bluuebunny/crossref_metadata_2025_split huggingface dataset:
A neglected source of household air pollution: a preliminary, mixed methods study of purposely produced household smoke in Wollo, Ethiopia
Authors: Wilkinson R , Afework T , Mortimore A , Phillips D I W , Willcox M , Levene D , Kaba M 
Published: October 2020

Abstract

Background
Ill health associated with household air pollution (HAP) is increasingly recognized as a public health problem in sub-Saharan Africa. To date, attempts to reduce HAP have focussed on smoke from cooking fires and have ignored traditional cultural practices which generate purposely produced smoke (PPS). This study aimed to investigate PPS prevalence, reasons for use and safety perceptions.

Methods
The study was conducted in Wollo, Ethiopia, and used a mixed methods approach of quantitative surveys (analysed descriptively) and qualitative interviews with householders and healthcare workers (analysed thematically).

Results
PPS use was reported by 99% of survey respondents and it was considered a fundamental part of life. Although reasons for use included housekeeping, culture/religion and well-being, coffee ceremony was most commonly cited (44% of respondents). Both householders and healthcare workers appeared to assume PPS is safe, except for people with certain underlying conditions. Healthcare workers felt the lack of evidence of harm from PPS meant there was no justification for intervention.

Conclusion
This study, the first in-depth study of PPS, has shown its use to be widespread, with many perceived benefits and thus a very important part of local culture in this sample Ethiopian community. Consequently, any public health interventions aimed at reducing HAP in this setting need to consider PPS.
Baseline disease activity influences subsequent achievement of patient acceptable symptom state in Sjögren’s syndrome
Authors: Park Eun Hye , Ha You-Jung , Kang Eun Ha , Song Yeong Wook , Scofield R Hal , Lee Yun Jong 
Published: October 2020

Abstract

Objectives
To investigate longitudinal changes of the EULAR SS Patient-Reported Index (ESSPRI) and EULAR SS Disease Activity Index (ESSDAI), and identify factors associated with patient acceptable symptom state (PASS) in patients with primary SS (pSS).

Methods
We assessed ESSPRI, ESSDAI, clinical ESSDAI (ClinESSDAI), EULAR Sicca Score, EuroQoL 5-dimension (EQ-5D), Fatigue Severity Score, Beck Depression Inventory, and patient global assessment (PGA) for pSS, and visual analogue scale (VAS) scores for glandular and extra-glandular symptoms at baseline and follow-up. The responses to the currently available standards of care were evaluated by the PASS, the minimal clinically important improvement (MCII) of ESSPRI and ESSDAI, and a modified SS Responder Index-30 (mSSRI-30) response.

Results
Among 115 patients enrolled, 102 (88.7%) completed a median 3-year follow-up. The ESSPRI, ClinESSDAI and EQ-5D levels remained stable, although the PGA and ESSDAI significantly improved (both P &lt;0.05). Of the 102 patients, 52 (51.0%) patients achieved the PASS at the follow-up and tended to attain the ESSPRI-MCII and mSSRI-30 (both P &lt; 0.001) more frequently than the non-PASS group. Multivariate analysis revealed that the PASS was significantly associated with baseline ESSPRI negatively [odds ratio (OR) 0.609] and ESSDAI positively (OR 1.224). When categorized using baseline ESSPRI and ESSDAI, a subgroup of low ESSPRI and high ESSDAI reached a PASS achievement rate of 79.3%.

Conclusion
Although longitudinal changes in ESSPRI and ClinESSDAI are stable in pSS, baseline ESSPRI and ESSDAI could provide prognostic information on the subsequent achievement of PASS, using currently available treatments. A categorization model using ESSPRI and ESSDAI may have clinical implications.
Does craniofacial morphology relate to sleep apnea severity reduction following weight loss intervention? A patient-level meta-analysis
Authors: Sutherland Kate , Chapman Julia L , Cayanan Elizabeth A , Lowth Aimee B , Hoyos Camilla M , Wong Keith K H , Yee Brendon J , Grunstein Ronald R , Cistulli Peter A , Marshall Nathaniel S 
Published: October 2020

Abstract

Study Objectives
Obesity is a common and reversible risk factor for obstructive sleep apnea (OSA). However, there is substantial unexplained variability in the amount of OSA improvement for any given amount of weight loss. Facial photography is a simple, inexpensive, and radiation-free method for craniofacial assessment. Our aims were (1) to determine whether facial measurements can explain OSA changes, beyond weight loss magnitude and (2) whether facial morphology relates to how effective weight loss will be for OSA improvement.

Methods
We combined data from three weight loss intervention trials in which participants had standardized pre-intervention facial photography (N = 91; 70.3% male, mean ± SD weight loss 10.4 ± 9.6% with 20.5 ± 51.2% apnea–hypopnea index [AHI] reduction). Three skeletal-type craniofacial measurements (mandibular length, lower face height, and maxilla-mandible relationship angle) were assessed for relationship to AHI change following weight loss intervention.

Results
Weight and AHI changes were moderately correlated (rho = 0.3, p = 0.002). In linear regression, an increased maxilla-mandible relationship angle related to AHI improvement (β [95% CI] −1.7 [−2.9, −0.5], p = 0.004). Maxilla-mandible relationship angle explained 10% in the variance in AHI over the amount predicted by weight loss amount (20%). The relationship between weight change and AHI was unaffected by the maxilla–mandible relationship angle (interaction term p &gt; 0.05).

Conclusions
Regardless of facial morphology, weight loss is similarly moderately predictive of OSA improvement. Increased maxilla-mandible relationship angle, suggestive of retrognathia, was weakly predictive of OSA response to weight loss. Although this is unlikely to be clinically useful, exploration in other ethnic groups may be warranted.
Replication Redux: The Reproducibility Crisis and the Case of Deworming
Authors: Ozier Owen 
Published: October 2020

Abstract
In 2004, a landmark study showed that an inexpensive medication to treat parasitic worms could improve health and school attendance for millions of children in many developing countries. Eleven years later, a headline in The Guardian reported that this treatment, deworming, had been “debunked.” The pronouncement followed an effort to replicate and re-analyze the original study, as well as an update to a systematic review of the effects of deworming. This story made waves amidst discussion of a reproducibility crisis in some of the social sciences. In this paper, I explore what it means to “replicate” and “reanalyze” a study, both in general and in the specific case of deworming. I review the broader replication efforts in economics, then examine the key findings of the original deworming paper in light of the “replication,” “reanalysis,” and “systematic review.” I also discuss the nature of the link between this single paper's findings, other papers’ findings, and any policy recommendations about deworming. Through this example, I provide a perspective on the ways replication and reanalysis work, the strengths and weaknesses of systematic reviews, and whether there is, in fact, a reproducibility crisis in economics.
Postdischarge Outcomes of Adolescents Attending a Long-term Addiction Treatment Program
Authors: Arria Amelia M. , Bugbee Brittany A. , Mader Joel , Smith Jacqueline M. , Winters Ken C. 
Published: October 2020

Objectives:
The purpose of this study was to: (1) describe the alcohol and other drug use patterns among adolescents discharged from a unique long-term semiresidential treatment program in Canada; (2) compare graduates and nongraduates on alcohol and other drug use, and 12-step program attendance; and (3) evaluate the relationship between psychosocial outcomes and continuous abstinence during the 2 years following discharge from the program (ie, obtaining education, becoming employed, maintaining a steady relationship with a significant other, and less involvement in deviant behaviors).

Materials and Methods:
Fifty individuals (41 treatment graduates and 9 treatment nongraduates) were interviewed by telephone after discharge. The time interval between discharge from treatment and study interview ranged from 2 to 9 years, with a median of 5 years. Additional data for 48 participants were obtained from administrative records at the treatment program.

Results:
Among the overall sample, 50.0% were abstinent for the first 2 years postdischarge, and maintaining abstinence for 2 years was more prevalent among program graduates than nongraduates (58.5% vs. 11.1%). Nearly all relapses involved alcohol or cannabis. With the exception of being in a serious relationship, continuous abstinence was unrelated to other psychosocial variables.

Conclusions:
This specialized, long-term residential program yielded high continuous abstinence rates for program graduates, but intensive support during and following treatment discharge for these young adults is warranted to improve educational attainment and employment prospects, and decrease deviant behaviors following discharge. Additional research is needed to more fully understand the long-term outcomes of adolescents attending community-based drug treatment programs.
Intrastromal Descemet Membrane Transplantation as a Potential Alternative to Bowman Layer Inlays in Eyes With Advanced Keratoconus
Authors: Oganesyan Oganes , Getadaryan Vostan , Oganesyan Carolina , van Dijk Korine , Melles Gerrit 
Published: October 2020

Abstract:
Herein, we report the outcomes of intrastromal Descemet membrane (DM) transplantation in corneas with advanced keratoconus. Three eyes (three patients) showed advanced keratoconus. No eye underwent prior UV-cross-linking or any other ocular surgery. In all eyes, A donor DM was implanted into a mid-stromal pocket and clinical outcomes were evaluated up to 24 months after surgery. All procedures were uneventful. Up to 24 months postoperatively, the DM graft was well-positioned and barely visible within the recipient stroma; all corneas were clear. No eye showed signs of keratoconus progression throughout the follow-up. No changes were observed in uncorrected and best contact lens corrected visual acuity, central endothelial cell density, corneal thinnest point pachymetry, and maximum keratometry values. No early or late postoperative complications were observed. Intrastromal DM transplantation may be an alternative to intrastromal Bowman layer transplantation in advanced keratoconus, to postpone deep anterior lamellar or penetrating keratoplasty.
A digital photograph study evaluating facial taperness and square face perception of Taiwanese females
Authors: Wu Tzu-Ying , Chou Chein-Yu , Liang Yu-Ming , Chang Kuo-Wei , Wu Cheng-Hsien 
Published: October 2020

Background:
This study assessed the perception of facial taperness in Taiwanese females among people with dental knowledge and laypersons. Additionally, this study also specified the criteria by which “square face” was defined regarding Taiwanese females’ facial taperness.

Methods:
A series of digitally modified photos with different levels of facial taperness (Gonion to Gonion/Zygoma point to Zygoma point—Go-Go/Zy-Zy ratio ranges from 65% to 90%) were randomly arranged and presented to the raters. Visual analog scale (VAS) lines were used for scoring the photos on a scale of 0–100. The true or false question about “defining square face” was incorporated in the same questionnaire. The reliability of the true/false square face question and the esthetic evaluation by VAS were assayed. The receiver operating characteristic curve was used to define the cutoff point on “square face.” The effects on the raters’ genders, orthodontic treatment experience, and their professional background on the perception of a square face were assayed.

Results:
The overall reliability of the raters was within the acceptable range. The VAS score evaluation revealed that the average expectation for best facial taperness was 75%, whereas the facial taperness of over 83% was considered as the square face. The facial taperness reaching to 90% was regarded as the most unattractive. Gender, therapy, and professional experience have no impact on the standard of square facial form evaluation.

Conclusion:
A face with a taperness greater than 83% was evaluated as a square face, and a face with a taperness around 75% was considered as the most attractive.
The current outcomes and future challenges in pediatric vascularized composite allotransplantation
Authors: Azoury Saïd C. , Lin Ines , Amaral Sandra , Chang Benjamin , Levin L. Scott 
Published: October 2020

Purpose of reviewWe review the outcomes and future challenges associated with pediatric vascularized composite allotransplantation, including follow-up data from our bilateral pediatric hand–forearm transplantation.Recent findingsIn 2015, the first heterologous pediatric upper extremity hand–forearm transplant was performed at the Children's Hospital of Philadelphia, and in 2019, the first pediatric neck reconstructive transplantation was performed in Poland. The 5-year follow-up of the pediatric upper extremity recipient demonstrates similar growth rates bilaterally, an increase in bone age parallel to chronologic age, and perhaps similar overall growth to nontransplant norms. The pediatric upper extremity recipient continues to make gains in functional independence. He excels academically and participates in various extracurricular activities. Future challenges unique to the pediatric population include ethical issues of informed consent, psychosocial implications, limited donor pool, posttransplant compliance issues, and greater life expectancy and therefore time to inherit the many complications of immunosuppression.SummaryCurrently, we recommend pediatric vascularized composite allotransplantation (VCA) for bilateral upper extremity amputees, preferably on immunosuppression already, and those patients who would have the most potential gain not available through standard reconstructive techniques while being able to comply with postoperative immunosuppression protocols, surveillance, rehabilitation, and follow-up.
Comparison of Perceptions of Spiritual Care Among Patients With Life-Threatening Cancer, Primary Family Caregivers, and Hospice/Palliative Care Nurses in South Korea
Authors: Kang Kyung-Ah , Kim Shin-Jeong 
Published: October 2020

This study aimed to compare perceptions of spiritual care among patients with life-threatening cancer, their primary family caregivers, and hospice/palliative care nurses.
Data were collected using both structured and unstructured approaches. Structured questionnaire data were examined using statistical analysis methods, and unstructured data were examined using content analysis to compare the 3 participant groups. The questionnaire revealed that among all 3 groups, spiritual care was commonly perceived to relate to “having the opportunity for internal reflection,” “finding meaning,” “encouraging hope,” and “listening to and being with patients.” Content analysis of the unstructured data revealed 5 themes: “Caring with sincerity,” “Strengthening spiritual resources,” “Alleviating physical pain and discomfort” (among patients and primary family caregivers only), “Improving spiritual care service,” and “Multifaceted cooperation” (among hospice/palliative care nurses only). Our findings suggest that for patients with life-threatening illnesses such as terminal cancer, spiritual care should not be limited to religious practice but should also satisfy inner existential needs, for example, by encouraging hope, providing empathy, and helping patients find meaning in their circumstances.
Correlation Between Corneal Nerve Density and Symptoms of Small Fiber Neuropathy in Patients With Fibromyalgia: The Confounding Role of Severe Anxiety or Depression
Authors: Ramírez Manuel , Guerra-Juárez Arturo , Miyake Daniel-Yoshiro , Sebastian-Arellano Christian , Estrada-Mata Aranza-Guadalupe , González-Moyotl Nadia-Janet , Rodríguez-Aguayo Allan-Miguel , Martínez-Lavin Manuel , Martínez-Martínez Laura-Aline 
Published: October 2020

Objective
A consistent line of investigation proposes fibromyalgia as a dysautonomia-associated neuropathic pain syndrome. Comorbid anxiety or depression amplifies fibromyalgia symptoms. The recent recognition of small fiber neuropathy in fibromyalgia patients supports the neuropathic nature of the illness. Corneal confocal microscopy accurately identifies small nerve fiber pathology. The newly developed Small-Fiber Symptom Survey captures the spectrum of small fiber neuropathy symptoms. We aimed to correlate corneal nerve density with different fibromyalgia disease severity questionnaires including the Small-Fiber Symptom Survey. We defined the possible confounding role of comorbid anxiety or depression severity in the clinical-pathological association.

Methods
This is a case series of 28 women with fibromyalgia. A single ophthalmologist quantified corneal subbasal plexus nerve density. Corneal innervation was correlated (Spearman ρ) with the following clinical questionnaires scores: Small-Fiber Symptom Survey, Revised Fibromyalgia Impact Questionnaire, and COMPASS-31 (Composite Autonomic Symptom Survey 31-Item Score). Validated inquiry forms assessed the comorbid anxiety and/or depression severity.

Results
There were no clinical-pathological correlations in the group as a whole. In the subgroup of fibromyalgia women without severe anxiety or depression (n = 13), there was a strong negative correlation between corneal nerve density with the Small-Fiber Symptom Survey score (ρ = −0.771, p = 0.002) and COMPASS-31 score (ρ = −0.648, p = 0.017). Patients with profound anxiety or depression (n = 15) had more intense symptoms but had not clinical-pathological correlations.

Conclusions
Small fiber neuropathy and dysautonomia symptoms correlate with corneal denervation in women with fibromyalgia without severe anxiety or depression. This clinical-pathological association reinforces fibromyalgia as a dysautonomia-related neuropathic pain syndrome. Severe anxiety or depression distorts fibromyalgia symptoms.

Practical point
Corneal confocal microscopy may become a useful procedure to study fibromyalgia patients.
Inertial confinement fusion: a defence context
Authors: Randewich Andrew , Lock Rob , Garbett Warren , Bethencourt-Smith Dominic 
Published: October 2020

Almost 30 years since the last UK nuclear test, it remains necessary regularly to underwrite the safety and effectiveness of the National Nuclear Deterrent. To do so has been possible to date because of the development of continually improving science and engineering tools running on ever more powerful high-performance computing platforms, underpinned by cutting-edge experimental facilities. While some of these facilities, such as the Orion laser, are based in the UK, others are accessed by international collaboration. This is most notably with the USA via capabilities such as the National Ignition Facility, but also with France where a joint hydrodynamics facility is nearing completion following establishment of a Treaty in 2010. Despite the remarkable capability of the science and engineering tools, there is an increasing requirement for experiments as materials age and systems inevitably evolve further from what was specifically trialled at underground nuclear tests (UGTs). The data from UGTs will remain the best possible representation of the extreme conditions generated in a nuclear explosion, but it is essential to supplement these data by realizing new capabilities that will bring us closer to achieving laboratory simulations of these conditions. For high-energy-density physics, the most promising technique for generating temperatures and densities of interest is inertial confinement fusion (ICF). Continued research in ICF by the UK will support the certification of the deterrent for decades to come; hence the UK works closely with the international community to develop ICF science. UK Ministry of Defence © Crown Owned Copyright 2020/AWE.
This article is part of a discussion meeting issue ‘Prospects for high gain inertial fusion energy (part 1)'.
The importance of the laser pulse-ablator interaction dynamics prior to the ablation plasma phase in inertial confinement fusion studies
Authors: Kaselouris E. , Fitilis I. , Skoulakis A. , Orphanos Y. , Koundourakis G. , Clark E. L. , Chatzakis J. , Bakarezos Μ. , Papadogiannis N. A. , Dimitriou V. , Tatarakis M. 
Published: October 2020

This work presents studies which demonstrate the importance of the very early heating dynamics of the ablator long before the ablation plasma phase begins in laser driven inertial confinement fusion (ICF) studies. For the direct-drive fusion concept using lasers, the development of perturbations during the thermo-elasto-plastic (TEP) and melting phases of the interaction of the laser pulse with the ablator's surface may act as seeding to the subsequent growth of hydro-dynamic instabilities apparent during the acceleration phase of the interaction such as for instance the Rayleigh–Taylor and the Richtmyer–Meshkov, which strongly affect the implosion dynamics of the compression phase. The multiphysics-multiphase finite-element method (FEM) simulation results are experimentally validated by advanced three-dimensional whole-field dynamic imaging of the surface of the ablator allowing for a transverse to the surface spatial resolution of only approximately 1 nm. The study shows that the TEP and melting phases of the interaction are of crucial importance since transverse perturbations of the ablator's surface can reach tens of nanometres in amplitude within the TEP and melting phases. Such perturbations are of Rayleigh type and are transferred from the ablator to the substrate from the very first moments of the interaction.This article is part of a discussion meeting issue ‘Prospects for high gain inertial fusion energy (part 1)’.
Reflectivity and spectral shift from laser plasmas generated by high-contrast, high-intensity KrF laser pulses
Authors: Kovács Zs. , Bali K. , Gilicze B. , Szatmári S. , Földes I. B. 
Published: October 2020

The energy and spectrum of the reflected 248 nm radiation are studied from solid targets up to 1.15 × 10
18
W cm
−2
intensity. The experiments used the 700 fs directly amplified pulses of the KrF system which was cleaned from prepulses with the new Fourier-filtering method providing 12 orders of magnitude temporal contrast. Increasing the intensity from 10
15
W cm
−2
results in increasing absorption up to more than 90% above 10
18
W cm
−2
. This is accompanied by increasing x-ray conversion exhibiting a less steep power law dependence for low-Z matter than for gold. Strong blue shift of the reflected radiation from the backward propagating plasma was observed. It is shown that in the case of KrF laser pulses of highest contrast, vacuum heating can be one of the dominant absorption mechanisms.

This article is part of a discussion meeting issue ‘Prospects for high gain inertial fusion energy (part 1)’.