bluuebunny/crossref_metadata_2025_split huggingface dataset:
Global Patterns and Prevalence of Dual and Poly-Tobacco Use: A Systematic Review
Authors: Chen Daniel Tzu-Hsuan , Girvalaki Charis , Mechili Enkeleint A , Millett Christopher , Filippidis Filippos T 
Published: April 2021

Abstract

Introduction
Improving understanding of the epidemiology of dual and poly-tobacco product use is essential for tobacco control policy and practice. The present study aimed to systematically review existing epidemiologic evidence on current dual and poly-tobacco use among adults globally.

Methods
We systematically searched online databases for studies published up to June 30, 2020. We included quantitative studies with measures of nationally representative prevalence of current dual or poly-tobacco use among adults. Prevalence estimates for each country were extracted manually and stratified by WHO regions and World Bank income classifications.

Results
Twenty studies with nationally representative prevalence data on current dual or poly-tobacco use in the adult population across 48 countries were included. Definitions of dual and poly-tobacco use varied widely. Prevalence of dual and poly-tobacco use was higher in low- and lower-middle-income countries compared to other higher-income countries. Current dual use of smoked and smokeless tobacco products among males ranged from 0.2% in Ukraine (2010) and Mexico (2009) to 17.9% in Nepal (2011). Poly-tobacco use among males ranged from 0.8% in Mexico (2009) and 0.9% in Argentina (2010) to 11.4% in the United Kingdom and 11.9% in Denmark in 2012. Dual tobacco use was generally higher in South-East Asia; poly-tobacco use was prevalent in Europe as well as in South-East Asia.

Conclusions
This is the first systematic review of the prevalence estimates of dual and poly-tobacco use among adults globally. The results of the current study could significantly help health policy makers to implement effective tobacco control policies.

Implications
This study demonstrates that dual/poly-tobacco use is common in many countries of the world, and highlights the need for in-depth exploration of this field in future studies, especially in high prevalence regions such as South-East Asian and European countries. In light of this, the global tobacco control community and health authorities should also agree upon a consistent operational definition of dual and poly-tobacco use to propel research and improve surveillance of dual/poly-use in health surveys for better communication and understanding of these phenomena.
Bm-miR172c-5p Regulates Lignin Biosynthesis and Secondary Xylem Thickness by Altering the Ferulate 5 Hydroxylase Gene in Bacopa monnieri
Authors: Jeena Gajendra Singh , Joshi Ashutosh , Shukla Rakesh Kumar 
Published: April 2021

Abstract
MicroRNAs (miRNAs) are small non-coding, endogenous RNAs containing 20–24 nucleotides that regulate the expression of target genes involved in various plant processes. A total of 1,429 conserved miRNAs belonging to 95 conserved miRNA families and 12 novel miRNAs were identified from Bacopa monnieri using small RNA sequencing. The Bm-miRNA target transcripts related to the secondary metabolism were further selected for validation. The Bm-miRNA expression in shoot and root tissues was negatively correlated with their target transcripts. The Bm-miRNA cleavage sites were mapped within the coding or untranslated region as depicted by the modified RLM-RACE. In the present study, we validate three miRNA targets, including asparagine synthetase, cycloartenol synthase and ferulate 5 hydroxylase (F5H) and elucidate the regulatory role of Bm-miR172c-5p, which cleaves the F5H gene involved in the lignin biosynthesis. Overexpression (OE) of Bm-miR172c-5p precursor in B. monnieri suppresses F5H gene, leading to reduced lignification and secondary xylem thickness under control and drought stress. By contrast, OE of endogenous target mimics (eTMs) showed enhanced lignification and secondary xylem thickness leading to better physiological response under drought stress. Taken together, we suggest that Bm-miRNA172c-5p might be a key player in maintaining the native phenotype of B. monnieri under control and different environmental conditions.
Patient-Reported Outcome–Based Quality Indicators in Dutch Primary Care Physical Therapy for Patients With Nonspecific Low Back Pain: A Cohort Study
Authors: Verburg Arie C , van Dulmen Simone A , Kiers Henri , Nijhuis-van der Sanden Maria W G , van der Wees Philip J 
Published: April 2021

Abstract

Objective
The purpose of this study was to define and select a core set of outcome-based quality indicators, accepted by stakeholders on usability and perceived added value as a quality improvement tool, and to formulate recommendations for the next implementation step.

Methods
In phase 1, 15 potential quality indicators were defined for patient-reported outcome measures and associated domains, namely the Numeric Pain Rating Scale (NPRS) for pain intensity, the Patient Specific Functioning Scale (PSFS) for physical activity, the Quebec Back Pain Disability Scale for physical functioning, and the Global Perceived Effect—Dutch Version for perceived effect. Their comparability and discriminatory characteristics were described using cohort data. In phase 2, a core set of quality indicators was selected based on consensus among stakeholders in focus group meetings.

Results
In total, 65,815 completed treatment episodes for patients with nonspecific low back pain were provided by 1009 physical therapists from 219 physical therapist practices. The discriminability between physical therapists of all potential 15 quality indicators was adequate, with intraclass correlation coefficients between 0.08 and 0.30. Stakeholders selected a final core set of 6 quality indicators: 2 process indicators (the routine measurement of NPRS and the PSFS) and 4 outcome indicators (pretreatment and posttreatment change scores for the NPRS, PSFS, Quebec Back Pain Disability Scale, and the minimal clinically important difference of the Global Perceived Effect—Dutch Version).

Conclusion
This study described and selected a core set of outcome-based quality indicators for physical therapy in patients with nonspecific low back pain. The set was accepted by stakeholders for having added value for daily practice in physical therapy primary care and was found useful for quality improvement initiatives. Further studies need to focus on improvement of using the core set of outcome-based quality indicators as a quality monitoring and evaluation instrument.

Impact
Patient-reported outcome–based quality indicators developed from routinely collected clinical data are promising for use in quality improvement in daily practice.
COVID-19 and Territorial Policy Dynamics in Western Europe: Comparing France, Spain, Italy, Germany, and the United Kingdom
Authors: Vampa Davide 
Published: April 2021

Abstract
This article seeks to assess and explain territorial policy dynamics in five European countries—Italy, Spain, Germany, France and the United Kingdom—from the start of the COVID-19 pandemic up to early 2021. The crisis has clearly highlighted well-known differences between centralized and decentralized systems. Yet focusing on this dichotomy is not sufficient. It is suggested that, while the distribution of authority between central and regional governments matters, policy dynamics—that is, how different territorial levels interact in policy-making processes—are even more important in driving multi-level responses to the emergency. Whether these dynamics are hierarchical (France), competitive (Italy and Spain), cooperative (Germany) or mixed (the United Kingdom) depends on how pre-crisis institutional, sectoral and political “causal forces” moderate the impact of an exogenous shock.
Toxicokinetic and Genotoxicity Study of NNK in Male Sprague Dawley Rats Following Nose-Only Inhalation Exposure, Intraperitoneal Injection, and Oral Gavage
Authors: Hu Shu-Chieh , Bryant Matthew S , Sepehr Estatira , Kang Hyun-Ki , Trbojevich Raul , Lagaud Guy , Mehta Darshan , Ding Wei , Mittelstaedt Roberta A , Pearce Mason G , Bishop Michelle E , Davis Kelly J , Lewis Sherry M , Chemerynski Susan , Yee Steven B , Coraggio Melis , Rosenfeldt Hans , Yeager R Philip , Howard Paul C , Tang Yunan 
Published: April 2021

Abstract
The tobacco-specific nitrosamine NNK [4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone] is found in tobacco products and tobacco smoke. NNK is a potent genotoxin and human lung carcinogen; however, there are limited inhalation data for the toxicokinetics (TK) and genotoxicity of NNK in vivo. In the present study, a single dose of 5 × 10−5, 5 × 10−3, 0.1, or 50 mg/kg body weight (BW) of NNK, 75% propylene glycol (vehicle control), or air (sham control) was administered to male Sprague-Dawley (SD) rats (9–10 weeks age) via nose-only inhalation (INH) exposure for 1 h. For comparison, the same doses of NNK were administered to male SD rats via intraperitoneal injection (IP) and oral gavage (PO). Plasma, urine, and tissue specimens were collected at designated time points and analyzed for levels of NNK and its major metabolite 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) and tissue levels of DNA adduct O6-methylguanine by LC/MS/MS. TK data analysis was performed using a non-linear regression program. For the genotoxicity subgroup, tissues were collected at 3 h post-dosing for comet assay analysis. Overall, the TK data indicated that NNK was rapidly absorbed and metabolized extensively to NNAL after NNK administration via the three routes. The IP route had the greatest systemic exposure to NNK. NNK metabolism to NNAL appeared to be more efficient via INH than IP or PO. NNK induced significant increases in DNA damage in multiple tissues via the three routes. The results of this study provide new information and understanding of the TK and genotoxicity of NNK.
First Expansion of the Public Tomato Brown Rugose Fruit Virus (ToBRFV) Nextstrain Build; Inclusion of New Genomic and Epidemiological Data
Authors: van de Vossenberg Bart T. L. H. , Dawood Thikra , Woźny Marek , Botermans Marleen 
Published: April 2021

Tomato brown rugose fruit virus (ToBRFV) is a tobamovirus that was first detected in Israel and Jordan following an outbreak of a new disease infecting tomato in 2014. Since then, the virus has been reported from all continents except Oceania and Antarctica. In response to the first finding of the virus in The Netherlands, the Dutch National Plant Protection Organization created a ToBRFV Nextstrain build (v1). In this report, we announce 47 new (near) complete ToBRFV genomes and the generation of the new ToBRFV Nextstrain (v2) build containing 118 ToBRFV genomes with associated geographic and epidemiological data. Examples of utilization of the genomic sequences are presented, and we report the first sequence from South America and present a novel hypothesis on the possible ToBRFV center of origin. [Formula: see text] Copyright © 2021 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Postoperative Pain Mediates the Association Between Peripheral Nerve Blocks and Postoperative Sleep Following Lower Extremity Arthroplasty
Authors: Giordano Nicholas A. , Kent Michael , Andersen Stephanie G. , Scott-Richardson Maya , Highland Krista B. 
Published: April 2021

Objectives:
Despite substantial research showing the bidrectional relationship between sleep and pain, there remains a dearth of research examining the role of perioperative pain management interventions in mitigating postoperative sleep disturbances. This secondary analysis of a prospective observational multisite study examined the association between peripheral nerve block (PNB) use during total knee or total hip arthroplasty (TKA/THA) procedures and postoperative pain and sleep outcomes.

Materials and Methods:
Adult patients undergoing TKA or THA procedures were recruited from 2 tertiary care facilities. Average pain and sleep disturbance scores were collected preoperatively and at 1- and 2-week postoperatively. Participants were not randomized to receive PNB. Postoperative outcomes were compared based on receipt of PNB during surgery. Structural equation modeling path analysis was utilized to model multiple co-occurring relationships, including mediation pathways between perioperative pain management approaches, pain, and postoperative sleep outcomes.

Results:
Of the 197 participants, 53% received PNB. Mediation analyses indicated that PNB was indirectly associated with 1-week sleep disturbance via its effects on 1-week pain intensity (β=−0.02, 95% confidence interval [CI] −0.04, −0.001, P=0.04). In addition, PNB was indirectly associated with 2-week sleep disturbance, via its effects on 1-week pain intensity and 1-week sleep disturbance (β=−0.04, 95% CI −0.07, −0.02, P=0.04). Lastly, PNB was indirectly associated with 2-week pain intensity via its effects on 1-week pain intensity (β=−0.10, 95% CI −0.19, −0.02, P=0.02).

Conclusions:
Receipt of PNB during TKA or THA was found to be associated with improved 1-week postoperative pain intensity, which in turn was found to be associated with lower sleep disturbances at both 1- and 2-week postoperative time points. Multimodal opioid sparing pain management interventions, capable of improving postoperative sleep, are vital to improving recovery and rehabilitation following arthroplasty.
Diagnostic Potential of Coagulation-Related Biomarkers for Sepsis in the Emergency Department: Protocol for a Pilot Observational Cohort Study
Authors: Arora Jaskirat , Klowak Jennifer A. , Parpia Sameer , Zapata-Canivilo Marcelo , Faidi Walaa , Skappak Christopher , Gregoris Rachael , Kretz Colin A. , Dwivedi Dhruva J. , de Wit Kerstin , Welsford Michelle , Fox-Robichaud Alison 
Published: April 2021

Background:
Between 75% and 80% of patients with sepsis arrive in the hospital through the emergency department. Early diagnosis is important to alter patient prognosis, but currently, there is no reliable biomarker. The innate immune response links inflammation and coagulation. Several coagulation -related biomarkers are associated with poor prognosis in the ICU. The role of coagulation biomarkers to aid in early sepsis diagnosis has not previously been investigated. The objective of our study is to determine the individual or combined accuracy of coagulation and inflammation biomarkers with standard biochemical tests to diagnose adult septic patients presenting to the emergency department.

Methods:
in the Emergency Department is a prospective, observational cohort study with a target enrolment of 250 suspected septic patients from two Canadian emergency departments. The emergency physicians will enroll patients with suspected sepsis. Blood samples will be collected at two time points (initial presentation and 4 hr following). Patients will be adjudicated into septic, infected, or not infected status in accordance with the Sepsis-3 definitions. Patient demographics, cultures, diagnosis, and biomarkers will be reported using descriptive statistics. Optimal cut off values with sensitivity and specificity for each biomarker will be determined using C-statistics to distinguish between septic and nonseptic patients. Stepwise multiple logistic regression analysis with exclusion of nonsignificant covariates from the final model will be used to establish a panel of biomarkers.

Conclusions:
Our protocol describes the processes and methods for a pragmatic observational biomarker study in the emergency department. This study will seek to determine the potential diagnostic importance of early coagulation abnormalities to identify additional tools for sepsis diagnosis.
Comparison of Horizontal Corneal Diameter Measurements Using Orbscan IIz, OPD Scan III, and IOLMaster 700
Authors: Cruz Sebastian , Valenzuela Felipe , Stoppel Juan , Maul Eugenio , Gibbons Allister 
Published: April 2021

Purpose:
To compare three automated devices for measuring the horizontal corneal diameter (white to white [WTW]).

Methods:
In 65 eyes of 38 patients, the WTW distance was measured independently by three examiners using the following techniques: Orbscan IIz tomography system (Bausch & Lomb), IOLMaster 700 (Carl Zeiss Meditec), and OPD Scan III (NIDEK). We tested for systematic differences in measurements and estimated the limits of agreement (LoA) using linear mixed-effects models.

Results:
The mean WTW distance was 11.8±0.40 mm with Orbscan IIz, 12.1±0.5 mm with IOLMaster 700 and 12.0±0.4 mm with OPD Scan III. The mean difference between IOLMaster 700 and Orbscan IIz was 0.33 (95% CI, 0.28 to 0.38; P<0.001), between OPD Scan III and Orbscan IIz was 0.24 mm (95% CI, 0.21 to 0.28; P<0.001), and between IOL Master 700 and OPD Scan III was 0.09 (95% CI, 0.05 to 0.12; P<0.001). The 95% LoA for Orbscan IIz versus IOLMaster 700 was −0.69 to 0.03 mm, Orbscan IIz versus OPD Scan III was −0.52 to −0.03 mm, and OPD versus IOLMaster 700 was −0.39 to 0.22 mm.

Conclusions:
The data suggest that these devices are not interchangeable for usual clinical practice. Adjustments based on mean differences were not enough to compensate for interinstrument discrepancy in WTW measurements.
Video Viewing Blink Rate in Normal and Dry Eyes
Authors: Mitchell Travis , Murri Michael , Pflugfelder Stephen C. 
Published: April 2021

Objectives:
Decreased blink rate during video display viewing (VDV) has been reported; however, patients with tear dysfunction often complain of more frequent blinking. The objectives were to compare blink rates during conversation and VDV in normal and dry eyes and correlate blink rates with signs and symptoms.

Methods:
Blink rate was measured with an infrared blink sensor for 2 minutes during conversation and for 2 minutes while watching a video clip (VDV) in patients without dry eye disease (control, n=18) and in patients with tear dysfunction from meibomian gland dysfunction (MGD, n=23), conjunctivochalasis (CCh, n=19), and aqueous tear deficiency (n=34; non-Sjögren syndrome n=18 and Sjögren syndrome n=16). Patients completed visual analogue questionnaires assessing irritation frequency and severity and blink frequency and underwent an ocular surface evaluation. Group comparisons and correlations were calculated.

Results:
Compared with control, conversational and VDV blink rates were significantly higher in CCh and aqueous tear deficiency (P≤0.005). Self-reported blink frequency was higher in all tear dysfunction groups compared with control. The VDV blink rate was significantly lower than the conversation blink rate in the control group (P=0.006) but not in any of the tear dysfunction groups. Conversational and VDV blink rates were significantly correlated with irritation frequency and severity.

Conclusions:
Blink rate decreases during VDV in normal eyes; however, this blink rate suppression was not observed in patients with tear dysfunction, perhaps because of their irritation symptoms or tear instability.
The Contemporary Epidemiology, Microbiology and Management of Chronic Osteomyelitis in US Children
Authors: McNeil J. Chase , Joseph Marritta , Sommer Lauren M. , Vallejo Jesus G. 
Published: April 2021

Background:
While the majority of pediatric osteomyelitis cases are acute in nature, a significant subset present with prolonged symptoms often associated with substantial morbidity. Little data exist to guide clinicians in the management of these infections. We sought to describe the epidemiology, clinical features and management of chronic osteomyelitis (CO) in children.

Methods:
We reviewed hospital admissions for CO from 2011 to 2018 at Texas Children’s Hospital. Cases were included if symptoms lasted ≥28 days on presentation. Cases were classified as those associated with: (1) a contiguous focus of infection; (2) penetrating trauma; (3) orthopedic hardware; (4) postacute CO (PACO, those occurring after ≥28 days of therapy for acute osteomyelitis); and (5) primary hematogenous CO.

Results:
One hundred fourteen cases met inclusion criteria. The median patient age was 11.8 years and 35.9% had comorbidities. 70.2% of patients underwent ≥1 surgical procedure. A microbiologic etiology was identified in 72.8% of cases and Staphylococcus aureus was most common (39.4%). Contiguous focus of infection was more often associated with polymicrobial disease with or without Pseudomonas. Postacute CO was caused by S. aureus in 95%. The median duration of total therapy was 210 days. 26.3% of patients experienced treatment failure of which 46% underwent repeat hospital admission/surgery. There was no association between duration of intravenous therapy for CO and treatment failure.

Conclusions:
Children with CO represent a diverse group both in terms of pathogenesis and microbiology. Pathogenesis and clinical presentation can provide clues to microbiologic etiology. Prolonged intravenous therapy does not appear to improve outcomes in CO.
Descriptive Study of Employee Engagement With Workplace Wellness Interventions in the UK
Authors: Mulaney Bianca , Bromley-Dulfano Rebecca , McShane Erin K. , Stepanek Martin , Singer Sara J. 
Published: April 2021

Objective:
To explore sequential steps of employee engagement in wellness interventions and the impact of wellness interventions on employee health.

Methods:
Using previously collected survey data from 23,667 UK employees, we tabulated intervention availability, awareness, participation, and associated health improvement and compared engagement by participation and risk status.

Results:
Employees’ awareness of wellness interventions at their workplaces was often low (mean 43.3%, range 11.6%–82.3%). Participation was highest in diet/nutrition initiatives (94.2%) and lowest in alcohol counseling and smoking cessation interventions (2.1%). Employees with health risks were less likely than lower-risk employees to report awareness, participation, and health improvements from wellness interventions addressing the relevant health concern.

Conclusion:
Employers and policymakers should consider variation in intervention engagement as they plan and implement wellness interventions. Engaging employee populations with higher health risks requires a more targeted approach.
Variation in Employment in Healthcare Occupations and County-Level Differences in COVID-19 Cases in the United States of America
Authors: Le Dong , Hawkins Devan 
Published: April 2021

Objective:
To study how county-level differences in employment in healthcare occupations contributes to county-level differences in COVID-19 cases.

Method:
The number of active COVID-19 cases were gathered from the Johns Hopkins University Coronavirus Resource Center weekly between April 22, 2020 and July 1, 2020. Data for the number of workers employed in healthcare occupations were collected at the county-level from the American Community Survey. These data were combined to explore the association between employment patterns and rates of COVID-19 cases.

Result:
Counties with more employment in healthcare-related occupations experienced higher rate of COVID-19. This association was strongest in April and May compared to later months of the pandemic.

Conclusion:
Employment in healthcare occupations may contribute to the spread of COVID-19. Intervention to protect workers may help to prevent the spread of COVID-19 and other infectious diseases.