bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stigma Attached to Smoking Pregnant Women: A Qualitative Insight in the General French Population
Authors: Loyal Deborah , Sutter Anne-Laure , Auriacombe Marc , Serre Fuschia , Calcagni Nicolas , Rascle Nicole 
Published: September 2021

Abstract

Introduction
Cigarette consumption during pregnancy has major health consequences for women and unborn children. The stigma of smoking during pregnancy might hinder mothers-to-be’s access to adequate healthcare and smoking cessation, especially in disadvantaged groups. This qualitative study was designed to describe extensively the public stigma associated with smoking during pregnancy.

Aims and Methods
Participants were French adults recruited from the general population through social networks (N = 100). They were asked to answer three pairs of open-ended questions regarding cognitions, emotions, and behaviors elicited in the general population by pregnant smoking women. An inductive thematic analysis was performed and interjudge agreement was computed on 30% of the corpus analyzed deductively. Finally, independence (chi-square) between themes and gender, education, parenthood, and smoking status was tested.

Results
Themes (n = 25) were defined regarding cognitions (n = 9, eg, irresponsible, thoughtless, and unmindful), emotions (n = 8, eg, anger and disgust), and behaviors, (n = 8, eg, inform and persuade, and moralize and blame). Global interjudge agreement was strong (κ = .8). No difference was observed in themes according to gender, parental status, or education, indicating a heterogenous awareness of stigma. However, some differences were observed according to smoking status (χ 2 = 69.59, p = .02) (eg, nonsmokers more frequently stressed immorality).

Conclusions
The stigma associated with smoking during pregnancy includes various components that might be measured and targeted in interventions to improve access to adequate healthcare and smoking cessation in this specific population.

Implications
This qualitative study explores the stigma that the general French population attaches to pregnant women who smoke. Themes regarding cognitions (eg, irresponsible, thoughtless, and unmindful), emotions (eg, anger and disgust), and behaviors (eg, inform and persuade, and moralize and blame) were identified. These themes could guide further research regarding scale development and antistigma interventions to support smoking cessation.
A Real-World Evaluation of a Smokeless Tobacco Cessation Text Message Program for Veterans: Outcomes and Comparison to Cigarette Smokers
Authors: Christofferson Dana E , Blalock Dan V , Knoeppel Jennifer , Beckham Jean C , Hamlett-Berry Kim , Hertzberg Jeffrey S 
Published: September 2021

Abstract

Introduction
Smokeless tobacco (ST) use and cessation rates have remained unchanged while cigarette smoking has declined, and cessation rates have increased. Text message programs have proved effective for cigarette smokers but have not been evaluated for ST users. The Veterans Health Administration (VHA) created a ST-specific arm of its SmokefreeVET automated text message program to help veteran ST users quit.

Aims and Methods
A retrospective evaluation was conducted on a real-world sample of veteran ST users (n = 1139) who subscribed to SmokefreeVET between 2017 and 2020. Time in program, abstinence, and nicotine replacement therapy (NRT) use were evaluated and compared to 9764 cigarette smokers who subscribed to SmokefreeVET.

Results
Younger subscribers were more likely to opt out early; 54% of ST users and 60% of cigarette smokers completed the 6-week program. ST users were more likely to report abstinence than cigarette smokers at all time points: the primary outcome, 30-day abstinence at 6 months, was 3.9% in ST users and 2.6% in cigarette smokers (p = .05) and the secondary outcome, abstinence at 3 months, was 5.3% in ST users and 3.4% in cigarette smokers (p = .03). NRT was used by 17% of ST users and was associated with a trend toward higher abstinence compared to ST users who did not use NRT.

Conclusion
A real-world sample of ST users were more likely to report abstinence after using the SmokefreeVET text program than cigarette smokers. Automated text message programs may be effective for increasing cessation among ST users and warrant further investigation.

Implications
Smokeless tobacco (ST) cessation is an important public health priority and of importance for veteran and military populations that have higher rates of ST use. There have been relatively few studies conducted investigating the effectiveness of text message interventions for ST cessation, despite the proven efficacy for cigarette smokers. This study provides evidence from a large, real-world sample that text message programs may be effective for ST users and suggests that further research into this treatment modality for ST users is needed.
GIGANTEA influences leaf senescence in trees in two different ways
Authors: Fataftah Nazeer , Bag Pushan , André Domenique , Lihavainen Jenna , Zhang Bo , Ingvarsson Pär K , Nilsson Ove , Jansson Stefan 
Published: September 2021

Abstract
GIGANTEA (GI) genes have a central role in plant development and influence several processes. Hybrid aspen T89 (Populus tremula x tremuloides) trees with low GI expression engineered through RNAi show severely compromised growth. To study the effect of reduced GI expression on leaf traits with special emphasis on leaf senescence, we grafted GI-RNAi scions onto wild-type rootstocks and successfully restored growth of the scions. The RNAi line had a distorted leaf shape and reduced photosynthesis, probably caused by modulation of phloem or stomatal function, increased starch accumulation, a higher carbon-to-nitrogen ratio, and reduced capacity to withstand moderate light stress. GI-RNAi also induced senescence under long day (LD) and moderate light conditions. Furthermore, the GI-RNAi lines were affected in their capacity to respond to “autumn environmental cues” inducing senescence, a type of leaf senescence that has physiological and biochemical characteristics that differ from those of senescence induced directly by stress under LD conditions. Overexpression of GI delayed senescence under simulated autumn conditions. The two different effects on leaf senescence under LD or simulated autumn conditions were not affected by the expression of FLOWERING LOCUS T. GI expression regulated leaf senescence locally—the phenotype followed the genotype of the branch, independent of its position on the tree—and trees with modified gene expression were affected in a similar way when grown in the field as under controlled conditions. Taken together, GI plays a central role in sensing environmental changes during autumn and determining the appropriate timing for leaf senescence in Populus.
Mobilizing Knowledge in Frontline Work: A Conceptual Framework and Empirical Exploration
Authors: Møller Anne Mette 
Published: September 2021

AbstractFrontline workers bring different forms of knowledge to bear on decisions and actions. Even so, knowledge has so far received limited attention in the street-level literature. This article develops a nuanced understanding of what constitutes knowledge in frontline work and shows how different forms of knowledge are mobilized on the ground. Taking a practice-based and abductive approach, the article draws on qualitative data from a multi-sited organizational ethnography in three Danish child welfare agencies as well as insights from a broad range of literature to build a conceptual framework for studying knowledge mobilization in frontline work. The framework delineates three interdependent forms of knowledge—knowledge-that, knowledge-how, and knowledge-by-acquaintance—that are all essential in frontline work. Knowledge-that is explicit and includes research evidence. Knowledge-how is rooted in experience and acquired through practice. Knowledge-by-acquaintance is rooted in encounters and denotes frontline workers’ “sense” of a case or situation. The empirical work shows how each form of knowledge is mobilized in practice. The findings yield important insights into the dynamics of knowledge mobilization at the frontlines, including the detrimental effects of rapid turnover, the conditions for realizing ideals such as evidence-based practice and data-driven decision-making, and the potential implications of digitalization and algorithmization.
Standardization of inducer-activated broad host range expression modules: debugging and refactoring an alkane-responsive AlkS/PalkB device
Authors: Arce-Rodríguez Alejandro , Benedetti Ilaria , Borrero-de Acuña José Manuel , Silva-Rocha Rafael , de Lorenzo Víctor 
Published: September 2021

Abstract
Although inducible heterologous expression systems have been available since the birth of recombinant DNA technology, the diversity of genetic devices and their coming together in the corresponding vectors often result in a lack of reproducibility and interoperability. In an effort to increase the predictability of expression of genes of interest in a variety of possible bacterial hosts, we propose a composition standard for debugging and reassembling all regulatory parts that participate in the performance of such devices. As a case study, we addressed the n-octane and dicyclopropyl ketone-inducible PalkB promoter of the alkane biodegradation pOCT plasmid of Pseudomonas putida. The standardized expression module included an edited alkS transcription factor divergently expressed and separated from PalkB by a synthetic buffer segment. The DNA sequence of the alkS gene was modified to alleviate the catabolite repression exerted by several carbon and nitrogen sources through the Crc/Hfq complex of some hosts. The PalkB promoter and the alkS variants were then formatted as Standard European Vector Architecture cargoes, and their activity in P. putida was quantified with fluorescent and luminescent reporters. Despite considerable editing of the DNA sequences involved, the thereby refactored module basically kept the functioning parameters of the original configuration. The same qualities were inspected when the system was passed to Escherichia coli and Pseudomonas aeruginosa. We argue that the application of the compositional standard thereby implemented in the AlkS/PalkB module to other promoter/regulator pairs will enable more complex genetic programming in non-model bacteria.
Vestibular Perceptual Thresholds in Older Adults With and Without Age-related Hearing Loss
Authors: Gabriel Grace A. , Harris Laurence R. , Gnanasegaram Joshua J. , Cushing Sharon L. , Gordon Karen A. , Haycock Bruce C. , Pichora-Fuller M. Kathleen , Campos Jennifer L. 
Published: September 2021

Objectives:
Older adults with age-related hearing loss (ARHL) are at greater risk of falling and have greater mobility problems than older adults with normal hearing (NH). The underlying cause of these associations remains unclear. One possible reason is that age-related declines in the vestibular system could parallel those observed in the auditory system within the same individuals. Here, we compare the sensitivity of vestibular perceptual abilities (psychophysics), vestibular end-organ functioning (vestibular evoked myogenic potentials and video head impulse tests), and standing balance (posturography) in healthy older adults with and without ARHL.

Design:
A total of 46 community-dwelling older adults, 23 with ARHL and 23 with NH, were passively translated in heave (up and down) and rotated in pitch (tilted forward and backward) in the dark using a motion platform. Using an adaptive staircase psychophysical procedure, participants’ heave and pitch detection and discrimination thresholds were determined. In a posturography task, participants’ center of pressure (COP) path length was measured as they stood on a forceplate with eyes open and closed, on firm and compliant surfaces, with and without sound suppression. Baseline motor, cognitive, and sensory functioning, including vestibular end-organ function, were measured.

Results:
Individuals with ARHL were less sensitive at discriminating pitch movements compared to older adults with NH. Poorer self-reported hearing abilities were also associated with poorer pitch discrimination. In addition to pitch discrimination thresholds, lower pitch detection thresholds were significantly associated with hearing loss in the low-frequency range. Less stable standing balance was significantly associated with poorer vestibular perceptual sensitivity.

Discussion:
These findings provide evidence for an association between ARHL and reduced vestibular perceptual sensitivity.
Increase in Osteoporotic U-Type Sacral Fractures: Role of the Transiliac-Transsacral Screw Versus Lumbopelvic Fixation
Authors: Wright Raymond D. , Cassidy R. Carter , Kark Jonathan 
Published: September 2021

Summary:
As the population is increasing in age, so increases the number of osteoporotic fractures. U-shaped sacral fractures can be difficult to diagnose and may be a source of disability in patients when left untreated. Many patients with osteoporotic fractures are of advanced age and may experience rapid medical decline when these fractures cause immobility. We present surgical options for U-shaped sacral fracture management.
Effect of a Multicomponent Sepsis Transition and Recovery Program on Mortality and Readmissions After Sepsis: The Improving Morbidity During Post-Acute Care Transitions for Sepsis Randomized Clinical Trial*
Authors: Taylor Stephanie Parks , Murphy Stephanie , Rios Aleta , McWilliams Andrew , McCurdy Lewis , Chou Shih-Hsiung , Hetherington Timothy , Rossman Whitney , Russo Mark , Gibbs Michael , Kowalkowski Marc A. 
Published: September 2021

OBJECTIVES:
To evaluate whether a nurse navigator-led, multicomponent Sepsis Transition And Recovery program improves 30-day mortality and readmission outcomes after sepsis hospitalization.

Desig
n: Multisite pragmatic randomized clinical trial.

SETTING:
Three hospitals in North Carolina from January 2019 to March 2020.

PATIENTS:
Eligible patients hospitalized for suspected sepsis and deemed high-risk for mortality or readmission by validated internal risk models.

INTERVENTIONS:
Patients were randomized to receive usual care alone (i.e., routine transition support, outpatient care; n = 342) or additional Sepsis Transition And Recovery support (n = 349). The 30-day intervention involved a multicomponent transition service led by a nurse navigator through telephone and electronic health record communication to facilitate best practice postsepsis care strategies during and after hospitalization including: postdischarge medication review, evaluation for new impairments or symptoms, monitoring comorbidities, and palliative care approach when appropriate. Clinical oversight was provided by a Hospital Medicine Transition Services team.

MEASUREMENTS AND MAIN RESULTS:
The primary outcome was a composite of mortality or hospital readmission at 30 days. Logistic regression models were constructed to evaluate marginal and conditional odds ratios (adjusted for prognostic covariates: age, comorbidity, and organ dysfunction at enrollment). Among 691 randomized patients (mean age = 63.7 ± 15.1 yr; 52% female), a lower percentage of patients in the Sepsis Transition And Recovery group experienced the primary outcome compared with the usual care group (28.7% vs 33.3%; risk difference, 4.7%; odds ratio, 0.80; 95% CI, 0.58–1.11; adjusted odds ratio, 0.80; 95% CI, 0.64–0.98). There were 74 deaths (Sepsis Transition And Recovery: 33 [9.5%] vs usual care: 41 [12.0%]) and 155 rehospitalizations (Sepsis Transition And Recovery: 71 [20.3%] vs usual care: 84 [24.6%]).

CONCLUSIONS:
In a multisite randomized clinical trial of patients hospitalized with sepsis, patients provided with a 30-day program using a nurse navigator to provide best practices for postsepsis care experienced a lower proportion of either mortality or rehospitalization within 30 days after discharge. Further research is needed to understand the contextual factors associated with successful implementation.
A retrospective clinical study of patients with pregnancy-associated breast cancer among multiple centers in China (CSBrS-008)
Authors: Jin Yu-Chun , Du Jun-Xian , Fu Shao-Mei , Chen Qin , Qiu Yi-Ran , Pei An , Yao Yi-Jing , Zhu Wei , Wu Ke-Jin 
Published: September 2021

Abstract

Background:
Pregnancy-associated breast cancer (PABC) is a special type of breast cancer that occurs during pregnancy and within 1 year after childbirth. With the rapid social development and the adjustment of reproductive policies in China, the average age of females at first childbirth is increasing, which is expected to lead to an increase in the incidence of PABC. This study aimed to accumulate clinical experience and to investigate and summarize the prevalence, diagnosis, and treatment of PABC based on large multicenter samples in China.

Methods:
According to the Chinese Society of Breast Surgery, a total of 164 patients with PABC in 27 hospitals from January 2016 to December 2018 were identified. The pregnancy status, clinicopathological features, comprehensive treatment methods, and outcomes were retrospectively analyzed. Survival curves were plotted using the Kaplan-Meier method.

Results:
A total of 164 patients of PABC accounted for 0.30% of the total number of cases in the same period; of which, 83 patients were diagnosed during pregnancy and 81 patients during lactation. The median age of PABC was 33 years (24–47 years). Stage I patients accounted for 9.1% (15/164), stage II 54.9% (90/164), stage III 24.4% (40/164), and stage IV 2.4% (4/164). About 9.1% (15/164) of patients were luminal A. Luminal B patients accounted the most (43.3% [71/164]). About 15.2% (25/164) of patients were human epidermal growth factor receptor 2 (Her-2) overexpression and 18.9% (31/164) of patients were triple-negative breast cancer. For pregnancy breast cancer, 36.1% (30/83) of patients received direct surgery and 20.5% (17/83) received chemotherapy during pregnancy. About 31.3% (26/83) chose abortion or induction of labor. The median follow-up time was 36 months (3–59 months); 11.0% (18/164) patients had local recurrence or distant metastasis and 3.0% (5/164) died.

Conclusions:
It is safe and feasible to standardize surgery and chemotherapy for PABC.
Clinical risk score for postoperative pneumonia following heart valve surgery
Authors: Wang Da-Shuai , Huang Xiao-Fan , Wang Hong-Fei , Le Sheng , Du Xin-Ling 
Published: September 2021

Abstract

Background:
Postoperative pneumonia (POP) is one of the most common infections following heart valve surgery (HVS) and is associated with a significant increase in morbidity, mortality, and health care costs. This study aimed to identify the major risk factors associated with the occurrence of POP following HVS and to derive and validate a clinical risk score.

Methods:
Adults undergoing open HVS between January 2016 and December 2019 at a single institution were enrolled in this study. Patients were randomly assigned to the derivation and validation sets at 1:1 ratio. A prediction model was developed with multivariable logistic regression analysis in the derivation set. Points were assigned to independent risk factors based on their regression coefficients.

Results:
POP occurred in 316 of the 3853 patients (8.2%). Multivariable analysis identified ten significant predictors for POP in the derivation set, including older age, smoking history, chronic obstructive pulmonary disease, diabetes mellitus, renal insufficiency, poor cardiac function, heart surgery history, longer cardiopulmonary bypass, blood transfusion, and concomitant coronary and/or aortic surgery. A 22-point risk score based on the multivariable model was then generated, demonstrating good discrimination (C-statistic: 0.81), and calibration (Hosmer-Lemeshow χ
2 = 8.234, P = 0.312). The prediction rule also showed adequate discriminative power (C-statistic: 0.83) and calibration (Hosmer-Lemeshow χ
2 = 5.606, P = 0.691) in the validation set. Three risk intervals were defined as low-, medium-, and high-risk groups.

Conclusion:
We derived and validated a 22-point risk score for POP following HVS, which may be useful in preventive interventions and risk management.

Trial Registration:
Chictr.org, ChiCTR1900028127; http://www.chictr.org.cn/showproj.aspx?proj=46932
Biomechanical evaluation of a novel transtibial posterior cruciate ligament reconstruction using high-strength sutures in a porcine bone model
Authors: Duan Ming-Yi , Sun Rui , Zhuang Lei-Ting , Zhang Hang-Zhou 
Published: September 2021

Abstract

Background:
Multiple techniques are commonly used for posterior cruciate ligament (PCL) reconstruction. However, the optimum method regarding the fixation of PCL reconstruction after PCL tears remains debatable. The purpose of this study was to compare the biomechanical properties among three different tibial fixation procedures for transtibial single-bundle PCL reconstruction.

Methods:
Thirty-six porcine tibias and porcine extensor tendons were randomized into three fixation study groups: the interference screw fixation (IS) group, the transtibial tubercle fixation (TTF) group, and TTF + IS group (n = 12 in each group). The structural properties of the three fixation groups were tested under cyclic loading and load-to-failure. The slippage after the cyclic loading test and the stiffness and ultimate failure load after load-to-failure testing were recorded.

Results:
After 1000 cycles of cyclic testing, no significant difference was observed in graft slippage among the three groups. For load-to-failure testing, the TTF + IS group showed a higher ultimate failure load than the TTF group and the IS group (876.34 ± 58.78 N vs. 660.92 ± 77.74 N [P < 0.001] vs. 556.49 ± 65.33 N [P < 0.001]). The stiffness in the TTF group was significantly lower than that in the IS group and the TTF + IS group (92.77 ± 20.16 N/mm in the TTF group vs. 120.27 ± 15.66 N/m in the IS group [P = 0.001] and 131.79 ± 17.95 N/mm in the TTF + IS group [P < 0.001]). No significant difference in the mean stiffness was found between the IS group and the TTF + IS group (P = 0.127).

Conclusions:
In this biomechanical study, supplementary fixation with transtibial tubercle sutures increased the ultimate failure load during load-to-failure testing for PCL reconstruction.
A rare case report of anal canal adenocarcinoma
Authors: Song Xiaowei , Zhao Huimin , Yang Yongping , Zhao Linxian , Zhao Yongqing , Li Jiannan 
Published: September 2021

Abstract

Rationale:
Anal canal adenocarcinoma is a kind of rare malignant tumor of the intestinal tract with a low incidence rate.

Patient concerns:
A 42-year-old man came to our department with anal tenderness accompanied by intermittent drainage of mucus discharge for 2 weeks.

Diagnoses:
The computer tomography showed a strip-shaped high-density shadow in the rectal wall. The magnetic resonance imaging showed a cyst-like mass of about 33 × 57 × 30 mm in the anal area. The lesion penetrated the anal canal, and plaque-shaped high signal shadow can be seen in the left side of the anus. The intraoperative pathology indicated the mass as anal canal adenocarcinoma.

Interventions:
The abdominal perineal resection was performed for this patient. The postsurgical pathology showed that the tumor was anal canal adenocarcinoma with large amounts of mucus.

Outcomes:
The patient recovered well and was discharged from our department at 12th day post-surgery. This patient received further pelvic radiotherapy.

Lessons:
Anal canal adenocarcinoma is a kind of malignant tumor that is extremely rare clinically. Computer tomography, magnetic resonance imaging, coloscopy, and histopathology are vital for the diagnosis of anal canal adenocarcinoma. Comprehensive treatment, including abdominal perineal resection, radiotherapy, and chemotherapy, is important for the treatment of anal canal adenocarcinoma.