bluuebunny/crossref_metadata_2025_split huggingface dataset:
Renewable energy consumption in Africa: the role of economic well-being and economic freedom
Authors: Amoah Anthony , Kwablah Edmund , Korle Kofi , Offei Daniel 
Published: September 2020

AbstractThis study investigates the role of economic well-being and economic freedom as drivers of renewable energy consumption using the share of renewables in total energy consumption in Africa. To achieve this, the study employs a panel data of 32 African countries over the period 1996-2017. To deal with identification challenges associated with panel time-series data, we use the Dynamic Ordinary Least Squares econometric technique. As part of our findings, first, we have evidence that increasing economic well-being in Africa increases the share of renewables in total energy consumption to a point after which it turns negative (inverted U shape). Second, the disaggregated measures of economic freedom show that both property rights and tax burden decrease the share of renewables in total energy consumption. On the contrary, an increase in trade freedom and business freedom measures increases the share of renewables in total energy consumption. Toward the goal of promoting access to affordable, reliable, sustainable, and modern energy for all by 2030, governments in Africa should actively encourage trade freedom and business freedom to enhance the share of renewable energy consumption. Similarly, reducing the tax burden will promote the share of renewable energy consumption. Likewise, we call for further investigation into our evidence of a negative relationship between property rights and the share of renewables in total energy consumption.
A mixed-methods sequential explanatory design comparison between COVID-19 infection control guidelines’ applicability and their protective value as perceived by Israeli healthcare workers, and healthcare executives’ response
Authors: Gesser-Edelsburg Anat , Cohen Ricky , Shahbari Nour Abed Elhadi , Hijazi Rana 
Published: September 2020

Abstract
Background
Healthcare workers (HCWs) are on the front line of the COVID-19 outbreak, and their constant exposure to infected patients and contaminated surfaces puts them at risk of acquiring and transmitting the infection. Therefore, they must employ protective measures. In practice, HCWs in Israel were not fully prepared for this sudden COVID-19 outbreak. This research aimed to identify and compare: (1) Israeli HCWs’ perceptions regarding the official COVID-19 guidelines’ applicability and their protective value, and (2) HCWs executives’ response to HWCs’ concern regarding personal protective equipment (PPE) shortage.

Methods
A mixed-methods sequential explanatory design consists of: (1) An online survey of 242 HCWs about the application of the guidelines and PPE, and (2) Personal interviews of 15 HCWs executives regarding PPE shortage and the measures they are taking to address it.

Results
A significant difference between the perceived applicability and protective value was found for most of the guidelines. Some of the guidelines were perceived as more applicable than protective (hand hygiene, signage at entrance, alcohol rub sanitizers at entrance, and mask for contact with symptomatic patients). Other were perceived as less applicable than protective (prohibited gathering of over 10 people, maintaining a distance of 2 m’, and remote services).

Conclusions
HCWs need the support of the healthcare authorities not only to provide missing equipment, but also to communicate the risk to them. Conveying the information with full transparency, while addressing the uncertainty element and engaging the HCWs in evaluating the guidelines, are critical for establishing trust.
Performance of a real-time PCR approach for diagnosing Schistosoma haematobium infections of different intensity in urine samples from Zanzibar
Authors: Keller Dominique , Rothen Julian , Dangy Jean-Pierre , Saner Corina , Daubenberger Claudia , Allan Fiona , Ame Shaali M. , Ali Said M. , Kabole Fatma , Hattendorf Jan , Rollinson David , Seyfarth Ralf , Knopp Stefanie 
Published: September 2020

Abstract
Background
Efforts to control and eliminate schistosomiasis have accelerated over the past decade. As parasite burden, associated morbidity and egg excretion decrease, diagnosis with standard parasitological methods becomes harder. We assessed the robustness and performance of a real-time PCR (qPCR) approach in comparison with urine filtration microscopy and reagent strip testing for the diagnosis of Schistosoma haematobium infections of different intensities.

Methods
The robustness of DNA isolation and qPCR was validated in eight laboratories from Europe and Africa. Subsequently, 792 urine samples collected during cross-sectional surveys of the Zanzibar Elimination of Schistosomiasis Transmission (ZEST) project in 2012–2017 were examined with qPCR in 2018. Diagnostic sensitivity of the qPCR was calculated at different infection intensity categories, using urine filtration microscopy as reference test. Spearman’s rank correlation between Ct-values and S. haematobium egg counts was assessed and Ct-value percentiles for infection intensity categories determined.

Results
S. haematobium Dra1 DNA-positive samples were identified correctly in all eight laboratories. Examination of urine samples from Zanzibar revealed Dra1 DNA in 26.8% (212/792) by qPCR, S. haematobium eggs in 13.3% (105/792) by urine filtration, and microhaematuria in 13.8% (109/792) by reagent strips. Sensitivity of the qPCR increased with augmenting egg counts: 80.6% (29/36) for counts between 1 and 4 eggs, 83.3% (15/18) for counts between 5 and 9 eggs, 100% (23/23) for counts between 10 and 49 eggs, and 96.4% (27/28) for counts of 50+ eggs. There was a significant negative correlation between Ct-values and egg counts (Spearman’s rho = − 0.49, P < 0.001). Seventy-five percent of the Ct-values were ≥ 33 in the egg-negative category, < 31 in the light intensity category, and < 24 in the heavy intensity category.

Conclusions
While the sensitivity of the qPCR was ~ 80% for very light intensity infections (egg counts < 10), in general, the Dra1 based qPCR assay detected twice as many S. haematobium infections compared with classical parasitological tests. The qPCR is hence a sensitive, urine-based approach for S. haematobium diagnosis that can be used for impact assessment of schistosomiasis elimination programmes, individual diagnosis, and in improved format also for verification and certification of elimination.

Trial registration
ISRCTN, ISRCTN48837681. Registered 05 September 2012 - Retrospectively registered.
Mental health interventions for adolescents living with HIV or affected by HIV in low- and middle-income countries: systematic review
Authors: Bhana Arvin , Abas Melanie Amna , Kelly Jane , van Pinxteren Myrna , Mudekunye Lynette Alice , Pantelic Marija 
Published: September 2020

Background
Mental health difficulties and mental disorders are common in adolescents living with HIV or who are affected by HIV because of living in HIV-affected households in low- and middle-income (LMICs) countries, but little is known about the interventions that target these individuals and whether they are effective.

Aims
This systematic review aims to address these gaps by examining what has worked and what has not worked to support the mental health of adolescents living with HIV or affected by HIV in low- and middle-income contexts (PROSPERO Number: CRD42018103269).

Method
A systematic literature review of online databases from the year 2000 to 2018, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, included English-language publications of quantitative evaluations of psychosocial interventions aiming to improve mental health among adolescents living with HIV and adolescents from HIV-affected households (aged 10–24 years) in LMICs.

Results
Out of 2956 articles, 16 studies from 8 LMICs met the inclusion criteria. Thirteen studies focused on adolescents affected by HIV and only three studies on adolescents living with HIV. Only five studies included were from Sub-Saharan Africa. Interventions most often used a family-strengthening approach strengthening caregiver–adolescent relationships and communication and some problem-solving in groups or individually. Five studies reported statistically significant changes in adolescent and caregiver mental health or mental well-being, five among adolescents only and two among caregivers only.

Conclusions
Research on what works to improve mental health in adolescents living with HIV in LMIC is in its nascent stages. Family-based interventions and economic strengthening show promise.
Clinicopathologic Features Predictive of Distant Metastasis in Patients Diagnosed With Invasive Breast Cancer
Authors: Ali Basim , Mubarik Fatima , Zahid Nida , Sattar Abida K. 
Published: September 2020

PURPOSE National Comprehensive Cancer Network and European Society for Medical Oncology guidelines suggest screening for distant metastasis (M1) in symptomatic patients or those with locally advanced breast cancer. These guidelines are based on studies that often used pathologic staging for analysis. Physician variability in screening for M1 has also resulted in overuse of diagnostic tests. We sought to identify clinicopathologic features at diagnosis that could guide testing for metastatic disease. METHODS Patients diagnosed with invasive breast cancer between January 2014 and December 2015 were identified from our institutional database. Demographic and clinical variables were collected, including receptor profiles and clinical TNM staging. Rates of upstaging for each clinical stage and rates of concordance of pathologic and clinical staging were analyzed. Univariate analysis and multivariate regression analysis ( P < .05) identified predictors of upstaging to stage IV disease. RESULTS A total of 370 patients met the inclusion criteria. Seventy patients (18.9%) had metastatic disease at diagnosis. The rate of upstaging for stages I, IIA, IIB, and III were 0%, 5.6%, 18.8%, and 36.6%, respectively. Advancing clinical stage, tumor size, and nodal status resulted in a significantly higher rate ( P < .001) of upstaging to M1 disease. Age and hormone receptor status were not associated with upstaging to stage IV disease. Clinical stages I-III were concordant with pathologic staging in 65(42.8%) of 152 patients (kappa’s index, 0.197; P < .000). CONCLUSION Advancing clinical stage, tumor size, and nodal status at diagnosis were predictive of upstaging to M1 disease in patients with breast cancer. Distant metastatic workup should be considered in patients with clinical stage IIB disease or higher.
Ultrasound Characterization of Disordered Antral Follicle Development in Women with Polycystic Ovary Syndrome
Authors: Jarrett Brittany Y , Vanden Brink Heidi , Oldfield Alexis L , Lujan Marla E 
Published: September 2020

Abstract

Context
The mechanism of oligo-anovulation in polycystic ovary syndrome (PCOS) is unknown.

Objectives
To evaluate follicular and endocrine characteristics of anovulatory and sporadic ovulatory cycles in women with PCOS.

Design
Prospective, longitudinal study.

Setting
Academic clinical research unit.

Participants
26 reproductive-aged women (18-38 years) with PCOS, observed during natural anovulatory (PCOS-Anov; n = 12) and sporadic ovulatory cycles (PCOS-Ov; n = 14), and 12 controls.

Interventions
Transvaginal ultrasonography and venipuncture were performed every other day for 4 to 6 weeks in women with PCOS or at 1 interovulatory interval in control subjects.

Main Outcome Measures
Follicle number and diameter (ie, ≥2 mm) were quantified at each visit. Individual growth profiles were assessed for all follicles that grew to ≥7 mm. Blood samples were assayed for follicle-stimulating hormone, luteinizing hormone, estradiol, and progesterone.

Results
Follicular excess, or heightened follicle number versus controls, was observed across anovulatory and sporadic ovulatory cycles in PCOS. In PCOS-Anov, follicles emerged cyclically in some women (6/12; 50%) and continuously in others (6/12; 50%), then grew to a mean maximum diameter of 7.2 mm and regressed within 4.7 days. In PCOS-Ov, follicles mostly emerged cyclically as part of a cohort and dominant follicles showed normal growth to ovulation—albeit mean and maximum luteal progesterone concentrations were significantly lower versus controls.

Conclusions
Follicle growth and regression were detected on ultrasonography amidst perpetual follicular excess in PCOS. Documentation of continuous follicle recruitment and turnover, the absence of persistence, and altered luteal progesterone following sporadic ovulation, provide formative data on antral follicle development in PCOS.
Resistance Exercise Dosage in Men with Prostate Cancer: Systematic Review, Meta-analysis, and Meta-regression
Authors: LOPEZ PEDRO , TAAFFE DENNIS R. , NEWTON ROBERT U. , GALVÃO DANIEL A. 
Published: September 2020

ABSTRACT

Purpose
Resistance exercise improves an array of treatment-related adverse effects in men with prostate cancer; however, the minimal dosage required is unknown. We systematically reviewed the resistance training effects in prostate cancer patients to determine the minimal dosage regarding the exercise components (type, duration, volume, and intensity) on body composition, physical function, muscle strength, cardiorespiratory fitness, body mass index, and prostate-specific antigen.

Methods
Using PRISMA guidelines, MEDLINE, CINAHL, EMBASE, SPORTDiscus, and Web of Science databases were searched. Eligible randomized controlled trials examined prostate cancer patients undertaking resistance-based exercise programs during or after treatment. Meta-analysis was undertaken when more than three studies were included. Associations between mean differences and exercise components were tested by univariate and multivariate meta-regression analysis.

Results
Twenty-three articles describing 21 trials and involving 1748 prostate cancer patients were included. Exercise improved fat mass (−1% in body fat and −0.6 kg in fat mass), lean mass (~0.5 kg in lean and appendicular lean mass), functional capacity (i.e., chair rise, 400-m test, 6-m fast walk, and stair climb tests), and fitness outcomes (i.e., V̇O2peak and muscle strength) (P = 0.040–<0.001) with no change in body mass index or prostate-specific antigen (P = 0.440–0.735). Meta-regression indicated no association between exercise type, resistance training duration, weekly volume and intensity, and primary outcomes (P = 0.075–0.965). There was a significant association between exercise intensity and chest press muscle strength (favoring moderate intensity, P = 0.012), but not in other secondary outcomes.

Conclusion
In untrained older men with prostate cancer initiating an exercise program, lower volume at moderate to high intensity is as effective as higher volume resistance training for enhancing body composition, functional capacity, and muscle strength in the short term. A low exercise dosage may help reduce barriers to exercise and enhance adherence.
Effectiveness of HIIE versus MICT in Improving Cardiometabolic Risk Factors in Health and Disease: A Meta-analysis
Authors: MATTIONI MATURANA FELIPE , MARTUS PETER , ZIPFEL STEPHAN , NIEß ANDREAS M. 
Published: September 2020

ABSTRACT

Purpose
We aimed to investigate differences between high-intensity interval exercise (HIIE, including high-intensity interval training and sprint interval training) and moderate-intensity continuous training (MICT) on physical fitness, body composition, blood pressure, blood lipids, insulin and glucose metabolism, inflammation, and endothelial function.

Methods
Differences between HIIE and MICT were summarized using a random-effects meta-analysis on the effect size (Cohen’s d). A meta-regression was conducted using the following subgroups: population, age, training duration, men ratio, exercise type, baseline values (clinical relevant ranges), and type of HIIE. Studies were included if at least one of the following outcomes were reported: maximal oxygen uptake (V˙O2max), flow-mediated dilation (FMD), body mass index (BMI), body mass, percent body fat, systolic and diastolic blood pressure, high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides, total cholesterol, C-reactive protein (CRP), fasting glucose and insulin, glycated hemoglobin (HbA1c), and insulin resistance (HOMA-IR). A total of 55 studies were included.

Results
Overall, HIIE was superior to MICT in improving V˙O2max (d = 0.40, P < 0.001) and FMD (d = 0.54, P < 0.05). Oppositely, MICT was superior to HIIE in improving HbA1c (d = −0.27, P < 0.05). No differences were observed in BMI (d = −0.02), body mass (d = −0.05), percent body fat (d = 0.04), systolic blood pressure (d = −0.04), diastolic blood pressure (d = 0.03), HDL (d = −0.05), LDL (d = 0.08), triglycerides (d = 0.03), total cholesterol (d = 0.14), CRP (d = −0.11), fasting insulin (d = 0.02), fasting glucose (d = 0.02), and HOMA-IR (d = −0.04). Moderator analyses indicated that the difference between HIIE and MICT was affected by different subgroups.

Conclusion
Overall, HIIE showed to be more effective in improving cardiovascular health and cardiorespiratory fitness, whereas MICT was superior in improving long-term glucose metabolism. In the process of personalized training counseling, health-enhancing effects of exercise training may be improved by considering the individual risk profiles.
Risk factors of geriatrics index of comorbidity and MDCT findings for predicting mortality in patients with acute mesenteric ischemia due to superior mesenteric artery thromboembolism
Authors: Tang Wei , Jin Bo , Kuang Lian-Qin , Zhang Jing , Li Chun-Xue , Wang Yi 
Published: September 2020

Objectives: To identify risk factors of geriatrics index of comorbidity (GIC) and multidetector CT (MDCT) findings for predicting mortality in patients with acute mesenteric ischemia (AMI) due to superior mesenteric artery (SMA) thromboembolism. Methods: 33 patients with AMI due to SMA thromboembolism underwent abdominal MDCT and angiography. Patients’ comorbidities and MDCT findings of ischemic bowel/mesenteric injuries, regions of SMA involved by thromboembolism, and degrees of SMA stenosis were retrospectively reviewed. The comorbidities were classified into 1–4 levels according to GIC. The association of MDCT signs and GIC classification with mortality were analyzed. Diagnostic performances of risk factors associated with mortality were evaluated by receiver operating characteristic (ROC) curve analyses. Results: Eighteen patients (54.5%) died during hospitalization or follow-up, including one patient with class 1, two patients with class 2, eight patients with class 3, and seven patients with class 4 according to GIC. Three risk factors significantly associated with mortality were identified, including pneumatosis and/or portomesenteric venous gas (PPMVG) (p = 0.017), four regions of SMA involved by thromboembolism (region I + II + III + IV) (p = 0.036), and class 3 + 4 of comorbidities (p = 0.001). The sensitivity and specificity of PPMVG, region I + II + III + IV, class 3 + 4 of comorbidities, and the three risk factors combined for diagnosing mortality were 33.3 and 100%, 27.8 and 100%, 83.3 and 73.3%, and 88.9 and 73.3%, respectively. The areas under the ROC curve (AUC) of the three risk factors combined (0.88) and class 3 + 4 of comorbidities (0.78) were larger than that of PPMVG (0.67) and region I + II + III + IV (0.64). The mortality rate rose from 15.4% in patients without risk factor to 66.7%, 100%, and 100% in patients with one, two, and three factors, respectively. Conclusion: Three risk factors for mortality were identified in patients with AMI due to SMA thromboembolism, including PPMVG and four regions of SMA involved by thromboembolism on MDCT images, and class 3 + 4 of comorbidities. Close monitoring of these risk factors could possibly lower the mortality. Advances in knowledge: Risk factors based on GIC and MDCT findings may be used to predict mortality in patients with AMI. Close monitoring of these risk factors could possibly lower the mortality.
A SOLIDARIEDADE COMO FUNDAMENTO PARA O ENFRENTAMENTO DO COVID-19 NA UNIÃO EUROPEIA
Authors: Diz Jamile Bergamaschine Mata , Costa Elizabeth Accioly Rodrigues , Silva Alice Rocha da 
Published: September 2020

Objetivo: O presente artigo busca estabelecer como os procedimentos e normas estabelecidos pela União Europeia foram determinados diante da crise gerada pela propagação rápida de uma pandemia, tendo a solidariedade como fundamento da própria existência do espaço europeu integrado.Metodologia: O trabalho foi estabelecido a partir da análise do arcabouço institucional e legal da União Europeia, desde o pedido de auxílio feito pela Itália em fevereiro de 2020, delimitando-se, a partir, deste recorte temporal, as medidas utilizadas pela União para mitigar os efeitos da crise. A partir de uma metodologia histórica e dedutiva o conteúdo das premissas foi especificado, a partir de um binômio correto/incorreto, válido/inválido, real/fictício, não havendo níveis definitivos de conclusão.Resultados: Com uma linha do tempo específica, concluiu-se que apesar de contar com instrumentos específicos, tais não foram suficientes para evitar a rápida disseminação e contágio gerado pelo COVID-19.Contribuições: As duas principais contribuições desta pesquisa foram de demonstrar a necessidade de incremento aos mecanismos de proteção civil europeu, evitando que as decisões sejam tomadas com “atraso” e sem apresentar soluções efetivas, assim como reforçar o dever de solidariedade como parâmetro para ações concretas que venham a especificar em que medida cada Estado pode cooperar com os demais, sempre sob o manto da União Europeia. Vale mencionar que a escolha pela análise da União Europeia se deve ao fato desta representar um referencial de integração cooperativa e dialógica, num espaço de auxílio e cooperação mútuos que poderia servir como modelo para outras regiões.
Multidrug-resistant Campylobacter jejuni, Campylobacter coli and Campylobacter lari isolated from asymptomatic school-going children in Kibera slum, Kenya
Authors: Gitahi Nduhiu , Gathura Peter B. , Gicheru Michael M. , Wandia Beautice M. , Nordin Annika 
Published: September 2020

Background: The objective of this study was to determine the prevalence of thermophilic Campylobacter spp. in asymptomatic school-going children and establish the antibiotic resistance patterns of the isolates towards the drugs used to treat campylobacteriosis, including macrolides, quinolones and tetracycline. Campylobacter spp. are a leading cause of enteric illness and have only recently shown resistance to antibiotics. Methods: This study isolated Campylobacter spp., including Campylobacter coli, Campylobacter jejuni and Campylobacter lari, in stool samples from asymptomatic school-going children in one of the biggest urban slums in Kenya. The disc diffusion method using EUCAST breakpoints was used to identify antibiotic-resistant isolates, which were further tested for genes encoding for tetracycline resistance using primer-specific polymerase chain reaction. Results: In total, 580 stool samples were collected from 11 primary schools considering both gender and age. Subjecting 294 biochemically characterized Campylobacter spp. isolates to genus-specific PCR, 106 (18.27% of stool samples) isolates were confirmed Campylobacter spp. Out of the 106 isolates, 28 (4.83%) were Campylobacter coli, 44 (7.58%) were Campylobacter jejuni while 11 (1.89%) were Campylobacter lari. Campylobacter jejuni had the highest number of isolates that were multi-drug resistant, with 26 out of the 28 tested isolates being resistant to ciprofloxacin (5 mg), nalidixic acid (30 mg), tetracycline (30 mg) and erythromycin (15 mg). Conclusions: In conclusion, asymptomatic school going children in the study area were found to be carriers of multidrug resistant Campylobacter coli, Campylobacter jejuni and Campylobacter lari at 84%. A one-health approach, which considers overlaps in environment, animals and human ecosystems, is recommended in addressing multidrug resistane in Campylobacter, since animals are the main reservoirs and environmental contamination is evident.