bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of health and nutritional literacy with sun exposure in adults using structural equation modelling
Authors: SaeidiFard Nasim , mehrizi Ali Asghar Haery , Akbarzadeh Zahra , Janbozorgi Nasim , Montazeri Ali , Yaseri Mehdi , Shab-Bidar Sakineh 
Published: March 2021

Abstract
Background: Inadequate health and nutritional literacy is a common problem among adults which is associated with poor health outcomes. Therefore, this study aimed to investigate the relationship between health and nutritional literacy to sun exposure behavior. Methods: We conducted a cross-sectional study on 261 adults (18-65 years) in Iran. Knowledge, motivation, health literacy, nutritional literacy and sun exposure behavior using an interview-assisted questionnaire was evaluated. Using the information–motivation–behavioral skills model and structural equation modeling, we tested whether health and nutritional literacy was associated with the complex relationships among knowledge of vitamin D, attitudes toward sun exposure and sun exposure behavior. Beta and p values were calculated.Results: Health literacy (β= 0.29, p<0.001) and nutritional literacy (β= 0.14, p=0.02) was directly associated with sunlight exposure. Indirect relationships also existed between knowledge and sunlight exposure through health literacy (β = 0.33, p<0.001) and nutritional literacy (β = 0.22, p=0.01). The model had good fit (x2/df = 1.422; RMSEA = 0.040; CFI = 0.851; NFI = 0.657). There were no significant relationship between health literacy and motivation (β = 0.11, p=0.16), nutritional literacy and motivation (β = 0.06, p=0.42) and motivation and sun exposure (β = 0.01, p=0.91). Conclusions: Our findings showed that individuals with sufficient health and nutritional literacy more likely to have exposure to sunlight. Health and nutritional literacy should be considered when educating adults about vitamin D supplements and sunlight exposure.
Evaluation of Quality of life, Social Support and Coping Strategies and Illness Adjustment in patients with breast cancer: Across sectional study
Authors: Okati-Aliabad Hassan , Ansari-Moghadam Alireza , Mohammadi Mahdi , Shahraki-Sanavi Fariba , Kargar Shiva 
Published: March 2021

Abstract
Background: This study aimed to assess the quality of life (QOL), social support and coping strategies, and illness adjustment among breast cancer patients in general and on type of breast surgery.Methods: We conducted a cross-sectional study at the Ali-Ebne-Abitaleb and Khatam-Al-Anbia hospitals in Zahedan, Iran, 2020. We recruited patients with breast cancer who underwent lumpectomy(n=44), mastectomy(n=64), and not any surgery (n=15) by census method. Data collection tools were the breast cancer-specific module (QLQ-BR 23), The adjustment to illness measurement inventory for Iranian women with breast cancer (AIMI- IBC), and the multidimensional scale of perceived social support (MSPSS) questionnaires. We performed statistical analysis by ANOVA, independent sample t-test, Kruskal-Wallis, Mann-Whitney U-test, and multiple linear regression analysis to adjust for covariates.Results: We recruited a total of 120 patients with breast cancer in this survey. 53.3% of patients underwent a mastectomy, 34.2% lumpectomy, and 12.5% of patients had not been surgery. Patients in the functioning scale reported high scores for body image (mean=78.61, SD=26.69) and future perspective (mean=55.27, SD=26.71). Patients on the symptom scale had a high score upset by hair loss (mean= 49.16, SD=38.88). Generally, patients received a high social support level, especially from family members, and used a positive coping strategy to have high illness adjustment more than a negative coping strategy. Also, patients who underwent lumpectomy had a better sexual life and body image and more illness adjustment than the other two groups of patients.Conclusion: Early detection of the disease, support for patients, and educational programs to use appropriate coping strategies can improve breast cancer women's quality of life and disease adaptation.
A Discrete Huber-braun Neuron Model: From Nodal Properties to Network Performance
Authors: He Shaoba , Rajagopal Karthikeyan , Karthikeyan Anitha , Sriniva Ashokkumar 
Published: March 2021

Abstract
Many of the well-known neuron models are continuous time systems with complex mathematical definitions. Literatures have shown that a discrete mathematical model can effectively replicate the complete dynamical behaviour of a neuron with much reduced complexity. Hence, we propose a new discrete neuron model derived from the Huber-Braun neuron with two additional slow and subthreshold currents alongside the ion channel currents. We have also introduced temperature dependent ion channels to study its effects on the firing pattern of the neuron. With bifurcation and Lyapunov exponents we showed the chaotic and periodic regions of the discrete model. Further to study the complexity of the neuron model, we have used the sample entropy algorithm. Though the individual neuron analysis gives us an idea about the dynamical properties, it’s the collective behaviour which decides the overall behavioural pattern of the neuron. Hence, we investigate the spatiotemporal behaviour of the discrete neuron model in single- and two-layer network. We have considered noise and obstacles as the two important factor which changes the excitability of the neurons in the network. When there is no noise or obstacle, the network display simple wave propagation with highly excitable neurons. Literatures have shown that spiral waves can play a positive role in breaking through quiescent areas of the brain as a pacemaker by creating a coherence resonance behaviour. Hence, we are interested in studying the induced spiral waves in the network. In this condition when an obstacle is introduced the wave propagation is disturbed and we could see multiple wave re-entry and spiral waves. Now when we consider only noise with no obstacle, for selected noise variances the network supports wave re-entry. By introducing an obstacle in this noisy network, the re-entry soon disappears, and the network soon enters idle state with no resetting. In a two-layer network when the obstacle is considered only in one layer and stimulus applied to the layer having the obstacle, the wave re-entry is seen in both the layer though the other layer is not exposed to obstacle. But when both the layers are inserted with an obstacle and stimuli also applied to the layers, they behave like independent layers with no coupling effect. This in a two-layer network stimulus play an important role in spatiotemporal dynamics of the network. Similar noise effects like the single layer network are also seen in the two-layer network.
The Homogeneous Conversion Mechanism of Cellulose Pyrolysis Tar Under the Effect of Steam
Authors: Tang Feng , Jin Yuqi , Chi Yong , Ma Jiayu , Zhu Zhongxu , Gong Jinhua 
Published: March 2021

Abstract
Biomass accounts for the largest proportion of rural solid waste with high moisture content, which affects the thermal treatment process. This paper studied the effect of steam on the pyrolysis tar of microcrystalline cellulose (MCC) by a two-stage fixed bed. The experiments had been carried out under different steam/feedstock mass ratios (S/F= 0, 0.8, 1.2, 1.6) when the first stage was at 600℃, and the second stage was at 800 ℃. The tar content in the syngas was reduced effectively from 6.68% to 2.30% when the S/F addition was from 0 to 1.6. The steam could promote craking of compounds to form more stable compounds. To further study the removal mechanism of tar, the main tar component, phosphonic acid, (p-hydroxyphenyl-) , was investigated using density functional theory (DFT). It was concluded that intermediate product from cellulose pyrolysis was more likely to react with H 2 O and made against the production of phosphonic acid, (p-hydroxyphenyl-), consistent with the experimental results.
Using Graph Networks to Quantify the Cumulative Importance of Riparian Wetlands within a Watershed
Authors: Tyrna Abbey , Brooks Robert P 
Published: March 2021

Abstract
Wetlands provide many valuable ecosystem functions including nutrient cycling and retention, sediment capture, flood reduction, carbon storage, and habitat for water-dependent plant and wildlife species. The alteration of landscapes and the deterioration of upstream wetlands have been determined to be detrimental to downstream stream and watershed health. The position of the wetland in the landscape and its quality and size can significantly change the influence it has on stream condition. This research tests the efficacy of graphed networks created from the terrestrial-wetland-stream landscape to quantify the cumulative benefits of riparian wetlands within a watershed. We tested a combination of network parameters such as node degree, betweenness centrality, and the integral index of connectivity. Graphed networks are created by nodes that are connected by edges. Nodes were defined as stream reaches that extend out to the riparian landscape and edges as the stream confluences that connect them. Nodes were weighted by their capacity to perform ecosystem functions and the opportunity for such functions. We found that the network-based approach can quantify the impact of riparian wetland loss revealing that some riparian losses within the watershed were inherently worse than others at reducing connectivity and cumulative wetland function within the watershed. Incorporating these network metrics into wetland assessments can quantify the cumulative influence of geographic position, wetland function and size on overall wetland benefits within the watershed. This new approach can be applied to watershed planning efforts to assist managers with identifying wetlands for protection, enhancement, and re-establishment.
Synthesis and Characterization of Synthetic Sand by Geopolymerization of Industrial Wastes (Fly ash&amp; GGBS) Replacing the Natural River Sand
Authors: Gnanadurai Lizia Thankam , Renganathan Neelakantan Thruvas , Selvaraj Christopher Gnanaraj 
Published: March 2021

Abstract
The diminution of the natural sources in the form of dredging the riverbanks and blasting the mountain ranges has always dented the balance of the eco system which in turn results in disasters as well at times. This alarming situation accelerates the global warming, threatens the biota life in riverbanks, diminishes the ground water level, harms the aquatic life and affects the growth of agriculture. This study is an attempt to synthesis fine aggregates from the industrial byproducts such as fly ash and GGBS through the process of geopolymerization which enables the formation of aluminosilicate networks upon the addition of the alkaline activator solution (Na 2 SiO 3 + NaOH) into the byproducts which is then allowed for oven drying as well as air drying to accelerate the process. The Fly ash geopolymerized fine aggregate(F-GFA) and the GGBS geopolymerized fine aggregate(G-GFA) were noted to exhibit adequate physiochemical and mechanical properties in par with the natural sand. The production of GFA is considered as eco friendly process since it ceases the extensive usage of river sand and incorporates the effective usage of Industrial by products (Fly ash and GGBS) thereby minimizing the land pollution and its consequent harmful hazards. Though the F-GFA and G-GFA showcased higher water absorption ratio than the natural sand, owing to the unreacted fly ash and GGBS particles. Nevertheless, the same initiated the adequate compressive strength attainment up to 90% of natural sand, by reacting with the lime expelled out of the hydration process of cement in the mortar specimens developed in this experimental study. The microstructure of the samples was further examined through Optical microscope, Scanning Electron microscope (SEM) and X-Ray Diffraction (XRD) analysis in order to corroborate the experimental results of this study. The results thus obtained, strongly recommend the potential of the F-GFA and G-GFA as an ideal replacement material for natural sand.
Truffle Species Strongly Shapes its Surrounding Soil Mycobiota in a Pinus Armandii Forest
Authors: Liu Dong , Herrera Mariana , He Xinhua , Perez-Moreno Jesús , Yu Fuqiang 
Published: March 2021

Abstract
Purpose: Truffles contribute to crucial dynamics in the soil systems, being involved in plentiful ecological functions important for ecosystems. Despite this, the interactions between truffles and surrounding mycobiota remain unknown. Here, we aimed to shed light on how much truffle species could affect their surrounding soil mycobiota. Methods: Using traditional chemical analysis and ITS Illumina sequencing, we compared soil nutrients and the mycobiota in soil, gleba and peridium of the two truffle species, Tuber indicum (Ti) and T. pseudohimalayense (Tp), inhabiting the same Pinus armandii forest in southwestern China.Result: Tp soil was more acidic and had higher nutrients (total C, N contents) than Ti soil. Fungal richness and diversity of ascomata tissues and surrounding soils were significantly higher in Tp than in Ti. Truffle species recruited unique soil mycobiota around its ascomata: in Ti soil, fungal taxa including Suillus, Alternaria, Phacidium, Mycosphaerella, Halokirschsteiniothelia, Pseudogymnoascus were abundant while in Tp soil the species of Melanophyllum, Inocybe, Rhizopogon, Rhacidium, and Lecanicillium showed higher abundances. Three dissimilarity tests including adonis, anosim and mrpp showed the differences of fungal community structure between the truffle and their surrounding soil was stronger in Tp than in Ti, and such differences extended to truffle tissues (peridium and gleba). Redundancy analysis further demonstrated that relationships between soil fungal taxa and soil properties had changed from negative (Tp) to positive (Ti) and shifted from a moisture-driving (Tp) to a total N-driving (Ti). Conclusion: Overall, our results showed that the different interactions between truffle and soil system although the causative peculiarity of these associations needs to be further studied.
Performance of Primary Health Care Workers in Detection of Mental Disorders Comorbid with Epilepsy in Rural Ethiopia
Authors: Tsigebrhan Ruth , Fekadu Abebaw , Medhin Girmay , Newton Charles R. , Prince Martin J. , Hanlon Charlotte 
Published: March 2021

Abstract
Background: Timely detection and management of comorbid mental disorders in people with epilepsy is essential to improve outcomes. The objective of this study was to measure the performance of primary health care (PHC) workers in identifying comorbid mental disorders in people with epilepsy against a standardised reference diagnosis and a screening instrument in rural Ethiopia.Methods: People with active convulsive epilepsy were identified from the community, with confirmatory diagnosis by trained PHC workers. Documented diagnosis of comorbid mental disorders by PHC workers was extracted from clinical records. The standardized reference measure for diagnosing mental disorders was the Operational Criteria for Research (OPCRIT plus) administered by psychiatric nurses. The mental disorder screening scale (Self-Reporting Questionnaire; SRQ-20), was administered by lay data collectors. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of PHC worker diagnosis against the reference standard diagnosis was calculated. Logistic regression was used to examine the factors associated with misdiagnosis of comorbid mental disorder by PHC workers. Results: A total of 237 people with epilepsy were evaluated. The prevalence of mental disorders with standardised reference diagnosis was 13.9% (95% confidence interval (CI) 9.6%, 18.2%) and by PHC workers was 6.3% (95%CI 3.2%, 9.4%). The prevalence of common mental disorder using SRQ-20 at optimum cut-off point (9 or above) was 41.5% (95% CI 35.2%, 47.8%). The sensitivity and specificity of PHC workers diagnosis was 21.1% and 96.1%, respectively, compared to the standardised reference diagnosis. In those diagnosed with comorbid mental disorders by PHC workers, only 6 (40%) had SRQ-20 score of 9 or above. When a combination of both diagnostic methods (SRQ-20 score ≥9 and PHC diagnosis of depression) was compared with the standardised reference diagnosis of depression, sensitivity increased to 78.9% (95% (CI) 73.4, 84.4%) with specificity of 59.7% (95% CI 53.2, 66.2%). Only older age was significantly associated with misdiagnosis of comorbid mental disorders by PHC (adjusted odds ratio, 95% CI= 1.06, 1.02 to 1.11).Conclusion: Routine detection of co-morbid mental disorder in people with epilepsy was very low. Combining clinical judgement with use of a screening scale holds promise but needs further evaluation.
Efficacy Differences of First-line EGFR-TKIs Alone vs. in Combination with Chemotherapy in Advanced Lung Adenocarcinoma Patients with Sensitive EGFR Mutation and Concomitant Non-EGFR Genetic Alteration(s)
Authors: Zhang Guowei , Cheng Ruirui , Niu Yuanyuan , Wang Huijuan , Yan Xiangtao , Zhang Mina , Zhang Xiaojuan , Yang Jinpo , Wei Chunhua , Ma Zhiyong 
Published: March 2021

Abstract
Objective: To explore whether EGFR-TKI combined with chemotherapy would benefit patients with advanced lung adenocarcinoma with both sensitive EGFR mutation and concomitant non-EGFR genetic alterations. Materials and Methods: Cases of advanced lung adenocarcinoma with EGFR mutation combined with concomitant non-EGFR genetic alterations were retrospectively collected. And the patients were required to receive first-line EGFR-TKI and chemotherapy combination or EGFR-TKI monotherapy. Demographic, clinical and pathological data were collected, and the electronic imaging data were retrieved to evaluate the efficacy and time of disease progression. Survival data were obtained through face-to-face or telephone follow-up. The differences between the two groups in objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS) and overall survival (OS) were investigated. Results: 107 patients were included, including 63 in the combination therapy group and 44 in the monotherapy group. The ORR were 78% and 50% (P =0.003), and DCR were 97% and 77% (P =0.002), respectively. At a median follow-up of 13.7 months, a PFS event occurred in 38.1% and 81.8% of patients in the two groups, with median PFS of 18.8 and 5.3 months, respectively (P <0.0001). Median OS was unreached in the combination group, and 27.8 months in the monotherapy group (P =0.31). According to the Cox multivariate regression analysis, combination therapy was an independent prognostic factor of PFS. Conclusion: In patients with EGFR-mutant advanced lung adenocarcinoma with concomitant non-EGFR genetic alterations, combination of TKI and chemotherapy was significantly superior to EGFR-TKI monotherapy, which should be the preferred treatment option.
Modelling Trends of Cd4 Counts for Patients on Antiretroviral Therapy (Art) : After a Change in Who Guidelines in Kenya
Authors: Mugo Caroline W , Shkedy Ziv , Mwalili Samuel , Braekers Roel , Wandede Dolphine , Mwachari Christina 
Published: March 2021

Abstract
Background In resource-limited settings, changes in CD4 counts constitute an important component in patient monitoring and evaluation of treatment response as these patients do not have access to routine viral load testing. In this study, we quantified trends on CD4 counts in patients on highly active antiretroviral therapy (HAART) in a comprehensive health care clinic in Kenya between 2011 and 2017.We evaluated the rate of change in CD4 cell count in response to antiretroviral treatment. We further assessed factors that influenced time to treatment change focusing on baseline characteristics of the patients and different initial drug regimens used. The study involved 529 naïve HIV patients that had at least two CD4 count measurements for the period. The relationship between CD4 cell count and time was modeled using a semi parametric mixed effects model while the Cox proportional hazards model was used to assess factors associated with the first regimen change. Results The results demonstrated that CD4 counts increased over time and these trends were similar regardless of the treatment regimen used. Males were less likely to have drug regimens switch (adjusted hazard ratio (aHR) 0.5101, 95% CI: 0.1906 -1.3647) compared to females.Tenoforvir (TDF) based regimens had a lower drug substitution (aHR 0.2796, 95% CI: 0.0961-0.8629) compared to Zinovudine (AZT). Conclusion The backbone used was found to be associated with regimen changes among the patients with fewer switches being observed, with the use of TDF when compared to AZT. There was however no significant difference between TDF and AZT in terms of the change in CD4 count over time.
Evaluation of Three Ni-Ti Systems in Retreatment of Curved Root Canals Obturated by Gutta-Percha With iRoot SP
Authors: Chen Yi , Tian Weiping , Wang Lisha , Qi Fan , Sun Mengyu , Li Rong , Que Kehua 
Published: March 2021

Abstract
Background

To evaluate the retreatability of curved root canals obturated with gutta-percha (GP) and iRoot SP using three different Ni-Ti systems through micro-computed tomographic (micro-CT) analysis.
Methods

A total of 51 curved root canals of permanent molars with angles of curvature ranging from 20° to 40° were used. The root canals were prepared with the ProTaper Next (PTN) rotary system to size 25, .06 taper and filled with iRoot SP and GP using the single cone technique. Samples were randomly divided into three groups (n = 17 each) according to the retreatment system used: Group I. ProTaper Universal Retreatment (PTR) system + ProTaper Next system up to PTN X2; Group II. Waveone Gold (WOG) system (WOG25); Group III. Reciproc Blue (RB) system (RB25). The ability to regain apical patency, the volume of residual filling material, and dentinal microcrack were assessed using micro-CT imaging. Data were analyzed statistically using two-way analysis of variance and chi-square test with a significance level of 5%.
Results

There were no significant differences among the systems tested in the reestablishment of apical patency and reduction of filling materials (P > 0.05), but RB system exhibited better reestablishment root canal ability in the upper portion of curvature and the reduction of filling materials in the apical third (P < 0.05). Intergroup analysis indicated that PTR system induced significantly more dentinal microcracks than other two systems (P < 0.05).
Conclusions

All three tested Ni-Ti instruments showed the similar retreatability of curved root canals obturated with gutta-percha and iRoot SP. RB system may be more effective and safer in curved root canal retreatment.