bluuebunny/crossref_metadata_2025_split huggingface dataset:
Food environment in and around schools and colleges of Delhi and National Capital Region (NCR) in India
Authors: Bassi Shalini , Bahl Deepika , Arora Monika , Tullu Fikru Tesfaye , Dudeja Sakshi , Gupta Rachita 
Published: September 2021

Abstract
Background
Food policies and environment (availability, accessibility, affordability, marketing) in and around educational institutes can influence food choices and behaviours of children and adolescents.

Methods
Cross-sectional, mixed-methods study was implemented in schools (n = 9; Private = 6, Public = 3) and colleges (n = 4) from Delhi and National Capital Region (India). The data was collected from students of schools (n = 253) and colleges (n = 57), parents of school students (n = 190), teachers (n = 12, schools = 9, colleges = 3) and canteen operators of Private schools and colleges (n = 10; schools = 6, and colleges = 4). The primary and secondary data was collected to: 1) identify the strengths and weaknesses of the existing guidelines and directives (desk review); 2) examine food environment, existing policies and its implementation (structured observations, in-depth interviews, surveys, focus group discussions), and; 3) assess food choices, behaviours of students (focus group discussions). The thematic analysis was used for qualitative data and descriptive analysis for quantitative data.

Results
The available food and beverage options, in and around the participating educational institutes were either high in fat, salt and sugar (HFSS), despite government and educational institute guidelines on restricting the availability and accessibility of HFSS foods. The healthy food and beverage options were expensive compared to HFSS foods both inside and outside educational institutes. In total, 37 vendors (Private = 27; Public:10) were observed outside schools at dispersal and twelve at lunchtime. Around colleges, vendors (n = 14) were seen throughout the day. Students from all Private schools (n = 6) and colleges (n = 2) were exposed to food and beverage advertisements either HFSS (Private schools = 1–3 and colleges = 0–2 advertisements), whereas no advertisements were observed around Public schools.

Conclusion
It is imperative to implement food policies to improve the food environment in and around educational institutes to ensure the availability of healthy foods to establish and sustain healthy eating behaviours among students. Thus, the study findings emphasise stringent implementation, regular monitoring and surveillance of recently introduced Food Safety and Standards (Safe food and balanced diets for children in school) Regulation 2020, ensuring its compliance through effective enforcement strategies.
The risk factors of heart failure in elderly patients with hip fracture: what should we care
Authors: You Fei , Ma Chaoyang , Sun Fangfang , Liu Lian , Zhong Xiuwen 
Published: September 2021

Abstract
Background
Heart failure is a common adverse postoperative complication in elderly patients. It is necessary to explore the risk factors of heart after the operation of elderly patients with hip fracture during hospitalization.

Methods
Patients with hip fractures admitted to our hospital from January 1, 2019 to December 31 2020 were included, all the patients received internal fixation surgery. The characteristics of patients with and without postoperative heart failure were compared. Multivariate logistic regression analyses were applied to analyze the risk factors of heart failure in elderly patients with hip fracture.

Results
A total of 283 patients with hip fractures were included, the incidence of heart failure was 12.37 %. There were significant differences in the age, hypertension, anemia hypoalbuminemia and duration of surgery between heart failure and no heart failure group(all p < 0.05). There were no significant differences in the gender, BMI, diabetes mellitus, hyperlipidemia, history of heart failure, cognitive dysfunction, type of fracture, preoperative oxygen saturation, white blood cell count, platelet count, red blood cell count, creatinine, alanine aminotransferase, aspartate aminotransferase and estimated blood loss during surgery between heart failure and no heart failure group(all p > 0.05). Logistic regression analyses indicated that age ≥ 70y(OR2.446, 95% CI1.044 ~ 4.149), hypertension(OR2.152, 95% CI1.125 ~ 4.023), anemia(OR3.094, 95% CI1.294 ~ 5.907), hypoalbuminemia(OR2.377, 95% CI1.205 ~ 4.537), duration of surgery ≥ 120 min(OR1.683, 95% CI1.094 ~ 2.782) were the risk factors of heart failure in elderly patients with hip fracture(all p < 0.05).

Conclusions
The incidence of postoperative heart failure in elderly patients with hip fracture is relatively high, which is the result of a combination of high-risk factors. Peri-period risk assessment and prevention of related risks are the keys to a good prognosis for patients.
No beneficial effect on survival but a decrease in postoperative complications in patients with rectal cancer undergoing robotic surgery: a retrospective cohort study
Authors: Lei Xiong , Yang Lingling , Huang Zhixiang , Shi Haoran , Zhou Zhen , Tang Cheng , Li Taiyuan 
Published: September 2021

Abstract
Background
Robotic surgery has been taken as a new modality to surpass the technical limitations of conventional surgery. Here we aim to compare the oncologic outcomes of patients with rectal cancer receiving robotic vs. laparoscopic surgery.

Methods
Data from patients diagnosed with rectal cancer between March 2011 and December 2018 were obtained for outcome assessment at the First Affiliated Hospital of Nanchang University. All patients were separated into two groups: a robot group (patients receiving robotic surgery, n = 314) and a laparoscopy group (patients receiving laparoscopic surgery, n = 220). The primary endpoint was survival outcomes. The secondary endpoints were the general conditions of the operation, postoperative complications and pathological characteristics.

Results
The 5-year overall survival (OS) and disease-free survival (DFS) at years 1, 3 and 5 were 96.6%, 88.7%, and 87.7% vs. 96.7%, 88.1%, and 78.4%, and 98.6%, 80.2-, and 73.5% vs. 96.2-, 87.2-, and 81.1% in the robot and laparoscopy groups, respectively (P > 0.05). In the multivariable-adjusted analysis, robotic surgery was not an independent prognostic factor for OS and DFS (P = 0.925 and 0.451, respectively). With respect to the general conditions of the operation, patients in the robot group had significantly shorter operation times (163.5 ± 40.9 vs. 190.5 ± 51.9 min), shorter times to 1st gas passing [2(1) vs. 3(1)d] and shorter hospital stay days [7(2) vs. 8(3)d] compared to those in the laparoscopy group (P < 0.01, respectively). After the operation, the incidence of short- and long-term complications in the robot group was significantly lower than that in the laparoscopy group (15.9% vs. 32.3%; P < 0.001), especially for urinary retention (1.9% vs. 7.3%; 0.6% vs. 4.1%, P < 0.05, respectively). With regard to pathological characteristics, TNM stages II and III were more frequently observed in the robot group than in the laparoscopy group (94.3% vs. 83.2%, P < 0.001). No significant difference were observed in lymph nodes retrieved, lymphovascular invasion and circumferential resection margin involvement between the two groups (P > 0.05, respectively).

Conclusions
This monocentre retrospective comparative cohort study revealed short-term advantages of robot-assisted rectal cancer resection but similar survival compared to conventional laparoscopy.
Cross-cultural validation of the IRB Researcher Assessment Tool: Chinese Version
Authors: Liu Xing , Wu Ying , Yang Min , Li Yang , Hahne Jessica , Khoshnood Kaveh , Coleman Linda , Wang Xiaomin 
Published: September 2021

Abstract
Background
Using an effective method for evaluating Institutional Review Board (IRB) performance is essential for ensuring an IRB’s effectiveness, efficiency, and compliance with applicable human research standards and organizational policies. Currently, no empirical research has yet been published in China evaluating IRB performance measures by the use of a standardized tool. This study was therefore conducted to develop a Chinese version of the IRB Researcher Assessment Tool (IRB-RAT), assess the psychometric properties of the Chinese version (IRB-RAT-CV), and validate the tool for use in China.

Methods
In this cultural adaptation, cross-sectional validation study, the IRB-RAT-CV was developed through a back-translation process and then distributed to 587 IRB staff members and researchers in medical institutions and schools in Hunan Province that review biomedical and social-behavioral research. Data from the 470 valid questionnaires collected from participants was used to evaluate the reliability, content validity, and construct validity of the IRB-RAT-CV.

Results
Participants’ ratings of their ideal and actual IRB as measured by the IRB-RAT-CV achieved Cronbach's alpha 0.989 and 0.992, Spearman-Brown coefficient 0.964 and 0.968, and item-total correlation values ranging from 0.631 to 0.886 and 0.743 to 0.910, respectively.

Conclusion
The IRB-RAT-CV is a linguistically and culturally applicable tool for assessing the quality of IRBs in China.
Nursing management of fatigue in cancer patients and suggestions for clinical practice: a mixed methods study
Authors: Tolotti Angela , Bonetti Loris , Pedrazzani Carla , Bianchi Monica , Moser Laura , Pagnucci Nicola , Sari Davide , Valcarenghi Dario 
Published: September 2021

Abstract
Background
Fatigue is a complex and frequent symptom in cancer patients, influencing their quality of life, but it is still underestimated and undertreated in clinical practice. The aims of this study were to detect the presence of fatigue in cancer patients, describe how patients and nurses perceived it and how nurses managed fatigue.

Methods
This is a mixed methods study. Data were collected in two oncological wards using the Brief Fatigue Inventory (BFI), an ad hoc questionnaire, patient interviews, focus groups with nurses and the review of nursing records. Interviews and focus groups were analysed through thematic analysis. We used SPSS 22.0 for quantitative data and Nvivo 10 for qualitative data analysis.

Results
A total of 71 questionnaires were analysed (39 males, mean age 65.7 years). Fatigue was reported 5 times (7%) in nursing records, while in 17 cases (23.9%) problems associated to it were reported. Twelve patients were interviewed. Five themes were identified: feeling powerless and aggressive, my strategies or what helps me, feeling reassured by the presence of family members, feeling reassured by nurses’ gestures, and being informed. Three themes were identified through the focus groups: objectivity and subjectivity in the assessment of fatigue, nurses’ contribution to the multidisciplinary management of fatigue, and difficulty in evaluating outcomes.

Conclusions
The approach to the management of fatigue was unstructured. Patients were satisfied with the care they received but needed more information and specific interventions. Useful aspects were identified that could be used to change health professionals’ approach towards the management of fatigue.
Facilitators and barriers to post-discharge pain assessment and triage: a qualitative study of nurses’ and patients’ perspectives
Authors: Chen Jinying , Wijesundara Jessica G. , Patterson Angela , Cutrona Sarah L. , Aiello Sandra , McManus David D. , McKee M. Diane , Wang Bo , Houston Thomas K. 
Published: September 2021

AbstractBackgroundAfter hospital discharge, patients can experience symptoms prompting them to seek acute medical attention. Early evaluation of patients’ post-discharge symptoms by healthcare providers may improve appropriate healthcare utilization and patient safety. Post-discharge follow-up phone calls, which are used for routine transitional care in U.S. hospitals, serve as an important channel for provider-patient communication about symptoms. This study aimed to assess the facilitators and barriers to evaluating and triaging pain symptoms in cardiovascular patients through follow-up phone calls after their discharge from a large healthcare system in Central Massachusetts. We also discuss strategies that may help address the identified barriers.MethodsGuided by the Practical, Robust, Implementation and Sustainability Model (PRISM), we completed semi-structured interviews with 7 nurses and 16 patients in 2020. Selected nurses conducted (or supervised) post-discharge follow-up calls on behalf of 5 clinical teams (2 primary care; 3 cardiology). We used thematic analysis to identify themes from interviews and mapped them to the domains of the PRISM model.ResultsParticipants described common facilitators and barriers related to the four domains of PRISM: Intervention (I), Recipients (R), Implementation and Sustainability Infrastructure (ISI), and External Environment (EE). Facilitators include: (1) patients being willing to receive provider follow-up (R); (2) nurses experienced in symptom assessment (R); (3) good care coordination within individual clinical teams (R); (4) electronic health record system and call templates to support follow-up calls (ISI); and (5) national and institutional policies to support post-discharge follow-up (EE). Barriers include: (1) limitations of conducting symptom assessment by provider-initiated follow-up calls (I); (2) difficulty connecting patients and providers in a timely manner (R); (3) suboptimal coordination for transitional care among primary care and cardiology providers (R); and (4) lack of emphasis on post-discharge follow-up call reimbursement among cardiology clinics (EE). Specific barriers for pain assessment include: (1) concerns with pain medication misuse (R); and (2) no standardized pain assessment and triage protocol (ISI).ConclusionsStrategies to empower patients, facilitate timely patient-provider communication, and support care coordination regarding pain evaluation and treatment may reduce the barriers and improve processes and outcomes of pain assessment and triage.
The SToICAL trial: study protocol for the soft tissue injection of corticosteroid and local anaesthetic trial—a single site, non-inferiority randomised control trial evaluating pain after soft tissue corticosteroid injections with and without local anaesthetic
Authors: Jones M. , Evans J. , Fullilove S. , Doyle E. , Gozzard C. 
Published: September 2021

Abstract
Background
Corticosteroid injections are used in the treatment of hand and wrist conditions. The co-administration of a local anaesthetic and corticosteroid aims to reduce pain after the injection, although no studies have directly compared this with using corticosteroid alone. The aim is to determine whether pain experienced during the 24 h after a corticosteroid injection to the hand and wrist is no worse than (not inferior to) the pain experienced after a corticosteroid and local anaesthetic injection.

Methods
A single-site, patient- and assessor-blinded, non-inferiority randomised control trial recording pain visual analogue scale (VAS) scores in patients with a clinical diagnosis of trigger finger, de Quervains tenosynovitis or carpal tunnel syndrome, treated with a 1-ml triamcinolone (40 mg/1 ml) injection co-administered with or without 1 ml of 1% lidocaine. The primary aim is to investigate a difference in pain VAS scores at 1 h after the injection using a mean change score.
A 95% power calculation was made using a minimally clinical important difference of 20 mm as the clinically admissible margin of non-inferiority and an assumed standard deviation of 25 mm, from previous studies. Including a 20% fall out rate, 100 patients are required.

Discussion
Patients with a clinical diagnosis of trigger finger, de Quervains and carpal tunnel syndrome, are over the age 18 years old and who are able to give written informed consent will be included. Patients will be excluded if they have had previous surgery or corticosteroid injection for the condition being treated at the site considered for injection.
Patients will be electronically randomised and injections delivered during their clinic appointment. Pain is assessed using a 100-mm VAS score taken, before and at the time of injection and at 5 min, 1 h, 2 h, 3 h and 24 h after the injection. The secondary outcomes are to determine a difference in pain VAS score at the time of injection and during the 24 h after.

Trial registration
This study is registered on the IRAS (259336) on November 11, 2019, and EudraCT database on October 31, 2019 (2019-003742-32). REC/HRA approval was given in January 2020, and Clinical Trial Authorisation from the MHRA was given in December 2019. The study is registered on ClinicalTrials.gov (NCT04253457) on February 5, 2020.
Use of monitoring technology and injury incidence among recreational runners: a cross-sectional study
Authors: Mayne Richard S. , Bleakley Chris M. , Matthews Mark 
Published: September 2021

Abstract
Background
Monitoring technology is increasingly accessible to recreational runners. Our aim was to examine patterns of technology use in recreational runners, and its potential association with injury.

Methods
We conducted a cross-sectional questionnaire study in a sample of adult runners. Recruitment took place at three different 5 km parkrun event across Northern Ireland. Demographics, technology use, running behaviour and running-related injury (RRI) history were examined. Regression analyses were performed to determine relationships between variables.

Results
Responses were obtained from 192 of 483 eligible finishers (39.8% response rate). Average age was 45.9 years (SD 10.3), with males (47.1 years SD 9.7) slightly older than females (44.8 years SD 10.8). On average, participants ran 3.0 days per week (SD 1.3), with an average weekly distance of 22.6 km (SD 19.7). Males typically ran further (MD 6.2 km/week; 95% CI 0.4 to 12.0) than females. Monitoring technology was used by 87.4% (153/175); with GPS watches the most common device (87.6% (134/153)). Runners using monitoring technology ran further (MD 14.4 km/week; 95% CI 10.3 to 18.5) and more frequently (MD 1.3 days/week; 95% CI 0.7 to 1.9) than those who did not use monitoring technology. There was no significant difference in average age between runners who used monitoring technology and those who did not (MD 4.0 years; 95% CI −0.7 to 8.7). RRI was reported by 40.6% (71/175) of participants in the previous 12 months. In a univariate analysis, none of the selected predictors (age, number of days run per week, distance run per week, or usage of technology to modify training pattern) (p > 0.1) were associated with RRI.

Conclusions
This study found a high prevalence of monitoring technology usage among recreational runners. While the incidence of RRI remains high, it is not associated with the usage of monitoring technology. Further prospective research should examine if monitoring technology can reduce RRI incidence among recreational runners in future.
Managing the energy trilemma in the Philippines
Authors: Yap Josef T. , Gabriola Aaron Joseph P. , Herrera Chrysogonus F. 
Published: September 2021

Abstract
Background
The transition to an energy mix with lower carbon emissions is hampered by the existence of the so-called Energy Trilemma. The primary consequence is a trade-off between various objectives of energy policy, e.g., equity and sustainability. This conflict can lead to policy gridlock if policymakers are unable to prioritize the goals. This paper proposes a framework and methodology to manage the trilemma by applying methods related to multi-criteria decision-making in order to assign weights to the various components of the trilemma.

Results
Following the International Energy Agency (IEA), an expanded concept of energy security is adopted and translates to a version of the trilemma different from that of the World Energy Council. This study takes into account autarky, price, supply, and carbon emissions. The values of these variables are generated by a software called PLEXOS and are incorporated in a welfare function. Trade-offs and complementarities among the four variables are taken into account by the equations in the PLEXOS model. Meanwhile, weights for each of the components of the trilemma are obtained using the Analytical Hierarchy Process. The experts interviewed for this exercise are considered hypothetical heads of the Philippine Department of Energy (DOE).

Conclusion
Two scenarios were compared: a market-based simulation and one where a carbon-tax was imposed. As expected, the carbon-tax leads to a fall in the level of carbon emissions but a rise in the cost of electricity. Because the demand for electricity has a higher price elasticity among lower income classes, the carbon-tax will worsen equity. Attempting to resolve the conflict among the goals of energy policy is difficult leading to a possible gridlock. Policy options can, however, be ranked using the values generated by the welfare function. The ranking clearly depends on the preference or priorities of the hypothetical head of the DOE but at least a decision could be reached. In this manner, trade-offs are measured and the trilemma can be managed even if it is not resolved.
Occurrence of Metarhizium spp. isolated from forest samples in South India and their potential in biological control of banana stem weevil Odoiporus longicollis Oliver
Authors: Velavan Viswakethu , Rangeshwaran Rajagopal , Sivakumar Gopalswamy , Sasidharan T. O. , Sundararaj Ramachandran , Kandan Aravindaram 
Published: September 2021

Abstract
Background
Thirty-six entomopathogenic fungi (EPF) were isolated from soil and insect cadaver samples, collected from different forest types, viz., wet evergreen, moist deciduous, dry deciduous and scrub type in South India. Partial sequences of two parsimony informative genes ITS and RPB1 were determined under a phylogenetic approach for assessing the genetic diversity.

Results
Twenty-seven RPB1 gene sequences and 34 sequences of ITS1, 5.8S and ITS2 regions belonging to 36 EPF were analysed for identification and characterization. Four species of Metarhizium viz., M. anisopliae, M. roberstii, M. majus and M. guizhouense were differentiated. The isolates could be grouped into four main clades of 1–5. Most of the fungi appeared to be closely related to M. anisopliae. Based on the colony characters, colour, conidial size and shape, 27 isolates were morphologically identified as M. anisopliae. Seven strains were apparently related to M. robertsii, three isolates were similar to M. majus and the remaining one was identified as M. guizhouense. Morphological studies in congruence with phylogenetic analysis resolved the species diversity. Bioassay studies showed that M. quizhouense, M. majus and M. robertsii were effective against the banana stem weevil Odoiporus longicollis.

Conclusions
This is the first attempt to study the diversity and occurrence of Metarhizium species in forests of South India. Wet evergreen forest of Aralam in South India was rich in EPF diversity particularly for three species namely, M. quizhouense, M. robertsii and M. anisopliae.