bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dietary intakes of total polyphenol and its subclasses in relation to incidence of chronic kidney disease: a prospective population-based cohort study
Authors: Mirmiran Parvin , Yuzbashian Emad , Rahbarinejad Pegah , Asghari Golaleh , Azizi Fereidoun 
Published: March 2021

Abstract
Objective
Chronic Kidney Disease (CKD) is nowadays a public health challenge worldwide. Accordingly, this study is aiming to evaluate the association between long-term intake of total polyphenol and its subclasses, and the incidence of CKD.
Methods
A sample of 3021 Iranian Adults (47% men) were selected from the the Tehran Lipid and Glucose Study population. The participants aged 20–79 years and had no diagnosis of CKD at baseline. Total polyphenol intake and its major subclasses including flavonoids, phenolic acids, stilbenes, and lignans, was assessed by a validated and reliable Food Frequency Questionnaire (FFQ). The of the were broadly categorized as flavonoids, phenolic acids, stilbenes, and lignans. The Modification of Diet in Renal Disease Study equation was used to calculate the Estimated Glomerular Filtration Rate (eGFR), and, CKD was defined as eGFR < 60 mL/min/1.73 m2. Hazard ratio and 95% confidence intervals of CKD by total polyphenols quartiles were assessed by Cox-regression analysis.
Results
In this study, we documented 355 cases of diagnosed CKD over 11,058.464 person-years. The mean ± SD age of participants was 37.3 ± 12.6 years at baseline. After adjustment of the potential confounders, it was revealed that a moderate intake of lignans (≤ 6.8 mg) was negatively associated with the incidence of CKD, whereas there was no significant association between the higher amounts of lignan intake and CKD. No significant associations were observed between the consumption of total polyphenols and the incidence of CKD (HR: 0.97, 95% CI 0.67–1.40).
Conclusions
Data of the current study suggest that in the case of lignan with protective properties, a moderate amount of lignan favorably reduced the incidence of CKD by approximately 32%, whereas higher amounts possessed a null effect.
Action Observation Treatment-Based Exoskeleton (AOT-EXO) for Upper Extremity After Stroke: Study Protocol for a Randomised Controlled Trial
Authors: Chen Zejian , Xia Nan , He Chang , Gu Minghui , Xu Jiang , Han Xiaohua , Huang Xiaolin 
Published: March 2021

Abstract
Background
Stroke produces multiple symptoms, including sensory, motor, cognitive and psychological dysfunctions, among which motor deficit is the most common and is widely recognized as a major contributor to long-term functional disability. Robot-assisted training is effective in promoting upper extremity muscle strength and motor impairment recovery after stroke. Additionally, action observation treatment can enhance the effects of physical and occupational therapy by increasing neural activation. The AOT-EXO trial aims to investigate whether action observation treatment coupled with robot-assisted training could enhance motor circuit activation and improve upper extremity motor outcomes.
Methods
The AOT-EXO trial is a multicentre, prospective, three-group randomized controlled trial (RCT). We will screen and enrol 132 eligible patients in the trial implemented in the Department of Rehabilitation Medicine of Tongji Hospital, Optical Valley Branch of Tongji Hospital and Hubei Province Hospital of Integrated Chinese & Western Medicine in Wuhan, China.
Prior to study participation, written
informed consent will be obtained from eligible patients in
accordance with the Declaration of Helsinki.
The enrolled stroke patients will be randomised to three groups: the CT group (conventional therapy); EXO group (exoskeleton therapy) and AOT-EXO group (action observation treatment-based exoskeleton therapy). The patients will undergo blinded assessments at baseline, post-intervention (after 4 weeks) and follow-up (after 12 weeks). The primary outcome will be the Fugl-Meyer Assessment for Upper Extremity (FMA-UE). Secondary outcomes will include the Action Research Arm Test (ARAT), modified Barthel Index (MBI), kinematic metrics assessed by inertial measurement unit (IMU), resting motor threshold (rMT), motor evoked potentials (MEP), functional magnetic resonance imaging (fMRI) and safety outcomes.
Discussion
This trial will provide evidence regarding the feasibility and efficacy of the action observation treatment-based exoskeleton (AOT-EXO) for post-stroke upper extremity rehabilitation and elucidate the potential underlying kinematic and neurological mechanisms.
Trial Registration:
Chinese Clinical Trial Registry identifier: ChiCTR1900026656. Registered on 17 October 2019.
Design and Validation of a Questionnaire to Measure the Acceptance of Telemedicine by Healthcare Professionals in Germany
Authors: Verfürth Martina 
Published: March 2021

Abstract
Background: Telemedicine allows healthcare professionals to manage patient treatments remotely and to benefit from the interaction of telemedicine centers. Even though telemedicine responds to the current burdens in healthcare systems, these complex infrastructures depend on technology, financing, organization, policy, legislation, and, not least, on their corresponding acceptance by the user. Little is known in this context about the drivers for this acceptance by healthcare professionals giving treatment. Germany, with the highest healthcare spending in the world, is particularly lagging here. As there is less focus on guidance for building acceptance constructs, and, in particular, little research on the acceptance of interactive telemedicine by healthcare professionals in Germany, the objective was the collection of the relevant factors influencing German healthcare professionals in the implementation of telemedicine service programs (TSSs). Acceptance constructs were built and operationalized in a questionnaire, taking into consideration the gold standard technology acceptance model of Davis.Methods: A literature review was conducted to identify the acceptance factors that had already been detected and frequently confirmed. These factors were evaluated according to the coverage of the interactive infrastructures with telemedicine centers and how accurately they fitted Germany. The identified factors were adapted, and missing factors were designed, via an idea collection for items. The reliability of the developed constructs was tested using a field test to check the constructs using item revision analysis.Results: Frequently supported external variables, taken from 17 filtered studies covering the technical, organizational, social, legal, and individual context, were identified. However, the review showed that there was less focus on the German setting and the interactive aspect, so the market-related variables were adapted and new constructs of “trust in the telemedicine center” and “relationship to patient” were added. Ten variables were proven to have a reliability, measured with Cronbach’s Alpha, of more than 0.7.Conclusion: This paper enhances the already existing technology acceptance studies in healthcare by covering German specifications and the interactive character of TSSs. A corresponding questionnaire has been developed ready for future research.
Early Prediction of Clinical Response to Anti-TNF Treatment using Multi-omics and Machine Learning in Rheumatoid Arthritis
Authors: Yoosuf Niyaz , Maciejewski Mateusz , Ziemek Daniel , Jelinsky Scott A. , Folkersen Lasse , Müller Malin , Sahlström Peter , Vivar Nancy , Catrina Anca , Berg Louise , Klareskog Lars , Padyukov Leonid , Brynedal Boel 
Published: March 2021

Abstract
ObjectivesAdvances in immunotherapy by blocking TNF have remarkably improved treatment outcomes for rheumatoid arthritis patients. Although treatment specifically targets TNF, the downstream mechanisms of immune suppression are not completely understood. The present study was aimed to detect biomarkers and expression signatures of treatment response to TNF inhibition.MethodsPeripheral blood mononuclear cells were obtained from 39 patients collected before anti-TNF treatment initiation (day 0) and after three months. Response to treatment was defined based on the EULAR criteria and classified 23 patients as responders and 16 as non-responders. We investigated differences in gene expression in peripheral blood mononuclear cells, the proportion of cell types and cell phenotypes in peripheral blood using flow cytometry, and the level of proteins in plasma. Finally, using biological measurements, we run machine learning models to predict non-response. ResultsThe gene expression analysis in baseline samples revealed notably a higher expression of the gene EPPK1 in future responders. We also detected the suppression of genes and proteins following treatment, including suppression of expression of the gene, T-cell inhibitor CHI3L1, and its protein YKL-40. The gene expression results were replicated in an independent cohort. Finally, machine learning models mainly based on transcriptomics data showed high predictive utility (ROC AUC ± SEM: 0.81 ± 0.17) in classifying non-response to anti-TNF treatment in RA.ConclusionsOur integrative multi-omics analyses identified new biomarkers for prediction of response, found pathways influenced by treatment and suggested new predictive models of anti-TNF treatment in RA patients.
The meaning of laparoscopic procedure against inguinal hernia
Authors: Sato Hideaki , Yoshizawa Jyoji , Sugiyama Akihide , Nakagami Tomokazu , Watarai Yu 
Published: March 2021

Abstract
Background

Laparoscopic approach, especially laparoscopic percutaneous extraperitoneal closure (LPEC) for inguinal hernia (IH) is widely spread but few studies have compared its invasiveness with that of conventional approach (POTTS). This study compared the role and invasiveness of LPEC with POTTS at our institute.
Material and methods

The records of 940 IH patients from 2014 to 2019 were analyzed on the basis of age, sex, method of surgery, pre- and post-operative diagnosis, postoperative symptoms, and complications.
Results

The POTTS group comprised 393 males, of which 44 were diagnosed with contralateral hernia (7.1%). In the LPEC group, 158 males had an average age of 3.88 years. The contralateral patent processus vaginalis (CPPV) was identified in 148 patients during operation. POTTS operation time for patients aged < 1 year was 42.7 minutes, vs 33.4 minutes for LPEC. The two groups experienced comparable paces of fever and first oral intake time; however, pain and recurrence rate were greater in the LPEC group.
Conclusion

LPEC can be performed to avoid contralateral recurrences; surgical time is reduced for patients aged < 1 year. However, the reduced invasiveness of LPEC compared to that of POTTS did not minimize postoperative symptoms or complications.
Use, Perception, and Local Management of Copernicia Prunifera (Miller) H. E. Moore in Rural Communities in the Brazilian Savanna
Authors: Almeida José Afonso Santana , Feitosa Nágila Alves , Sousa Leilane Carvalho , Silva Raimundo Nonato Oliveira , Morais Rodrigo Ferreira , Monteiro Julio Marcelino , Junior Jose Ribamar Sousa 
Published: March 2021

Abstract
Background
Copernicia prunifera is a species native to the northeastern region of Brazil and is economically important as a source of income for many human populations in the region that carry out intense extractive activity on the species. This study aimed to evaluate the uses, management, and perception of the species by local extractors.
Methods
Two communities were studied, Bem Quer, where 15 extractors were interviewed, and Cana, where 21 extractors considered specialists were interviewed, totaling a sample of 36 informants. A regression analysis was used to explore the relationships between social variables (age, time in extractive activity, and income obtained from extraction) with the number of leaves exploited. The relationship between time of extraction, and time of residence in the community was also analyzed.
Results
The leaf was indicated as the most used part, from which an important powder is extracted for the production of wax. In addition, the leaf was also indicated for fertilization and construction. Uses were also indicated for the stem (construction) and fruit (forage). The relationship between the socioeconomic variables, income obtained through extraction and the amount of leaves extracted (in thousands) was significant (R2 = 0.73 and p < 0.001). However, the other variables analyzed in this study, such as the time spent extracting leaves and the amount of time residing in the community (R2 = 0.03 and p > 0.05), the number of leaves extracted and the age of informants (R2 = 0.05 and p > 0.05) and number of leaves extracted and time of extraction (R2 = 0.04 and p > 0.05) did not indicate a relationship.
Conclusion
C. prunifera was had a great economic and cultural importance for studied communities. It is possible that the economic factor is the preponderant force that directs the management strategies of native species.
Pedestrians in Iran: Determinants of Unsafe Traffic Behaviors of Pedestrians
Authors: Aghdam Fatemeh Bakhtari , Bazargani Homayoyn Sadeghi , Sarbakhsh Parvin , Pashaie Tahere , Ponent Koen , Nicknejad Maryam 
Published: March 2021

Abstract
Background: Pedestrians are among the most vulnerable groups in traffic accidents. This study investigates the determinants of traffic behaviors of pedestrians. Methods: In this cross-sectional study, the behavior of 600 pedestrians in the city of Urmia, northwestern Iran, was evaluated from May to October 2018, using a pedestrian traffic behavior questionnaire consisting of five dimensions: traffic violations, traffic distraction, adherence to traffic rules, aggressive behavior, and positive behaviors. Cluster sampling was conducted among 30% of the health centers in each district of the city. Thereafter, individuals were randomly selected from each center depending on the covered population. Results: Although 17% of the pedestrians demonstrated safe traffic behaviors, over 85% were distracted, more than 80% did not comply with traffic laws, the majority violated rules and displayed no positive traffic behaviors, and half of the participants were aggressive. Age, gender, marital status, education level, daily walking rate, and transportation mode were significant predictors of traffic behavior.Conclusion: Most pedestrians demonstrate unsafe traffic behaviors. The youth, those who were single, those with lower education, and those with less walking rate showcased higher unsafe behaviors. Training and intervention programs should be implemented to improve all domains of pedestrian traffic behaviors factoring in age and other predictors.
Detecting Land Use Modification And Its Influence on Resident Communities
Authors: Endalew Tesfahun Admas 
Published: March 2021

Abstract
Background

The study intended to detecting the land use land cover changes, trends and their magnitude between 1986 and 2019 years by using GIS and remote sensing in Fagita Lekoma District, Amhara region, Ethiopia. Three satellite data set of Landsat Thematic Mapper for 1986, Enhanced Thematic Mapper Plus for 2002 and Operational Land Imager for 2019 were used generate land use and land cover maps of the study area. Post classification comparison changed detection method was employed to identify gains and losses between Land Use Land Cover classes. Socioeconomic survey, key informant interview and field observation were also used conclude the encouragement of land use /land cover change in the study area.
Results

The result shows that cultivated land and wetland similarly decline in the entire study periods. In the 33 years, forest lands expanded by upon 200% of the original forest cover what was existed on the base year. Whereas, a result of the socioeconomic analysis the expansion of Acacia decurrens tree plantations and agricultural land are main causes of land use land cover change in the study area. The impact of this land use land cover change is more significant on the livelihood condition and status of the study area.
Conclusion

The land use system of the study area highly converted cultivation land into forest/tree plantation. Mainly, the expansion of Acacia decurrens tree plantation on farmland is increasing the income of local residence when compare with the previous living condition in the study area.
Effect of an intervention on antibiotic prescription control for respiratory diseases: a systematic review of randomized controlled trials
Authors: Yue Chang , Cui Zhezhe , Yang Guanghong , He Xun , Wang Lei , Xin Zhang , Tang Lei 
Published: March 2021

Abstract
Background The global health system is improperly using antibiotics, particularly in the treatment of respiratory diseases. We aimed to examine the effectiveness of implementing a unifaceted or multifaceted intervention for unreasonable antibiotic prescriptions.
Methods Relevant literature published in the databases of Pubmed, Embase, Science Direct, Cochrane Central Register of Controlled Trials (CENTRAL), Chinese Journal Full-text (CNKI) and Wanfang was searched. Data were independently filtered and extracted by two reviewers based on a pre-designed inclusion and exclusion criteria. The Cochrane collaborative bias risk tool was used to evaluate the quality of the included studies.
Results A total of 1,074 relevant studies were obtained of which 69 were included in the systematic review. Fifty-nine studies reported positive results, that is, the primary results in the intervention groups were superior to those in the control groups. The remaining 10 studies had negative or partially negative results. In 22 studies the outcome variable was the antibiotic prescription rate with detailed reports of the number of prescriptions being further analyzed, of which 19 involved educational interventions for doctors, including: (1) Online training using email, web pages and webinar, (2) Antibiotic guidelines for information dissemination measures by email, postal or telephone reminder, (3) Training doctors in communication skills, (4) Short-term interactive educational seminars, and (5) Short-term field training sessions. Seventeen studies of interventions for health care workers also included: (6) Regular or irregular assessment/audit of antibiotic prescriptions, (7) Prescription recommendations from experts and peers delivered at a meeting or online, (8) Publicly reporting on doctors' antibiotic usage to patients, hospital administrators, and health authorities, (9) Monitoring/feedback prescribing behavior to general practices by email or poster, and (10) Studies involving patients and their families (n=10). Seventeen studies were rated as having a low risk of bias while five were rated as having a high risk of bias.
Conclusion Implementing multiple interventions in health care institutions can effectively reduce antibiotic prescription rates. Adding multiple feedback interventions to educational interventions may be a more reasonable control method.
Registrations: This systematic review was registered in PROSPERO, registration number: CRD42020192560.
A framework to determine soil-water retention relation for mine wastes and its applications in emergency risk assessment
Authors: Wang Haibin , Chen Quan , Zhang Liwei , Li Xiaochun 
Published: March 2021

Abstract
Tailing dams and waste dumps formed by the accumulation of mine wastes are usually at long-term unsaturated state under evaporation and consolidated drainage conditions. Soil-water retention relation is one of the key constitutive relations to analyze the seepage processes in tailing dams and waste dumps. In this study, typical coarse- and fine-grained tailings from a metallurgical mine were chosen to study the soil-water retention characteristics of the tailing samples. To begin with, the relationship between volumetric water content and suction of the tailing samples was experimentally measured, and typical soil-water characteristic curves (SWCCs) (i.e., Gardner, van Genuchten and Fredlund–Xing curves) were applied to fit the experimental data. After that, four empirical models to estimate the parameters in SWCCs (i.e., Aubertin-1998 model, Aubertin-2003 model, Vanapalli-2005 model and Chin-2010 model) were tested, and the Vanapalli-2005 model was the best-fit model for the tailing samples. Furthermore, this study proposes a generalized emergency risk assessment soil-water retention characteristics model for tailing dams and waste dumps, and a framework for the quick estimation of parameters in the SWCC is proposed as well. The recommended soil-water retention characteristics model and the related parameters can be used to predict water levels in tailing dams and waste dumps, which are very helpful for emergency risk assessment under rainstorm or flooding conditions.
Hand hygiene and safety behaviours at shopping centres in COVID-19: an observation in Wa township in Ghana
Authors: Fielmua Nicholas , Guba Bismarck Yelfogle , Mwingyine Darius Tuonianuo 
Published: March 2021

Abstract
This study observed hand hygiene and safety behaviours of shoppers and shop keepers with respect to COVID-19 safety protocols in shopping centres in Wa, a business centre in North-western Ghana. Based on the theory of planned behaviour, the behaviours of 751 customers of 50 shops with handwashing facilities were observed from April to June 2020. It was observed that adherence to COVID-19 safety protocols at shopping centres was very poor. Although the shops observed provided handwashing facilities, 91.3% of the customers did not practise handwashing before entering the shops. Also, 84.2% of them did not wear mouth-and-nose masks during shopping. Similarly, for 78% of the shops observed, no shop attendant wore a mask. Despite the provision of handwashing facilities and widespread advocacy to minimise COVID-19 infections, the citizenry, especially the youth, demonstrated a poor attitude towards safety measures. Non-adherence to COVID-19 protocols was higher in shops where there was no pressure to conform to the protocols. The findings, amidst the increasing number of infections, suggest that attitude and perceived behavioural control are critical to the fight against the COVID-19 pandemic and, as such, could be good entry points for behavioural interventions.
Monitoring of water and sanitation services within an integrated decentralised monitoring system: experiences from Ghana
Authors: Akanbang Bernard Afiik Akanpabadai 
Published: March 2021

Abstract
Monitoring of water and sanitation services has for a long time been project driven in the developing world. The need for data to inform subnational planning and delivery of quality services has led to the adoption of decentralised integrated monitoring. However, little is known about the strengths and weaknesses of this approach in the monitoring of water and sanitation services. A case study design in which document reviews were combined with 22 key informant interviews held between March and July 2019 in the Upper West Region of Ghana were used to investigate the research problem. Findings show that integration enhanced the processes for validating and using monitoring data and ensuring downward accountability. However, logistical and financial support and inadequate critical reflection is a major challenge under the integration. The paper calls for special attention to be paid to funding and logistics for monitoring water and sanitation services.