bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cycling kinematics in healthy adults for musculoskeletal rehabilitation guidance
Authors: Yum Haeun , Kim Hyang , Lee Taeyong , Park Moon Seok , Lee Seung Yeol 
Published: December 2021

Abstract
Background
Stationary cycling is commonly used for postoperative rehabilitation of physical disabilities; however, few studies have focused on the three-dimensional (3D) kinematics of rehabilitation. This study aimed to elucidate the three-dimensional lower limb kinematics of people with healthy musculoskeletal function and the effect of sex and age on kinematics using a controlled bicycle configuration.

Methods
Thirty-one healthy adults participated in the study. The position of the stationary cycle was standardized using the LeMond method by setting the saddle height to 85.5% of the participant’s inseam. The participants maintained a pedaling rate of 10–12 km/h, and the average value of three successive cycles of the right leg was used for analysis. The pelvis, hip, knee, and ankle joint motions during cycling were evaluated in the sagittal, coronal, and transverse planes. Kinematic data were normalized to 0–100% of the cycling cycle. The Kolmogorov-Smirnov test, Mann-Whitney U test, Kruskal-Wallis test, and k-fold cross-validation were used to analyze the data.

Results
In the sagittal plane, the cycling ranges of motion (ROMs) were 1.6° (pelvis), 43.9° (hip), 75.2° (knee), and 26.9° (ankle). The coronal plane movement was observed in all joints, and the specific ROMs were 6.6° (knee) and 5.8° (ankle). There was significant internal and external rotation of the hip (ROM: 11.6°), knee (ROM: 6.6°), and ankle (ROM: 10.3°) during cycling. There was no difference in kinematic data of the pelvis, hip, knee, and ankle between the sexes (p = 0.12 to 0.95) and between different age groups (p = 0.11 to 0.96) in all anatomical planes.

Conclusions
The kinematic results support the view that cycling is highly beneficial for comprehensive musculoskeletal rehabilitation. These results might help clinicians set a target of recovery ROM based on healthy and non-elite individuals and issue suitable guidelines to patients.
Capacity of community advisory boards for effective engagement in clinical research: a mixed methods study
Authors: Mugenyi Levicatus , Mijumbi Andrew , Nanfuka Mastula , Agaba Collins , Kaliba Fedress , Semakula Irene Seryazi , Nazziwa Winfred Badanga , Ochieng Joseph 
Published: December 2021

Abstract
Background
Community engagement is a key component in health research. One of the ways health researchers ensure community engagement is through Community Advisory Boards (CABs). The capacity of CABs to properly perform their role in clinical research has not been well described in many resource limited settings. In this study, we assessed the capacity of CABs for effective community engagement in Uganda.

Methods
We conducted a cross sectional study with mixed methods. We used structured questionnaires and key informant interviews (KII) to collect data from CAB members, trial investigators, and community liaison officers. For quantitative data, we used descriptive statistics while for qualitative data we used content analysis.

Results
Seventy three CAB members were interviewed using structured questionnaires; 58.9% males, median age 49 years (IQR 24–70), 71.2% had attained tertiary education, 42.5% never attended any research ethics training, only 26% had a training in human subject protection, 30.1% had training in health research, 50.7% never attended any training about the role of CABs, and 72.6% had no guidelines for their operation. On the qualitative aspect, 24 KIIs cited CAB members to have some skills and ability to understand and review study documents, offer guidance on community norms and expectations and give valuable feedback to the investigators. However, challenges like limited resources, lack of independence and guidelines, and knowledge gaps about research ethics were cited as hindrances of CABs capacity.

Conclusion
Though CABs have some capacity to perform their role in the Ugandan setting, their functionality is limited by lack of resources to facilitate their work, lack of independence, lack of guidelines for their operations and limited knowledge regarding issues of research ethics and protection of the rights of trial participants.
Stressors and level of stress among different nursing positions and the associations with hyperlipidemia, hyperglycemia, and hypertension: a national questionnaire survey
Authors: Chang Po-Ya , Chiou Shu-Ti , Lo Wen-Yen , Huang Nicole , Chien Li-Yin 
Published: December 2021

Abstract
Background
Nurses are faced with varying job stressors depending on their positions and duties. Few previous studies have compared job stress and related chronic conditions among different nursing positions. The objectives were to compare job stressors among clinical registered nurses, nurse practitioners, and head nurses and explore the impact of job stressors and stress level on hyperlipidemia, hyperglycemia, and hypertension.

Methods
Secondary data extracted from a survey of health-care workers conducted from May to July 2014 across 113 hospitals in Taiwan was used. This analysis included 17,152 clinical registered nurses, 1438 nurse practitioners, and 2406 head nurses. Socio-demographic characteristics, job stressors, stress levels, and hyperlipidemia, hyperglycemia, and hypertension variables were extracted.

Results
Perceived stressors differed among clinical registered nurses, nurse practitioners, and head nurses, but overall stress level did not. Nurse practitioners and head nurses showed significantly higher prevalence of hyperlipidemia, hyperglycemia, and hypertension than clinical registered nurses. Higher stress levels, age, body mass index, work hours, and caring for family members were positively associated with hyperlipidemia, hyperglycemia, and hypertension. After adjustment for these variables, risk of hyperlipidemia, hyperglycemia, and hypertension did not differ across the nursing positions.

Conclusions
Although stressors vary by different nursing positions, overall stress level does not. Hyperlipidemia, hyperglycemia, and hypertension are related to stress level, age, body mass index, weekly working hours, and caring for family members. Hence, alleviating job stress and avoiding long working hours are likely to reduce the risk of hyperlipidemia, hyperglycemia, and hypertension in nurses.
P-tau and neurodegeneration mediate the effect of β-amyloid on cognition in non-demented elders
Authors: Ma Ling-Zhi , Hu Hao , Wang Zuo-Teng , Ou Ya-Nan , Dong Qiang , Tan Lan , Yu Jin-Tai 
Published: December 2021

Abstract
Background
There are many pathological changes in the brains of Alzheimer’s disease (AD) patients. For many years, the mainstream view on the pathogenesis of AD believes that β-amyloid (Aβ) usually acts independently in addition to triggering functions. However, the evidence now accumulating indicates another case that these pathological types have synergies. The objective of this study was to investigate whether effects of Aβ pathology on cognition were mediated by AD pathologies, including tau-related pathology (p-tau), neurodegeneration (t-tau, MRI measurements), axonal injury (NFL), synaptic dysfunction (neurogranin), and neuroinflammation (sTREM2, YKL-40).

Methods
Three hundred seventy normal controls (CN) and 623 MCI patients from the ADNI (Alzheimer’s Disease Neuroimaging Initiative) database were recruited in this research. Linear mixed-effects models were used to evaluate the associations of baseline Aβ with cognitive decline and biomarkers of several pathophysiological pathways. Causal mediation analyses with 10,000 bootstrapped iterations were conducted to explore the mediation effects of AD pathologies on cognition.

Results
Tau-related pathology, neurodegeneration, neuroinflammation are correlated with the concentration of Aβ, even in CN participants. The results show that age, gender, and APOE ε4 carrier status have a moderating influence on some of these relationships. There is a stronger association of Aβ with biomarkers and cognitive changes in the elderly and females. In CN group, Aβ pathology is directly related to poor cognition and has no mediating effect (p < 0.05). In mild cognitive impairment, tau-related pathology (26.15% of total effect) and neurodegeneration (14.8% to 47.0% of total effect) mediate the impact of Aβ on cognition.

Conclusions
In conclusion, early Aβ accumulation has an independent effect on cognitive decline in CN and a tau, neurodegeneration-dependent effect in the subsequent cognitive decline in MCI patients.
New surgical realities: implementation of an enhanced recovery after surgery protocol for gynecological laparoscopy—a prospective study
Authors: Jimenez Jose Carlos Vilches , Serrano Beatriz Tripiana , Muñoz Emilia Villegas , Pérez Belinda Sanchez , Jimenez Lopez Jesús S. 
Published: December 2021

Abstract
Background
Multimodal rehabilitation allows optimization of functional recovery in surgery patients by reducing the postoperative stress and hospital stay duration, without increasing the morbidity and mortality. It is reportedly successful in other surgical disciplines, and guidelines for its application to gynecological surgery are available; however, most evidence for these guidelines is derived from observational and/or retrospective studies. Therefore, this study aimed to investigate the applicability of an enhanced recovery after surgery (ERAS) protocol in laparoscopic gynecological surgery and its influence on the postoperative stay, morbidity, mortality, and readmission, through a prospective approach.

Methods
This prospective cohort study was performed on 90 patients who underwent laparoscopic hysterectomy for benign causes from October 2017 to October 2019. Patients in whom the ERAS (ERAS group, n = 30) and traditional (control group, n = 60) protocols were implemented were compared. All patients were followed for 6 months.

Results
The groups were homogeneous and did not differ significantly with respect to the demographic characteristics (age, ASA score, body mass index), surgical indications, and surgery types. Adherence to the ERAS protocol was over 99%. The postoperative hospital-stay durations were 1.73 days (r = 1–3) and 2.97 days (r = 2–6) in the ERAS and control groups, respectively (p = 0.000). No significant intergroup differences were observed in the rates of complications and readmissions.

Conclusions
The ERAS protocol is applicable in laparoscopic gynecological surgery and can be implemented with good adherence. This can allow optimization of patient recovery by reducing the hospital stay duration, without increasing the rates of morbidity, mortality, or readmission.
The association of multimodal analgesia and high-risk opioid discharge prescriptions in opioid-naive surgical patients
Authors: Langnas Erica , Rodriguez-Monguio Rosa , Luo Yanting , Croci Rhiannon , Dudley R. Adams , Chen Catherine L. 
Published: December 2021

Abstract
Background
Opioids and multimodal analgesia are widely administered to manage postoperative pain. However, little is known on how improvements in inpatient pain control are correlated with high-risk (> 90 daily OME) discharge opioid prescriptions for opioid naïve surgical patients.

Methods
We conducted a retrospective observational study of adult opioid-naïve patients undergoing surgery from June 2012 through December 2018 at a large academic medical center. We used multivariate logistic regression to assess whether multimodal analgesic drugs consumed in the 24 h prior to discharge was associated with a reduction in high-risk opioid discharge prescriptions. We identified other risk factors for receiving a high-risk discharge opioid prescription.

Results
Among the 32,511 patients, 83% of patients were discharged with an opioid prescription. In 2013, 34.1% of patients with a discharge opioid prescription received a high-risk prescription and this declined to 17.7% by 2018. Use of multimodal analgesic agents during the final 24 h of hospitalization increased each year, with over 80% receiving at least one multimodal analgesic agent by 2018. The median OME consumed in the 24 h prior to discharge peaked in 2013 at 31 and steadily decreased to 19.8 by 2018. There was a significant association between the use of acetaminophen in the 24 h prior to discharge and a high-risk prescription at discharge (p < 0.01). OMEs consumed in the 24 h prior to discharge was a significant predictor of receiving a high-risk discharge prescription, even at low doses. Other factors associated with receipt of a high-risk discharge opioid prescription included male gender, race, history of anxiety disorder, and discharge service.

Discussion
Use of multimodal analgesia regimens in hospitalized surgical patients in the 24 h prior to hospital discharge increased between 2012 and 2018. Simultaneously, opioid use prior to hospital discharge decreased. Despite these gains, approximately one in five discharge prescriptions was high-risk (> 90 daily OME). In addition, we found that prescribing of discharge opioids above inpatient opioid requirements remains common in opioid naive surgical patients.

Conclusion
Providers should account for pre-discharge opioid consumption and use of multimodal analgesia when considering the total and daily OME’s that may be appropriate for an individual surgical patient on the discharge opioid prescription.
Obstructive sleep apnea and associated factors among hypertensive patients attending a tertiary cardiac center in Tanzania: a comparative cross-sectional study
Authors: Pallangyo Pedro , Mgopa Lucy R. , Mkojera Zabella , Komba Makrina , Millinga Jalack , Misidai Nsajigwa , Swai Happiness J. , Mayala Henry , Bhalia Smita , Wibonela Salma , Janabi Mohamed 
Published: December 2021

Abstract
Background
There is mounting evidence for a reciprocal yet bidirectional association between sleep-disordered breathing and hypertension. Obstructive sleep apnea (OSA), a common cause of systemic hypertension is an independent risk factor for hypertension-related cardiovascular morbidity and mortality. In this comparative hospital-based cross-sectional study, we sought to explore the burden of obstructive sleep apnea and its associated risk factors among hypertensive patients attending Jakaya Kikwete Cardiac Institute.

Methodology
A total of 1974 individuals (i.e. 1289 hypertensive and 685 normotensives) were consecutively enrolled in this study. The Berlin questionnaire and Epworth Sleepiness Scale were utilized in the assessment of OSA and excessive daytime sleepiness (EDS) respectively. Logistic regression analyses were employed in the determination of associated factors for OSA.

Results
The mean age was 53.4 years and females constituted the large majority (60.4%) of participants. About three quarters (74.1%) of participants had excess body weight, 11.6% had diabetes, 8.0% had asthma and 18.6% had history of recurrent nasal congestion. Positive family history of snoring was reported by 43.1% of participants and 36.9% had a personal history of snoring. Persons with hypertension displayed a higher frequency (42.1%) of OSA compared to their normotensive counterparts (11.8%), p < 0.001. Multivariate logistic regression analyses revealed hypertension (OR 5.1, 95% CI 3.2-8.2, p < 0.001), diabetes mellitus (OR 2.2, 95% CI 1.3-3.5, p < 0.01), chronic nasal congestion (OR 1.6, 95% CI 1.1-2.5, p = 0.01), obesity (OR 2.4, 95% CI 1.8-3.3, p < 0.001), increased neck circumference (OR 2.7, 95% CI 1.2-6.4, p = 0.02), family history of snoring (OR 5.5, 95% CI 4.0-7.5, p < 0.001), and working > 8 h/24 h (OR 0.6, 95% CI 0.4-1.0, p = 0.03) to have an independent association for OSA. Furthermore, participants with hypertension displayed superior odds for OSA compared to their normotensive counterparts across all subgroup analyses.

Conclusion
OSA is considerably common among patients with hypertension in a tertiary health care setting in Tanzania. Positive family history of snoring was the strongest associated factor; however, excess body weight proved to be the strongest modifiable risk factor. In view of its pervasiveness, OSA should be an integral part of the medical evaluation in hypertensive individuals.
Prescribed fire limits wildfire severity without altering ecological importance for birds
Authors: Latif Quresh S. , Saab Victoria A. , Dudley Jonathan G. 
Published: December 2021

AbstractBackgroundFire suppression and anthropogenic land use have increased severity of wildfire in western U.S. dry conifer forests. Managers use fuels reduction methods (e.g., prescribed fire) to limit high-severity wildfire and restore ecological function to these fire-adapted forests. Many avian species that evolved in these forests, however, are adapted to conditions created by high-severity wildfire. To fully understand the ecological implications of fuels reduction treatments, we need to understand direct treatment effects and how treatments modulate subsequent wildfire effects on natural communities. We studied bird population and community patterns over nine years at six study units, including unburned (2002–2003), after prescribed fire (2004–2007), and after wildfire (2008–2010). We used a before-after, control-impact (BACI) approach to analyze shifts in species occupancy and richness in treated units following prescribed fire and again in relation to burn severity following wildfire.ResultsWe found examples of both positive and negative effects of wildfire and prescribed fire on bird species occupancy depending on and largely consistent with their life history traits; several woodpecker species, secondary cavity-nesting species, aerial insectivores, and understory species exhibited positive effects, whereas open cup canopy-nesting species and foliage- or bark-gleaning insectivores exhibited negative effects. Wildfire affected more species more consistently through time than did prescribed fire. Wildfire burned units initially treated with prescribed fire less severely than untreated units, but the slopes of wildfire effects on species occupancy were similar regardless of prior prescribed fire treatment.ConclusionsOur results suggest managers can employ prescribed fire to reduce wildfire severity without necessarily altering the ecological importance of wildfire to birds (i.e., the identity of species exhibiting negative versus positive responses). Additional study of the ecological implications of various fuels reduction practices, representing a range of intensities and fire regimes, would further inform forest management that includes biodiversity objectives.
Using artificial intelligence to predict the intrauterine insemination success rate among infertile couples
Authors: Sene Azadeh Akbari , Zandieh Zahra , Soflaei Mojgan , Torshizi Hamid Mokhtari , Sheibani Kourosh 
Published: December 2021

AbstractBackgroundTo evaluate the use of artificial intelligence (AI) in predicting the success rate of intrauterine insemination (IUI) treatment among infertile couples and also to determine the importance of each of the parameters affecting IUI success. This study was a retrospective cohort study in which information from 380 infertile couples undergoing IUI treatment (190 cases resulting in positive pregnancy test and 190 cases of failed IUI) including underlying factors, female factors, sperm parameters at the beginning of the treatment cycle, and fertility results were collected from 2013 to 2019 and evaluated to determine the effectiveness of AI in predicting IUI success.ResultsWe used the most important factors influencing the success of IUI as a neural network input. With the help of a three-layer neural network, the accuracy of the AI to predict the success rate of IUI was 71.92% and the sensitivity and specificity were 76.19% and 66.67%, respectively. The effect of each of the predictive factors was obtained by calculating the ROC curve and determining the cut-off point.ConclusionsThe morphology, total motility, and progressive motility of the sperm were found to be the most important predictive factors for IUI success. In this study, we concluded that by predicting IUI success rate, artificial intelligence can help clinicians choose individualized treatment for infertile couples and to shorten the time to pregnancy.
Using side flow jets as a scour countermeasure downstream of a sluice gate
Authors: Abdelmoaty Mohamed S. , Zayed Mahmoud 
Published: December 2021

AbstractBackgroundLocal scour is one of the main problems affecting the stability and operation of control hydraulic structures. Many techniques were used to control the resulting scour. In the recent study, a new technique was used to control local scour downstream single-gate hydraulic regulator by using side flow jets. This study aimed to demonstrate the effect of side jets at different angles on the local scour parameters (depth, length, and volume) and energy dissipation in the downstream hydraulic regulator.ResultsA physical model was used to represent the open channel, regulator, and the side jets with different angles. Five flow discharges, four jet angles, and three gate openings were applied through the experiment. The experiment results showed that the presence of side jets had a remarkable effect on the parameters of the local scour hole and energy dissipation. They dissipated more energy of hydraulic jump than in the absence of jets, and consequently, scour hole dimensions were significantly reduced. Regression analysis was used to deduce equations that can predict the development of local scour downstream sluice gate considering the inclination angle of side flow jets under different flow conditions.ConclusionsSide flow jets can be used as scour reducer techniques with the advantages of eliminating the jet clog produced from sediments and suspended solids.
Analyzing the relationship between sustainable development indicators and renewable energy consumption
Authors: Aboul-Atta Tarek Abdel-Latif , Rashed Rania Hamed 
Published: December 2021

AbstractThe transition to renewable energy sources remains a major challenge for developed and developing countries. Therefore, the study aims at investigating the relationship between sustainable development indicators and renewable energy consumption utilizing integrated data sets for 255 indicators expressing the sustainable development goals from 137 developed and developing countries. Principal component analysis then multiple linear regression tests are employed to conclude a mathematical model representing the numerical relationship between a set of sustainable development indicators and renewable energy consumption. The statistical analysis results include (i) an inverse correlation between Sustainable Development Index which expresses the dominant factor representing collected data and renewable energy consumption, (ii) a set of sustainable development indicators as the determinants of renewable energy consumption. The findings explain the rapid transformation of low Sustainable Development Index countries towards renewable energy technology by realizing the effective role of using renewable energy as a local solution. Moreover, the findings manifest the importance of the given sustainable development indicators in obtaining a more significant increase in renewable energy consumption. Using the concluded mathematical mode, planners and decision-makers can compromise the concluded indicators to attain a serious progressing step towards renewable energy transition aligned with achieving sustainable development.