bluuebunny/crossref_metadata_2025_split huggingface dataset:
“It was just for us”: qualitative evaluation of an exercise intervention for African-American couples
Authors: Hornbuckle Lyndsey M. , Barroso Cristina S. , Rauer Amy , Jones Chloe S. , Winters-Stone Kerri M. 
Published: May 2021

Abstract
Background
Promoting long-term exercise adherence should be a key focus for health and fitness professionals working to reduce obesity and cardiometabolic health disparities, and all-cause mortality in inactive African-American (AA) adults. Data have suggested that romantic partners can improve long-term exercise adherence and that this dyadic approach should be examined in exercise interventions. Therefore, the purpose of this study was to conduct a qualitative evaluation of a pilot exercise intervention conducted in older AA couples.

Methods
Two semi-structured focus groups were utilized to compare participants’ perceptions of and experiences during the pilot intervention across two randomly assigned treatment conditions (exercising together with partner [ET; n = 8] versus exercising separately [ES: n = 6]). Participants (mean age: 64.7 ± 6.8 years) of a previous 12-week pilot exercise intervention (walking ≥3 days/week, 30 min/day plus supervised resistance training 2 days/week) were interviewed. Verbatim transcripts were coded using an open coding approach.

Results
Three key themes (intervention value/benefits, intervention difficulties, and suggested improvements) emerged. Although all couples identified health and relationship benefits of the intervention, some differences surfaced within themes across the two intervention groups.

Conclusions
Overall, these qualitative data suggest that couples had a positive experience while participating in the pilot study. In addition, key learning points to improve the intervention were identified including a more gradual transition to independent exercise, more flexibility training, and the incorporation of tangential education. These data will help investigators continue to develop the intervention, which is ultimately designed to promote long-term exercise adherence to reduce cardiometabolic health disparities in the AA community.
How are academic achievement and inhibitory control associated with physical fitness, soil-transmitted helminth infections, food insecurity and stunting among South African primary schoolchildren?
Authors: Gerber Markus , Lang Christin , Beckmann Johanna , du Randt Rosa , Gall Stefanie , Seelig Harald , Long Kurt Z. , Ludyga Sebastian , Müller Ivan , Nienaber Madeleine , Nqweniso Siphesihle , Pühse Uwe , Steinmann Peter , Utzinger Jürg , Walter Cheryl 
Published: May 2021

AbstractBackgroundCardiovascular fitness has been associated with both executive function and academic achievement in multiple cohort studies including children and adolescents. However, research is scarce among children from low- and middle-income countries. Hence, this paper focuses on South African primary schoolchildren living in marginalized areas and examines if academic achievement and inhibitory control can be explained by children’s age, socioeconomic status, soil-transmitted helminth infections, food insecurity, stunting, grip strength, and cardiorespiratory fitness.MethodsThe sample of this cross-sectional study consisted of 1277 children (48% girls, mean age: 8.3 years). Data were assessed via questionnaires, stool samples, anthropometric measurements, 20 m shuttle run test, grip strength test, Flanker task, and school grades. Data were analysed with mixed linear regression models with random intercepts for school classes, separately for boys and girls.ResultsHigher socioeconomic status was most closely associated with academic achievement among boys (p < 0.05), whereas higher levels of cardiorespiratory fitness and not being stunted explained most variance in academic achievement in girls (p < 0.05). Higher age turned out to be associated with better performance in the Flanker task (p < 0.01). Additionally, in boys, higher grip strength was associated with better information processing and inhibitory control of attention (p < 0.01), whereas in girls, higher cardiorespiratory fitness levels were positively associated with these cognitive abilities (p < 0.05).ConclusionsAcademic performance has been shown to be compromised in schoolchildren living in marginalised areas, compared to schoolchildren in less disadvantaged parts of South Africa. The present study suggests that cardiorespiratory fitness and grip strength are two potentially modifiable factors that are associated with children’s academic achievement and cognitive performance, and that should be targeted in future school-based interventions.
An ecological study of chronic kidney disease in five Mesoamerican countries: associations with crop and heat
Authors: Hansson Erik , Mansourian Ali , Farnaghi Mahdi , Petzold Max , Jakobsson Kristina 
Published: May 2021

Abstract
Background
Mesoamerica is severely affected by an epidemic of Chronic Kidney Disease of non-traditional origin (CKDnt), an epidemic with a marked variation within countries. We sought to describe the spatial distribution of CKDnt in Mesoamerica and examine area-level crop and climate risk factors.

Methods
CKD mortality or hospital admissions data was available for five countries: Mexico, Guatemala, El Salvador, Nicaragua and Costa Rica and linked to demographic, crop and climate data. Maps were developed using Bayesian spatial regression models. Regression models were used to analyze the association between area-level CKD burden and heat and cultivation of four crops: sugarcane, banana, rice and coffee.

Results
There are regions within each of the five countries with elevated CKD burden. Municipalities in hot areas and much sugarcane cultivation had higher CKD burden, both compared to equally hot municipalities with lower intensity of sugarcane cultivation and to less hot areas with equally intense sugarcane cultivation, but associations with other crops at different intensity and heat levels were not consistent across countries.

Conclusion
Mapping routinely collected, already available data could be a first step to identify areas with high CKD burden. The finding of higher CKD burden in hot regions with intense sugarcane cultivation which was repeated in all five countries agree with individual-level studies identifying heavy physical labor in heat as a key CKDnt risk factor. In contrast, no associations between CKD burden and other crops were observed.
Health behaviors and metabolic risk factors are associated with dyslipidemia in ethnic Miao Chinese adults: the China multi-ethnic cohort study
Authors: Nie Fang , Wang Ziyun , Zeng Qibing , Guan Han , Yang Jingyuan , Luo Peng , Du Lunwei , Wang Junhua , Hong Feng 
Published: May 2021

Abstract
Background
Cardiovascular risk factors in Chinese ethnic minority groups are rarely reported.

Objective
To quantify the cardiovascular risk factors in Miao Chinese adults and to examine the association of health behaviors and metabolic risk factors with dyslipidemia.

Methods
A cross-sectional analysis was conducted using baseline data from the China Multi-Ethnic Cohort (CMEC) study. A representative sample of 5559 Miao participants aged 30 to 79 years were surveyed and given physical and laboratory exams. The proportion of behavioral and metabolic risk factors were described in ethnic Miao adults. Logistic regression was utilized to evaluate the odds ratio (OR) and 95% confidence interval (CI) of the association between health behaviors and metabolic risk factors with dyslipidemia.

Results
In Miao Chinese adults, the prevalence of dyslipidemia was 32.8%. After multivariate adjustment, subjects with poor waist-to-hip ratio (WHR), body mass index (BMI), fasting blood glucose (FBG) and blood pressure (BP) were more likely to have higher risk of triglycerides (TG) abnormality, regardless of gender and age. Furthermore, the strongly association was detected between poor WHR and low density lipoprotein cholesterol (LDL-C) abnormality (adjusted OR = 5.24, 95%CI: 2.42–11.34) in the older subgroup (≥ 60 years). Males who current smoking were an independent risk factor only for high density lipoprotein cholesterol (HDL-C) abnormality (adjusted OR = 1.44, 95%CI: 1.05–1.99). However, in the subgroup age, current smoker were at greater risk of high TG and low HDL-C. Males with regular drinking were less likely to be high LDL-C (adjusted OR = 0.51, 95%CI: 0.32–0.81).

Conclusions
The present findings indicated that Miao adults with metabolic risk factors were at greater risk of dyslipidemia.
Effect of a novel stretching technique on shoulder range of motion in overhead athletes with glenohumeral internal rotation deficits: a randomized controlled trial
Authors: Gharisia Omar , Lohman Everett , Daher Noha , Eldridge Alan , Shallan Amjad , Jaber Hatem 
Published: May 2021

Abstract
Background
The cross-body and the modified sleeper stretch have been used to improve posterior shoulder soft tissue flexibility and to increase glenohumeral joint internal rotation (GHJ IR) in overhead athletes. However, due to the inability to stabilize patient’s scapula and control GHJ rotation with the cross-body stretch and the potential for subacromial impingement or symptoms’ aggravation with the modified sleeper stretch, a new stretching technique (Passive Glenohumeral Internal Rotation with Clam Shell Bridging) was developed as an alternative to these commonly used stretches that may allow for greater stability of the scapula without reproducing symptoms. Thus, the current study aimed to examine and compare a novel stretching technique to the traditional modified sleeper stretch to determine the effect on glenohumeral IR range of motion (ROM) and self-reported pain in overhead athletes with glenohumeral internal rotation deficits (GIRD).

Methods
Forty-two overhead athletes with GIRD [mean age 25.9 ± 2.6 years, 20 males and 22 females] participated in this study. Participants were randomly assigned into either novel stretching group or modified sleeper stretching group. IR ROM was measured with a digital inclinometer before, immediately, and at week 4 post intervention, while pain was measured with Numeric Pain Rating Scale before and at week 4 post intervention.

Results
There was no significant group by time interaction effect for IR ROM (p = 0.27); however, there was a significant change over time (p < 0.001, η2 = 0.77). Both groups demonstrated a significant increase in IR from baseline to immediate and week 4, and from immediate to week 4 (p < 0.001). There was a significant group by time interaction for pain intensity (p < 0.001, η2 = 0.72). Results showed a significant reduction in pain intensity over time in the novel group (p = 0.001, d = 2.18), but not in the traditional group (p = 0.231, d = 0.46).

Conclusion
Both stretches appear to be effective at improving IR ROM in overhead athletes with GIRD. However, the novel stretching might be more effective at reducing shoulder pain and thus may be more appropriate for symptomatic patients.

Trial registration
Prospectively registered in February 6, 2017 under Clinical Trial Registry # NCT03044236.
Conditions associated with worse acceptance of a simplified accelerated recovery after surgery protocol in laparoscopic colorectal surgery
Authors: de Queiroz Fábio Lopes , Lacerda-Filho Antonio , Alves Adriana Cherem , de Oliveira Fábio Henrique , Neto Paulo Rocha França , de Almeida Paiva Rodrigo 
Published: May 2021

Abstract
Background
Enhanced Recovery Surgical Programs were initially applied to colorectal procedures and used as multimodal approach to relieve the response to surgical stress. An important factor that negatively impacts the success of these programs is the poor tolerance of these patients to certain items in the adopted protocol, especially with regard to post-operative measures. The identification of these factors may help to increase the success rate of such programs, ensuring that benefits reach a greater number of patients and that resources are better allocated. Thus, the aims of this study were to assess the results of the implementation of a Simplified Accelerated Recovery Protocol (SARP) and to identify possible factors associated with failure to implement postoperative protocol measures in patients submitted to laparoscopic colorectal surgery.

Methods
161 patients were randomly divided into two groups. The SARP group (n = 84) was submitted to the accelerated recovery program and the CC group (n = 77), to conventional postoperative care. The SARP group was further divided into two subgroups: patients who tolerated the protocol (n = 51) and those who did not (n = 33), in order to analyze factors contributing to protocol nontolerance.

Results
The groups had similar sociodemographic and clinical characteristics. The SARP group had a shorter hospital stay, better elimination of flatus, was able to walk and to tolerate a diet sooner (p < 0.0001). Complications rates and readmissions to emergency room were similar between groups. Multivariate analysis revealed that prolonged operating time, stoma creation and rates of surgical complications were independently associated with poor adherence to SARP (p < 0.0001).

Conclusions
The use of our SARP resulted in improved recovery from laparoscopic colorectal surgery and proved to be safe for patients. Extensive surgeries, occurrence of complications, and the need for ostomy were variables associated with poor program adhesion.
Trial registration Trial Registry: RBR2b4fyr—Date of registration: 03 October 2017.
Does cervical facet degeneration impact surgical outcomes and sagittal balance in patients with radiculopathy?
Authors: Wang Zheng , Liu Zhen , Wang Zhi-Wei , Ding Wen-Yuan , Yang Da-Long 
Published: May 2021

Abstract
Purpose
In our present study, we aimed to investigate (1) whether cervical facet degeneration (FD) affects the clinical functional scores of patients with cervical radiculopathy after single-segment anterior cervical discectomy fusion (ACDF) and (2) whether FD affects the sagittal parameters of the cervical spine.

Methods
A total of 120 enrolled patients who underwent single-segment ACDF for radiculopathy with more than 2 years of follow-up were classified into two groups based on whether the preoperative mean FD was greater than or less than the mean FD grading score: mild FD group (mean score ≤ 2, n = 102) or severe FD group (mean score > 2, n = 48). Sagittal alignment changes and clinical functional scores were compared between the 2 groups. The relevant factors for FD were identified using multivariate logistic regression.

Results
Age, duration of symptoms, disc height and interfacet distance were independently associated with preoperative FD (age: P < 0.001; duration of symptoms: P = 0.020; disc height: P < 0.001; interfacet distance: P = 0.045). Compared with the mild FD group, the preoperative VAS (neck pain) score and NDI of the severe FD group were also higher, and the improvement of neck symptoms was better during the follow-up period. However, all clinical scores and radiographic parameters showed no significant differences during the 2-year follow-up. Additionally, no significant differences in the sagittal parameter changes were presented.

Conclusion
Patients with severe FD tended to experience more severe neck pain before surgery and greater improvement of neck symptoms at the follow-up visit. However, 2-year clinical efficacy and sagittal alignment after ACDF may not be markedly affected by preoperative FD severity. ACDF is considered to be a good choice for patients with radiculopathy, especially for patients with severe FD.
Using real-world data to estimate the changing trends in the prevalence and incidence of type 2 diabetes mellitus in Xiamen of China from 2014 to 2019
Authors: He Weiwei , Xu Qiushi , Han Lili , Wu Ting , Shi Xiulin , Ye Lishan , Yao Guanhua , Li Xuejun 
Published: May 2021

Abstract
Background
The prevalence of diabetes is increasing worldwide. Our study aimed to estimate the changing trends in the prevalence and incidence of diagnosed type 2 diabetes mellitus (T2DM) among Xiamen residents and the floating population using real-world data.

Method
We used real-world data from the System of Xiamen Citizens Health Information from 2014 to 2019 to estimate the changing trends in the prevalence and incidence of diagnosed T2DM. The System included the diagnosis of diabetes and the prescription of hypoglycemic drugs. Prevalent cases of T2DM were individuals who were diagnosed with T2DM and/or using hypoglycemic drugs. Incident cases were individuals with diagnosed T2DM and/or using hypoglycemic drugs in 2014 or 2019 who had not been diagnosed and/or did not use hypoglycemic drugs in the past.

Results
In 2014 and 2019, the prevalence of T2DM in Xiamen was 4.04 and 4.84%, respectively. In 2014 and 2019, the incidence rate of T2DM in Xiamen was 14.1 per 1000 person-year and 15.0 per 1000 person-year, respectively. There was a significant increase in both the prevalence (Prevalence difference: 0.80, 95%CI 0.76–0.83%, P < 0.001) and the incidence of T2DM (Incidence difference: 0.9, 95%CI 0.7–1.1, P < 0.001). in Xiamen. The prevalence and incidence of T2DM in people aged 18–39 increased significantly (P < 0.001), while the prevalence and incidence of T2DM in people aged 40–69 reduced significantly (P < 0.001).

Conclusions
There was a significant increase in the prevalence and incidence of T2DM in Xiamen from 2014 to 2019 especially among those with younger age.
A four-hypoxia-genes-based prognostic signature for oral squamous cell carcinoma
Authors: Zhao Chenguang , Zhou Yingrui , Ma Hongwei , Wang Jinhui , Guo Haoliang , Liu Hao 
Published: May 2021

AbstractBackgroundOral squamous cell carcinoma (OSCC) is one of the most common maligancies of the head and neck. The prognosis was is significantly different among OSCC patients. This study aims to identify new biomarkers to establish a prognostic model to predict the survival of OSCC patients.MethodsThe mRNA expression and corresponding clinical information of OSCC patients were downloaded from The Cancer Genome Atlas and Gene Expression Omnibus. Additionally, a total of 26 hypoxia-related genes were also obtained from a previous study. Univariate Cox regression analysis and LASSO Cox regression analysis were performed to screen the optimal hypoxia-related genes which were associated with the prognosis of OSCC. to establish the predictive model (Risk Score) was established for estimating the patient's overall survival (OS). Multivariate Cox regression analysis was used to determine whether the Risk Score was an independent prognostic factor. Based on all the independent prognostic factors, nomogram was established to predict the OS probability of OSCC patients. The relative proportion of 22 immune cell types in each patient was evaluated by CIBERSORT software.ResultsWe determined that a total of four hypoxia-related genes including ALDOA, P4HA1, PGK1 and VEGFA were significantly associated with the prognosis of OSCC patients. The nomogram established based on all the independent factors could reliably predict the long-term OS of OSCC patients. In addition, our resluts indicated that the inferior prognosis of OSCC patients with high Risk Score might be related to the immunosuppressive microenvironments.ConclusionThis study shows that high expression of hypoxia-related genes including ALDOA, P4HA1, PGK1 and VEGFA is associated with poor prognosis in OSCC patients, and they can be used as potential markers for predicting prognosis in OSCC patients.
Hospital contextual factors affecting the implementation of health technologies: a systematic review
Authors: Grossi Adriano , Hoxhaj Ilda , Gabutti Irene , Specchia Maria Lucia , Cicchetti Americo , Boccia Stefania , de Waure Chiara 
Published: May 2021

Abstract
Background
To keep a high quality of assistance it is important for hospitals to invest in health technologies (HTs) that have the potential of improving health outcomes. Even though guidance exists on how HTs should be introduced, used and dismissed, there is a surprising gap in literature concerning the awareness of hospitals in the actual utilization of HTs.

Methods
We performed a systematic literature review of qualitative and quantitative studies aimed at investigating hospital contextual factors that influence the actual utilization of HTs. PubMed, Scopus, Web of Science, Econlit and Ovid Medline electronic databases were searched to retrieve articles published in English and Italian from January 2000 to January 2019. The quality of the included articles was assessed using the Critical Appraisal Skills Programme checklist for qualitative studies, Newcastle-Ottawa Scale for the cross-sectional studies and the Mixed Methods Appraisal Tool for mixed method studies.

Results
We included 33 articles, which were of moderate to high methodological quality. The included articles mostly addressed the contextual factors that impact the implementation of information and communication technologies (ICTs). Overall, for all HTs, the hospital contextual factors were part of four categories: hospital infrastructure, human resource management, financial resources and leadership styles.

Conclusion
Our systematic review reported that the contextual factors influencing the HTs utilization at hospital level are mainly explored for ICTs. Several factors should be considered when planning the implementation of a new HTs at hospital level. A potential publication bias might be present in our work, since we included articles published only in English and Italian Language, from January 2000 to January 2019. There remains a gap in the literature on the facilitators and barriers influencing the implementation and concrete utilization of medical and surgical HTs, suggesting the need for further studies for a better understanding.
Application of verbal autopsy in routine civil registration in Lusaka District of Zambia
Authors: Mapoma C. Chabila , Munkombwe Brian , Mwango Chomba , Bwalya Bupe Bwalya , Kalindi Audrey , Gona N. Philimon 
Published: May 2021

Abstract
Background
Ascertaining the causes for deaths occurring outside health facilities is a significant problem in many developing countries where civil registration systems are not well developed or non-functional. Standardized and rigorous verbal autopsy methods is a potential solution to determine the cause of death. We conducted a demonstration project in Lusaka District of Zambia where verbal autopsy (VA) method was implemented in routine civil registration system.

Methods
About 3400 VA interviews were conducted for bodies “brought-in-dead” at Lusaka’s two major teaching hospital mortuaries using a SmartVA questionnaire between October 2017 and September 2018. Probable underlying causes of deaths using VA and cause-specific mortality fractions were determined.. Demographic characteristics were analyzed for each VA-ascertained cause of death.

Results
Opportunistic infections (OIs) associated with HIV/AIDS such as pneumonia and tuberculosis, and malaria were among leading causes of deaths among bodies “brought-in-dead”. Over 21.6 and 26.9% of deaths were attributable to external causes and non-communicable diseases (NCDs), respectively. The VA-ascertained causes of death varied by age-group and sex. External causes were more prevalent among males in middle ages (put an age range like 30–54 years old) and NCDs highly prevalent among those aged 55 years and older.

Conclusions
VA application in civil registration system can provide the much-needed cause of death information for non-facility deaths in countries with under-developed or non-functional civil registration systems.