bluuebunny/crossref_metadata_2025_split huggingface dataset:
Proteção de dados e tributação na Alemanha: repercussões do Regulamento Geral sobre Proteção de Dados
Authors: Seer Prof. Dr. Roman , Brandau Signoretti Diogo 
Published: May 2020

Em 25.05.2018 entrou em vigor em todos os estados-membros da UE o RGPD. O processo de tributação alemão não passou incólume. O legislador nacional introduziu, por meio da „Gesetz [Lei] zur Änderung des Bundesversorgungsgesetzes und anderer Vorschriften“, de 17.7.2017, um grande número de normas de acompanhamento na Abgabenordnung (AO). As relações entre o RGPD, a AO e, parcialmente, também a Lei Federal de Proteção de Dados (BDSG) não são claras. Logo, o âmbito de aplicação do RGPD no tocante à seara tributária [alemã] não foi ainda claramente determinado. O presente artigo esclarece a relação entre os novos dispositivos, bem como se se dedica a questões polêmicas e demonstra as vastas possibilidades de tutela jurídica da proteção de dados, junto às quais a nova autoridade de controle federal para proteção de dados e liberdade de informação, como órgão federal, passou recentemente a ter um papel importante
Exposure to environmental tobacco smoke and prevalence of asthma among adolescents in a Middle Eastern country
Authors: Booalayan Hussain , Abdulrasool Mosa , Al-Shanfari Saad , Boujarwa Abdulwahab , Al-Mukaimi Abdullah , Alkandery Omar , Akhtar Saeed 
Published: May 2020

Abstract
Background: There is increasing evidence linking exposure to environmental tobacco smoke (ETS) at homes to the development of asthma among adolescents. Few studies have addressed this issue in the Middle Eastern countries including Kuwait. Therefore, this study cross-sectional assessed the prevalence of ETS exposure at home, prevalence of asthma and other respiratory morbid conditions and examined the ETS exposure and personal smoking status as risk factors for self-reported asthma among high-school students in Kuwait. Methods: During October 2015, a cross-sectional study design was implemented using a self-administered modified version of the ISAAC (International study of asthma and allergies in childhood) questionnaire among students enrolled in nine high-schools of Hawally Governorate of Kuwait. Prevalence of ETS exposure and self-reported asthma were computed. Multivariable log-binomial regression models were used to evaluate association between exposures of interest and self-reported asthma status. Results: Of 800 invited students, 746 (92.2%) participated, of whom 74.8% were Kuwaiti and 50.1% were female with a mean (SD) age of 16.8 (0.68) years. ETS exposure prevalence at home was 54% and personal current smoking was 12.4%. Self-reported asthma prevalence was 20.5%. Furthermore, the prevalence of physician-diagnosed asthma, wheezing during the last 12 months and wheezing ‘ever’ was 16.4%, 20.1% and 26.2%, respectively. Final multivariable log-binomial regression model showed that compared to the adolescents without asthma, adolescents with self-reported asthma tended to be current smokers (adjusted prevalence ratio (adjusted PR) = 1.82; 95% CI: 1.30 – 2.56; p = 0.001) or significantly more likely to have had ETS exposure at home (adjusted PR = 1.64; 95% CI: 1.21 – 2.23; p = 0.002). Conclusions: We recorded high prevalence of ETS exposure at home, high prevalence of self-reported asthma and identified ETS exposure at home and being a current smoker as strong risk factors for self-reported asthma among adolescents. Voluntary household smoking bans may substantially minimize the ETS exposure among adolescents. Additionally, such restriction may inculcate an antismoking attitude and prevent smoking initiation among adolescents. Such efforts are likely to pay dividends in terms of reduction in ETS exposure and associated asthma risk and other smoking-related morbidities in this and other similar settings.
Analysis of exosomal circRNAs upon irradiation in pancreatic cancer cell repopulation
Authors: Chen Yi-yun , Jiang Ming-jie , Chen Zhi-long , Tian Ling 
Published: May 2020

Abstract
Background : Pancreatic cancer is one of most malignant tumors. However, radiotherapy can lead to tumor recurrence, which is caused by the residual surviving cells repopulation stimulated by some molecular released from dying cells. Exosomes may mediate cell-cell communication and transfer kinds of signals from the dying cells to the surviving cells for stimulating tumor repopulation. Circular RNAs (circRNAs) may be one vital kind of exosomal cargos involving in modulating cancer cell repopulation. Methods: Next generation sequencing (NGS) and bioinformatics were performed to analyze and annotate the expression and function of exosome-derived circRNAs in pancreatic cells during radiation. 4 circRNAs were chosen for qRT-PCR analysis to validate the sequencing results. Results: In this study, 3,580 circRNAs were annotated in literatures and circBase among 12,572 identified circRNAs. There were 196 filtered differentially expressed circRNAs (the up-regulation and down-regulation respectively is 182 and 14, fold change >2, p-value <0.05). Regulation of metabolic process and lysine degradation were the main biological processes and pathway enrichment according to Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis. Conclusions: The hsa_circ_0002130-hsa_miR_4482-3p-NBN interaction network suggested potential miRNA sponge and target mRNA. Our results provided potential functions of circRNAs to explore molecular mechanisms and therapeutic targets in pancreatic cancer cell repopulation upon irradiation.
Severe acute malnutrition and its associated factors among children under-five years: a facility-based cross-sectional study
Authors: Ghimire Umesh , Aryal Binod Kumar , Gupta Ankush Kumar , Sapkota Suman Sapkota 
Published: May 2020

Abstract
Background: Despite consistent efforts to enhance child nutrition, poor nutritional status of children continues to be a major public health problem in Nepal. This study identified the predictors of severe acute malnutrition (SAM) among children aged 6-59 months in the two districts of Nepal. Methods: We used data from a cross-sectional study conducted among 6 to 59 months children admitted to the Outpatient Therapeutic Care Centres (OTCC). The nutritional status of children was assessed using mid-upper arm circumference (MUAC) measurement. To determine which variables predict the occurrence of SAM, adjusted odds ratio was computed using multivariate logistic regression and p-value <0.05 was considered as significant. Results: Out of 398 children, 5.8 percent were severely malnourished and the higher percentage of female children were malnourished. Multivariate analysis showed that severe acute malnutrition was significantly associated with family size (five or more members) (Adjusted Odds Ratio [AOR]: 3.96; 95% Confidence Interval [CI]: 1.23 - 12.71). Children from severely food insecure households (AOR: 4.04; 95% CI: 1.88-10.53) were four times more likely to be severely malnourished. Higher odds of SAM were found among younger age-group (AOR: 12.10; 95% CI: 2.06 - 71.09) children (0 - 12 vs. 24 - 59 months). . Conclusions: The findings of this study indicated that household size, household food access, and the child’s age were the major predictors of severe acute malnutrition. Engaging poor families in kitchen gardening to ensure household food access and nutritious diet to the children, along with health education and promotion to the mothers of young children are therefore recommended to reduce child undernutrition.
Catastrophic Healthcare Expenditure and Coping Strategies among Patients Attending Cancer Treatment Services in Addis Ababa, Ethiopia
Authors: Kasahun Gebremicheal Gebreslassie , Gebretekle Gebremedhin Beedemariam , Gecho Yohannes Hailemichael , Woldemariam Aynalem Abraha , Fenta Teferi Gedif 
Published: May 2020

Abstract
Background: With the rapid increase in magnitude and mortality of cancer, which is costly disease to manage, several patients particularly in developing countries are facing a huge financial burden. The aim of the study was to examine the incidence of catastrophic health expenditure (CHE), identify associated factors and coping strategies among patients attending cancer treatment services in Addis Ababa, Ethiopia.Methods: A hospital based cross-sectional survey of patients with cancer was conducted in public and private hospitals between January and March 2018. Data was collected using a structured questionnaire. All direct medical and nonmedical expenditures were measured and reported as expenditure (US$) per patient (1US$ equivalent to 23.41 Ethiopian Birr). The CHE was estimated using a threshold of 10% of annual household income.Results: A total of 352 (response rate of 87.1%) participants were interviewed. Majority (73.3%) of the respondents were females; most (94%) from public hospitals and their mean (±SD) age was 48±13.2 years. Breast (36.9%) and Cervical (16.5%) cancers accounted the largest proportion. Vast majority (74.4%) of patients experienced CHE with mean overall expenditure of $2366 per patient (median: $1708). Medical expenditure sharedthe highest overall expenditure (83.6%) with mean medical and nonmedical costs of $1978 (median: $1394) and $388 (median: $222), respectively. Patients who took greater than six cycles of chemotherapy (AOR: 3.64; 95% CI: 1.11-11.92), and age (AOR: 1.03; 95% CI: 1.01-1.06) were significantly associated with CHE. Household saving (85.5%) followed by financial support (43.0%) were the main coping strategies.Conclusion: A substantial number of patients with cancer are exposed to CHE with considerable medical expenditure. Hence, while efficient mobilization of the over introduced health insurance scheme other better prepayment or insurance mechanisms should also be considered to ensure financial risk protection and realize universal health coverage for patients with cancer.
Exploring the reasons why women prefer to give birth at home in rural northern Ghana: A qualitative study
Authors: Adatara Peter , Strumpher Johanita , Ricks Esmeralda 
Published: May 2020

Abstract
Background: Skilled birth care during childbirth is reported in literature as one critical strategy for reducing maternal morbidity and mortality. Despite the importance of birth care provided by skilled birth attendants, women in rural areas of northern Ghana still give birth utilising the birth services provided by Traditional Birth Attendants.The aim of this study therefore is to explore and describe the factors and experiences of a small group of rural women choosing homebirth in rural northern Ghana. Methods: A qualitative approach was adopted to explore the reasons for women preference to deliver at home in rural areas of northern Ghana. Individual interviews were used to obtain a thick description of factors and experiences of women associated with home births in rural areas in Ghana. The research population consisted of 10 women who utilised birth care services provided by Traditional Birth Attendants in a rural of northern Ghana. Data collected from the interviews were transcribed verbatim and analysed to identify themes. Results: A study with a small group of women showed that these women gave birth at home in rural northern Ghana due to: Perceived poor quality of care and conduct of skilled birth attendants; women received better care from Traditional Birth Attendants; due to financial constraints and women lacked access to healthcare facilities in the rural areas. Conclusion : The study highlighted some barriers experienced by participants to the utilisation of birth care services provided by skilled birth attendants in rural northern Ghana. Management of healthcare facilities should facilitate the implementation of a supportive supervision in the maternity units to improve the quality of care and attitude delivered by skilled birth attendants in maternity care in rural communities.
Anxiety related disorders in adolescents in the United Arab Emirates: a population based cross-sectional study
Authors: Al-Yateem Nabeel , Issa Wegdan Bani , Rossiter Rachel C , Al-Shujairi Arwa , Radwan Hadia , Awad Manal , Fakhry Randa , Mahmoud Ibrahim 
Published: May 2020

Abstract
Background: Anxiety disorders are common among children and adolescents. However, there is a paucity of up-to-date data on the prevalence and correlates of anxiety-related disorders among children and adolescents in the United Arab Emirates (UAE).Methods: We conducted a cross sectional study to determine the prevalence of specific anxiety-related disorders (e.g., generalized anxiety disorder, panic disorder, separation anxiety, social anxiety) in the UAE, and identify correlations between these disorders and adolescents’ demographic variables. Participants were 968 adolescents aged 13–18 years attending secondary schools across the UAE. Convenience sampling was used to recruit participants. We collected demographic information and data about participants’ anxiety levels. Anxiety was assessed using the Arabic and English versions of the Screen for Child Anxiety Related Disorders scale. Univariate analyses (independent sample t-tests and analysis of variance) were performed to evaluate factors affecting participants’ anxiety scores. Chi-square tests were used to compare factors associated with anxiety disorders.Results: Participants’ mean age was 16±1.8 years, and 65.8% were female. The overall prevalence of anxiety disorders was 28%, with this being significantly higher in girls (33.6%) than boys (17.2%) (p<0.0001). Participants aged <16 years had higher generalized anxiety, separation anxiety, and social anxiety scores compared with those aged ≥16 years (p≤0.05). Those from households with a maid had significantly higher generalized anxiety, panic disorder, separation anxiety, and significant school avoidance scores than those without a maid (p≤0.05). In addition, participants from middle and low economic backgrounds had higher separation anxiety scores compared with children from high economic backgrounds (p≤0.05). The multivariate analysis showed the main associated factors with anxiety were gender (being female, p<0.001) and caregiver (other than mother and father together, p<0.001). Conclusions: We found a high incidence of anxiety-related disorders among school-aged adolescents in the UAE, with girls being more affected than boys. This suggests that age-appropriate initiatives are urgently needed to reduce the high rate of anxiety-related disorders. It may also be necessary to further investigate the two main associated factors with anxiety identified in this study (being female and non-parental caregivers).
Psychosocial barriers and enablers of exclusive breastfeeding: lived experiences of mothers in low-income townships, North West Province, South Africa
Authors: Witten Chantell Beverley , Claasen Nicole , Kruger Herculina S , Coutsoudis Anna , Grobler Herman 
Published: May 2020

Abstract
Background: Despite national efforts to promote exclusive breastfeeding (EBF), South Africa’s EBF rate is only 32%. The aim of this study was to examine the rate of EBF discontinuation and the lived experiences of breastfeeding mothers at postnatal time points 3-14 days, 4-8 weeks, 10-14 weeks and 20-24 weeks. Methods: This community-based mixed-methods study collected data within a prospective cohort study on socio-demographics, the Edinburgh Postnatal Depression Scale (EPDS) and the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) at 6-8 weeks with infant feeding data collected at 4-8, 10-14 and 20-24 weeks from 159 mothers living in low income areas. Six focus groups with 32 mothers with infants aged 6-24 weeks were conducted. Descriptive statistics was used for the quantitative data and thematic analysis for qualitative data.Results: The majority of mothers were unmarried (84.9%), living with family (69.2%) and unemployed (74.2%). EBF decreased from 34% at 4-8 weeks to 9.7% at 20-24 weeks. Mixed feeding with infant formula increased from 17.0% to 30.6% and food feeding from 3.1% to 54.2%. While there were no statistically significant associations between EBF and any of the quantitative socio-demographic variables, in the qualitative data, codes associated with barriers were more than enablers. The themes were Mothers’ attributes (wellbeing, experiences and relationships) with the code mother’s stress the strongest barrier, Mother’s knowledge, attitudes and practices of breastfeeding with the code conventional medicines the strongest barrier, Family environment with the code home setting the strongest barrier, Social environment with public spaces and places a barrier and in Baby cues the code baby stomach ailments the barrier. Within these same themes mother’s positive emotions, benefits of breastfeeding, support in the home, access to information and services from health professionals and baby’s health were strong enabling factors. Conclusions: Low EBF, high mixed feeding and a high EPDS score were explained by the barriers identified in the qualitative data. The data suggests that mothers from low-income households would be better supported through interventions that address food insecurity; family relationships and those that build confidence in mothers and resilience in confronting difficult and hostile breastfeeding environments.
Health-related quality of life (FACT-GP) in Sweden
Authors: Bagge Ann-Sophie Lindqvist , Carlander Anders , Fahlke Claudia , Bagge Roger Olofsson 
Published: May 2020

Abstract
Background: Many studies have used disease-specific instruments, such as the Functional Assessment of Cancer Therapy (FACT), when studying health-related quality of life (HRQOL) in patients. Few studies however, have described normative HRQOL values in the general population using FACT - General Population (FACT-GP) . The general aim of the present study is thus to describe the normative HRQOL values in the general Swedish population by using the FACT-GP instrument and to investigate to what degree sociodemographic factors and status of self-rated health (SRH) correlate with HRQOL. Methods: The participants consisted of a pre-stratified (gender, age and education) sample of Swedish citizens that previously had enrolled to be a part of a web panel hosted by a research institute (SOM Institute) at the University of Gothenburg in Sweden. The HRQOL was assessed by using the FACT-GP and SRH. Results: A higher FACT-GP score was mainly associated with males, higher age, higher income and better SRH. The results showed that the Swedish sample scored lower on FACT-GP than previous studies. Conclusions: Since HRQOL is frequently used as an important endpoint in healthcare research, there is an increasing need for normative data. The results from this study serve as a general population standard against which other studied HRQOL-data could be evaluated.
Racial/Ethnic differences in the prevalence and incidence of Metabolic Syndrome in high-income countries: a protocol for a systematic review
Authors: Adjei Nicholas Kofi , Samkange-Zeeb Florence , Kebede Mihiretu , Saleem Maham , Heise Thomas L , Zeeb Hajo 
Published: May 2020

Abstract
Background: Metabolic Syndrome is a constellation of various cardiovascular and type 2 diabetes risk factors, such as abdominal obesity, atherogenic dyslipidemia, high blood pressure and high blood glucose, but its prevalence varies widely by geographical region, sex and race/ethnicity. The objective of this study will be to examine the prevalence and incidence of metabolic syndrome among adults of different racial/ethnic origins in high-income countries. Methods: We designed and registered a study protocol for a systematic review of descriptive epidemiological data. Observational studies (e.g. cross-sectional and cohort studies) reporting morbidity data of metabolic syndrome and conducted in a wide range of adult people (e.g. different racial/ethnic origins, including migrants) will be included. The primary outcome will be the prevalence and incidence of metabolic syndrome. Secondary outcomes will be the prevalence and incidence of individual components of metabolic syndrome (e.g. abdominal obesity, dyslipidemia, high blood pressure and high blood glucose). Literature searches will be conducted in several electronic databases (from inception onwards), including MEDLINE, Web of Science Core Collection (Science Citation Index and Social Science Citation Index), CINAHL, and Cochrane Library. Two investigators will independently screen all reference titles, abstracts, and full-text articles. The methodological quality (or potential bias) of selected studies will be appraised using an appropriate tool. Our results will be described narratively. Random-effects meta-analysis will be conducted, if feasible and appropriate. Additional analyses will be conducted to explore the potential sources of heterogeneity.Conclusion: This systematic review will identify, evaluate and integrate prevalence and incidence data of metabolic syndrome, with focus on racial/ethnic differences in high-income countries. We anticipate our findings may guide policy formulation and identify knowledge gaps in the literature that future research should address.Systematic review registration: PROSPERO, CRD42020157189
Comparison of the effect of rapeseed oil or amaranth seed oil supplementation on weight loss, body composition, and changes in the metabolic profile of obese patients following 3-week body mass reduction program: a randomized clinical trial
Authors: Moszak Małgorzata , Zawada Agnieszka , Juchacz Aldona , Grzymisławski Marian , Bogdański Paweł 
Published: May 2020

Abstract
Background: Amaranth seed oil (ASO) and rapeseed oil (RSO) are representative functional food with glucose and cholesterol-lowering, antioxidant, and hepatoprotective properties. We aimed to compare the effect of RSO and ASO on weight loss and metabolic parameters during the 3-week body mass reduction program.Methods: Eighty-one obese subjects (BMI > 30 kg/m2) aged 25-70 years enrolled in a 3-week body mass reduction program based on calorie-restricted diet and physical activity. The participants were randomly administered 20 mL/d of ASO (AO group) or 20 mL/d of RSO (RO group) or were assigned to the control (C) group (without oil supplementation). Anthropometric and metabolic parameters were measured at baseline and at an endpoint. Results: At the end of the study, significant (P < 0.05) decrease in weight, BMI, WC (waist circumference), HC (hip circumference), FM (fat mass), LBM (lean body mass), VFM (visceral fat mass), and TBW% (total body water) were observed in all groups. There were no significant improvements in clinical parameters in the C group, while reduction in fasting insulin (Δ -5.9, P = 0.001 and Δ -5.7, P = 0.005) and HOMA-IR (Δ -1.1, P = 0.02 and Δ -0.5, P = 0.03) were observed in the RO and AO groups. Compared to the RO group, significant improvement in fasting glucose Δ -8.5, (P = 0.03), total cholesterol (Δ -14.6, P = 0.03), non-HDL cholesterol (Δ 15.9, P = 0.01), TG/HDL ratio (Δ -0.6, P = 0.03), LDL cholesterol (Δ -12.3, P = 0.04), and triglycerides (Δ -6.5, P = 0.000) in the AO group were observed. Conclusions: The 3-week body mass reduction intervention resulted in a significant reduction in weight, BMI, WC, HC, FM, and VFM in all the studied groups. Except for HOMA-IR, in clinical parameters were no statistical differences between all groups. However, the trend to improvement in insulin level and HDL% was noticed only in AO and RO. Therapies targeting edible oils with high nutritional value as RSO and ASO may in the future be a promising tool in support metabolic measurement improvement during the body mass reduction programs.Take home message: Supplementation with RSO or ASO may bring additional benefits to obese patients undertaking a weight reduction program.Trial registration: DRKS00017708