bluuebunny/crossref_metadata_2025_split huggingface dataset:
Design and evaluation of psychometric properties of cigarette smoking tendency questionnaire for female adolescents (CTQFA)
Authors: Jafari Alireza , Peyman Nooshin , Gholian-Aval Mahdi , Mahdizadeh Mehrsadat , Tehrani Hadi 
Published: September 2021

Abstract
Background
The tendency of women to smoke has increased in recent years and the prevalence of smoking among women is increasing. The purpose of this study was to design and evaluation the psychometric properties of the smoking tendency questionnaire for Iranian female adolescents.

Methods
This cross-sectional study was performed on 604 female adolescents in Iran in 2021. The bank of questions was designed based on the qualitative study concepts and review of the literature. To perform the psychometric evaluation, steps such as face validity (qualitative), content validity (qualitative and quantitative) and construct validity (confirmatory factor analysis) were performed. The reliability of the instrument was assessed using McDonald’s omega coefficient and Cronbach’s alpha coefficient.

Results
Based on the results of psychometrics (face, content, and construct validity), the number of questions was reduced from 102 to 52, and 50 questions were removed. Finally, a questionnaire with 52 questions and 5 subscales of the tendency to experience smoking (14 items), re-experience smoking (8 items), cigarette dependence (9 items), intention to quit smoking (9 items), and smoking cessation (12 items) was approved. The content validity ratio (CVR) and content validity index (CVI) for all questions were 0.770 and 0.938, respectively. The Cronbach’s alpha and McDonald’s omega coefficients for all questions were 0.903 and 0.904, respectively.

Conclusion
Based on the results of this questionnaire, 52 questions, and 5 subscales can be used to assess the tendency of female adolescents to cigarette smoking.
Evaluating the use of a recommender system for selecting optimal messages for smoking cessation: patterns and effects of user-system engagement
Authors: Chen Jinying , Houston Thomas K. , Faro Jamie M. , Nagawa Catherine S. , Orvek Elizabeth A. , Blok Amanda C. , Allison Jeroan J. , Person Sharina D. , Smith Bridget M. , Sadasivam Rajani S. 
Published: September 2021

Abstract
Background
Motivational messaging is a frequently used digital intervention to promote positive health behavior changes, including smoking cessation. Typically, motivational messaging systems have not actively sought feedback on each message, preventing a closer examination of the user-system engagement. This study assessed the granular user-system engagement around a recommender system (a new system that actively sought user feedback on each message to improve message selection) for promoting smoking cessation and the impact of engagement on cessation outcome.

Methods
We prospectively followed a cohort of current smokers enrolled to use the recommender system for 6 months. The system sent participants motivational messages to support smoking cessation every 3 days and used machine learning to incorporate user feedback (i.e., user’s rating on the perceived influence of each message, collected on a 5-point Likert scale with 1 indicating strong disagreement and 5 indicating strong agreement on perceiving the influence on quitting smoking) to improve the selection of the following message. We assessed user-system engagement by various metrics, including user response rate (i.e., the percent of times a user rated the messages) and the perceived influence of messages. We compared retention rates across different levels of user-system engagement and assessed the association between engagement and the 7-day point prevalence abstinence (missing outcome = smoking) by using multiple logistic regression.

Results
We analyzed data from 731 participants (13% Black; 73% women). The user response rate was 0.24 (SD = 0.34) and user-perceived influence was 3.76 (SD = 0.84). The retention rate positively increased with the user response rate (trend test P < 0.001). Compared with non-response, six-month cessation increased with the levels of response rates: low response rate (odds ratio [OR] = 1.86, 95% confidence interval [CI]: 1.07–3.23), moderate response rate (OR = 2.30, 95% CI: 1.36–3.88), high response rate (OR = 2.69, 95% CI: 1.58–4.58). The association between perceived message influence and the outcome showed a similar pattern.

Conclusions
High user-system engagement was positively associated with both high retention rate and smoking cessation, suggesting that investigation of methods to increase engagement may be crucial to increase the impact of the recommender system for smoking cessation.

Trial registration
Registration Identifier: NCT03224520. Registration date: July 21, 2017.
Childhood vaccination uptake and associated factors among children 12–23 months in rural settings of the Gambia: a community-based cross-sectional study
Authors: Touray Ebrima , Barrow Amadou , Kinteh Bakary , Badjie Mansour , Nget Musa , Touray Jainaba , Kinteh Sambou L. S. , Jatta Solomon P. S. , Ceesay Lamin 
Published: September 2021

Abstract
Background
Globally, immunization prevents 2–3 million deaths annually from vaccine-preventable diseases such as diphtheria, tetanus, pertussis, influenza, and measles. In developing countries, several immunization programs have made progress, but the coverage remains a standstill in some areas. In order to inform policies and practices, the present study aimed at assessing vaccination uptake and contextual-associated factors among children aged 12–23 months in rural Gambia.

Methods
A community-based triangulated cross-sectional design was conducted in January 2020, with 200 caregivers with children aged 12–23 months in selected households in rural communities across Upper River Region of the Gambia using multistage sampling technique were recruited. A structured interview questionnaire was developed and Infant Welfare Cards were assessed to elicit information regarding contextual household characteristics towards childhood immunization uptake. Percentages, chi-square/fisher exact test for variables with p-value ≤0.15 were considered for inclusion into logistic regression model. The significance level was set at p < 0.05. The adjusted Odds Ratio (aOR) with 95% Confidence Interval (CI) were reported to declare significance.

Results
The proportion of children who received all the required vaccines was 66%. At the level of antigen-specific coverage, about 88.5% received BCG, 71% received OPV 3, 82.5% received Penta 3, while 72 and 71% received Measles-Rubella and yellow fever, respectively. Caregivers who had primary education level 88.8% (aOR = 0.112; 95% CI = 0.029–0.434), secondary & above 87.2% (aOR = 0.128; 95% CI = 0.029, 0. 561) and arabic/madrassa 95.7% (aOR = 0.043; 95% CI = 0.008–1.227) were less likely to be fully vaccinated when compared to those who have never been to school. Farmers are less likely by 88.9% (aOR = 0.111; 95% CI 0.020, 0.635) while children from family size of more than 20 members had reduced odds (aOR = 0.420; 95% CI = 0.197, 0.894) for their children to complete their vaccination schedule as compared to those with at most 20 household members.

Conclusion
There is moderately a burden of incomplete vaccination in rural Gambia. Vaccination programs should be constantly monitored and evaluated by the Ministry of Health, especially in rural areas. To increase societal awareness and vaccine acceptance, a robust community-based health education efforts are desperately needed as part of initiatives to increase vaccine service utilization for these high-risk classes.
The effect of hand hygiene promotion programs during epidemics and pandemics of respiratory droplet-transmissible infections on health outcomes: a rapid systematic review
Authors: Veys Koen , Dockx Kim , Van Remoortel Hans , Vandekerckhove Philippe , De Buck Emmy 
Published: September 2021

Abstract
Background
Public health strategies in the context of respiratory droplet-transmissible diseases (such as influenza or COVID-19) include intensified hand hygiene promotion, but a review on the effectiveness of different ways of promoting hand hygiene in the community, specifically for this type of infections, has not been performed. This rapid systematic review aims to summarize the effectiveness of community-based hand hygiene promotion programs on infection transmission, health outcomes and behavioral outcomes during epidemic periods in the context of respiratory droplet-transmissible diseases. We also included laboratory-confirmed health outcomes for epidemic-prone disease during interepidemic periods.

Methods
We searched for controlled experimental studies. A rapid systematic review was performed in three databases and a COVID-19 resource. Following study selection (in which studies performed in the (pre-)hospital/health care setting were excluded), study characteristics and effect measures were synthesized, using meta-analyses of cluster-RCTs where possible. Risk of bias of each study was assessed and the certainty of evidence was appraised according to the GRADE methodology.

Results
Out of 2050 unique references, 12 cluster-RCTs, all in the context of influenza, were selected. There were no controlled experimental studies evaluating the effectiveness of hand hygiene promotion programs in the context of COVID-19 that met the in−/exclusion criteria. There was evidence that preventive hand hygiene promotion interventions in interepidemic periods significantly decreased influenza positive cases in the school setting. However, no improvement could be demonstrated for programs implemented in households to prevent secondary influenza transmission from previously identified cases (epidemic and interepidemic periods).

Conclusions
The data suggest that proactive hand hygiene promotion interventions, i.e. regardless of the identification of infected cases, can improve health outcomes upon implementation of such a program, in contrast to reactive interventions in which the program is implemented after (household) index cases are identified.
Ultrasound assessment of the rectus femoris in patients with chronic obstructive pulmonary disease predicts poor exercise tolerance: an exploratory study
Authors: Deng Mingming , Liang Chaonan , Yin Yan , Shu Jun , Zhou Xiaoming , Wang Qiuyue , Hou Gang , Wang Chen 
Published: September 2021

AbstractBackgroundReduced exercise tolerance is an important clinical feature of chronic obstructive pulmonary disease (COPD) and is associated with poor prognosis. The 6-min walk test (6MWT) is widely used to assess exercise capacity; however, it is not commonly administered in primary medical institutions because it requires a suitable site and professional training. Ultrasound has great potential for evaluating skeletal muscle dimensions in COPD. However, whether skeletal muscle ultrasound can predict impaired exercise tolerance is unclear.MethodsThe study included 154 stable patients with COPD, who were randomly divided into a development set and a validation set. The thickness (RFthick) and cross-sectional area (RFcsa) of the rectus femoris were measured using ultrasound. Standardized RFthick(STD- RFthick) and Standardized RFcsa(STD-RFcsa) were obtained via standardization of RFthickand RFcsaby patients' height.ResultsStrong correlations were observed between the 6MWD and RFthick(r = 0.84,p < 0.001) and between the 6MWD and RFcsa(r = 0.81,p < 0.001). In the development set, the optimal cut-off values for men and women for predicting poor exercise tolerance were < 3.098 cm/m and < 3.319 cm/m for STD-RFthickand < 4.052 cm2/m and < 4.366 cm2/m for STD-RFcsa, respectively. In the validation set, the area under the curve (AUC) values for the prediction of a 6MWD < 350 by STD-RFthickand STD-RFcsawere 0.881 and 0.903, respectively. Finally, the predictive efficacy of STD-RFthick(AUC: 0.922), STD-RFcsa(AUC: 0.904), and the derived nomogram model (AUC: 0.98) for exercise tolerance was superior to that of the sit-to-stand test and traditional clinical features.ConclusionsRectus femoris ultrasound has potential clinical application to predict impaired exercise tolerance in patients with COPD.
The cumulative dose-dependent effects of metformin on the development of tuberculosis in patients newly diagnosed with type 2 diabetes mellitus
Authors: Heo Eunyoung , Kim Eunyoung , Jang Eun Jin , Lee Chang-Hoon 
Published: September 2021

AbstractBackgroundDiabetes mellitus (DM) is a well-known risk factor for tuberculosis (TB). Metformin, which is an essential anti-diabetic drug, has been shown to exhibit anti-TB effects in patients with DM. Its effect on preventing the development of TB among patients who are newly diagnosed with DM remains unclear.MethodsThis was a retrospective cohort study using the claims database of the Korean Health Insurance Review and Assessment Service. The study population included patients who were newly diagnosed with type 2 DM and who were treated with anti-diabetic drugs between 1 January 2003 and 31 March 2011. A patient was defined as a metformin user if he/she had taken metformin for more than 28 days within 6 months since cohort entry, and as a metformin non-user if he/she had never been treated with metformin. The development of TB within 2 years after the index date was compared by Cox proportional hazard regression models between metformin users and 1:1 propensity score (PS)-matched non-users.ResultsAmong 76,973 patients who were newly diagnosed with type 2 DM, 13,396 were classified as metformin users, 52,736 were classified as metformin non-users, and 10,841 were excluded from the final analysis. PS-matched Cox proportional hazard regression models revealed that metformin use was not associated overall with the prevention of TB development (HR 1.17; 95% CI 0.75–1.83;P = 0.482). There was a trend, however, towards a reduction in the development of TB among patients taking a higher cumulative dose of metformin. Patients who were in the highest quartile (Q4) of cumulative metformin dose had only a 10% risk of developing TB compared to metformin non-users. In contrast, during the early phases of metformin treatment, patients in the second quartile (Q2) of cumulative metformin use had a higher risk of developing TB than patients in the first quartile (Q1).ConclusionsOnly the highest cumulative doses of metformin were protective against the development of TB among patients who were newly diagnosed with type 2 DM; lower cumulative doses of metformin did not appear to reduce the incidence of active TB infection.
Associations between dental caries and systemic diseases: a scoping review
Authors: Sabharwal Amarpreet , Stellrecht Elizabeth , Scannapieco Frank A. 
Published: September 2021

Abstract
Background
The objective of this study was to evaluate and present evidence from animal and human clinical studies on associations between dental caries and systemic diseases, and to suggest potential mechanisms that might explain such associations.

Methods
An electronic search was conducted of PubMed, Embase and Cochrane Central Register of Controlled Trials for articles published from 2010 to 2020 in the English language. From the initial search, 404 full-text studies were assessed for eligibility. After excluding studies for technical and study limitations, a total of 67 studies were included in the summary tables and additional studies were included in the review to support evidence.

Results
Few systemic disease and conditions were found to be clinically meaningfully associated with caries experience. Best evidence from human and animal studies described association between metabolic diseases and dental caries. Several interesting animal studies were noted that could generate clinical hypotheses and further investigations in rodent models for cardiovascular injury and hyperglycemia. Inadequate data was found to suggest any modifications to current clinical practice or prevention guidelines.

Conclusions
Limited clinical evidence was found connecting several systemic diseases and dental caries. Inadequate data was found to suggest any modifications to current clinical practice or prevention guidelines.

Clinical significance
Understanding of associations between dental caries and systemic diseases play a crucial role in the treatment planning and education of the dental patient.
Dysregulation of lncRNAs in circulation of patients with periodontitis: results of a pilot study
Authors: Ghafouri-Fard Soudeh , Gholami Leila , Badrlou Elham , Sadeghpour Saba , Nazer Naghme , Shadnoush Mahdi , Sayad Arezou , Taheri Mohammad 
Published: September 2021

Abstract
Background
Periodontitis is a chronic inflammatory disorder with a complex etiology. Long non-coding RNAs (lncRNAs) have been shown to affect pathoetiology of periodontitis. We aimed at identification of expression of five lncRNAs, namely Linc0116, Linc00667, CDK6-AS1, FENDRR and DIRC3 in the circulation and gingival tissues of these patients compared with healthy controls.

Methods
In a pilot case–control study, we compared expressions of Linc0116, Linc00667, CDK6-AS1, FENDRR and DIRC3 lncRNAs between blood and tissue samples of patients with periodontitis and healthy controls using real time quantitative PCR technique. The present work was performed on samples got from 26 patients with periodontitis and 28 controls. Female/male ratio was 16/10 and 12/16 in cases and controls, respectively.

Results
There was no significant difference in the expressions of Linc0116, Linc00667, CDK6-AS1, FENDRR and DIRC3 genes between affected and unaffected tissues. However, expressions of Linc0116, Linc00667, CDK6-AS1, FENDRR and DIRC3 genes were significantly lower in the blood samples of patients when compared with control samples (Ratio of mean expression = 0.16, 0.14, 0.13, 0.10 and 0.14, respectively). Subsequently, we compared expressions of these lncRNAs between patients and controls in a sex-based manner. Expressions of Linc00667, FENDRR and DIRC3 genes were significantly lower in female patients compared with female controls (RME = 0.09, 0.07 and 0.10, respectively). Yet, there was no significant difference in expression of any of mentioned lncRNAs among male subgroups. Consistent with the similar levels of Linc0116, Linc00667, CDK6-AS1, FENDRR and DIRC3 in tissue samples of patients and controls, none of them could separate these two sets of samples. However, AUC values for of Linc0116, Linc00667, CDK6-AS1, FENDRR and DIRC3 expression levels in blood samples were 0.66, 0.72, 0.70, 0.72, 0.70 and 0.68, respectively with FENDRR having the best sensitivity value.

Conclusion
Taken together, lncRNAs might be involved in the pathologic events in the circulation of patients with periodontitis.
The effects of stillbirth and abortion on the next pregnancy: a longitudinal study
Authors: Feleke Berhanu Elfu , Feleke Teferi Elfu , Nigussie Azezu Asres , Misgan Eyaya 
Published: September 2021

Abstract
Background
Abortion and stillbirths are the common obstetrics condition in Ethiopia and their effect on the next pregnancy was not well identified in resource limited settings. The aim of the study was to assess the effect of stillbirth and abortion on the next pregnancy.

Methods
A prospective cohort study design was implemented. The study was conducted in Mecha demographic surveillance and field research center catchment areas. The data were collected from January 2015 to March 2019. Epi-info software was used to calculate the sample size. The systematic random sampling technique was used to select stillbirth and abortion women. Poison regression was used to identify the predictors of MCH service utilization; descriptive statistics were used to identify the prevalence of blood borne pathogens. The Kaplan Meier survival curve was used to estimate survival to pregnancy and pregnancy related medical disorders.

Results
1091 stillbirth and 3,026 abortion women were followed. Hepatitis B was present in 6% of abortion and 3.2% of stillbirth women. Hepatitis C was diagnosed in 4.7% of abortion and 0.3% of stillbirth women. HIV was detected in 3% of abortion and 0.8% of stillbirth women. MCH service utilization was determined by knowledge of contraceptives [IRR 1.29, 95% CI 1.18–1.42], tertiary education [IRR 4.29, 95% CI 3.72–4.96], secondary education. [IRR 3.14, 95% CI 2.73–3.61], married women [IRR 2.08, 95% CI 1.84–2.34], family size [IRR 0.67, 95% CI 1.001–1.01], the median time of pregnancy after stillbirth and abortion were 12 months. Ante-partum hemorrhage was observed in 23.1% of pregnant mothers with a past history of abortion cases and post-partum hemorrhage was observed in 25.6% of pregnant mothers with a past history of abortion. PREGNANCY INDUCED DIABETES MELLITUS was observed 14.3% of pregnant mothers with a past history of stillbirth and pregnancy-induced hypertension were observed in 9.2% of mothers with a past history of stillbirth.

Conclusion
Obstetric hemorrhage was the common complications of abortion women while Pregnancy-induced diabetic Mellitus and pregnancy-induced hypertension were the most common complications of stillbirth for the next pregnancy.
Effect of supercritical carbon dioxide fluid extract from Chrysanthemum indicum Linné on bleomycin-induced pulmonary fibrosis
Authors: Nie Juan , Liu Yanlu , Sun Chaoyue , Zheng Jingna , Chen Baoyi , Zhuo Jianyi , Su Ziren , Lai Xiaoping , Chen Jiannan , Zheng Jibiao , Li Yucui 
Published: September 2021

Abstract
Background
As a prevalent type of cryptogenic fibrotic disease with high mortality, idiopathic pulmonary fibrosis (IPF) still lacks effective therapeutic drugs. The compounds extracted from buds and flowers of Chrysanthemum indicum Linné with supercritical-carbon dioxide fluid (CISCFE) has been confirmed to have antioxidant, anti-inflammatory, and lung-protective effects. This paper aimed to clarify whether CISCFE could treat IPF induced by bleomycin (BLM) and elucidate the related mechanisms.

Methods
Rats (Sprague-Dawley, male) were separated into the following groups: normal, model, pirfenidone (50 mg/kg), CISCFE-L, −M, and -H (240, 360, and 480 mg/kg/d, i.g., respectively, for 4 weeks). Rats were given BLM (5 mg/kg) via intratracheal installation to establish the IPF model. A549 and MRC-5 cells were stimulated by Wnt-1 to establish a cell model and then treated with CISCFE. Haematoxylin-eosin (H&E) and Masson staining were employed to observe lesions in the lung tissues. Quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot (WB) were performed to observe changes in genes and proteins connected with the Wnt/β-catenin pathway.

Results
CISCFE inhibited the proliferation of MRC-5 cells (IC50: 2.723 ± 0.488 μg/mL) and A549 cells (IC50: 2.235 ± 0.229 μg/mL). In rats, A549 cells, and MRC-5 cells, BLM and Wnt-1 obviously induced the protein expression of α-smooth muscle actin (α-SMA), vimentin, type I collagen (collagen-I), and Nu-β-catenin. The mRNA levels of matrix metalloproteinase-3 (MMP-3) and − 9 (MMP-9), two enzymes that degrade and reshape the extracellular matrix (ECM) were also increased while those of tissue inhibitor of metalloproteinase 1 (TIMP-1) were decreased. However, CISCFE reversed the effects of BLM and Wnt-1 on the expression pattern of these proteins and genes.

Conclusion
These findings showed that CISCFE could inhibit IPF development by activating the Wnt/β-catenin pathway and may serve as a treatment for IPF after further investigation.