Search Results (436)

To limit global warming to 1.5 °C, it is imperative to accelerate the global energy transition. This transition is crucial for solving the climate issue and building a more sustainable future. Therefore, within the loaded capacity curve (LCC) theory framework, this study investigates the effects of digital adaptation, energy transition, export diversification, and income inequality on the load capacity factor (LCF). This study also attempts to investigate the integration effects of digital adaptation and energy transition, and digital adaptation and export diversification, on LCF. Furthermore, we explored how income inequality influences the LCF in economies. For this study, 112 countries were selected based on the data availability. Panel data from 2010 to 2021 were analyzed using the STATA software 13 application utilizing a two-step system generalized method of moments (GMM) approach. First, interestingly, our finding shows that digital adaptation and income significantly affect the LCF. An increase in income increases the LCF among the middle-income group of countries. Therefore, LCC is confirmed in this research. Surprisingly, energy transition, export diversification, and foreign direct investment negatively impact the LCF in the base model. Second, the impact of integrating digital adaptation and energy transition has a positive effect on LCF. Third, a negative correlation was observed between the interaction of export diversification and digital adaptation with the LCF. Fourth, a positive correlation was observed between the interaction of renewable energy and digital adaptation with the LCF. Finally, this study explores the impact of the energy transition, export diversification, and income inequality on the LCF with reference to the Organization of Petroleum Exporting Countries (OPEC). The result shows a negative effect between export diversification and LCF among OPECs at a 10% significance level. To improve the quality of our planet, policymakers must understand the forces causing climate change. By adopting a comprehensive perspective, the study aims to understand how these interrelated factors collaboratively influence the LCF thoroughly. Additionally, this research seeks to provide valuable insights related to energy transition, digital adaptation, and export diversification to policymakers, researchers, and stakeholders regarding possible avenues for cultivating a more joyful and sustainable global community. Full article

Inflammatory cytokines are involved in attention deficit hyperactivity disorder (ADHD), a highly prevalent neurodevelopmental disorder. To quantify the baseline levels of pro- and anti-inflammatory cytokines and their changes after methylphenidate (MPH), a total of 31 prepubertal children with ADHD were recruited and subclassified into only two ADHD presentations—ADHD attention deficit (n = 13) or ADHD combined (n = 18). The children were also screened for oppositional defiant conduct disorder (ODCD) and anxiety disorder. Blood samples were drawn at 09:00 and after 4.63 ± 1.87 months of treatment. Four pro-inflammatory cytokines (interleukin-1beta (IL-1β), IL-5, IL-6, tumor necrosis factor-alpha (TNF-α)) and three anti-inflammatory cytokines (IL-4, IL-10, IL-13) were measured using a Luminex^® assay. For statistics, a factorial analysis was performed in Stata 15.1. Overall, there were no statistically significant differences in the interleukin (IL) values induced by treatment. When grouped by presentation, the differences were present almost exclusively in ADHD-AD, usually with a profile opposite to that observed in ADHD-C, and with interactions between comorbid factors, with IL-1β (p = 0.01) and IL-13 (p = 0.006) being the ones reaching the greatest statistical significance. These differences are probably related to the ODCD factor, and they disappear after treatment. In conclusion, the changes observed in cytokine levels in prepubertal children only in the ADHD-AD presentation are probably related to comorbidities (specifically ODCD) and are mitigated after treatment. Full article

Background: Despite the availability of treatments such as surgery and hormonal therapy, women with endometriosis often endure chronic problems. This review aims to evaluate the effectiveness and safety of neuropelveology. Methods: In a systematic review with a meta-analysis, we searched three electronic databases: MEDLINE (PubMed), Scopus, Embase, and Web of Science (WOS). The search was conducted in January 2024 with no date or language restrictions using a carefully curated set of keywords. We conducted a comprehensive review, including all observational and clinical trials reporting data on neuropelveology approaches in the management of endometriosis, irrespective of geographical location. The studies included in our review were required to be published in peer-reviewed journals and be available in any language, with at least an abstract in English. The data of all included studies were summarized in excel (version 19) and were analyzed by Comprehensive Meta-analysis v3.3 (Biostat) and STATA (version 17). A multilevel meta-analysis was performed on studies with two arms (intervention and control) to evaluate the efficacy of neuropelveology in managing women with endometriosis. Results: After screening 476 records, 30 studies, published from 1952 to 2021, were included in this review, each employing various methodologies. The studies were divided into the following three categories: (a) efficacy of neurectomy or nerve resection (n = 20), (b) efficacy of neurolysis (nerve blocks) (n = 4), and (c) efficacy of neuromodulation (n = 6) in the management of endometriosis. Among the studies evaluating the efficacy of neurectomy or nerve resection, 10 studies (with 18 group comparisons) were included in the random-effects meta-analysis. Treatment success (not occurrence of pain) was higher with neurectomy vs. controls (RR = 0.497, 95% CI = 0.236 to 1.04, p = 0.06 (for experimental studies) and RR = 0.248, 95% CI = 0.14 to 0.43, p < 0.001 (for observational studies)), representing a 50% and 75.2% risk reduction in the recurrence of pain in experimental and observational studies, respectively. Similarly, neurolysis, particularly superior hypogastric plexus blocks and uterine nerve ethanol neurolysis, demonstrated encouraging outcomes in pain reduction and an improved quality of life for women with endometriosis. The efficacy of neuromodulation in managing endometriosis symptoms appears promising but requires further investigation. Conclusions: In conclusion, neuropelveology approaches, such as neurectomy, neurolysis, and neuromodulation, offer significant potential for pain reduction in endometriosis patients, albeit with risks of complications and high recurrence rates, necessitating careful patient selection and long-term monitoring. Full article

Drawing on Martin’s Multilevel Framework for Analyzing Mathematics Socialization and Identity Among African Americans this study explores the mechanisms that influence Black students’ decision-making processes related to math course taking in high school. Three years of student transcript data for 1561 Black seniors in a Southern California school district were analyzed using descriptive statistics and logistic regression analyses in STATA. The findings reveal factors that impact students’ ability and desire to complete a fourth year of math in high school, interconnected with institutional, structural, identity, and parental factors. One such finding is that accelerated 8th-grade math placement significantly increases the likelihood that a student would enroll in upper-level math coursework, such as “Beyond IM3” courses in high school. The researcher also investigated the influence of the concentration of Black math teachers in a school on the likelihood of a Black student enrolling in a Beyond IM3 math course. The results of this study contribute to an understanding of the limited racial diversity in STEM fields, highlighting the role of math as a major deterrent for Black students’ interest and persistence in STEM. The findings suggest the need for policy and curriculum changes to promote equitable access to advanced math coursework for Black students, especially in the 8th grade. This study also emphasizes the need to address the structural and institutional factors that influence Black students’ decision-making processes related to math course taking in high school. Full article

The objective of this meta-analysis was to evaluate the association between maternal and fetal genetic variants and the risk of preeclampsia, a pregnancy-related condition that affects women. Despite the unclear role of these genetic factors in the development of preeclampsia, this analysis aimed to provide insights into the potential contributing factors. An electronic search of online databases was conducted to identify relevant studies. Stata SE software was used for the meta-analysis. A random-effects model was used to establish the association between the genetic variants and preeclampsia risk. Egger’s test was utilized to evaluate publication bias. Ten observational studies were selected from databases that met the inclusion criteria and included seven genes and twenty polymorphisms to analyze preeclampsia susceptibility influenced by the genetic background of both the mother and fetus. Our meta-analysis revealed that both the maternal and fetal polymorphisms, FLT1 rs4769613, were significantly associated with the risk of preeclampsia. However, the association between the maternal ACE rs4646994 polymorphism and preeclampsia risk was not statistically significant. Nevertheless, a significant association was observed between the fetal ACE rs4646994 polymorphism and preeclampsia in a dominant genetic model. In this study, the associations between maternal and fetal polymorphisms in ERAP2, VEGF, VDR, REN, and MMP were not statistically significant. According to the available evidence, maternal and fetal polymorphisms can impact the likelihood of developing preeclampsia. Additional research is required to fully understand the underlying mechanisms connecting maternal and fetal polymorphisms to preeclampsia, and to formulate recommendations for screening pregnant women based on these genetic variations. Full article

Background: Depression is the most common mental illness worldwide and generates an enormous health and economic burden. Furthermore, it is known to be associated with an elevated risk of arteriosclerotic cardiovascular diseases (ASCVD), particularly stroke. However, it is not a factor reflected in many ASCVD risk models, including SCORE2. Thus, we analysed the relationship between depression, ASCVD and SCORE2 in our cohort. Methods: We analysed 9350 subjects from the Paracelsus 10,000 cohort, who underwent both a carotid artery ultrasound and completed a Beck Depression Inventory (BDI) screening. Patients were categorised binomially based on the BDI score. Atherosclerotic carotid plaque or absence was dichotomised for logistic regression modelling. Odds ratios and adjusted relative risks were calculated using Stata. Results: Subjects with an elevated BDI (≥14) had higher odds for carotid plaques compared to subjects with normal BDI, especially after adjusting for classical risk factors included in SCORE2 (1.21; 95%CI 1.03–1.43, p = 0.023). The adjusted relative risk for plaques was also increased (1.09; 95%CI 1.01–1.18, p = 0.021). Subgroup analysis showed an increased odds of plaques with increases in depressive symptoms, particularly in women and patients ≤55 yrs. Conclusions: In our cohort, the BDI score is associated with subclinical atherosclerosis beyond classical risk factors. Thus, depression might be an independent risk factor which may improve risk stratification if considered in ASCVD risk prediction models, such as SCORE2. Furthermore, reminding clinicians to take mental health into consideration to identify individuals at increased atherosclerosis risk may provide added opportunities to address measures which can reduce the risk of ASCVD. Full article

Soil-transmitted helminthiases (STH) are among the neglected tropical diseases and infect more than 24% of the world population. The World Health Organization recommends regular monitoring of STH’s prevalence and intensity following mass drug administrations to evaluate their effectiveness and inform future control strategies. This study evaluated the prevalence, intensity, and risk factors of STH infections among school children aged 6 to 14 years old in northwestern Tanzania. A cross-sectional study was conducted among 728 school children in the Kagera region in 2021. Participants were selected using a two-stage cluster sampling method. A questionnaire was used to collect data on the risk factors. Stool samples were examined using the Kato–Katz technique. The data were analysed using STATA. The overall prevalence of STH was 56.2% (95% CI: 52.5–59.8, 409/728). About 5.7% and 1.1% of the infected children had moderate-intensity infections with Ascaris lumbricoides and Trichuris trichiura, respectively. Risk factors included the mother’s occupation as a farmer (aOR: 1.2, p = 0.002) and not washing hands with water and soap (aOR: 1.4, p = 0.035). Washing one’s hands after using the toilet (aOR: 0.6; p = 0.024) is a preventive measure against STH infections. STH was prevalent in the study area. The mother’s occupation (farmer) and the lack of handwashing with water and soap influenced STH transmission. Conversely, washing hands after visiting the toilet and after playing with soil reduced the risk of STH infection. Full article

Telecommunications firms face intense competition driven by rapid innovation and shifting consumer expectations. To remain competitive, companies are adopting Total Quality Management (TQM) to enhance customer satisfaction, corporate stability, and sustainability. This study examines TQM’s effects on customer satisfaction within Gulf Cooperation Council (GCC) countries’ telecommunications sector using secondary data from three firms’ quarterly reports (2019–2023). Descriptive, correlation, and regression analyses with STATA software reveal a significant increase in net promoter scores, indicating firms’ commitment to meeting evolving customer needs. Employee engagement and process management positively affect customer satisfaction, while continuous improvement practices and customer focus do not show a statistically significant influence. The research underscores TQM’s importance in fostering sustainable customer satisfaction by enabling telecom companies to adopt customer-centric strategies for achieving sustainable growth and long-term success. Aligning business processes with customer needs, especially in complaint handling, is crucial. The study advocates for implementing advanced customer relationship management (CRM) systems to better understand customer preferences. These strategic initiatives are vital for telecom firms to maintain competitiveness, enhance customer satisfaction, and contribute to the region’s overall economy. Full article

Objective: The purpose of this study was to explore the knowledge, perception, attitude, and self-efficacy of psychiatrists regarding the role of occupational therapy in mental health practice. Materials and Methods: This study utilized a cross-sectional design to examine the perspectives of psychiatrists from various Middle Eastern countries on occupational therapy practice. A self-developed tool was mainly used to assess occupational therapy knowledge, autonomy, attitude, and self-efficacy. STATA version 16.0 was employed for all subsequent statistical analyses. The data were analyzed using the Kruskal–Wallis and chi-square tests. Results: A total of 117 participants (psychiatrists) from various Middle Eastern countries, including Kuwait, Bahrain, Saudi Arabia, and Jordan, took part in this study. Overall, no significant differences were found between the sites in terms of knowledge and self-perception of occupational therapy autonomy, indicating a lack of understanding about the unique nature of occupational therapy as a distinct health care profession (p-values > 0.05). However, this study’s participants demonstrated a positive attitude and self-efficacy towards occupational therapy. Conclusions: In order to promote the desired therapeutic outcomes, a referral form for occupational therapy, encompassing the main areas of intervention, was proposed. Such a referral form can help inform psychiatrists about the key components of occupational therapy services in mental health practice, thus facilitating the desired interprofessional collaboration and patient outcomes. This study’s implications and future directions are also discussed. Full article

The morphological aspects of urban growth on wetlands in Africa are under-researched. Using the Densu Delta Ramsar site in Accra, Ghana, as a case study, this paper analyses the morphological patterns and drivers of urban growth and its impact on wetlands. Data were obtained through remote-sensing, ground truthing, and limited key informant interviews. The analysis combined land use/land cover, building coverage and spatial autoregressive and ordinary least square regression techniques with the aid of ArcGIS version 10.8.2, QGIS version 3.34 and STATA version 17 software. The findings reveal that urban growth at the Ramsar site follows discernible spatial patterns consistent with the spreading pancake, village magnet, and ribbon development models. However, the primary force behind these patterns is growing demand for land to meet housing needs, aided by the failure of state institutions to perform their land use control and wetland protection functions. To achieve sustainable urban development, there is an urgent need to ensure effective wetland management by enforcing existing land use, development control, and wetland protection measures. This calls for the strengthening, resourcing, and closer collaboration of the relationships between the various state agencies responsible for urban planning and wetland management. There is also the need to engage and sensitise political leaders to increase their commitment to implementing wetland protection and pro-environmental policies. Full article

(1) Background: Large language models (LLMs) are revolutionising various scientific fields by providing advanced support tools. However, the effectiveness of these applications depends on extensive, up-to-date databases to ensure certainty and predictive power. Transparency about information sources in Medicine remains a significant issue. (2) Methods: To evaluate Google Gemini’s accuracy and reproducibility in endodontic diagnosis and treatment, 60 questions were designed based on the European Society of Endodontology Position Statements. Thirty questions were randomly selected and answered using Gemini during April 2023. Two endodontic experts independently scored the answers using a 3-point Likert scale. Discrepancies were resolved by a third expert. The relative frequency and absolute percentage of responses were detailed. Accuracy was assessed using the Wald binomial method, and repeatability was assessed using percentage agreement, Brennan and Prediger’s coefficient, Conger’s generalised kappa, Fleiss’ kappa, Gwet’s AC, and Krippendorff’s alpha, all with 95% confidence intervals. Statistical analysis was performed using STATA software. (3) Results: A total of 900 answers were generated. The percentage of correct answers varied from 0% to 100% per question. Overall accuracy was 37.11% with a 95% confidence interval of 34.02–40.32%; (4) Conclusions: Gemini is not currently designed for medical use and therefore needs to be used with caution when considered for this purpose. Full article

The corporate strategic planning of businesses in sub-Saharan Africa (SSA) largely focuses on immediate financial performance with minimal credence to social sustainability. Thus, studies on the linkage between corporate governance (CG) and sustainability reporting have focused on developed economies. This study therefore investigated the role of institutional ownership in the impact of board committee characteristics on social sustainability reporting. This study involved strongly balanced panel data with 1969 observations of 275 publicly listed non-financial firms in SSA within the timeframe of 2012 to 2021. Data were analyzed using STATA 14.1. The hypotheses were tested using the two-step system of the generalized method of moment (GMM) using the Arellano–Bond dynamic panel data estimation method. The rate of social sustainability reporting was 39.4%. Relatively, Mauritian and South African firms had the most effective board committee characteristics and higher levels of social sustainability reporting. Although institutional ownership had no significant effect on social sustainability reporting, it moderated the effect of sustainability committee independence and sustainability committee gender diversity on social sustainability reporting. This paper presents a new perspective on the corporate governance and social sustainability literature by examining the effect of institutional ownership on board committee characteristics and social sustainability reporting in SSA. In terms of policy implication, there is the need for mandatory regulatory and legal CG framework that is regularly updated at national and regional levels in SSA to motivate listed firms to establish sustainability committees with efficient characteristics to promote social sustainability reporting. Full article

(1) Background and rationale: To validate the reported therapeutic coverage, a lymphatic filariasis post-mass drug administration (MDA) campaign survey was conducted in the Lukonga health zone from 10 June to 15 July 2023. (2) Materials and methods: This was a descriptive, cross-sectional study conducted at the community level in 30 villages in the Lukonga health zone from 10 June to 15 July 2023. The study population included all individuals from the visited communities. The study variables included age, sex, drug use (ivermectin + albendazole), adverse events, and adherence to MDA guidelines for supervised drug use. Questionnaires were administered on Android phones using the SurveyCTO platform. Stata version 17 was used for data analysis. (3) Results: Of the 1092 respondents, 54.8% were female and one-third were between the ages of 5 and 14. Two-thirds of the households surveyed, or 64%, had more than six people living in them, and 1031 individuals, or 94%, reported being present during the community mass drug distribution. Notably, 678 individuals, or 66%, reported taking the drugs offered, and 66.4% of those who took the drugs reported doing so in the presence of drug distributors. Thus, the survey coverage was 65.7% [95% CI: 62.9–68.7]. The results of this study show that the survey coverage was above the 65% threshold recommended by the WHO but below the 82.3% reported by the Lukonga health zone. The main reason for non-compliance was a fear of ivermectin-related side effects (47%). Supervised or directly observed treatment was not adhered to (66.4%). (4) Discussion and conclusions: Key challenges to further increase treatment coverage include assessing data quality, building capacity, motivating drug distributors, improving data reporting tools, proper recording by drug distributors, and accurate reporting on non-residents who take the drugs during the MDA. In addition, harmonization of the numerator for calculating drug coverage in the health zone is critical. It is imperative to provide the public with explicit information regarding the objective of drug distribution and the probable adverse effects. Full article

Objective. Diet-related disease is rising, disproportionately affecting minority communities in which small food retail stores swamp supermarkets. Barriers to healthy food access were exacerbated by the pandemic. We examined the following: (1) individual- and household-level factors in a sample of Baltimore community members who regularly shop at corner stores and (2) how these factors are associated with indicators of dietary quality. Design. Cross-sectional data were collected using an online survey to capture sociodemographics, anthropometrics, and food sourcing, spending, and consumption patterns. Concurrent quantitative and qualitative analyses were conducted in Stata 18 and ATLAS.ti. Setting. This study was set in Baltimore, Maryland, USA. Participants. The participants included adults (n = 127) living or working in Baltimore who identified as regular customers of their neighborhood corner store. Results. The respondents were majority Black and low-income, with a high prevalence of food insecurity (62.2%) and overweight/obesity (66.9%). Most (82.76%) shopped in their neighborhood corner store weekly. One-third (33.4%) of beverage calories were attributed to sugar-sweetened beverages, and few met the recommended servings for fruits and vegetables or fiber (27.2% and 10.4%, respectively). Being Black and not owning a home were associated with lower beverage and fiber intake, and not owning a home was also associated with lower fruit and vegetable intake. Food insecurity was associated with higher beverage intake, while WIC enrollment was associated with higher fruit and vegetable and fiber intakes. Open-ended responses contextualized post-pandemic food sourcing and consumption in this setting. Conclusions. This paper helps characterize the consumers of a complex urban food system. The findings will inform future strategies for consumer-engaged improvement of local food environments. Full article

This study examines the association between nurses’ perception of caring and attitudes toward caring for dying patients in end-of-life care units. We used a descriptive cross-sectional design with convenience sampling. Data were collected from May to June 2021 through self-reported questionnaires from 303 Spanish nurses (mean age = 48 years, 78.9% female). Participants completed the Caring Dimension Inventory (CDI-25) and the Frommelt Attitudes Toward Care of the Dying scale. Demographic and training information were collected. Data were analyzed using Stata 16.0. Attitudes toward Care of the Dying Patient were significantly higher in nurses with palliative care training (β = 2.829, p = 0.018) and those who scored higher on the psychosocial (β = 0.789, p = 0.0001) and technical dimensions (β = 0.487, p = 0.011) of the CDI-25. Multivariate analysis identified the psychosocial dimension of the CDI-25 scale (β = 0.783, p = 0.0001) and palliative care training (β = 2.686, p = 0.017) as the only significant variables associated with Attitudes toward Care of the Dying Patient. Overall, nurses exhibited a positive attitude toward caring for dying patients. Our results could potentially help nursing directors identify those with the necessary qualities and training for optimal end-of-life care and to further plan training courses to provide optimal care in end-of-life situations. Full article