bluuebunny/crossref_metadata_2025_split huggingface dataset:
The availability of global guidance for the promotion of women’s, newborns’, children’s and adolescents’ health and nutrition in conflicts
Authors: Aboubaker Samira , Evers Egmond Samir , Kobeissi Loulou , Francis Lauren , Najjemba Robinah , Miller Nathan P , Wall Steve , Martinez Daniel , Vargas Joseph , Ashorn Per 
Published: November 2020

BackgroundSignificant global gains in sexual, reproductive, maternal, newborn, child and adolescent health and nutrition (SRMNCAH&N) will be difficult unless conflict settings are adequately addressed. We aimed to determine the amount, scope and quality of publically available guidance documents, to characterise the process by which agencies develop their guidance and to identify gaps in guidance on SRMNCAH&N promotion in conflicts.MethodsWe identified guidance documents published between 2008 and 2018 through English-language Internet sites of humanitarian response organisations, reviewed them for their scope and assessed their quality with the AGREE II (Appraisal of Guidelines for REsearch and Evaluation II) tool. Additionally, we interviewed 22 key informants on guidance development, dissemination processes, perceived guidance gaps and applicability.FindingsWe identified 105 conflict-relevant guidance documents from 75 organisations. Of these, nine were specific to conflicts, others were applicable also to other humanitarian settings. Fifteen documents were technical normative guidelines, others were operational guides (67), descriptive documents (21) or advice on legal, human rights or ethics questions (2). Nutrition was the most addressed health topic, followed by communicable diseases and violence. The documents rated high quality in their ‘scope and purpose’ and ‘clarity of presentation’ and low for ‘rigour of development’ and ‘editorial independence’. Key informants reported end user need as the primary driver for guideline development and WHO technical guidelines as their main evidence base. Insufficient local contextualisation, lack of inter-agency coordination and lack of systematic implementation were considered problems in guideline development. Several guidance gaps were noted, including abortion care, newborn care, early child development, mental health, adolescent health beyond sexual and reproductive health and non-communicable diseases.InterpretationOrganisations are motivated and actively producing guidance for SRMNCAH&N promotion in humanitarian settings, but few documents address conflicts specifically and there are important guidance gaps. Improved inter-organisation collaboration for guidance on SRMNCAH&N promotion in conflicts and other humanitarian settings is needed.
Propionic and Methylmalonic Acidemias: Initial Clinical and Biochemical Presentation
Authors: Mobarak Amira , Dawoud Heba , Mokhtar Wesam A. , Sadek Abdelrahim A. , Bebars Gihan Mohamed , Othman Amr Ahmed , Magdy Rofaida M. , Nofal Hanaa , Zoair Amr 
Published: November 2020

PA and MAA have numerous nonspecific presentations, potentially leading to delayed diagnosis or misdiagnosis. In this paper, we present the clinical and biochemical characteristics of MMA and PA patients at initial presentation. Results. This is a retrospective review of 20 patients with PA (

n
=
10

) and MMA (

n
=
10

). The most observed symptoms were vomiting (85%) and refusing feeding (70%). Ammonia was

108.75
±
9.3

μmol/l, showing a negative correlation with pH and bicarbonate and positive correlation with lactate and anion gap. Peak ammonia did not correlate with age of onset (

r
=
0.11

and

p
=
0.64

) or age at diagnosis (

r
=
0.39

and

p
=
0.089

), nor did pH (

r
=
0.01

,

p
=
0.96

;

r
=
−
0.25

,

p
=
0.28

) or bicarbonate (

r
=
0.07

,

p
=
0.76

;

r
=
−
0.22

,

p
=
0.34

). There was no correlation between ammonia and C3 : C2 (

r
=
0.1

and

p
=
0.96

) or C3 (

r
=
0.23

and

p
=
0.32

). The glycine was

386
±
167.1

μmol/l, and it was higher in PA (

p
=
0.003

). There was a positive correlation between glycine and both pH (

r
=
0.56

and

p
=
0.01

) and HCO3 (

r
=
0.49

and

p
=
0.026

). There was no correlation between glycine and ammonia (

r
=
−
0.435

and

p
=
0.055

) or lactate (

r
=
0.32

and

p
=
0.160

). Conclusion. Clinical presentation of PA and MMA is nonspecific, though vomiting and refusing feeding are potential markers of decompensation. Blood gas, lactate, and ammonia levels are also good predictors of decompensation, though increasing levels of glycine may not indicate metabolic instability.
Politics, Economy, and Çiftliks: The History of Four Çiftliks in Larissa (Yenişehir-i Fener)
Authors: Yildiz Aysel 
Published: November 2020

Abstract
The Ottoman state authorities tried to prevent çiftlik formation in all parts of the empire. Yet, they also tried to keep this valuable and cash/kind-producing economic commodity under strict surveillance. The tax-farming and confiscation systems served as two important mechanisms of state control and ensured the state’s redistributive/reallocative role. Having the right to confiscate and redistribute estates, as well as being the ultimate decision maker in the tax-farming system, the Ottoman authorities acted as the chief regulator of the çiftlik market. Therefore, the central state was always a crucial party to be taken into consideration in the triangle of the çiftlik economy together with the peasantry and the çiftlik holders. This article provides a survey of four çiftliks in Larissa (Yenişehir-i Fener), namely Yeğenli, Göçeri, Köleler, and Zaim, in order to understand the redistributive and reallocative role of the Ottoman imperial center and its impact on the history of the region.
The Newly Found Oldest Patriarchal Berat
Authors: Kotzageorgis Phokion 
Published: November 2020

Abstract
This article discusses a newly found Ottoman document. It concerns the oldest—to date—patriarchal diploma of investiture (berat), which was issued for Patriarch Raphael i (1475–76). This and the other two known berats from that epoch constitute a successive set of such documents, and give scholars the opportunity to study the mechanisms of production of patriarchal diplomas of investiture that were so important for the Orthodox Church in the Ottoman period. Furthermore, these documents date from the formative period of the Orthodox Church under Ottoman rule, providing first-hand evidence on how the Church institution became stabilised under the Ottomans.
A New Detection Scheme of Wave-Breaking Events with Blocking Flow Configurations
Authors: Shi Ning , Nakamura Hisashi 
Published: November 2020

AbstractBlocking flow configurations, which tend to accompany strong circulation anomalies and therefore can cause extreme weather conditions, have recently been studied in relation to large-scale wave breaking (WB). Although WB events have been detected often from an instantaneous morphology perspective, the present study proposes a new approach for the detection from a wave-activity perspective in focusing on its accumulation, saturation, and release. This evolution of wave activity is theoretically equivalent to anomalous potential vorticity (PV) flux with its sign changing from negative to positive, which is utilized in this study to detect WB events that accompany high-amplitude height anomalies and blocking flow configurations. As in previous studies, a given WB event is classified into a high pressure type or low pressure type depending upon the sign of the primary PV anomaly center and further into an eastward or westward type depending upon the longitudinal movement of that center. The new method applied to the wintertime Northern Hemisphere shows that a WB event with a blocking anticyclone is likely to accompany an eastward-moving PV anomaly center, occurring mostly under anticyclonic westerly shear. By contrast, a WB event with a strong cyclonic anomaly mostly accompanies the eastward-moving PV anomaly center under cyclonic westerly shear. Composite analysis confirms the consistency between the sign-changing anomalous PV flux and convergence/divergence of wave-activity flux of quasi-stationary Rossby wave trains around the WB region.
The Wechsel Gneiss Complex of Eastern Alps: an Ediacaran to Cambrian continental arc and its Early Proterozoic hinterland
Authors: Neubauer Franz , Liu Yongjiang , Chang Ruihong , Yuan Sihua , Yu Shengyao , Genser Johann , Liu Boran , Guan Qingbin 
Published: November 2020

AbstractMany metamorphosed basement complexes in the Alps are polymetamorphic and their origin and geological history may only be deciphered by detailed geochronology on the different members including oceanic elements like ophiolites, arc successions, and continental passive margin successions. Here we present a case study on the Lower Austroalpine Variegated Wechsel Gneiss Complex and the overlying low-grade metamorphosed Wechsel Phyllite Unit at the eastern margin of Alps. The Wechsel Gneiss Complexes are known to have been overprinted by Devonian metamorphism, and both units were affected by Late Cretaceous greenschist facies metamorphism. New U–Pb zircon ages reveal evidence for two stages of continental arc-like magmatism at 500–520 Ma and 550–570 Ma in the Variegated Wechsel Gneiss Complex. An age of ca. 510 Ma of detrital zircons in metasedimentary rocks also constrain the maximum age of metasedimentary rocks, which is younger than Middle Cambrian. The overlying Wechsel Phyllite Unit is younger than 450 Ma (Late Ordovician) and seems to have formed by denudation of the underlying Variegated Wechsel Gneiss Complex. We speculate on potential relationships of the continental arc-type magmatism of the Variegated Wechsel Gneiss Complex and potential oceanic lithosphere (Speik complex) of Prototethyan affinity, which is also preserved in the Austroalpine nappe complex. The abundant, nearly uniform 2.1 Ga- and ca. 2.5 Ma-age signature of detrital zircons in metasediments (paragneiss, quartzite) of the Variegated Wechsel Gneiss Complex calls for Lower Proterozoic continental crust in the nearby source showing the close relationship to northern Gondwana prominent in West Africa and Amazonia.
Frequency of Leishmania spp. infection among HIV-infected patients living in an urban area in Brazil: a cross-sectional study
Authors: Cunha M. A. , Celeste B. J. , Kesper N. , Fugimori M. , Lago M. M. , Ibanes A. S. , Ouki L. M. , Neto E. A. Simões , Fonseca F. F. , Silva M. A. L. , Júnior W. L. Barbosa , Lindoso J. A. L. 
Published: November 2020

AbstractBackgroundThere is little information about the frequency ofLeishmaniainfection in asymptomatic people living with HIV (PLWH) and about the performance of laboratory diagnostic methods in coinfected patients in Latin America. The main objective of this study is to evaluate the frequency ofLeishmaniaspp. infection in HIV-infected patients living in an urban area in Brazil.MethodsTo detectLeishmaniainfection, diagnostic tests were performed to detect anti-Leishmaniaantibodies (ELISA usingLeptomonas seymouriantigens; ELISA using rK39 antigens; ELISA using rK28 antigens; indirect fluorescent-antibody test (IFAT); direct agglutination test (DAT)) andLeishmaniaDNA (polymerase chain reaction (PCR) with the target genes kDNA and ITS-1).ResultsThe frequency of at least one positive test was 15%. For ELISA usingLeptomonasantigens and IFAT, there was an association between CD4+ T lymphocyte counts and test positivity, with a higher positivity of these tests in more immunosuppressed patients (CD4+ T cell count < 200/mm3).ConclusionsAccording to our data, there was a high prevalence ofLeishmaniaspp. infections in this population living with HIV. Although there is the possibility of cross-reaction, some tests that are considered highly specific for the diagnosis ofLeishmaniainfection were positive. There was also an association between the positivity of some tests studied and lower values of CD4+ T lymphocytes.
Retrospective single center cohort study: effect of intensive home hemodialysis on right ventricular systolic pressure and clinical outcomes
Authors: Girsberger Michael , Chan Christopher T. 
Published: November 2020

AbstractBackgroundIncreased right ventricular systolic pressure (RVSP), a surrogate marker for pulmonary hypertension, is common in patients with end-stage kidney disease. Limited data suggest improvement of RVSP with intensive dialysis, but it is unknown whether these improvements translate to better clinical outcomes.MethodsWe conducted a retrospective single center cohort study at the Toronto General Hospital. All patients who performed intensive home hemodialysis (IHHD) for at least a year between 1999 and 2017, and who had a baseline as well as a follow-up echocardiogram more than a year after IHHD, were included. Patients were categorized into two groups based on the RVSP at follow-up: elevated (≥ 35 mmHg) and normal RVSP. Multivariate and cox regression analyses were done to identify risk factors for elevated RVSP at follow-up and reaching the composite endpoint (death, cardiovascular hospitalization, treatment failure), respectively.ResultsOne hundred eight patients were included in the study. At baseline, 63% (68/108) of patients had normal RVSP and 37% (40/108) having elevated RVSP. After a follow-up of 4 years, 70% (76/108) patient had normal RVSP while 30% (32/108) had elevated RVSP. 8 (10%) out of the 76 patients with normal RVSP and 15 (47%) out of the 32 patients with elevated RVSP reached the composite endpoint of death, cardiovascular hospitalization or technique failure. In a multivariate analysis, age, diabetes and smoking were not associated with elevated RVSP at follow-up. Elevated RVSP at baseline was not associated with a higher likelihood in reaching the composite endpoint or mortality.ConclusionMean RVSP did not increase in patients on IHHD over time, and maintenance of normal RVSP was associated with better clinical outcomes.
How do parents deal with their children’s chronic kidney disease? A qualitative study for identifying factors related to parent’s adaptation
Authors: Khorsandi Fatemeh , Parizad Naser , Feizi Aram , Hemmati MaslakPak Masumeh 
Published: November 2020

Abstract
Background
Parents’ adaptation affects the health outcomes of children with chronic kidney diseases (CKD). Identifying factors that affect parents’ adaptation is necessary to understand their adaptation status. This study aims to explore factors related to the adaptation of parents who have children with CKD.

Methods
This was a qualitative study with a content analysis approach. Seventeen parents of children with CKD were selected by using purposive sampling. The leading researcher performed semi-structured, in-depth, face-to-face interviews to collect data. Conventional content analysis was used to analyze data.

Results
Two main categories extracted from the data were “adaptation facilitators” and “adaptation barriers.” Adaptation facilitators were supported by three sub-categories: “social support”, “family capability” and “spiritual beliefs”. Four sub-categories of “adaptation barriers” were revealed as: “family-related barriers,” “mental stress by others,” “the chronic nature of the disease,” and “unfavorable treatment conditions.”

Conclusions
Identifying the factors influencing parental adaptation helps the medical staff to make the necessary interventions to support the parents. According to this study, increasing parent access to the required information, supporting them financially and emotionally, and helping them identify support resources can facilitate their adaptation to their child’s chronic illness. Also, identifying and eliminating adaptation barriers can help parents deal better with their child’s chronic disease.
Maternal HBsAg carriers and pregnancy outcomes: a retrospective cohort analysis of 85,190 pregnancies
Authors: Zhang Yulong , Chen Jiacheng , Liao Tingting , Chen Siwen , Yan Jianying , Lin Xiaoqian 
Published: November 2020

Abstract
Background
Nowadays, a positive HBV carrier status is common among pregnant women, especially in endemic areas (such as China), little is known about the impact of maternal HBV infection on the risk of adverse pregnancy outcomes. Pregnant women with HBV infection often develop obstetric complications, such as pregnancy-induced hypertension (PIH) syndrome, postpartum hemorrhage, and gestational diabetes mellitus (GDM), and their infants often exhibit neonatal complications.

Methods
This study undertook a retrospective cohort analysis to explore the association of HBV carrier status with adverse pregnancy outcomes. A cohort of 85,190 women including 9699 HBsAg-positive and 73,076 HBsAg-negative pregnancies was retrospectively analyzed.

Results
It’s found that HBsAg-positive pregnancies may result in higher risk of various maternal outcomes such as ICP (OR 3.4,95%CI 2.80 to 4.13), postpartum hemorrhage (OR 1.16,95%CI 1.00 to 1.34). Interestingly, there was a decreased risk of Preeclampsia (OR 0.91,95%CI 0.87 to 0.96), premature rupture of membrane (OR 0.91,95%CI 0.87 to 0.96) and gestational hypertension (OR 0.828,95%CI 0.701 to 0.978). And in vaginal delivery subgroup analysis, It’s found that the HBsAg-positive group had a higher risk of placental abruption (OR, 1.44; 95% CI, 1.16–1.79).

Conclusions
The present results suggest that compared with HBV positive pregnancies were more likely to be ICP and postpartum hemorrhage. HBV-positive pregnant women underwent vaginal delivery were more likely to have placental abruption and premature birth compared with HBV-negative women. Obstetricians should be aware of ICP, postpartum hemorrhage, placental abruption and premature birth in HBV-positive pregnant women.
Should we increase the focus on diet when considering associations between lifestyle habits and deliberate self-harm?
Authors: Berg Elizabeth , Wilhelm Kay , Handley Tonelle 
Published: November 2020

Abstract
Background
Despite increasing awareness of high rates of physical illness and poor lifestyle behaviours among patients with a history of repeated deliberate self-harm (DSH), there is little research on specific lifestyle factors that are potentially problematic for this group. This paper aims to explore the relationship between lifetime repeated DSH and certain lifestyle factors, including balanced meals, eating breakfast, consumption of ‘junk’ food, weight, exercise, substance/alcohol use, smoking and social support, in a cohort of patients who presented to the Emergency Department (ED) with suicidal ideation or DSH.

Methods
From 2007 to 2016, data from lifestyle and mental health measures were collected from 448 attenders at an outpatient clinic for DSH or suicidal ideation following ED presentation. Lifestyle behaviours (Fantastic Lifestyle Checklist) and mental health (Depression and Anxiety Stress Scale), clinical diagnosis and number of previous DSH episodes were measured on arrival. The associations between lifestyle variables and the number of lifetime DSH episodes were examined.

Results
Sex, age, depression symptoms, poor diet, and smoking were all associated with a higher average number of deliberate self-harm episodes across the lifespan. There were non-significant positive trends for the other poor lifestyle behaviours. There was no association between DSH episodes and diagnosis of depression or anxiety disorder. In a multiple linear regression model, the only factors that remained significant were age, smoking and eating balanced meals, however, the relationship between smoking and lifetime DSH was moderated by more immediate DSH behaviours.

Conclusion
In this sample of patients referred to a service following presentation to the ED with acute mental health concerns, balanced meals and smoking were the lifestyle behaviours that were found to have the strongest independent association with repeated DSH across the lifespan.
Psychometric properties of the moral injury symptom scale among Chinese health professionals during the COVID-19 pandemic
Authors: Zhizhong Wang , Koenig Harold G. , Yan Tong , Jing Wen , Mu Sui , Hongyu Liu , Guangtian Liu 
Published: November 2020

Abstract
Background
Moral injury among physicians and other health professionals has attracted attention in the mainstream literature, this study aim to assess the psychometric properties of the 10-item Moral Injury Symptoms Scale-Health Professional (MISS-HP) among healthcare professionals in China.

Methods
A total of 583 nurses and 2423 physicians were recruited from across mainland China. An online survey was conducted from March 27 to April 26, 2020 (during the middle of the COVID-19 pandemic) using the Chinese version of the MISS-HP. Reliability was assessed by internal consistency reliability and test-retest reliability. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to determine scale structure.

Results
Cronbach’s α of the scale for both samples was acceptable (0.71 for nurses and 0.70 for physicians), as was test-retest reliability (ICCs for the individual items ranged from 0.41 to 0.74, with 0.77 for the overall scale in physicians). EFA suggested three factors, and the CFA indicated good fit to the data. Convergent validity was demonstrated with the 4-item Expressions of Moral Injury Scale (r = 0.45 for physicians, r = 0.43 for nurses). Discriminant validity was demonstrated by correlations with burnout and well-being (r = 0.34–0.47), and concurrent validity was suggested by correlations with depression and anxiety symptoms (r = 0.37–0.45). Known groups validity was indicated by a higher score in those exposed to workplace violence (B = 4.16, 95%CI: 3.21–5.10, p < 0.001).

Conclusions
The MISS-HP demonstrated acceptable reliability and validity in a large sample of physicians and nurses in mainland China, supporting its use as a screening measure for moral injury symptoms among increasingly stressed health professionals in this country during the COVID-19 pandemic.
The potential impact of an anti-stigma intervention on mental health help-seeking attitudes among university students
Authors: Shahwan Shazana , Lau Jue Hua , Goh Chong Min Janrius , Ong Wei Jie , Tan Gregory Tee Hng , Kwok Kian Woon , Samari Ellaisha , Lee Ying Ying , Teh Wen Lin , Seet Vanessa , Chang Sherilyn , Chong Siow Ann , Subramaniam Mythily 
Published: November 2020

AbstractBackgroundThe reluctance of young adults to seek mental health treatment has been attributed to poor mental health literacy, stigma, preference for self-reliance and concerns about confidentiality. The purpose of this study was to examine the potential impact of an anti-stigma intervention that includes education about depression, information about help-seeking as well as contact with a person with lived experience, on help seeking attitudes.MethodsA pre-post study design was employed. Changes in help-seeking attitudes were measured using the Inventory of Attitudes towards Seeking Mental Health Services (IASMHS) immediately post-intervention and after 3 months. Sociodemographic data, information on past experiences in the mental health field and contact with people with mental illness were collated. Three hundred ninety university students enrolled in the study. Linear mixed models were used to examine the effects of the intervention.ResultsScores on all subscales of the IASMHS, Psychological Openness (PO), Help-seeking Propensity (HP) and Indifference to Stigma improved significantly post-intervention and at 3-month follow-up compared to pre-intervention, with HP demonstrating the highest effect size. However, a significant decline was observed on all three scales at 3-month follow-up compared to post-intervention. Gender, having friends/family with mental illness, and previous experience in the mental health field moderated the intervention effects for the PO and HP subscales.ConclusionThe study showed that the brief anti-stigma intervention was associated with improvements in help-seeking attitudes among university students with differential effects among certain sub-groups. As the beneficial outcomes appeared to decrease over time, booster sessions or opportunities to participate in mental health-related activities post-intervention may be required to maintain the desired changes in help-seeking attitudes.