bluuebunny/crossref_metadata_2025_split huggingface dataset:
In vivo mitochondrial ATP production is improved in older adult skeletal muscle after a single dose of elamipretide in a randomized trial
Authors: Roshanravan Baback , Liu Sophia Z. , Ali Amir S. , Shankland Eric G. , Goss Chessa , Amory John K. , Robertson H. Thomas , Marcinek David J. , Conley Kevin E. 
Published: July 2021

Background
Loss of mitochondrial function contributes to fatigue, exercise intolerance and muscle weakness, and is a key factor in the disability that develops with age and a wide variety of chronic disorders. Here, we describe the impact of a first-in-class cardiolipin-binding compound that is targeted to mitochondria and improves oxidative phosphorylation capacity (Elamipretide, ELAM) in a randomized, double-blind, placebo-controlled clinical trial.

Methods
Non-invasive magnetic resonance and optical spectroscopy provided measures of mitochondrial capacity (ATPmax) with exercise and mitochondrial coupling (ATP supply per O2 uptake; P/O) at rest. The first dorsal interosseous (FDI) muscle was studied in 39 healthy older adult subjects (60 to 85 yrs of age; 46% female) who were enrolled based on the presence of poorly functioning mitochondria. We measured volitional fatigue resistance by force-time integral over repetitive muscle contractions.

Results
A single ELAM dose elevated mitochondrial energetic capacity in vivo relative to placebo (ΔATPmax; P = 0.055, %ΔATPmax; P = 0.045) immediately after a 2-hour infusion. No difference was found on day 7 after treatment, which is consistent with the half-life of ELAM in human blood. No significant changes were found in resting muscle mitochondrial coupling. Despite the increase in ATPmax there was no significant effect of treatment on fatigue resistance in the FDI.

Conclusions
These results highlight that ELAM rapidly and reversibly elevates mitochondrial capacity after a single dose. This response represents the first demonstration of a pharmacological intervention that can reverse mitochondrial dysfunction in vivo immediately after treatment in aging human muscle.
Anemia design effects in cluster surveys of women and young children in refugee settings
Authors: Hulland Erin N. , Leidman Eva , Wilkinson Caroline , Tondeur Mélody , Bilukha Oleg 
Published: July 2021

Background
Nutrition surveys in many refugee settings routinely estimate anemia prevalence in high-risk population groups. Given the lack of information on anemia design effects (DEFF) observed in surveys in these settings, the goal of this paper is to better understand the magnitude and distribution of DEFFs and intracluster correlation coefficients (ICCs) in order to inform future survey design.

Methods
Two-stage cluster surveys conducted during 2013–2016 were included if they measured hemoglobin in refugee children aged 6–59 months and/or non-pregnant women aged 15–49 years. Prevalence of anemia, anemia DEFFs and ICCs, mean cluster size, number of clusters, and total sample size were calculated per-survey for non-pregnant women and children. Non-parametric tests were used to assess differences and correlations of ICC and DEFF between women and children and inter-regional differences.

Results
Eighty-seven unique cluster surveys from nine countries were included in this analysis. More than 90% of all surveys had ICC values for anemia below 0.10. Median ICC for children was 0.032 (IQR: 0.015–0.048), not significantly different from that observed for non-pregnant women for whom the median was 0.024 (IQR: -0.002–0.055). DEFFs were significantly higher for children [1.54 (IQR: 1.21–1.82)] versus women [1.20 (IQR: 0.99–1.46)]. Regional differences in DEFFs and ICCs were observed.

Conclusions
Both ICCs and DEFF were relatively small for both non-pregnant women and preschool children and fall in a narrow range. Differences in ICCs between women and children were non-significant, suggesting similar inter-cluster distributions of anemia; significant differences in DEFF were likely attributable to differing cluster sizes. Given regional differences in both ICCs and DEFFs, location-specific values are preferred. However, in the absence of other context-specific information, we suggest using DEFFs of 1.4–1.8 if mean cluster size is around 20, and DEFFs of 1.2–1.4 if mean cluster size is around 10.
Accuracy of online symptom checkers and the potential impact on service utilisation
Authors: Ceney Adam , Tolond Stephanie , Glowinski Andrzej , Marks Ben , Swift Simon , Palser Tom 
Published: July 2021

Objectives
The aims of our study are firstly to investigate the diagnostic and triage performance of symptom checkers, secondly to assess their potential impact on healthcare utilisation and thirdly to investigate for variation in performance between systems.

Setting
Publicly available symptom checkers for patient use.

Participants
Publicly available symptom-checkers were identified. A standardised set of 50 clinical vignettes were developed and systematically run through each system by a non-clinical researcher.

Primary and secondary outcome measures
System accuracy was assessed by measuring the percentage of times the correct diagnosis was a) listed first, b) within the top five diagnoses listed and c) listed at all. The safety of the disposition advice was assessed by comparing it with national guidelines for each vignette.

Results
Twelve tools were identified and included. Mean diagnostic accuracy of the systems was poor, with the correct diagnosis being present in the top five diagnoses on 51.0% (Range 22.2 to 84.0%). Safety of disposition advice decreased with condition urgency (being 71.8% for emergency cases vs 87.3% for non-urgent cases). 51.0% of systems suggested additional resource utilisation above that recommended by national guidelines (range 18.0% to 61.2%). Both diagnostic accuracy and appropriate resource recommendation varied substantially between systems.

Conclusions
There is wide variation in performance between available symptom checkers and overall performance is significantly below what would be accepted in any other medical field, though some do achieve a good level of accuracy and safety of disposition. External validation and regulation are urgently required to ensure these public facing tools are safe.
Prevalence of male circumcision in four culturally non-circumcising counties in western Kenya after 10 years of program implementation from 2008 to 2019
Authors: Odoyo-June Elijah , Davis Stephanie , Owuor Nandi , Laube Catey , Wambua Jonesmus , Musingila Paul , Young Peter W. , Aoko Appolonia , Agot Kawango , Joseph Rachael , Mwandi Zebedee , Ojiambo Vincent , Lucas Todd , Toledo Carlos , Wanyonyi Ambrose 
Published: July 2021

Introduction
Kenya started implementing voluntary medical male circumcision (VMMC) for HIV prevention in 2008 and adopted the use of decision makers program planning tool version 2 (DMPPT2) in 2016, to model the impact of circumcisions performed annually on the population prevalence of male circumcision (MC) in the subsequent years. Results of initial DMPPT2 modeling included implausible MC prevalence estimates, of up to 100%, for age bands whose sustained high uptake of VMMC pointed to unmet needs. Therefore, we conducted a cross-sectional survey among adolescents and men aged 10–29 years to determine the population level MC prevalence, guide target setting for achieving the goal of 80% MC prevalence and for validating DMPPT2 modelled estimates.

Methods
Beginning July to September 2019, a total of 3,569 adolescents and men aged 10–29 years from households in Siaya, Kisumu, Homa Bay and Migori Counties were interviewed and examined to establish the proportion already circumcised medically or non-medically. We measured agreement between self-reported and physically verified circumcision status and computed circumcision prevalence by age band and County. All statistical were test done at 5% level of significance.

Results
The observed MC prevalence for 15-29-year-old men was above 75% in all four counties; Homa Bay 75.6% (95% CI [69.0–81.2]), Kisumu 77.9% (95% CI [73.1–82.1]), Siaya 80.3% (95% CI [73.7–85.5]), and Migori 85.3% (95% CI [75.3–91.7]) but were 0.9–12.4% lower than DMPPT2-modelled estimates. For young adolescents 10–14 years, the observed prevalence ranged from 55.3% (95% CI [40.2–69.5]) in Migori to 74.9% (95% CI [68.8–80.2]) in Siaya and were 25.1–32.9% lower than DMMPT 2 estimates. Nearly all respondents (95.5%) consented to physical verification of their circumcision status with an agreement rate of 99.2% between self-reported and physically verified MC status (kappa agreement p-value<0.0001).

Conclusion
This survey revealed overestimation of MC prevalence from DMPPT2-model compared to the observed population MC prevalence and provided new reference data for setting realistic program targets and re-calibrating inputs into DMPPT2. Periodic population-based MC prevalence surveys, especially for established programs, can help reconcile inconsistencies between VMMC program uptake data and modeled MC prevalence estimates which are based on the number of procedures reported in the program annually.
Predicting performance in 4 x 200-m freestyle swimming relay events
Authors: Wu Paul Pao-Yen , Babaei Toktam , O’Shea Michael , Mengersen Kerrie , Drovandi Christopher , McGibbon Katie E. , Pyne David B. , Mitchell Lachlan J. G. , Osborne Mark A. 
Published: July 2021

Aim
The aim was to predict and understand variations in swimmer performance between individual and relay events, and develop a predictive model for the 4x200-m swimming freestyle relay event to help inform team selection and strategy.

Data and methods
Race data for 716 relay finals (4 x 200-m freestyle) from 14 international competitions between 2010–2018 were analysed. Individual 200-m freestyle season best time for the same year was located for each swimmer. Linear regression and machine learning was applied to 4 x 200-m swimming freestyle relay events.

Results
Compared to the individual event, the lowest ranked swimmer in the team (-0.62 s, CI = [−0.94, −0.30]) and American swimmers (−0.48 s [−0.89, −0.08]) typically swam faster 200-m times in relay events. Random forest models predicted gold, silver, bronze and non-medal with 100%, up to 41%, up to 63%, and 93% sensitivity, respectively.

Discussion
Team finishing position was strongly associated with the differential time to the fastest team (mean decrease in Gini (MDG) when this variable was omitted = 31.3), world rankings of team members (average ranking MDG of 18.9), and the order of swimmers (MDG = 6.9). Differential times are based on the sum of individual swimmer’s season’s best times, and along with world rankings, reflect team strength. In contrast, the order of swimmers reflects strategy. This type of analysis could assist coaches and support staff in selecting swimmers and team orders for relay events to enhance the likelihood of success.
Risk factors for precancerous cervical lesion among women screened for cervical cancer in south Ethiopia: Unmatched case-control study
Authors: Beyene Tesfalidet , Akibu Mohammed , Bekele Henok , Seyoum Wengelawit 
Published: July 2021

Background
Nearly 90% of deaths from cervical cancer occur in a low resource setting. In Ethiopia, the magnitude of precancerous cervical lesions ranges from 7% to 28%. Precancerous cervical lesions may progress to cervical cancer. Early screening and treatment of precancerous cervical lesions is a cost-effective way to avert the growth of cervical cancer. However, there has been limited research on risk factors for precancerous cervical lesions in Ethiopia. Therefore, this study aimed to identify risk factors for precancerous cervical lesions among women screened for cervical cancer in south Ethiopia.

Method
A facility-based unmatched case-control study was carried out in five health facilities in south Ethiopia between 8 May to 28 September 2018. Interviewer administered questionnaires were used to collect data from 98 cases and 197 controls. Multivariate logistic regression was employed to identify determinants of precancerous cervical lesions.

Results
Women aged 30–39 years (AOR = 2.51, 95% CI: 1.03–6.08), monthly income ≤66 (AOR = 3.51, 95% CI: 1.77–6.97), initiation of first sexual intercourse at age less than or equal to 20 (AOR = 2.39, 95% CI: 1.14–5.47), having more than one lifetime sexual partner (AOR = 4.70, 95% CI: 2.02–10.95), having a partner/ husband with more than one lifetime sexual partner (AOR = 2.98, 95% CI: 1.35–6.65) had higher odds of precancerous cervical lesions.

Conclusion and recommendation
Strategies to prevent precancerous cervical lesions should focus on modification of lifestyle and sexual behaviour. The findings of this study highlight several implications for policymakers: targeting older women for cervical cancer screening, addressing inequalities and education relating to risky sexual behaviour may reduce precancerous cervical lesions. Furthermore, future longitudinal studies are needed to assess the awareness of women about cervical cancer screening.
‘Excessive sweating is not a feminine thing’: A qualitative study of women’s experiences suffering from primary hyperhidrosis
Authors: Shayesteh Alexander , Persson Margareta , Brulin Christine , Nylander Elisabet 
Published: July 2021

Background
Primary hyperhidrosis, excessive focal sweating is a common disease equally affecting men and women. Women tend to seek care more often and assess being more affected by hyperhidrosis in their daily life. The aim of this study was to explore experiences of living with primary hyperhidros in a sample of 15 women.

Methods
Individual, semi-structured interviews with a purposive sample of 15 women diagnosed with primary hyperhidrosis and analysed by qualitative content analysis utilising an inductive approach.

Results
The analysis resulted in a theme, constantly guarding the female image, based on three categories, misfitting the feminine norms, avoiding the attention of others and passing like any woman. Primary hyperhidrosis in women disrupted the ideal feminine appearance. Wearing clothes that concealed hyperhidrosis and distancing from social gatherings, in combination with negative remarks by others, created stress and anxiety and had a negative effect on self-esteem. Women felt poorly understood by others regarding the extent of their sweating and were misunderstood in intimate situations while trying to reduce the sweat production. Choices regarding education and career opportunities were affected, since being exposed and receiving attention due to primary hyperhidrosis was unwanted. Treatment with botulinum toxin liberated women from excessive sweating and removed a social handicap they described living with.

Conclusion
Primary hyperhidrosis in women disrupts the feminine appearance, lowers self-esteem and hinders social interactions. Clinicians assessing primary hyperhidrosis need to be aware that women may report the impairments from primary hyperhidrosis as being more associated with body image and appearance than with functional reductions in daily life. Educating patients, providing accurate information regarding the disease via media and cooperating with patient groups are important for increasing awareness and achieving progress in care for women with primary hyperhidrosis.
Protocol for a scoping review of research on abortion in sub-Saharan Africa
Authors: Juma Kenneth , Ouedraogo Ramatou , Mwoka Meggie , Ajayi Anthony Idowu , Igonya Emmy , Otukpa Emmanuel Oloche , Ushie Boniface Ayanbekongshie 
Published: July 2021

Introduction
Unsafe abortion is a leading cause of maternal mortality, and access to safe abortion services remains a public health priority in sub-Saharan Africa (SSA). A considerable amount of abortion research exists in the region; however, the spread of existing evidence is uneven such that some countries have an acute shortage of data with others over-researched. The imbalance reflects the complexities in prioritization among researchers, academics, and funders, and undeniably impedes effective policy and advocacy efforts. This scoping review aims to identify and map the landscape of abortion research in SSA, summarize existing knowledge, and pinpoint significant gaps, both substantive and geographic, requiring further investigation. This review will provide direction for future research, investments, and offer guidance for policy and programming on safe abortion.

Materials and methods
We utilize the Joanna Briggs Institute’s methodology for conducting scoping reviews. We will perform the search for articles in 8 electronic databases (i.e., PubMed, AJOL, Science Direct, SCOPUS, HINARI, Web of Knowledge, CINAHL, and WHO Regional Databases). We will include studies written in English or French language, produced or published between January 1, 2011, and July 31, 2021, and pertain directly to the subject of abortion in SSA. Using a tailored extraction frame, we will extract relevant information from publications that meet the inclusion criteria. Data will be analyzed using descriptive statistics and thematic analysis in response to key review questions.

Ethics and dissemination
Formal ethical approval is not required, as no primary data will be collected. The findings of this study will be disseminated through peer-reviewed publications and conference presentations.
Políticas educativas, buenas prácticas y TIC
Authors: De Pablos Pons Juan , Colás Bravo Pilar , Villaciervos Moreno Patricia 
Published: July 2021

Esta aportación está vinculada a la difusión de los resultados de un proyecto de investigación titulado “Políticas educativas autonómicas y sus efectos sobre la innovación pedagógica en el uso de las TIC en los centros escolares”, que se ha desarrollado en el marco del Plan Nacional de I+D 2004-2007. El trabajo se centra en el análisis del discurso que explicita las políticas educativas en Andalucía, dirigidas a la incorporación de las TIC en el sistema educativo. El estudio realizado permite, por un lado, conocer y detallar los conceptos implícitos en las mismas respecto a “buenas prácticas” con TIC, innovación educativa con TIC, y usos de las TIC, y por otro, determinar los principales ámbitos de incidencia de la intervención política, así como los programas de incentivación relacionados con la innovación y buenas prácticas con TIC.
Immunological predictors of type 1 diabetes mellitus (literature review)
Authors: Korneva K. G. , Strongin L. G. , Zagainov V. E. 
Published: July 2021

Background: Type 1 diabetes mellitus (T1DM) is a chronic autoimmune disease characterized by insulin deficiency due β-cell destruction and following hyperglycaemia. Specific markers of T1DM are pancreatic islet-targeting autoantibodies that are found months to years before symptom onset, and can be used to identify individuals who are at risk of developing T1DM.Aim: The study is aimed at the review of current knowledge of diabetes-related autoantibodies as biomarkers of T1DM.Materials and methods: Foreign and national clinical studies on this topic were included. PubMed, Medline and ­eLibrary were searched.Results: Modern ideas about known diabetes-specific autoantibodies as markers of autoimmune inflammation of β-cells of the pancreas were discussed. The analysis of their independent diagnostic value in predicting the occurrence of T1DM were carried out.Conclusion: There is no unified concept in the literature on this issue. Current data on autoantibodies in T1DM show a ­significant individual variability in the timing, dynamic changes and autoantibody composition in T1DM progression.
Possibilities of application a fixed combination of alogliptin and pioglitazone for type 2 diabetes mellitus treatment
Authors: Shestakova M. V. , Antsiferov M. B. , Ametov A. S. , Galstyan G. R. , Demidova T. Y. , Mkrtumyan A. M. , Petunina N. A. 
Published: July 2021

Hyperglycemia in T2DM is based on three main mechanisms: insulin resistance, progressive β-cell dysfunction, and excess glucose production by the liver.The onset of T2DM is usually preceded by a long period of insulin resistance. Prescribing sugar drugs that affect different links of pathogenesis, reducing a steady decrease in glycemia. To date, in clinical practice, various combinations of hypoglycemic drugs are used, the choice of which is determined by the characteristics of the course of diabetes in the patient, the presence of concomitant diseases and complications of diabetes, as well as the dominant clinical problem. This resolution provides an expert council opinion on the feasibility of using a combination of alogliptin and pioglitazone in patients with type 2 diabetes.
Prognostic value of the neutrophil-to-lymphocyte ratio in acute organophosphorus pesticide poisoning
Authors: Mu Yuhang , Hu Boqi , Gao Nan , Pang Li 
Published: July 2021

Abstract
This study investigates the ability of blood neutrophil-to-lymphocyte ratio (NLR) to predict acute organophosphorus pesticide poisoning (AOPP). Clinical data of 385 patients with AOPP were obtained within 24 h of admission, and NLR values were calculated based on neutrophil and lymphocyte counts. The patients were divided into two groups – good and poor – based on prognosis. Poor prognosis included in-hospital death and severe poisoning. The factors affecting prognosis were analyzed by logistic regression analysis, and the prognostic value of NLR was evaluated using the area under the receiver operating characteristic curve (AUC). Univariate logistic regression analysis showed that NLR levels, serum cholinesterase, and creatinine levels were good predictors of AOPP. Multivariate logistic regression analysis showed that high NLR was an independent risk factor for severe poisoning (adjusted odds ratio [AOR], 1.13; 95% CI, 1.10–1.17; p < 0.05) and in-hospital mortality (AOR, 1.07; 95% CI, 1.03–1.11; p < 0.05). NLR values >13 and >17 had a moderate ability to predict severe poisoning and in-hospital mortality, respectively (AUC of 0.782 [95% CI, 0.74–0.824] and 0.714 [95% CI, 0.626–0.803], respectively). Our results show that high NLR at admission is an independent indicator of poor prognosis in AOPP and can be used to optimize treatment and manage patients.
Beyond Parroting: Using English Fun Dubbing to Improve English Oral Performance
Authors: Wu Huiqi , Ekstam Jane M. 
Published: July 2021

Abstract
The present paper is a response to the current problematic situation of oral English teaching at the tertiary level in China and the increasing popularity of web-based mobile oral English learning in oral English classes. Our paper focuses on the use of mobile-phone-based educational software known as “English Fun Dubbing” (EFD) and its advantages in terms of teaching and learning phonetics and oral English in the college classroom. The starting point was a needs analysis which revealed the lack of practice regarding English speaking. In this study, an action research method was adopted, involving 40 second-year students, who employed “classroom teaching + English Fun Dubbing” model as the intervention. Extensive examples from this model were used to build up a picture of the blended learning processes at work. Several imitation tasks, a conversational activity and a speech-delivering task were designed and implemented. Direct observation and the results of the questionnaire survey provided the evidence of the improvement in the students’ oral performance. It is our aim to develop the present project to incorporate oral proficiency. The main results of this action research were reflected in the adjustments in the pedagogical treatment, the changes in the role of the teacher and the student, and the shifts in the students’ attitudes towards their learning process.