fatma , Ravikumar Yamuna , Velmurugan Ramaiyan 
Published: May 2021

Abstract
Background
Ranitidine is a histamine-2 (H2) blocker, which decreases the amount of acid created by the stomach. In September 2019, the drug was recalled due to impurities N-nitrosodimethylamine (NDMA) by the Food and Drug Administration (FDA), European Medicines Agency (EMA), and Health Canada. NDMA is a carcinogen based on results from laboratory tests. The objective of the study is to assess the awareness among the physicians and pharmacists in and around Chennai about the ranitidine recall notification and its related issues. A descriptive, cross-sectional study was carried out where a questionnaire was administered on 198 physicians and 113 pharmacists who were enrolled in the study. Awareness, knowledge, and issues related to recall notification were recorded from the participants.

Results
Results showed that only 75% of the study participants were aware of the notification and the issues related, with significantly more participants from the urban area compared with the rural area. When the notification was known by many, the reasons pertaining to the notification were not known.

Conclusion
Overall, the awareness assessed among physicians and pharmacists was not satisfactory. Physicians and pharmacists are the most responsible healthcare providers and to be updated with every notification on medication published by regulatory bodies.
Outcome measures in forensic mental health services: A systematic review of instruments and qualitative evidence synthesis
Authors: Ryland Howard , Cook Jonathan , Yukhnenko Denis , Fitzpatrick Raymond , Fazel Seena 
Published: May 2021

Abstract

Background
Outcome measurement in forensic mental health services can support service improvement, research, and patient progress evaluation. This systematic review aims to identify instruments available for use as outcome measures in this field and assess the evidence for the most common instruments, specific to the forensic context, which cover multiple outcome domains.

Methods
Studies were identified by searching seven online databases. Additional searches were then performed for 10 selected instruments to identify additional information on their psychometric properties. Instrument manuals and gray literature was reviewed for information about instrument development and content validity. The quality of evidence for psychometric properties was summarized for each instrument based on the COnsensus-based Standards for health Measurement INstruments (COSMIN) approach.

Results
A total of 435 different instruments or variants were identified. Psychometric information on the 10 selected instruments was extracted from 103 studies. All 10 instruments had a clinician reported component with only two having patient reported scales. Half of the instruments were primarily focused on risk. No instrument demonstrated adequate psychometric properties in all eight COSMIN categories assessed. Only one instrument, the Camberwell Assessment of Need: Forensic Version, had adequate evidence for its development and content validity. The most evidence was for construct validity, while none was identified for construct stability between groups.

Conclusions
Despite the large number of instruments potentially available, evidence for their use as outcome measures in forensic mental health services is limited. Future research and instrument development should involve patients and carers to ensure adequate content validity.
Cluster Headache and Other Trigeminal Autonomic Cephalalgias
Authors: Nahas Stephanie J. 
Published: May 2021

ABSTRACT

PURPOSE OF REVIEW
The trigeminal autonomic cephalalgias (TACs) are relatively rare, but they represent a distinct set of syndromes that are important to recognize. Despite their unique features, TACs often go undiagnosed or misdiagnosed for several years, leading to unnecessary pain and suffering. A significant proportion of TAC presentations may have secondary causes.

RECENT FINDINGS
The underlying pathophysiology of TACs is likely rooted in hypothalamic dysfunction and derangements in the interplay of circuitry involving trigeminovascular, trigeminocervical, trigeminoautonomic, circadian, and nociceptive systems. Recent therapeutic advancements include a better understanding of how to use older therapies more effectively and the identification of new approaches.

SUMMARY
TAC syndromes are rare but important to recognize because of their debilitating nature and greater likelihood for having potentially serious underlying causes. Although treatment options have remained somewhat limited, scientific inquiry is continually advancing our understanding of these syndromes and how best to manage them.
Diagnosing Secondary and Primary Headache Disorders
Authors: Dodick David W. 
Published: May 2021

ABSTRACT

PURPOSE OF REVIEW
This article provides a systematic diagnostic approach to the patient with headache.

RECENT FINDINGS
The vast majority of patients presenting with headache in clinical practice have a primary headache disorder. The most common primary headache disorder in clinical practice is overwhelmingly migraine. Unfortunately, a substantial proportion of patients with migraine do not receive an accurate diagnosis. In addition, the clinical features of migraine overlap with secondary causes of headache, making a careful history and deliberative evaluation for warning symptoms or signs of a secondary headache disorder of paramount importance.

SUMMARY
The approach to the patient with headache requires knowledge of the diagnostic criteria for primary headache disorders, recognition of the importance of a systematic evaluation for red flags associated with secondary headache disorders, and awareness of the pearls and pitfalls encountered in the diagnostic evaluation of a patient with headache.
The nexus between improved water supply and water-borne diseases in urban areas in Africa: a scoping review
Authors: Mutono Nyamai , Wright Jim A , Mutembei Henry , Muema Josphat , Thomas Mair L.H , Mutunga Mumbua , Thumbi Samuel Mwangi 
Published: May 2021

Background: The sub-Saharan Africa has the fastest rate of urbanisation in the world. However, infrastructure growth in the region is slower than urbanisation rates, leading to inadequate provision and access to basic services such as piped safe drinking water. Lack of sufficient access to safe water has the potential to increase the burden of waterborne diseases among these urbanising populations. This scoping review assesses how the relationship between waterborne diseases and water sufficiency in Africa has been studied. Methods: In April 2020, we searched the Web of Science, PubMed, Embase and Google Scholar databases for studies of African cities that examined the effect of insufficient piped water supply on selected waterborne disease and syndromes (cholera, typhoid, diarrhea, amoebiasis, dysentery, gastroneteritis, cryptosporidium, cyclosporiasis, giardiasis, rotavirus). Only studies conducted in cities that had more than half a million residents in 2014 were included. Results: A total of 32 studies in 24 cities from 17 countries were included in the study. Most studies used case-control, cross-sectional individual or ecological level study designs. Proportion of the study population with access to piped water was the common water availability metrics measured while amounts consumed per capita or water interruptions were seldom used in assessing sufficient water supply. Diarrhea, cholera and typhoid were the major diseases or syndromes used to understand the association between health and water sufficiency in urban areas. There was weak correlation between the study designs used and the association with health outcomes and water sufficiency metrics. Very few studies looked at change in health outcomes and water sufficiency over time. Conclusion: Surveillance of health outcomes and the trends in piped water quantity and mode of access should be prioritised in urban areas in Africa in order to implement interventions towards reducing the burden associated with waterborne diseases and syndromes.