bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antidiabetic, anti-inflammatory and cytotoxic potential of Theobroma cacao Linn. husk aqueous extracts
Authors: Cura Julius Kevin , Basilio Antonio , Llagas Ma. Cristina De Las 
Published: December 2021

Abstract
Background
Theobroma cacao Linn. husks are considered agricultural wastes, but studies show that they exhibit natural compounds that may be used in alternative medicine. Hence, this study was conducted to determine the antidiabetic, anti-inflammatory, and cytotoxic potential of T. cacao husk aqueous extracts (TCE).

Results
A significantly higher glucose dialysis retardation index (GDRI) was shown by 10% TCE than the rest of the concentrations (1%, 3%, 5%, 7%) (P<0.05), and its activity is comparable with 5% Metformin (positive control) after 30 min, 60 min, 120 min and 180 min of incubation. The 7% TCE also showed significantly higher GDRI than the 5%, 3%, and 1% concentrations (P<0.05), and its activity is comparable with 5% Metformin after 60 min and 180 min of incubation. Moreover, 10% TCE exhibited a significantly higher glucose uptake percentage than the rest of the samples (P<0.05) and has activity comparable with 5% Metformin. The anti-inflammatory assay showed a significantly higher inhibition rate of 10% TCE than the rest of the concentrations (P<0.05), and its activity is comparable with 5% Diclofenac (positive control). The cytotoxicity assay showed that the percentage mortality of brine shrimps after 24 h of exposure to the different TCE samples is less than 50%.

Conclusion
This study concludes that T. cacao husk aqueous extract has potential antidiabetic and anti-inflammatory properties without being toxic to cells.
Predicting students at risk of academic failure using ensemble model during pandemic in a distance learning system
Authors: Karalar Halit , Kapucu Ceyhun , Gürüler Hüseyin 
Published: December 2021

AbstractPredicting students at risk of academic failure is valuable for higher education institutions to improve student performance. During the pandemic, with the transition to compulsory distance learning in higher education, it has become even more important to identify these students and make instructional interventions to avoid leaving them behind. This goal can be achieved by new data mining techniques and machine learning methods. This study took both the synchronous and asynchronous activity characteristics of students into account to identify students at risk of academic failure during the pandemic. Additionally, this study proposes an optimal ensemble model predicting students at risk using a combination of relevant machine learning algorithms. Performances of over two thousand university students were predicted with an ensemble model in terms of gender, degree, number of downloaded lecture notes and course materials, total time spent in online sessions, number of attendances, and quiz score. Asynchronous learning activities were found more determinant than synchronous ones. The proposed ensemble model made a good prediction with a specificity of 90.34%. Thus, practitioners are suggested to monitor and organize training activities accordingly.
Can Africa achieve herd immunity?
Authors: Lucero-Prisno Don Eliseo , Ogunkola Isaac Olushola , Esu Ekpereonne Babatunde , Adebisi Yusuff Adebayo , Lin Xu , Li Hao 
Published: December 2021

AbstractThe World Health Organization described herd immunity, also known as population immunity, as the indirect fortification from an infectious disease that happens when a population is immune either through vaccination or immunity developed through previous exposure to infection. The emergence of COVID-19 vaccine is a step towards the achievement of herd immunity. Over one billion people across the globe have been vaccinated and Africa recorded only 2%. The objective of this article was to develop a forecast of the number of people to be vaccinated to achieve herd immunity in the 13 WHO-identified priority African countries for COVID-19. Herd immunity is achieved when one infected person in a population causes less than one secondary case on average, corresponding to the effective basic reproduction number (R0). Vaccine delivery and distribution infrastructure including the cold chain remains weak. Vaccine hesitancy is also one of the limiting factors that may hinder herd immunity in Africa. In order to achieve herd immunity globally, African countries should not be excluded in fair and equal distribution of vaccines. Relevant stakeholders should foster commitment as well as community sensitization on COVID-19 vaccines and integration of COVID-19 vaccines in existing healthcare services.
Detecting low blood concentrations in joints using T1 and T2 mapping at 1.5, 3, and 7 T: an in vitro study
Authors: van Leeuwen Flora H. P. , Lena Beatrice , Zwanenburg Jaco J. M. , van Vulpen Lize F. D. , Bartels Lambertus W. , Fischer Kathelijn , Nap Frank J. , de Jong Pim A. , Bos Clemens , Foppen Wouter 
Published: December 2021

Abstract
Background
Intra-articular blood causes irreversible joint damage, whilst clinical differentiation between haemorrhagic joint effusion and other effusions can be challenging. An accurate non-invasive method for the detection of joint bleeds is lacking. The aims of this phantom study were to investigate whether magnetic resonance imaging (MRI) T1 and T2 mapping allows for differentiation between simple and haemorrhagic joint effusion and to determine the lowest blood concentration that can be detected.

Methods
Solutions of synovial fluid with blood concentrations ranging from 0 to 100% were scanned at 1.5, 3, and 7 T. T1 maps were generated with an inversion recovery technique and T2 maps from multi spin-echo sequences. In both cases, the scan acquisition times were below 5 min. Regions of interest were manually drawn by two observers in the obtained T1 and T2 maps for each sample. The lowest detectable blood concentration was determined for all field strengths.

Results
At all field strengths, T1 and T2 relaxation times decreased with higher blood concentrations. The lowest detectable blood concentrations using T1 mapping were 10% at 1.5 T, 25% at 3 T, and 50% at 7 T. For T2 mapping, the detection limits were 50%, 5%, and 25%, respectively.

Conclusions
T1 and T2 mapping can detect different blood concentrations in synovial fluid in vitro at clinical field strengths. Especially, T2 measurements at 3 T showed to be highly sensitive. Short acquisition times would make these methods suitable for clinical use and therefore might be promising tools for accurate discrimination between simple and haemorrhagic joint effusion in vivo.
Semen parameters in men recovered from COVID-19: a systematic review and meta-analysis
Authors: Tiwari Sagar , KC Niranjan , Thapa Sajan , Ghimire Anuja , Bijukchhe Sanjeev , Sah Guru Sharan , Isnuwardana Ronny 
Published: December 2021

Abstract
Background
The novel beta-coronavirus disease (COVID-19) has infected millions of people globally with high risk among males than females. However, the effect of COVID-19 andrology is still a subject of dispute. We planned to analyze the overall consequences of COVID-19 on semen parameters and male sex hormones.

Main text
Systematic search was performed on MEDLINE and Scopus database until 11 June 2021. We included observational studies, which reported mean ± standard deviation of the semen parameters and serum sex hormones of those reproductive-aged males recovered from COVID-19 and controls who did not suffered from COVID-19. We used Random-effect model to pool the studies, as heterogeneity was present. The Q test and I2 evaluated heterogeneity. All articles were assessed with their quality and publication bias.
We assessed 966 articles for eligibility and found seven eligible studies. These 7 studies included 934 participants with mean age 37.34 ± 10.5 years. Random-effect model meta-analysis showed that men who recovered from COVID-19 had semen parameters less than those who had not suffered from COVID-19. The overall mean difference (MD) [95% confidence interval (CI)] in semen volume, sperm concentration, sperm number, and progressive sperm motility was − 0.20 (− 0.45, 0.05) ml, − 16.59 (− 34.82, 1.65) millions/ml, − 45.44 (− 84.56, − 6.31) millions per ejaculate, − 1.73 (− 8.20, 4.75) percentage respectively. Considering sex hormones, luteinizing hormone and prolactin levels were higher among those recovered with a significant MD (95% CI) of 3.47 (1.59, 5.35)U l−1 and 3.21 (1.71, 4.72)ng ml−1 respectively.

Conclusion
We found that COVID-19 affects both semen parameters and sexual hormones. However, the mechanism for testicular involvement remains doubtful.

Trial registration
PROSPERO CRD42021259445
Echocardiographic assessment of left ventricular function in ex situ heart perfusion using pump-supported and passive afterload working mode: a pilot study
Authors: Hondjeu Arnaud Romeo Mbadjeu , Mashari Azad , Ramos Ryan , Ruggeri Giulia Maria , Gellner Bryan , Ribeiro Roberto Vanin Pinto , Hiansen Joshua Qua , Yu Frank , Xin Liming , Adamson Mitchell Brady , Badiwala Mitesh Vallabh , Meineri Massimiliano 
Published: December 2021

AbstractEx situ heart perfusion (ESHP) has been developed to decrease cold ischemia time and allow metabolic assessment of donor hearts prior to transplantation. Current clinical ESHP systems preserve the heart in an unloaded condition and only evaluate the cardiac metabolic profile. In this pilot study we performed echocardiographic functional assessment using two alternative systems for left ventricular (LV) loading: pump supported afterload working mode (SAM) and passive afterload working modes (PAM). Six hearts were procured from male Yorkshire pigs. During cold ischemia, hearts were mounted on our custom made ESHP circuit and a 3D-printed enclosure for the performance of echocardiography with a standard TEE probe. Following perfusion with Langherdorf mode of the unloaded heart, the system was switched into different working modes to allow LV loading and functional assessment: pump supported (SAM) and passive (PAM). Echocardiographic assessment of left ventricular function in the donor hearts was performed in vivo and at 1 h of ESHP with SAM, after 4.5 h with PAM and after 5.5 h with SAM. We obtained good quality epicardial echocardiographic images at all time points allowing a comprehensive LV systolic assessment. All indices showed a decrease in LV systolic function throughout the trial with the biggest drop after heart harvesting. We demonstrated the feasibility of echocardiographic functional assessment during ESHP and two different working modes. The expected LV systolic dysfunction consisted of a reduction in EF, FAC, FS, and strain throughout the experiment with the most significant decrease after harvesting.
Changes in care in the fourth trimester in Ireland: 2010–2020
Authors: Doherty Jean , Brosnan Mary , Sheehy Lucille 
Published: December 2021

Background There has been a shift in maternity care over the past decade. The changes encountered by postnatal ward staff and the impact of these changes on women postnatally requires exploration. This study aimed to ascertain midwives' and healthcare assistants' perspectives of the changes in postnatal care and challenges to providing care in the current context. Methods This was a qualitative study involving two focus groups of 15 midwives and healthcare assistants from an Irish urban maternity hospital. The participants' responses were analysed thematically. Results Changes in women's clinical characteristics, including increased comorbidities and caesarean section rates, were highlighted as creating additional care needs. Furthermore, additional midwifery tasks and clinical protocols as well as shorter hospital stays leave little time for high-quality, woman-centred care. Participants highlighted a negative impact on maternal health from limited follow-up midwifery care in the community. Conclusions With additional midwifery duties and a reduction in time to complete them, additional community midwifery care is key to providing high-quality follow-on care after postnatal discharge from hospital.
Variables Affecting Complication Rates in Type III Paediatric Supracondylar Humerus Fractures
Authors: Livermore Andrew T. , Sansone Jason M. , Machurick Maxwell , Whiting Paul , Hetzel Scott B. , Noonan Kenneth J. 
Published: December 2021

Purpose Unstable supracondylar humerus (SCH) fractures may have different outcomes as a result of direction of displacement and pin configuration. This study evaluates the impact of fracture displacement, pin configuration and fellowship training on clinical and radiographic outcomes in unstable fractures. Methods A total of 99 patients with completely displaced type III fractures were identified at an academic centre and a local community hospital. Patient characteristics and the fellowship training of the treating surgeon were recorded, and injury films documented the direction of displacement. Pin configuration, coronal and sagittal alignment were recorded from postoperative radiographs and at healing. Radiographic outcomes including coronal, sagittal and rotational malunion as well as clinical complications were analyzed. Results Fractures with direct posterior displacement had a lower composite malunion rate compared with those with posterolateral (PL) or posteromedial (PM) displacement (6.9%, 36.4%, 29.2% respectively; p = 0.019). PM displacement had a higher rate of coronal malunion compared with PL (18.2% versus 0%; post hoc p = 0.024). All-lateral constructs resulted in more rotational malunions (20.9% versus 1.8%; p = 0.002) compared with crossed pinning. PL fractures treated with all-lateral fixation showed a trend toward increased rotational instability or malunion (23.8% versus 1.3%; p = 0.073). Higher composite complication rates were noted in patients treated by surgeons with non-paediatric, non-trauma fellowship training. Conclusion For displaced SCH fractures, all-lateral fixation is associated with higher rates of rotational instability and malunion. Posteromedially and posterolaterally displaced fractures have higher rates of malunion compared with fractures with straight posterior displacement. Fellowship training other than paediatric or trauma was associated with increased complications. Level of Evidence Level III
Photon-counting schemes for MIMO underwater wireless optical communication with arrayed PMTs
Authors: Li Jinjia , Ye Demao , Fu Kang , Wang Linning , Piao Jinlong , Li Changxiang , Wang Yongjin 
Published: December 2021

Underwater wireless optical communication (UWOC) is a promising means
of realizing large capacity and high rate in aquatic media. In this
paper, a photomultiplier tube (PMT)-based multiple-input
multiple-output (MIMO) UWOC system is investigated. Photon counting is
an effective technique used to detect very low-level light. A PMT with
an excellent photon-counting mode is adopted, and the performance in
terms of the bit error rate is discussed. The received optical power
can be predicted based on the detected photocount in each symbol
period, and the received photocount distribution may be simulated
through MATLAB. Furthermore, the optical link model and energy per bit
with on-off keying are evaluated for different water types at a 10 m
optical link distance. This MIMO-UWOC system combines the advantages
of PMTs and the MIMO scheme and has the potential to realize
long-distance optical link transmission.
Impact of the introduction of chikungunya and zika viruses on the incidence of dengue in endemic zones of Mexico
Authors: Fernandes-Matano Larissa , Monroy-Muñoz Irma Eloisa , Pardavé-Alejandre Hector Daniel , Uribe-Noguez Luis Antonio , Hernández-Cueto María de los Angeles , Rojas-Mendoza Teresita , Santacruz-Tinoco Clara Esperanza , Grajales-Muñiz Concepción , Muñoz-Medina José Esteban 
Published: December 2021

Background
With the arrival of chikungunya (CHIKV) and zika (ZIKV) viruses in Mexico, there was a decrease in diagnosed dengue virus (DENV) cases. During the first years of cocirculation (2015–2017), the algorithms established by epidemiological surveillance systems and the installed capacity limited us to one diagnostic test per sample, so there was an underestimation of cases until September 2017, when a multiplex algorithm was implemented. Therefore, the objective of this study was determine the impact of the introduction of CHIKV and ZIKV on the incidence of diagnosed DENV in endemic areas of Mexico, when performing the rediagnosis, using the multiplex algorithm, in samples from the first three years of co-circulation of these arboviruses.

Methodology and principal findings
For this, 1038 samples received by the Central Laboratory of Epidemiology between 2015 and 2017 were selected for this work. Viruses were identified by multiplex RT-qPCR, and the χ2 test was used to compare categorical variables. With the new multiplex algorithm, we identified 2.4 times the rate of arbovirosis as originally reported, evidencing an underestimation of the incidence of the three viruses. Even so, significantly less dengue was observed than in previous years. The high incidence rates of chikungunya and Zika coincided with periods of dengue decline. The endemic channel showed that the cases caused by DENV rose again after the circulation of CHIKV and ZIKV decreased. In addition, 23 cases of coinfection were identified, with combinations between all viruses.

Conclusions and significance
The results obtained in this study show for the first time the real impact on the detected incidence of dengue after the introduction of CHIKV and ZIKV in Mexico, the degree of underestimation of these arboviruses in the country, as well as the co-infections between these viruses, whose importance clinical and epidemiological are still unknown.
A novel approach of creating sustainable urban planning solutions that optimise the local air quality and environmental equity in Helsinki, Finland: The CouSCOUS study protocol
Authors: Demmler Joanne C. , Gosztonyi Ákos , Du Yaxing , Leinonen Matti , Ruotsalainen Laura , Järvi Leena , Ala-Mantila Sanna 
Published: December 2021

BackgroundAir pollution is one of the major environmental challenges cities worldwide face today. Planning healthy environments for all future populations, whilst considering the ongoing demand for urbanisation and provisions needed to combat climate change, remains a difficult task.ObjectiveTo combine artificial intelligence (AI), atmospheric and social sciences to provide urban planning solutions that optimise local air quality by applying novel methods and taking into consideration population structures and traffic flows.MethodsWe will use high-resolution spatial data and linked electronic population cohort for Helsinki Metropolitan Area (Finland) to model (a) population dynamics and urban inequality related to air pollution; (b) detailed aerosol dynamics, aerosol and gas-phase chemistry together with detailed flow characteristics; (c) high-resolution traffic flow addressing dynamical changes at the city environment, such as accidents, construction work and unexpected congestion. Finally, we will fuse the information resulting from these models into an optimal city planning model balancing air quality, comfort, accessibility and travelling efficiency.
Combining research and design: A mixed methods approach aimed at understanding and optimising inpatient medication storage systems
Authors: Wheeler Carly , Blencowe Alice , Jacklin Ann , Franklin Bryony Dean 
Published: December 2021

Background
Almost every patient admitted to hospital will receive medication during their stay. Medication errors are an important cause of patient morbidity and mortality, as well as an economic burden for healthcare institutions. Research suggests that current methods of storing medication on hospital wards are not fit for purpose, contributing to inefficiency and error.

Aim
To improve medication storage in inpatient areas, by exploring variation and challenges related to medication storage and designing a prototype solution.

Methods
Set in four hospitals in an English teaching hospital trust, the study used a mixed methods approach comprising a quantitative descriptive survey of storage facilities and practices followed by mixed methods observations of medication rounds and interviews with patients, nurses and pharmacy staff. Quantitative data were presented descriptively and qualitative data analysed thematically and using a human-centered design approach.

Results
We identified wide variation in medication storage facilities and practices across 77 wards. Observations and staff interviews in six wards revealed five problem areas: poor management of multiple storage facilities; lack of visibility and organisation of medication within trolleys; inadequate size of storage; lack of ownership and knowledge of standard practice; and use of key locks. Patients were largely satisfied with receiving their medication. Systematic and consistent physical organisation of medication in medication trolleys, and integrating and implementing principles of best practice, were identified as areas for intervention.

Discussion and conclusion
Variation in medication storage facilities and practices existed both across the organization and on individual wards. Multiple challenges were identified in how medication was stored, which if addressed may improve the efficiency and safety of medication administration and in turn, staff and patient experience. The use of design principles alongside a research approach resulted in a rapid, iterative process for developing and refining potential solutions to improve inpatient medication storage.
Determinants of dental caries among adolescent patients attending Hospitals in West Wollega Zone, Western Ethiopia: A case-control study
Authors: Guracho Tsega Tola , Atomssa Emiru Merdassa , Megersa Obsa Amante , Tolossa Tadesse 
Published: December 2021

Background
Dental caries is a prevalent disease in both developed and developing countries and is a public health problem among adolescents. This study aimed to assess the determinants of dental caries among adolescent patients in the west Wollega Zone, Western Ethiopia.

Methods
A hospital-based unmatched case-control study design was conducted in West Wollega Zone, West Ethiopia. A total of 133 cases and 266 controls participated in this study. Data were collected using pre-tested questionnaires from three hospitals. Epi-info version 7 was used for data entry and was analyzed using SPSS version 20. Frequency, proportion, mean and standard deviation were computed to summarize the data. Statistics are presented using tables and bar graphs. Multivariable binary logistic regression analysis was used to identify the determinants of dental caries at P < 0.05. The adjusted odds ratio with 95% confidence interval (CI) was used to show the strength of association between the predictors and dental caries.

Results
A total of 399 adolescents were enrolled in this study, yielding a response rate of 100%. The study found that, daily consumption of sugared coffee (AOR = 2.91, 95% CI:1.62, 5.23), khat chewing (AOR = 2.90, 95%CI: 1.46, 3.15), daily consumption of bread (AOR = 2.65, 95%CI: 1.44, 4.89), daily consumption of sweet foods (AOR = 2.04, 95%CI:1.19, 3.48), living in urban areas (AOR = 1.86, 95%CI:1.09, 3.15), and daily tooth brushing using toothpaste or stick (AOR = 0.48;95%CI, 0.28, 0.81) were significantly associated with dental caries among adolescents.

Conclusions and recommendations
In this study, drinking sugared coffee, daily consumption of bread, khat chewing, sugary food consumption, living in urban areas, and daily tooth brushing using toothpaste were significantly associated with dental caries. Therefore, improving dietary and drinking habits and strengthening regular tooth brushing are important for reducing dental caries among adolescents.