bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exposure to environmental tobacco smoke and prevalence of asthma among adolescents in a middle eastern country
Authors: Booalayan Hussain , Abdualrasool Mosa , Al-Shanfari Saad , Boujarwa Abdulwahab , Al-Mukaimi Abdullah , Alkandery Omar , Akhtar Saeed 
Published: August 2020

Abstract
Background
There is increasing evidence linking environmental tobacco smoke (ETS) exposure at homes to the development of asthma among adolescents. Few studies have addressed this issue in the Middle Eastern countries including Kuwait. Therefore, this cross-sectional study assessed the prevalence of ETS exposure at home, prevalence of asthma and other respiratory conditions and examined the ETS exposure at home and personal tobacco smoking as risk factors for self-reported asthma among high-school students in Kuwait.

Methods
In this cross-sectional study, we enrolled participants from nine high-schools of Hawally Governorate of Kuwait during October 2015. We adapted a previously validated self-administered questionnaire for data collection. Prevalence of self-reported asthma and ETS exposure (≥ 1 smoker at home vs. none) were computed. The association between exposures of interest and self-reported asthma status was examined using a multivariable log-binomial regression model.

Results
Of 800 enrolled participants, 746 (92.2%) consented and completed the questionnaire. The participants with mean (SD) age of 16.8 (0.68) years were predominantly Kuwaiti (74.8%) and female (50.1%). The prevalence of ETS exposure at home and personal current smoking was 54 and 12.4% respectively. 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. Fitted multivariable log-binomial regression model revealed that compared with the non-asthmatic, participants 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 have had ETS exposure at home (adjusted PR = 1.64; 95% CI: 1.21–2.23; p = 0.002).

Conclusions
We recorded a 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 may bring about reduction in ETS exposure and associated asthma risk and other smoking-related morbidities in this and other similar settings.
Asthma control factors in the Gulf Cooperation Council (GCC) countries and the effectiveness of ICS/LABA fixed dose combinations: a dual rapid literature review
Authors: Noibi Saeed , Mohy Ahmed , Gouhar Raef , Shaker Fadel , Lukic Tamara , Al-Jahdali Hamdan 
Published: August 2020

Abstract
Background
Asthma control is influenced by multiple factors. These factors must be considered when appraising asthma interventions and their effectiveness in the Gulf Cooperation Council (GCC) countries (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and United Arab Emirates [UAE]). Based on published studies, the most prevalent asthma treatment in these countries are fixed dose combinations (FDC) of inhaled corticosteroid and long-acting beta-agonist (ICS/LABA). This study is a rapid review of the literature on: (a) factors associated with asthma control in the GCC countries and (b) generalisability of ICS/LABA FDC effectiveness studies.

Methods
To review local factors associated with asthma control and, generalisability of published ICS/LABA FDC studies, two rapid reviews were conducted. Review 1 targeted literature pertaining to asthma control factors in GCC countries. Eligible studies were appraised, and clustering methodology used to summarise factors. Review 2 assessed ICS/LABA FDC studies in conditions close to actual clinical practice (i.e. effectiveness studies). Eligibility was determined by reviewing study characteristics. Evaluation of studies focused on randomised controlled trials (RCTs). In both reviews, initial (January 2018) and updated (November 2019) searches were conducted in EMBASE and PubMed databases. Eligible studies were appraised using the Critical Appraisal Skills Program (CASP) checklists.

Results
We identified 51 publications reporting factors associated with asthma control. These publications reported studies conducted in Saudi Arabia (35), Qatar (5), Kuwait (5), UAE (3), Oman (1) and multiple countries (2). The most common factors associated with asthma control were: asthma-related education (13 articles), demographics (11articles), comorbidities (11 articles) and environmental exposures (11 articles). Review 2 identified 61 articles reporting ICS/LABA FDC effectiveness studies from countries outside of the GCC. Of these, six RCTs were critically appraised. The adequacy of RCTs in informing clinical practice varied when appraised against previously published criteria.

Conclusions
Asthma-related education was the most recurring factor associated with asthma control in the GCC countries. Moreover, the generalisability of ICS/LABA FDC studies to this region is variable. Hence, asthma patients in the region, particularly those on ICS/LABA FDC, will continue to require physician review and oversight. While our findings provide evidence for local treatment guidelines, further research is required in GCC countries to establish the causal pathways through which asthma-related education influence asthma control for patients on ICS/LABA FDC therapy.
Understanding the acceptability, barriers and facilitators for chlamydia and gonorrhoea screening in technical colleges: qualitative process evaluation of the “Test n Treat” trial
Authors: Fleming Charlotte , Drennan Vari M. , Kerry-Barnard Sarah , Reid Fiona , Adams Elisabeth J. , Sadiq S. Tariq , Phillips Rachel , Majewska Wendy , Harding-Esch Emma M. , Cousins Emma C. , Yoward Freya , Oakeshott Pippa 
Published: August 2020

AbstractBackgroundLow uptake of sexually transmitted infection testing by sexually active young people is a worldwide public health problem. Screening in non-medical settings has been suggested as a method to improve uptake. The “Test n Treat” feasibility trial offered free, on-site rapid chlamydia/gonorrhoea tests with same day treatment for chlamydia (and gonorrhoea treatment at a local clinic,) to sexually active students (median age 17 years) at six technical colleges in London. Despite high rates of chlamydia (6% prevalence), uptake of testing was low (< 15%). In a qualitative study we explored the acceptability, including barriers and facilitators to uptake, of on-site chlamydia screening.MethodsIn 2016–17 we conducted a qualitative study in the interpretative tradition using face to face or telephone semi-structured interviews with students (n = 26), teaching staff (n = 3) and field researchers (n = 4). Interviews were digitally recorded, transcribed and thematically analysed.ResultsFrom the student perspective, feelings of embarrassment and the potential for stigma were deterrents to sexually transmitted infection testing. While the non-medical setting was viewed as mitigating against stigma, for some students volunteering to be screened exposed them to detrimental judgements by their peers. A small financial incentive to be screened was regarded as legitimising volunteering in a non-discrediting way. Staff and researchers confirmed these views. The very low level of knowledge about sexually transmitted infections influenced students to not view themselves as candidates for testing. There were also suggestions that some teenagers considered themselves invulnerable to sexually transmitted infections despite engaging in risky sexual behaviours. Students and researchers reported the strong influence peers had on uptake, or not, of sexually transmitted infection testing.ConclusionsThis study offers new insights into the acceptability of college-based sexually transmitted infection screening to young, multi-ethnic students. Future studies in similar high risk, hard to reach groups should consider linking testing with education about sexually transmitted infections, offering non stigmatising incentives and engaging peer influencers.
Work-related moderators of the relationship between organizational change and sickness absence: a longitudinal multilevel study
Authors: Grønstad Anniken , Kjekshus Lars Erik , Tjerbo Trond , Bernstrøm Vilde Hoff 
Published: August 2020

Abstract
Background
A sizeable body of research has demonstrated a relationship between organizational change and increased sickness absence. However, fewer studies have investigated what factors might mitigate this relationship. The aim of this study was to examine if and how the relationship between unit-level downsizing and sickness absence is moderated by three salient work factors: temporary contracts at the individual-level, and control and organizational commitment at the work-unit level.

Methods
We investigated the association between unit-level downsizing, each moderator and both short- and long-term sickness absence in a large Norwegian hospital (n = 21,085) from 2011 to 2016. Data pertaining to unit-level downsizing and employee sickness absence were retrieved from objective hospital registers, and moderator variables were drawn from hospital registers (temporary contracts) and the annual work environment survey (control and organizational commitment). We conducted a longitudinal multilevel random effects regression analysis to estimate the odds of entering short- (< = 8 days) and long-term (> = 9 days) sickness absence for each individual employee.

Results
The results showed a decreased risk of short-term sickness absence in the quarter before and an increased risk of short-term sickness absence in the quarter after unit-level downsizing. Temporary contracts and organizational commitment significantly moderated the relationship between unit-level downsizing in the next quarter and short-term sickness absence, demonstrating a steeper decline in short-term sickness absence for employees on temporary contracts and employees in high-commitment units. Additionally, control and organizational commitment moderated the relationship between unit-level downsizing and long-term sickness absence. Whereas employees in high-control work-units had a greater increase in long-term sickness absence in the change quarter, employees in low-commitment work-units had a higher risk of long-term sickness absence in the quarter after unit-level downsizing.

Conclusions
The results from this study suggest that the relationship between unit-level downsizing and sickness absence varies according to the stage of change, and that work-related factors moderate this relationship, albeit in different directions. The identification of specific work-factors that moderate the adverse effects of change represents a hands-on foundation for managers and policy-makers to pursue healthy organizational change.
The effect of the comorbidity burden on vitamin D levels in geriatric hip fracture
Authors: Moo Ing How , Kam Carmen Jia Wen , Cher Eric Wei Liang , Peh Bryan Ce Jie , Lo Chung Ean , Chua David Thai Chong , Lo Ngai Nung , Howe Tet Sen , Koh Joyce Suang Bee 
Published: August 2020

Abstract
Background
Elderly patients with hip fractures often have multiple medical comorbidities, and vitamin D deficiency is common in this population. Accumulating evidence links low vitamin D levels to various comorbidities. However, very little is known about the collective impact of comorbidities on vitamin D levels. The Charlson Comorbidity Index (CCI) is a validated comorbidity burden index. We hypothesized that a high CCI score is associated with vitamin D deficiency in elderly patients with hip fracture.

Methods
A retrospective cohort study was conducted among all hospitalized elderly patients aged > 60 years admitted for low-energy hip fracture in a single tertiary hospital from 2013 to 2015. Data regarding patient demographics, fracture type, serum 25-hydroxyvitamin D3 levels and age-adjusted CCI score were collected and analysed.

Results
Of the 796 patients included in the study, 70.6% (n = 562) of the patients were women and the mean age was 77.7 ± 8.0 years. The mean vitamin D level was 20.4 ± 7.4 ng/mL, and 91.7% ofhospitalized elderly patients with hip fracture had inadequate vitamin D level. There was no correlation between the individual serum vitamin D level with respect to age-adjusted CCI (Pearson correlation coefficient = 0.01; p = 0.87). After stratifying the CCI scores into low and high comorbidity burden groups (i.e., with scores 1–2 and ≥ 3), there was no relationship between the 2 subgroups for age-adjusted CCI and vitamin D levels (p = 0.497). Furthermore, there was also no association among age, gender, fracture type, and smoking status with the mean 25(OH)D level (p > 0.05).

Conclusion
Low vitamin D levels were highly prevalent in our hip fracture cohort. There was no relationship between the CCI score and vitamin D levels in the geriatric hip population. The comorbidity burden in geriatric patients with hip fractures did not seem to be a significant factor for vitamin D levels.
Liver transplantation and COVID-19: a case report and cross comparison between two identical twins with COVID-19
Authors: Nikoupour Hamed , Arasteh Peyman , Gholami Siavash , Nikeghbalian Saman 
Published: August 2020

Abstract
Background
To this date little information exists on the effects, clinical course and outcome of the COVID-19 among patients undergoing transplantation.

Case presentation
A 35 year old male referred with loss of sense of smell and taste after having close contact with his brother who was diagnosed with COVID-19 five days prior to his symptoms. The patient had undergone liver transplantation 3 years prior to his referral due to primary sclerosing cholangitis in association with ulcerative colitis and was using immunosuppressive medications. The patient referred to a local physician with mild symptoms of fatigue, cough, myalgia, dizziness, and nausea/vomiting with a fear of contracting the disease. Except for a CRP of 32 his other blood tests were normal. After 3 days of hospital admission the patient was discharged with a good condition. His brother had developed fever, chills, headache, mild dyspnea and an objective loss of sense of smell and taste and was sent home and advised to self-quarantine. Both patients had CT scans in favor of COVID-19.

Conclusion
Our patient who had liver transplantation and COVID-19 did not present more severe symptoms compared to his counterpart without liver transplantation and did not need to be hospitalized or be given antiviral drugs for COVID-19.
Breast self-examination and associated factors among women in Wolaita Sodo, Ethiopia: a community-based cross-sectional study
Authors: Lera Temesgen , Beyene Aman , Bekele Befekadu , Abreha Solomon 
Published: August 2020

Abstract
Background
The early detection of breast cancer plays an important role in decreasing morbidity and mortality of breast cancer. Breast self-examination (BSE) is one screening method used for the early detection of breast cancer. BSE involves the woman looking at and feeling each breast for possible lumps, distortions, or swellings. BSE is a simple exercise that can potentially save women’s lives, but BSE receives relatively little attention and no study has yet addressed BSE at the community level. Here we assessed BSE and associated factors among women aged 20–65 years in Wolaita Sodo city, Ethiopia.

Methods
This was a community-based, cross-sectional study. Systematic random sampling was used to select 626 women aged 20–65 years old. Data were collected using a pre-tested and structured questionnaire. Data were recorded using EpiData version 3.5.1 and exported to SPSS version 21 for cleaning and statistical analysis. Bivariable analysis was performed, and variables with a p-value < 0.25 were used in multiple logistic regression analysis. Multiple logistic regression was employed, and variables with p-values < 0.05 were considered statically significant.

Results
A total of 629 women aged between 20 and 65 years were included in the study. Over half (60.9%) of participants were aged between 20 and 29 years, and 8.2% were < 50 years old. Women who mentioned BSE as a method for the early detection of breast problems were 6.36-times (95% CI: 3.72, 10.71) more likely to perform BSE than those who reported that they did not know of any method. Those who had breast fed for 13–24 months were 2.43 times (95% CI: 1.28, 4.59) more likely to examine their breasts than those who breast fed for different durations or used other methods. Employed study participants were 3.13-times (95% CI: 1.14, 8.58) more likely to practice BSE than those who were not employed. Likewise, students were 3.73-times (95% CI: 1.19, 11.73) more likely to perform BSE.

Conclusions
In our sample, women’s practice of BSE was relatively low. Knowledge of BSE, breastfeeding up to 24 months, being employed, and being a student were factors affecting performing BSE. Educating girls and increasing awareness, including through electronic media, are important to encourage BSE and improve breast cancer outcomes.
Learning to prescribe and instruct exercise in physiotherapy education through authentic continuous assessment and rubrics
Authors: Chong Doris Yin Kei , Tam Barbara , Yau Suk Yu , Wong Arnold Yu Lok 
Published: August 2020

Abstract
Background
Authentic assessment and effective feedback are among various strategies that promote learning in the assessment process. These strategies are commonly used during clinical placements. However, they are rarely implemented in the didactic portion of physiotherapy education despite the benefits this type of assessment may bring to achieving students’ learning and outcome.

Methods
This mixed method study investigated how an authentic continuous assessment coupled with rubrics facilitated physiotherapy students’ learning process in a real-life complex skill of exercise prescription and instruction. The study also explored the relationship between different activities in the Learning Management System (LMS) and learning outcomes. Qualitative data was collected using a focus group and an analysis of discussion forum posts. Quantitative data included various information from a questionnaire, the LMS and assessment score.

Results
Thematic analyses from the focus group and discussion forum posts suggest that students used a cyclical self-regulated learning process as a result of authentic task design and rubrics for feedback facilitation. Interestingly, the discussion forum access was found to be moderately and significantly correlated with assessment score by Spearman’s rank correlation (ρ = 0.59, p < 0.01), while the students did not find the discussion forum useful.

Conclusions
Overall results suggest the promotion of self-regulated learning in this authentic continuous assessment. The roles and goals of each authentic task within the assessment should be made explicit in order to raise cognitive awareness of benefits.
Profile of gamma-delta (γδ) T lymphocytes in the peripheral blood of crossbreed dogs during stages of life and implication in aging
Authors: Marchetti Cristina , Borghetti Paolo , Cacchioli Antonio , Ferrari Luca , Armando Federico , Corradi Attilio , Cantoni Anna Maria 
Published: August 2020

Abstract
Background
Data on gamma-delta (γδ) T lymphocytes in the peripheral blood of dogs are scant, related only to healthy pure breed dogs and limited to a restricted age range. The aim of the study was to investigate the modulation of the γδ T lymphocyte (TCRγδ+) subpopulation in peripheral blood of crossbreed healthy dogs according to five identified stages of life: Puppy, Junior, Adult, Mature, Senior and to determine its implication in aging.
A rigorous method of recruitment was used to minimize the influence of internal or external pressure on the immune response. Twenty-three intact female and twenty-four intact male dogs were enrolled. Blood samples were collected and immunophenotyping of peripheral blood T lymphocytes and γδ T cell subpopulations was performed.

Results
The percentage of γδ T cells in peripheral blood lymphocytes was comparable with the value of 2.5% published by Faldyna and co-workers (2001), despite the percentage reported was investigated in less arranged age range groups and coming from four different dog pure breeds, whereas our data were recorded on wider age range groups and coming from crossbreed dogs. Therefore, the γδ T cell percentage (2.5%) is consistent and points out that such value is breed-independent. Statistical analysis highlighted differences in both percentage and absolute γδ T cells according to the stage of life. γδ T cells decreased significantly in the peripheral blood of elder dogs (Senior group) in comparison with previous stages of life (Puppy, Junior, and Adult groups). Differences in γδ T cells are significant and they are reported, for the first time, related to dog aging.

Conclusions
The study confirms dogs to be among the animals with a low TCRγδ+ cell profile. A decrease of the TCRγδ+ subpopulation percentage was observed in elder dogs. TCRγδ+ cells of group S were different from those of groups P, J, and A. The differences are reported for the first time in dog aging. Identifying the stage of life when the decrease of γδ T lymphocytes starts can be useful for providing a rationale for drafting a wellness plan trial to support thymus immune functions and mitigate its functional exhaustion.
Functional glutamate transporters are expressed in the carotid chemoreceptor
Authors: Li Chaohong , Huang Lu , Jia Xianglei , Zhao Baosheng , Chen Lingyun , Liu Yuzhen 
Published: August 2020

AbstractBackgroundThe carotid body (CB) plays a critical role in cyclic intermittent hypoxia (CIH)-induced chemosensitivity; however, the underlying mechanism remains uncertain. We have demonstrated the presence of multiple inotropic glutamate receptors (iGluRs) in CB, and that CIH exposure alters the level of some iGluRs in CB. This result implicates glutamatergic signaling in the CB response to hypoxia. The glutamatergic neurotransmission is not only dependent on glutamate and glutamate receptors, but is also dependent on glutamate transporters, including vesicular glutamate transporters (VGluTs) and excitatory amino acid transporters (EAATs). Here, we have further assessed the expression and distribution of VGluTs and EAATs in human and rat CB and the effect of CIH exposure on glutamate transporters expression.MethodsThe mRNA of VGluTs and EAATs in the human CB were detected by RT-PCR. The protein expression of VGluTs and EAATs in the human and rat CB were detected by Western blot. The distribution of VGluT3, EAAT2 and EAAT3 were observed by immunohistochemistry staining and immunofluorescence staining. Male Sprague-Dawley (SD) rats were exposed to CIH (FIO210–21%, 3 min/3 min for 8 h per day) for 2 weeks. The unpaired Student'st-test was performed.ResultsHere, we report on the presence of mRNAs for VGluT1–3 and EAAT1–3 in human CB, which is consistent with our previous results in rat CB. The proteins of VGluT1 and 3, EAAT2 and 3, but not VGluT2 and EAAT1, were detected with diverse levels in human and rat CB. Immunostaining showed that VGluT3, the major type of VGluTs in CB, was co-localized with tyrosine hydroxylase (TH) in type I cells. EAAT2 and EAAT3 were distributed not only in type I cells, but also in glial fibrillary acidic protein (GFAP) positive type II cells. Moreover, we found that exposure of SD rats to CIH enhanced the protein level of EAAT3 as well as TH, but attenuated the levels of VGluT3 and EAAT2 in CB.ConclusionsOur study suggests that glutamate transporters are expressed in the CB, and that glutamate transporters may contribute to glutamatergic signaling-dependent carotid chemoreflex to CIH.