bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prospective cohort study of exposure to tobacco imagery in popular films and smoking uptake among children in southern India
Authors: Kulkarni Muralidhar M. , Kamath Asha , Kamath Veena G. , Lewis Sarah , Bogdanovica Ilze , Bains Manpreet , Cranwell Jo , Fogarty Andrew , Arora Monika , Nazar Gaurang P. , Ballal Kirthinath , Naik Ashwath K. , Bhagawath Rohith , Britton John 
Published: August 2021

Background
Exposure to tobacco imagery in films causes young people to start smoking. Popular Indian films contain high levels of tobacco imagery, but those that do are required by law to display onscreen health warnings when smoking imagery occurs and to include other health promotion messaging before and during the film. We report a prospective cohort study of incident smoking in relation to exposure to film tobacco imagery and anti-tobacco messaging in a cohort of children in southern India.

Methods
We carried out a one-year longitudinal follow up questionnaire survey in 2018 of a cohort of 39,282 students in grades 6, 7 and 8 (aged between 10 and 15 years) in schools in the Udupi district of Karnataka State in India who participated in a 2017 cross-sectional study of exposure to smoking in films and ever smoking status.

Results
We obtained usable linked data in 2018 from 33,725 of the 39,282 (86%) participants with data from 2017. Incident smoking was reported by 382 (1.1%) participants. After adjusting for age, sex and common confounders significantly associated with incident smoking there was no significant independent effect of exposure to film smoking, either as a binary (Odds Ratio 1.6, 95% Confidence Interval (CI) 0.5 to 4.9) or as a graded variable, on smoking uptake. An exploratory analysis indicated that the presence of on-screen health warnings that complied fully with Indian law was associated with a significantly lower odds of smoking uptake (Odds Ratio 0.8 (0.6 to 1.0, p = 0.031) relative to the same exposure sustained in absence of compliant warnings.

Conclusion
Exposure to tobacco imagery in Indian films was not associated with a significantly increased risk of incident smoking in South Indian children. While it is possible that this finding is a false negative, it is also possible that the effect of film exposure has been attenuated by the presence of on-screen health warnings or other Indian tobacco-free film rules. Our findings therefore support the wider implementation of similar tobacco-free film measures in other countries.
Urinary minerals excretion among primary schoolchildren in Dubai—United Arab Emirates
Authors: Al Ghali Rola , El-Mallah Carla , Obeid Omar , El-Saleh Ola , Smail Linda , Haroun Dalia 
Published: August 2021

IntroductionUrinary excretion of calcium (Ca), magnesium (Mg), phosphorus (P), iodine and fluoride is used to assess their statuses and/or the existence of metabolic abnormalities. In the United Arab Emirates (UAE), the urinary concentration of these minerals among children have not been documented.Materials and methodsA cross-sectional study, including 593 subjects (232 boys and 361 girls), was conducted among healthy 6 to 11-year-old Emirati children living in Dubai. Non-fasting morning urine samples and anthropometrical measurements were collected and analyzed. Results were expressed as per mg of creatinine (Cr).ResultsOn average, estimated Cr excretion was 17.88±3.12 mg/kg/d. Mean urinary Ca/Cr, Mg/Cr and P/Cr excretions were 0.08±0.07 mg/mg, 0.09±0.04 mg/mg, and 0.57±0.26 mg/mg respectively. Urinary excretion of Ca, Mg and P were found to decrease as age increased. Urinary excretion and predicted intake of fluoride were lower than 0.05 mg/kg body weight per day. Surprisingly, more than 50% of the children were found to have urinary iodine excretion level above adequate.ConclusionThe Emirati schoolchildren had comparable levels of urinary Ca, Mg and P excretion to other countries. The 95% percentile allows the use of the current data as a reference value for the detection of mineral abnormalities. Fluoride excretion implies that Emirati children are at low risk of fluorosis. The level of urinary iodine excretion is slightly higher than recommended and requires close monitoring of the process of salt iodization to avoid the harmful impact of iodine overconsumption.
A 50 Hz magnetic field affects hemodynamics, ECG and vascular endothelial function in healthy adults: A pilot randomized controlled trial
Authors: Okano Hideyuki , Fujimura Akikatsu , Kondo Tsukasa , Laakso Ilkka , Ishiwatari Hiromi , Watanuki Keiichi 
Published: August 2021

Application of exposure to 50/60 Hz magnetic fields (MFs) has been conducted in the treatment of muscle pain and fatigue mainly in Japan. However, whether MFs could increase blood flow leading to muscle fatigue recovery has not been sufficiently tested. We investigated the acute effects of a 50 Hz sinusoidal MF at Bmax 180 mT on hemodynamics, electrocardiogram, and vascular endothelial function in healthy young men. Three types of regional exposures to a 50 Hz MF, i.e., forearm, upper arm, or neck exposure to MF were performed. Participants who received three types of real MF exposures had significantly increased ulnar arterial blood flow velocity compared to the sham exposures. Furthermore, after muscle loading exercise, MF exposure recovered hemoglobin oxygenation index values faster and higher than sham exposure from the loading condition. Moreover, participants who received real MF exposure in the neck region had significantly increased parasympathetic high-frequency activity relative to the sham exposure. The MF exposure in the upper arm region significantly increased the brachial artery flow-mediated dilation compared to the sham exposure. Computer simulations of induced in situ electric fields indicated that the order-of-magnitude estimates of the peak values were 100–500 mV/m, depending on the exposure conditions. This study provides the first evidence that a 50 Hz MF can activate parasympathetic activity and thereby lead to increase vasodilation and blood flow via a nitric oxide-dependent mechanism.
Trial registration: UMIN Clinical Trial Registry (CTR) UMIN000038834. The authors confirm that all ongoing and related trials for this drug/intervention are registered.
ELBW and ELGAN outcomes in developing nations–Systematic review and meta-analysis
Authors: Ramaswamy Viraraghavan Vadakkencherry , Abiramalatha Thangaraj , Bandyopadhyay Tapas , Shaik Nasreen Banu , Bandiya Prathik , Nanda Debasish , Pullattayil S. Abdul Kareem , Murki Srinivas , Roehr Charles Christoph 
Published: August 2021

Context
Morbidity and mortality amongst extremely low birth weight (ELBW) and extremely low gestational age neonates (ELGANs) in developing nations has not been well studied.

Objectives
Evaluate survival until discharge, short- and long-term morbidities of ELBW and ELGANs in LMICs.

Data sources
CENTRAL, EMBASE, MEDLINE and Web of Science.

Study selection
Prospective and retrospective observational studies were included.

Data extraction and synthesis
Four authors extracted data independently. Random-effects meta-analysis of proportions was used to synthesize data, modified QUIPS scale to evaluate quality of studies and GRADE approach to ascertain the certainty of evidence (CoE).

Results
192 studies enrolling 22,278 ELBW and 18,338 ELGANs were included. Survival was 34% (95% CI: 31% - 37%) (CoE–low) for ELBW and 39% (34% - 44%) (CoE—moderate) for ELGANs. For ELBW neonates, the survival for low-income (LI), lower middle-income (LMI) and upper middle income (UMI) countries was 18% (11% - 28%), 28% (21% - 35%) and 39% (36% - 42%), respectively. For ELGANs, it was 13% (8% - 20%) for LI, 28% (21% - 36%) for LMI and 48% (42% - 53%) for UMI countries. There was no difference in survival between two epochs: 2000–2009 and 2010–2020. Except for necrotising enterocolitis [ELBW and ELGANs—8% (7% - 10%)] and periventricular leukomalacia [ELBW—7% (4% - 11%); ELGANs—6% (5%-7%)], rates of all other morbidities were higher compared to developed nations. Rates of neurodevelopmental impairment was 17% (7% - 34%) in ELBW neonates and 29% (23% - 37%) in ELGANs.

Limitations
CoE was very low to low for all secondary outcomes.

Conclusions
Mortality and morbidity amongst ELBW and ELGANs is still a significant burden in LMICs. CoE was very low to low for all the secondary outcomes, emphasizing the need for high quality prospective cohort studies.

Trial registration
PROSPERO (CRD42020222873).
6-month mortality and readmissions of hospitalized COVID-19 patients: A nationwide cohort study of 8,679 patients in Germany
Authors: Günster Christian , Busse Reinhard , Spoden Melissa , Rombey Tanja , Schillinger Gerhard , Hoffmann Wolfgang , Weber-Carstens Steffen , Schuppert Andreas , Karagiannidis Christian 
Published: August 2021

Background
COVID-19 frequently necessitates in-patient treatment and in-patient mortality is high. Less is known about the long-term outcomes in terms of mortality and readmissions following in-patient treatment.

Aim
The aim of this paper is to provide a detailed account of hospitalized COVID-19 patients up to 180 days after their initial hospital admission.

Methods
An observational study with claims data from the German Local Health Care Funds of adult patients hospitalized in Germany between February 1 and April 30, 2020, with PCR-confirmed COVID-19 and a related principal diagnosis, for whom 6-month all-cause mortality and readmission rates for 180 days after admission or until death were available. A multivariable logistic regression model identified independent risk factors for 180-day all-cause mortality in this cohort.

Results
Of the 8,679 patients with a median age of 72 years, 2,161 (24.9%) died during the index hospitalization. The 30-day all-cause mortality rate was 23.9% (2,073/8,679), the 90-day rate was 27.9% (2,425/8,679), and the 180-day rate, 29.6% (2,566/8,679). The latter was 52.3% (1,472/2,817) for patients aged ≥80 years 23.6% (1,621/6,865) if not ventilated during index hospitalization, but 53.0% in case of those ventilated invasively (853/1,608). Risk factors for the 180-day all-cause mortality included coagulopathy, BMI ≥ 40, and age, while the female sex was a protective factor beyond a fewer prevalence of comorbidities. Of the 6,235 patients discharged alive, 1,668 were readmitted a total of 2,551 times within 180 days, resulting in an overall readmission rate of 26.8%.

Conclusions
The 180-day follow-up data of hospitalized COVID-19 patients in a nationwide cohort representing almost one-third of the German population show significant long-term, all-cause mortality and readmission rates, especially among patients with coagulopathy, whereas women have a profoundly better and long-lasting clinical outcome compared to men.
Prevalence of unculturable bacteria in the periapical abscess: A systematic review and meta-analysis
Authors: Altaie Alaa Muayad , Saddik Basema , Alsaegh Mohammed Amjed , Soliman Sameh S. M. , Hamoudi Rifat , Samaranayake Lakshman P. 
Published: August 2021

Objective
To assess the prevalence of unculturable bacteria in periapical abscess, radicular cyst, and periapical granuloma.

Methods
PubMed, Scopus, Science Direct, and Ovid databases were systematically searched from January 1990 to May 2020. All the included studies were cross-sectional design. The risk of bias was assessed using Joanna Briggs Institute check-list. Heterogeneity was described using meta-regression and mixed-effects model for lesion, country, and sequence technique moderators. Funnel plot and unweighted Egger’s regression test were used to estimate the publication bias. Microbiome data on diversity, abundance, and frequency of unculturable bacteria in the periapical lesions were reviewed, analysed, and the principal component analysis (PCA) was performed.

Results
A total of 13 studies out of 14,780, were selected for the final analysis. These studies focused on the prevalence of unculturable bacteria in periapical abscesses and related lesions. Approximately 13% (95% CI: 7–23%) of the cumulative number of bacteria derived from periapical abscesses was unculturable. Country moderator significantly (P = 0.05) affects the diversity summary proportion. While the pooled frequency of unculturable bacteria was 8%; 95% CI: 5, 14%, the estimate of the pooled abundance of unculturable bacteria was 5%; 95% CI: 2, 12% with a significant (P = 0.05) country moderator that affects the abundance summary proportion. Of the 62 unculturable bacteria, 35 were subjected to PCA and Peptostreptococcus sp. oral clone CK035 was the most abundant species in periapical abscesses. Hybridization techniques were found to be the most reliable molecular methods in detecting the abundance and frequency of unculturable bacteria.

Conclusion
The significant prevalence of unculturable bacteria in the periapical abscess, suggests that they are likely to play, a yet unknown, critical role in the pathogenesis and progression of the disease. Further research remains to be done to confirm their specific contributions in the virulence and disease progression.
Clinical relevance for circulating cold-inducible RNA-binding protein (CIRP) in patients with adult-onset Still’s disease
Authors: Fujita Yuya , Yago Toru , Asano Tomoyuki , Matsumoto Haruki , Matsuoka Naoki , Temmoku Jumpei , Sato Shuzo , Yashiro-Furuya Makiko , Suzuki Eiji , Watanabe Hiroshi , Kawakami Atsushi , Migita Kiyoshi 
Published: August 2021

Background
Adult-onset Still’s disease (AOSD) is a systemic autoinflammatory disease in which danger-associated molecular patterns (DAMPs)-mediated inflammasome activation seems to be involved in the disease pathogenesis. Cold-inducible RNA-binding protein (CIRP) belongs to a family of cold-shock proteins that respond to cellular stress and has been identified as a DAMP that triggers the inflammatory response. The aim of this study is to investigate the clinical significance of serum CIRP levels in AOSD.

Methods
Serum samples were obtained from 44 patients with active AOSD or 50 patients with rheumatoid arthritis (RA), 20 patients with systemic lupus erythematosus (SLE), and 15 healthy control patients (HCs). Serum levels of CIRP and IL-18 were determined using enzyme-linked immunosorbent assay. Results were compared among AOSD patients, RA patients, SLE patients and HCs. Results were also analyzed according to the clinical features of AOSD.

Results
Serum CIRP levels were significantly higher in AOSD patients compared with RA patients (median: 9.6 ng/mL, IQR [5.7–14.4] versus 3.2 ng/mL, IQR [1.9–3.8]; p < 0.001) and with HCs (2.8 ng/mL, [IQR; 1.4–4.9], p < 0.001). There was a significant positive correlation between serum CIRP levels and AOSD disease activity score (Pouchot’s score r = 0.45, p = 0.003) as well as between AOSD-specific biomarkers ferritin and IL-18. However, there was no significant difference in the serum CIRP levels among AOSD patients with three different disease phenotypes.

Conclusions
These results suggest that CIRP may play a significant role in the pathophysiology of AOSD and could be a potential biomarker for monitoring the disease activity of AOSD.
Using the first nationwide survey on non-communicable disease risk factors and different definitions to evaluate the prevalence of metabolic syndrome in Burkina Faso
Authors: Cissé Kadari , Samadoulougou Délwendé René Séverin , Bognini Joel Dofinissery , Kangoye Tiga David , Kirakoya-Samadoulougou Fati 
Published: August 2021

BackgroundThe burden of cardiovascular diseases is rising in the developing world including Sub-Saharan Africa. The rapid rise of cardiovascular disease burden is in part due to undetected and uncontrolled cardiovascular risk factors. The clustering of metabolic syndrome (MetS) components is associated with a high risk of cardiovascular diseases. This complex biochemical disorder is still poorly studied in western Africa. In this study, we aimed to determine the prevalence of metabolic syndrome and its determinants among the adult population in Burkina Faso.MethodsWe performed a secondary analysis of the data from the first national survey on non-communicable diseases risk factors using the World Health Organization (WHO) Stepwise approach. We included 4019 study participants aged 25 to 64 years. The metabolic syndrome prevalence was estimated using six different definitions.ResultsThe mean age was 38.6±11.1 years. Women represented 52.4% and three quarters (75%) lived in rural areas. The overall prevalence of metabolic syndrome according to the different definitions was 1.6% (95%CI:1.1–2.2) for the American College of Endocrinology, 1.8% (95%CI: 1.3–2.4) for the WHO, 4.3% (95%CI:3.5–5.2) for the National Cholesterol Education Program Adult Treatment Panel III, 6.2% (95%CI: 5.1–7.6) for the AAH/NHBI, 9.6%(95%CI: 8.1–11.3) for the International Diabetes Federation and 10.9% (95%: 9.2–12.7) for the Joint Interim Statement. The metabolic syndrome components with the highest prevalence were low High density lipoprotein (63.3%), abdominal obesity (22.3%) and hypertension (20.6%). People living in urban areas and those with older age have higher prevalence of metabolic syndrome regardless of the definition used.ConclusionOur findings suggest various levels of prevalence of MetS according to the definition used. Identifying the most appropriate criteria for MetS among the adult population is important to early detect and treat this syndrome and its components at the primary health care level to control the rising burden of cardiovascular diseases in the context of ongoing epidemiological transition in the country.
Primary care-based screening and management of depression amongst heavy drinking patients: Interim secondary outcomes of a three-country quasi-experimental study in Latin America
Authors: O’Donnell Amy , Schulte Bernd , Manthey Jakob , Schmidt Christiane Sybille , Piazza Marina , Chavez Ines Bustamante , Natera Guillermina , Aguilar Natalia Bautista , Hernández Graciela Yazmín Sánchez , Mejía-Trujillo Juliana , Pérez-Gómez Augusto , Gual Antoni , de Vries Hein , Solovei Adriana , Kokole Dasa , Kaner Eileen , Kilian Carolin , Rehm Jurgen , Anderson Peter , Jané-Llopis Eva 
Published: August 2021

Introduction
Implementation of evidence-based care for heavy drinking and depression remains low in global health systems. We tested the impact of providing community support, training, and clinical packages of varied intensity on depression screening and management for heavy drinking patients in Latin American primary healthcare.

Materials and methods
Quasi-experimental study involving 58 primary healthcare units in Colombia, Mexico and Peru randomized to receive: (1) usual care (control); (2) training using a brief clinical package; (3) community support plus training using a brief clinical package; (4) community support plus training using a standard clinical package. Outcomes were proportion of: (1) heavy drinking patients screened for depression; (2) screen-positive patients receiving appropriate support; (3) all consulting patients screened for depression, irrespective of drinking status.

Results
550/615 identified heavy drinkers were screened for depression (89.4%). 147/230 patients screening positive for depression received appropriate support (64%). Amongst identified heavy drinkers, adjusting for country, sex, age and provider profession, provision of community support and training had no impact on depression activity rates. Intensity of clinical package also did not affect delivery rates, with comparable performance for brief and standard versions. However, amongst all consulting patients, training providers resulted in significantly higher rates of alcohol measurement and in turn higher depression screening rates; 2.7 times higher compared to those not trained.

Conclusions
Training using a brief clinical package increased depression screening rates in Latin American primary healthcare. It is not possible to determine the effectiveness of community support on depression activity rates due to the impact of COVID-19.
The experiences of older individuals providing care to older dependents: A phenomenological study in Spain
Authors: Alcañiz-Garrán M. , García-Sanjuán S. , Ramos-Pichardo J. D. , Sanjuán-Quiles A. , Montejano-Lozoya R. 
Published: August 2021

Objective
Non-professional care provided in domestic settings by a family member or someone from the close environment and without a connection to a professional care service, is increasingly assumed by older people, mainly the spouses of those requiring care. The aim of this study was to describe the experience of older people providing care at home to older dependents.

Methods
A qualitative study was carried out to describe and explore the experience of older people, caregivers of dependent older people in the home.

Results
Four themes emerged as a result of the analysis: interpersonal relationships established in the caregivers’ immediate environment; the need and request for public and private resources; consequences of providing care during old age; and adaptation to the circumstance of being a caregiver during old age. Older people who provide home-based care, experience their situation as stressful, feel that it limits their daily life, deprives them of their freedom, and affects their interpersonal relationships and social activities.

Discussion
Older caregivers learn quickly and can manage the skills issues. The volume of work is their challenge. Interpersonal relationships are altered depending on the length of time spent together and the demand for care. Public services and benefits are not adapted to the demands of caregivers or dependent persons.
Depressive symptoms and associated factors among HIV positive patients attending public health facilities of Dessie town: A cross-sectional study
Authors: Damtie Yitayish , Kefale Bereket , Yalew Melaku , Arefaynie Mastewal , Adane Bezawit , Edmealem Afework , Andualem Atsedemariam 
Published: August 2021

Background
Depressive symptoms are the most common psychiatric complication of Human Immunodeficiency Virus (HIV) infection. They are associated with poor drug adherence, treatment failure, and increase the risk for suicide. There was limited evidence of depressive symptoms among HIV-positive patients in the study area. So, this study aimed to determine the prevalence of depressive symptoms and associated factors among HIV-positive patients attending public health facilities of Dessie town, North-central Ethiopia, 2019.

Method
A cross-sectional study was conducted on 380 HIV-positive patients attending ART clinics in Dessie town, North-central Ethiopia, 2019. Samples were selected using systematic random sampling and the data were collected by using structured, pretested, and interviewer-administered questionnaires. Patient Health Questionnaire (PHQ-9) at a cut-off point of 5 was used to assess depressive symptoms. The data were entered by Epi data version 3.1 and analyzed by SPSS version 25. A binary logistic regression model was used to identify factors associated with depressive symptoms. The Adjusted Odds Ratio (AOR) along with a 95% Confidence Interval (CI) was estimated to measure the association. The level of significance was declared at a p-value of less than 0.05.

Result
The prevalence of depressive symptoms among HIV positive patients was 15.5% (95% CI: (12.4%, 19.2%)). Age 40–49 years compared to 30–39 years (AOR = 2.96, 95% CI: (1.01, 8.68)), age ≥50 years compared to 30–39 years (AOR = 3.81, 95% CI: (1.05, 13.8)), having perceived stigma (AOR = 10.2, 95%CI: (4.26, 24.4)) taking medication other than Antiretroviral Therapy (ART) (AOR = 2.58, 95% CI: (1.25, 5.33)) and history of opportunistic infections (AOR = 5.17, 95% CI: (1.31, 20.4)) were factors associated with depressive symptoms.

Conclusion
The prevalence of depressive symptoms was low compared to previous studies. Age, perceived stigma, taking medication other than ART, and history of opportunistic infections were factors associated with depressive symptoms. Health education and counseling programs should be strengthened and target older patients, patients who took medications other than ART, patients who experienced perceived stigma and patients with a history of history opportunistic infections.