bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cigarette smokers’ perceptions of smoking cessation and associated factors in Karachi, Pakistan
Authors: Barolia Rubina , Iqbal Sajid , Virani Salim S. , Khan Faris , Petrucka Pammla 
Published: September 2021

AbstractObjectivesThe study explored the perceptions of adult smokers with cardiovascular and respiratory diseases regarding cigarette smoking cessation. We also explored factors that may hinder or facilitate smoking cessation process.DesignQualitative descriptive exploratory designSamplePurposive sample of 13 adult smokers with cardiovascular or respiratory diseases visiting outpatient cardiac and respiratory clinics at a private tertiary care hospitalMeasurementsIn‐depth, face‐to‐face, and semi‐structured interviews were conducted. The interviews were digitally recorded and transcribed verbatim followed by a six steps process of manual thematic analysis of data.ResultsMeaningful statements were assigned codes and grouped into categories. Categories were clustered under three themes representing individual factors, socio‐cultural factors, and institutional factors.ConclusionsSmoking cessation is influenced by personal, cultural, as well as social aspects. Institutionally, there is a need to recognize that smoking is a learned behavior; hence, prohibiting public smoking will potentially contribute to non‐smoking behaviors. Although the nature of misconceptions varies, this is imperative to ensure consistency in messaging, programming, and supports led by healthcare professionals.
Restoration of a Lake Ontario‐connected fen through invasive Typha removal
Authors: Graham Andie , Mudrzynski Bradley , Polzer Eli , Wilcox Douglas A. 
Published: September 2021

Lake‐level regulation that began in 1960 eliminated large fluctuations of Lake Ontario water levels, altering coastal wetland plant communities. More than a half century later, the altered hydroperiod supports dense, monotypic stands of invasive cattail (Typha angustifolia and Typha × glauca), which have diminished overall plant community diversity. As a result, Lake Ontario coastal wetlands are less capable of providing many of their traditional ecological functions. One such wetland is Buttonwood Fen, a floating, lake‐connected peatland on Lake Ontario's southern shore near Rochester, NY. We implemented cattail‐control measures from 2016 to 2018 with the goal of decreasing live and dead cattail biomass and increasing cover of native fen taxa. Site manipulation included removal of dead cattail biomass, cutting new cattail growth when rhizome carbohydrate reserves were at their lowest, and hand‐wicking regrowth with herbicide in early fall. Results showed a decrease in live cattail stem density and cover and dead biomass cover, as well as an increase in cover of fen taxa. Although not a replicated study, our results suggest that removing dead cattail biomass and targeted treatment of live cattail stems via cutting and hand‐wicking with glyphosate can reduce cattail and improve site quality.
Increasing Preparedness for Extreme Events using Plausibility‐Based Scenario Planning: Lessons from COVID‐19
Authors: Derbyshire James 
Published: September 2021

AbstractA striking feature of COVID‐19 is many countries’ low level of preparedness for it, despite pandemics being a known threat. This raises a question as to the reasons for this underpreparedness. While preparedness should have better reflected pandemics’ long‐run inevitability and potentially catastrophic impact, government‐planning horizons are short term, and the attentiveness of policymakers is bounded and subject to multiple demands. Preparedness is therefore affected by the fundamental uncertainty surrounding the exact nature, timing, and impact of a pandemic. While a subjective probability is attributable to such an event's occurrence, just like it is any other, if founded on scant knowledge and perceived as being low it may inhibit preparedness. Under such circumstances, preparedness may be better served by a focus on plausibility. Moreover, any tendency for policymakers to disregard highly uncertain, low‐probability, yet highly impactful events of this type is exacerbated by their “fat‐tailed” distribution, which obscures their potential extremity. This article considers how plausibility‐based scenario planning can increase preparedness for extreme events like a global pandemic, thereby reducing overconfidence in continued business‐as‐usual in their face, and emphasizing precaution in their wake. In so doing, the article contributes to what in this journal has recently been called “type B,” “generic and fundamental” risk science, which is concerned with identifying better ways to present and communicate uncertainties. In focusing on plausibility‐based scenario planning, the article highlights a method seldom previously discussed in relation to risk science, yet one that can contribute much to this type B component of it.
Hemicellulose‐remodelling transglycanase activities from charophytes: towards the evolution of the land‐plant cell wall
Authors: Franková Lenka , Fry Stephen C. 
Published: September 2021

SUMMARYTransglycanases remodel cell‐wall polymers, having a critical impact on many physiological processes. Unlike xyloglucan endotransglucosylase (XET) activity, widely studied in land plants, very little is known about charophyte wall‐modifying enzymes – information that would promote our understanding of the ‘primordial’ wall, revealing how the wall matrix is remodelled in the closest living algal relatives of land plants, and what changed during terrestrialisation. We conducted various in‐vitro assays for wall‐remodelling transglycosylases, monitoring either (a) polysaccharide‐to‐[3H]oligosaccharide transglycosylation or (b) non‐radioactive oligosaccharide‐to‐oligosaccharide transglycosylation. We screened a wide collection of enzyme extracts from charophytes (and early‐diverging land plants for comparison) and discovered several homo‐ and hetero‐transglycanase activities. In contrast to most land plants, charophytes possess high trans‐β‐1,4‐mannanase activity, suggesting that land plants’ algal ancestors prioritised mannan remodelling. Trans‐β‐1,4‐xylanase activity was also found, most abundantly in Chara, Nitella and Klebsormidium. Exo‐acting transglycosidase activities (trans‐β‐1,4‐xylosidase and trans‐β‐1,4‐mannosidase) were also detected. In addition, charophytes exhibited homo‐ and hetero‐trans‐β‐glucanase activities (XET, mixed‐linkage glucan [MLG]:xyloglucan endotransglucosylase and cellulose:xyloglucan endotransglucosylase) despite the paucity or lack of land‐plant‐like xyloglucan and MLG as potential donor substrates in their cell walls. However, trans‐α‐xylosidase activity (which remodels xyloglucan in angiosperms) was absent in charophytes and early‐diverging land plants. Transglycanase action was also found in situ, acting on endogenous algal polysaccharides as donor substrates and fluorescent xyloglucan oligosaccharides as acceptor substrates. We conclude that trans‐β‐mannanase and trans‐β‐xylanase activities are present and thus may play key roles in charophyte walls (most of which possess little or no xyloglucan and MLG, but often contain abundant β‐mannans and β‐xylans), comparable to the roles of XET in xyloglucan‐rich land plants.
Essential Emergency and Critical Care: a consensus among global clinical experts
Authors: Schell Carl Otto , Khalid Karima , Wharton-Smith Alexandra , Oliwa Jacquie , Sawe Hendry R , Roy Nobhojit , Sanga Alex , Marshall John C , Rylance Jamie , Hanson Claudia , Kayambankadzanja Raphael K. , Wallis Lee A , Jirwe Maria , Baker Tim 
Published: September 2021

BackgroundGlobally, critical illness results in millions of deaths every year. Although many of these deaths are potentially preventable, the basic, life-saving care of critically ill patients are often overlooked in health systems. Essential Emergency and Critical Care (EECC) has been devised as the care that should be provided to all critically ill patients in all hospitals in the world. EECC includes the effective care of low cost and low complexity for the identification and treatment of critically ill patients across all medical specialties. This study aimed to specify the content of EECC and additionally, given the surge of critical illness in the ongoing pandemic, the essential diagnosis-specific care for critically ill patients with COVID-19.MethodsIn a Delphi process, consensus (>90% agreement) was sought from a diverse panel of global clinical experts. The panel iteratively rated proposed treatments and actions based on previous guidelines and the WHO/ICRC’s Basic Emergency Care. The output from the Delphi was adapted iteratively with specialist reviewers into a coherent and feasible package of clinical processes plus a list of hospital readiness requirements.ResultsThe 269 experts in the Delphi panel had clinical experience in different acute medical specialties from 59 countries and from all resource settings. The agreed EECC package contains 40 clinical processes and 67 requirements, plus additions specific for COVID-19.ConclusionThe study has specified the content of care that should be provided to all critically ill patients. Implementing EECC could be an effective strategy for policy makers to reduce preventable deaths worldwide.
Chronic pain and mental health problems among Syrian refugees: associations, predictors and use of medication over time: a prospective cohort study
Authors: Strømme Elisabeth Marie , Igland Jannicke , Haj-Younes Jasmin , Kumar Bernadette Nirmal , Fadnes Lars T , Hasha Wegdan , Diaz Esperanza 
Published: September 2021

ObjectivesThis study aims to examine associations, predictors and pharmacological treatment of chronic pain and mental health problems among Syrian refugees in a longitudinal perspective.DesignProspective cohort study.SettingWe collected survey data among Syrian refugees in Lebanon granted resettlement to Norway (self-administered questionnaires) and at follow-up 1 year after arrival in Norway (structured telephone interviews).ParticipantsAdult Syrian refugees attending mandatory pretravel courses in Lebanon in 2017–2018 were invited to participate. In total, 353 individuals participated at both time points.Primary and secondary outcomesWe examined the cross-sectional associations between pain, mental health and migration-related exposures at baseline and follow-up and assessed whether associations changed significantly with time. Furthermore, we investigated the longitudinal association between mental health at baseline and pain at follow-up. We also evaluated temporal changes in use of analgesics and psychotropic drugs.ResultsWhile most refugees reported improved health from the transit phase in Lebanon to the early resettlement phase in Norway, a few had persisting and intertwined health problems. Most migration-related stressors were more closely associated with chronic pain and mental health problems after resettlement as compared with the transit phase. In parallel, poor mental health was associated with chronic pain in the follow-up (adjusted risk ratio (ARR) 1.5 (1.0, 2.2)), but not at baseline (ARR 1.1 (0.8, 1.5)). Poor mental health at baseline was a statistically significant predictor of chronic pain at follow-up among thosenotreporting chronic pain at baseline. At both timepoints, one in four of those with chronic pain used analgesics regularly. None with mental health problems used antidepressants daily.ConclusionsProviders of healthcare services to refugees should be attentive to the adverse effect of postmigration stressors and acknowledge the interrelations between pain and mental health. Possible gaps in pharmacological treatment of pain and mental health problems need further clarification.
Methodological quality of multivariate prognostic models for intracranial haemorrhages in intensive care units: a systematic review
Authors: Simon-Pimmel Jeanne , Foucher Yohann , Léger Maxime , Feuillet Fanny , Bodet-Contentin Laetitia , Cinotti Raphaël , Frasca Denis , Dantan Etienne 
Published: September 2021

ObjectivesPatients with severe spontaneous intracranial haemorrhages, managed in intensive care units, face ethical issues regarding the difficulty of anticipating their recovery. Prognostic tools help clinicians in counselling patients and relatives and guide therapeutic decisions. We aimed to methodologically assess prognostic tools for functional outcomes in severe spontaneous intracranial haemorrhages.Data sourcesFollowing Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations, we conducted a systematic review querying Medline, Embase, Web of Science, and the Cochrane in January 2020.Study selectionWe included development or validation of multivariate prognostic models for severe intracerebral or subarachnoid haemorrhage.Data extractionWe evaluated the articles following the CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies and Transparent Reporting of multivariable prediction model for Individual Prognosis Or Diagnosis statements to assess the tools’ methodological reporting.ResultsOf the 6149 references retrieved, we identified 85 articles eligible. We discarded 43 articles due to the absence of prognostic performance or predictor selection. Among the 42 articles included, 22 did not validate models, 6 developed and validated models and 14 only externally validated models. When adding 11 articles comparing developed models to existing ones, 25 articles externally validated models. We identified methodological pitfalls, notably the lack of adequate validations or insufficient performance levels. We finally retained three scores predicting mortality and unfavourable outcomes: the IntraCerebral Haemorrhages (ICH) score and the max-ICH score for intracerebral haemorrhages, the SubArachnoid Haemorrhage International Trialists score for subarachnoid haemorrhages.ConclusionsAlthough prognostic studies on intracranial haemorrhages abound in the literature, they lack methodological robustness or show incomplete reporting. Rather than developing new scores, future authors should focus on externally validating and updating existing scores with large and recent cohorts.
Association of antibiotics use in preschool age with atopic and allergic skin diseases in young adulthood: a population-based retrospective cohort study
Authors: Li Yajia , Jing Danrong , Huang Yuzhou , Su Juan , Li Jie , Li Ji , Tao Juan , Shan Shijun , Wang Xiaohui , Kang Xiaojing , Wu Bin , Chen Xiang , Shen Minxue , Xiao Yi 
Published: September 2021

BackgroundOveruse and misuse of antibiotics is a public health problem in low-income and middle-income countries. Although the association of antibiotics with atopic and allergic diseases has been established, most studies focused on prenatal exposure and the occurrence of disease in infants or young children.ObjectiveTo investigate the association of preschool use of antibiotics with atopic and allergic skin diseases in young adulthood.DesignPopulation-based retrospective cohort.Setting and participantsThe first-year college students (n=20 123) from five universities were investigated. The sampled universities are located in Changsha, Wuhan, Xiamen, Urumqi and Hohhot, respectively.MethodsWe conducted a dermatological field examination and a questionnaire survey inquiring the participants about the frequency of upper respiratory tract infection (URTI) and the preschool antibiotics use (prior to 7 years old). The two-level probit model was used to estimate the associations, and adjusted risk ratio (aRR) and 95% CI were presented as the effect size.ResultsA total of 20 123 participants with complete information was included in the final analysis. The frequent antibiotics use intravenously (aRR 1.36, 95% CI 1.14 to 1.62) and orally (aRR 1.18, 95% CI 1.01 to 1.38) prior to 7 years old was significantly associated with atopic dermatitis in young adulthood. Similar trends could be observed in allergic skin diseases among those who use antibiotics orally and intravenously, with RRs of 1.16 (95% CI 1.01 to 1.34) and 1.33 (95% CI 1.13 to 1.57), respectively.ConclusionsPreschool URTI and antibiotics use significantly increases the risk of atopic and allergic skin diseases in young adulthood.
A continuous PREMs and PROMs Observatory for elective hip and knee arthroplasty: study protocol
Authors: De Rosis Sabina , Pennucci Francesca , Lungu Daniel Adrian , Manca Mario , Nuti Sabina 
Published: September 2021

IntroductionScholars, healthcare practitioners and policymakers have increasingly focused their attention on patient-centredness. Patient-reported metrics support patient-driven improvement actions in healthcare systems. Despite the great interest, patient-reported outcome measures (PROMs) are still not extensively collected in many countries and not integrated with the collection of patient-reported experience measures (PREMs). This protocol describes the methodology behind an innovative observatory implemented in Tuscany, Italy, aiming at continuously and longitudinally collecting PROMs and PREMs for elective hip and knee total replacement.Methods and analysisThe Observatory is digital. Enrolled patients are invited via SMS or email to online questionnaires, which include the Oxford Hip Score or the Oxford Knee Score. Data are real-time reported to healthcare professionals and managers in a raw format, anonymised and aggregated on a web platform. The data will be used to investigate the relationship between the PROMs trend and patients’ characteristics, surgical procedure, hospital characteristics, and PREMs. Indicators using patient data will be computed, and they will integrate the healthcare performance evaluation system adopted in Tuscany.Ethics and disseminationThe data protection officers of local healthcare organisations and the regional privacy office framed the initiative referring to the national and regional guidelines that regulate patient surveys. The findings will be reported both in real time and for publication in peer-reviewed journals.
Prevalence and risk factors for SARS-CoV-2 infection in children with and without symptoms seeking care in Managua, Nicaragua: results of a cross-sectional survey
Authors: Huete-Pérez Jorge A , Ernst Kacey C , Cabezas-Robelo Cristiana , Páiz-Medina Lucia , Silva Sheyla , Huete Alejandra 
Published: September 2021

ObjectiveThis study aimed to capture key epidemiological data on SARS-CoV-2 infection in Nicaraguan children (≤18 years) seeking medical care, between 6 October and 16 November 2020.DesignIn this cross-sectional study, 418 children were recruited: 319 with symptoms characteristic of COVID-19 and 99 with no symptoms of illness. Children were tested for SARS-CoV-2 RNA using loop-mediated isothermal amplification. A questionnaire was employed to identify symptoms, risk factors, comorbidities and COVID-19 prevention measures.SettingResearch was carried out in four hospitals and two clinics in Managua, Nicaragua, where schools and businesses remained open throughout the COVID-19 pandemic.ParticipantsChildren were enrolled into a possible COVID-19 group if presenting with clinical symptoms. A comparison group included children lacking any COVID-19 symptoms attending routine check-ups or seeking care for issues unrelated to COVID-19.ResultsA high prevalence (43%) of SARS-CoV-2 infection was found, which was relatively equivalent in symptomatic and non-symptomatic children. Age distribution was similar between symptomatic and non-symptomatic children testing positive for SARS-CoV-2. Symptomatic children who tested positive for SARS-CoV-2 were 2.7 times more likely to have diarrhoea (26.7% in positive vs 12.0% in negative; OR=2.7 (95% CI 1.5 to 4.8), p=0.001) and were 2.0 times more likely to have myalgia (17.8% in positive vs 9.8% in negative; OR=2.0 (95% CI 1.0 to 3.8), p=0.04). Children with COVID-19 symptoms, who tested positive for SARS-CoV-2, were more likely to be under age 5 years and to have a pre-existing comorbid condition than children who tested positive but did not have symptoms.ConclusionsThis is the first paediatric study to provide laboratory-confirmed data on SARS-CoV-2 infection in Nicaragua, crucial for paediatric health services planning and a successful COVID-19 response. The high prevalence of the virus suggests widespread and sustained community transmission, underscoring the urgent need for robust data on the true extent of SARS-CoV-2 infection throughout Nicaragua.
Exploration of the psychometric properties of the Person-Centred Primary Care Measure (PCPCM) in a Chinese primary care population in Hong Kong: a cross-sectional validation study
Authors: Tse Emily Tsui Yee , Lam Cindy Lo Kuen , Wong Carlos King Ho , Chin Weng Yee , Etz Rebecca S , Zyzanski Stephen J , Stange Kurt C 
Published: September 2021

ObjectivesTo evaluate the validity and psychometric properties of the Chinese Person-Centred Primary Care Measure (PCPCM) in a Chinese-speaking population.DesignA cross-sectional study.SettingA primary care clinic in Hong Kong.Participants300 Chinese adult patients (150 males and 150 females) were recruited from a primary care clinic to complete a questionnaire containing the PCPCM, Consultation and Relational Empathy (CARE), Patient Enablement Index (PEI) and Adult (short version) Primary Care Assessment Tool (PCAT). The Chinese PCPCM was readministered to 118 participants after 14 days for test–retest reliability.Outcome measuresThe construct validity, reliability and sensitivity of the Chinese PCPCM.ResultsThe Chinese PCPCM was identified to have a one-factor construct, with good item fit and unidimensionality on Rasch analysis. Internal reliability was high (Cronbach’s alpha >0.8) with moderate test–retest reliability (intraclass correlation coefficient=0.622, p<0.001). Significant correlations (0.58, 0.42, 0.48) between the PCPCM and CARE, PEI and Adult (short version) PCAT scores supported good convergent construct validity. PCPCM scores were higher among patients who had known their doctors for a longer period or who were more likely to be able to see the same doctor at every visit, and among those who self-reported to have ‘better health’ rather than ‘worse health’.ConclusionThe Chinese PCPCM appears to be a valid, reliable and sensitive instrument for evaluating the quality of person-centred care among primary care patients in Hong Kong. Further studies are needed to confirm the utility of this instrument in other Chinese-speaking populations around the world.