bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychosocial determinants of quit motivation in older smokers from deprived backgrounds: a cross-sectional survey
Authors: Smith Pamela , Daniel Rhian , Murray Rachael L , Moore Graham , Nelson Annmarie , Brain Kate 
Published: May 2021

ObjectivesTo identify psychosocial determinants of quit motivation in older deprived smokers. The evidence may be used to optimise smoking cessation interventions for the target population.DesignCross-sectional survey using online recruitment methods including Facebook-targeted advertising.SettingUK, 2019.ParticipantsCurrent smokers aged 50 years or older and from a socioeconomically deprived background.Main outcome measuresMeasures included motivation to stop smoking, smoking history, perceived social support, self-efficacy for quitting, self-exempting beliefs and lung cancer risk perception. Multivariable regression was used to analyse factors associated with quit motivation.ResultsOf a total 578 individuals who consented to take part, 278 (48.1%) did not meet the inclusion criteria. Of the 300 eligible participants, most were recruited using Facebook (94.0%), were aged 50–64 years (83.7%) and women (85.7%). Most participants were renting from a housing association (72.0%) and had low education (61.0%). Higher motivation to quit was statistically significantly associated with a higher intensity of previous quit attempts (p=0.03), higher quit confidence (p=0.01), higher smoking self-efficacy (p=0.01), a lower risk-minimising beliefs score (p=0.01) and using traditional nicotine replacement therapy (NRT) when trying to stop smoking or cut down (p<0.001).ConclusionOlder smokers from deprived backgrounds face complex barriers to quitting smoking. Interventions are needed to increase self-efficacy for quitting, modify risk-minimising beliefs and target elements of previous quit attempts (ie, the use of NRT) that are associated with motivation to stop smoking.
Comparison between primary care service delivery in Malaysia and other participating countries of the QUALICOPC project: a cross-sectional study
Authors: Lim Ming Tsuey , Ong Su Miin , Tong Seng Fah , Groenewegen Peter , Sivasampu Sheamini 
Published: May 2021

ObjectivesMost countries including Malaysia have set goals to incorporate a strong primary care into the healthcare system. The aim of this study was to evaluate the strength of service delivery process dimensions in Malaysia and compare it with England, the Netherlands, Spain, North Macedonia, Romania and Turkey which participated in the Quality and Costs of Primary Care (QUALICOPC) study.MethodsThis cross-sectional study utilised the QUALICOPC study data on primary care performance, which was conducted in 2011–2013 (QUALICOPC in Europe Australia, New Zealand and Canada) and 2015–2016 (Malaysia). A standardised questionnaire was completed by primary care practitioners from participating countries. Multilevel regression analysis and composite scores were constructed to compare the performance of primary care on four process dimensions: accessibility, comprehensiveness, continuity of care and coordination.ResultsThe high-income countries with strong primary care performed better in comprehensiveness, continuity and coordination but poorer in accessibility to services compared with upper-middle-income countries. Among the upper-middle-income countries, Malaysia scored the best in comprehensiveness and coordination. None of the studied countries were having consistent performance over all indicators either in their respective best or worst primary care services delivery dimensions.ConclusionsThere is a wide variation in primary care services delivery across and within the studied countries. The findings indicate room for quality improvement activities to strengthen primary healthcare services. This includes addressing current healthcare challenges in response to the population health needs which are essential for more integrated and efficient primary care services delivery.
Study recruitment factors in advanced cancer: the Prognosis in Palliative care Study II (PiPS2) - a multicentre, prospective, observational cohort project
Authors: Kalpakidou Anastasia K , Todd Chris , Omar Rumana Z , Keeley Vaughan , Griffiths Jane , Spencer Karen , Vickerstaff Victoria , Christidoulides Karolina , Perry Rachel , Katsampa Dafni , Stone Patrick 
Published: May 2021

ObjectivesThe Prognosis in Palliative care Study II (PiPS2) was a large multicentre observational study validating prognostic tools in patients with advanced cancer. Many palliative care studies fail to reach their recruitment target. To inform future studies, PiPS2 rigorously monitored and identified any potential recruitment barriers.MethodsKey recruitment stages (ie, whether patients were eligible for the study, approached by the researchers and whether consent was obtained for enrolment) were monitored via comprehensive screening logs at participating sites (inpatient hospices, hospitals and community palliative care teams). The reasons for patients’ ineligibility, inaccessibility or decision not to consent were documented.Results17 014 patients were screened across 27 participating sites over a 20-month recruitment period. Of those, 4642 (27%) were ineligible for participation in the study primarily due to non-cancer diagnoses. Of 12 372 eligible patients, 9073 (73%) were not approached, the most common reason being a clinical decision not to do so. Other reasons included patients’ death or discharge before they were approached by the researchers. Of the 3299 approached patients, 1458 (44%) declined participation mainly because of feeling too unwell, experiencing severe distress or having other competing priorities. 11% (n=1841/17 014) of patients screened were enrolled in the study, representing 15% (n=1841/12 372) of eligible patients. Different recruitment patterns were observed across inpatient hospice, hospital and community palliative care teams.ConclusionsThe main barrier to recruitment was ‘accessing’ potentially eligible patients. Monitoring key recruitment stages may help to identify barriers and facilitators to enrolment and allow results to be put into better context.Trial registration numberISRCTN13688211.
Informal caregivers and advance care planning: systematic review with qualitative meta-synthesis
Authors: Silies Katharina Theodora , Köpke Sascha , Schnakenberg Rieke 
Published: May 2021

BackgroundAdvance care planning (ACP) is a communication process about a person’s values, life goals and preferences for current and future treatment and care. It can improve end-of-life care experiences for care recipients as well as for family caregivers. Knowledge about caregivers’ needs might support implementation of ACP interventions suitable to both care recipients and their caregivers.ObjectiveTo explore the experiences and attitudes of informal family caregivers, and their knowledge, regarding ACP.MethodsA systematic literature search was conducted (participants: family caregivers; intervention: advance care planning; databases: MEDLINE, PsycINFO, CINAHL, Cochrane Library). Thematic synthesis was applied to qualitative and mixed methods studies; quantitative studies were described in relation to the themes of the meta-synthesis.Results57 studies were included, of these 51 in the meta-synthesis. Three themes emerged: (1) caregiver’s individual conceptualisation of ACP, (2) caregiver’s relationships and (3) ACP process. These themes were incorporated into a longitudinal perspective on the caregiver’s ACP trajectory, encompassing the phases (A) life before, (B) ACP process, (C) utilisation of ACP and (D) life after. The implications for ACP activities are described according to each phase.ConclusionFor the benefit of care recipients, healthcare professionals should carefully consider caregivers’ conceptualisations of ACP as well as the relationships within the family. They need to be skilled communicators, sensitive to individual needs and equipped with sufficient time resources to tailor ACP interventions to their clients’ unique situation. Thus, they will support decision-making according to care recipients’ wishes, caregivers’ end-of-life experience and their life after bereavement.PROSPERO registration numberCRD42018082492.
Changes in health and social well-being in the COVID-19 clinically vulnerable older English population during the pandemic
Authors: Di Gessa Giorgio , Price Debora 
Published: May 2021

BackgroundPeople with specific health profiles and diseases (such as diabetes, lung and heart conditions) have been classified as ‘clinically vulnerable’ (CV) to COVID-19, that is, at higher risk of severe illness and mortality from COVID-19, and were targeted for shielding. However, there is as yet little evidence on how the pandemic and shielding impacted the health and social well-being of CV older people.MethodsWe used data from wave 9 (2018/2019) and the first COVID-19 substudy (June/July 2020) of the English Longitudinal Study of Ageing. Using logistic and linear regression models, we investigated associations between being CV and health and social well-being during the pandemic, while controlling for prepandemic levels of the outcome variables. We also explored the interactions between CV and age group (50s, 60s, 70s, 80+), and between CV and shielding.ResultsCV people were more likely to report worse health and social well-being outcomes during the pandemic, even taking into account prepandemic differences. However, changes in health were not uniform across different age groups, and CV respondents were generally at greater risks of deterioration in health and social well-being compared with those not CV in the same age group. CV respondents who were shielding reported worse outcomes compared with those not CV and not shielding.ConclusionsWhile policies focusing on shielding CV older people reduce rates of hospitalisation and death from COVID-19, policymakers should also pay attention to understanding and addressing the wider needs of this group if their long-term health and social well-being are not to be compromised.
Cardiovascular complications of systemic lupus erythematosus: impact of risk factors and therapeutic efficacy—a tertiary centre experience in an Appalachian state
Authors: McVeigh Elise Danielle , Batool Amna , Stromberg Arnold , Abdel-Latif Ahmed , Kazzaz Nayef Mohammed 
Published: May 2021

ObjectivesCardiovascular complications became a notable cause of morbidity and mortality in patients with lupus as therapeutic advancements became more efficient at managing other complications. The Appalachian community in Kentucky has a higher prevalence of traditional cardiovascular risk factors, predisposing them to cardiovascular events. Namely, the mean body mass index of the members of the Kentucky Appalachian community was reported at 33 kg/m2and 94.3% of male members of this community use tobacco. We sought to identify risk factors that predispose patients with lupus to cardiovascular morbidities and examine the effect of immunomodulatory drugs.MethodsWe identified 20 UKHS patients having both a lupus diagnosis and experienced at least one cardiovascular event. We chose three controls matched for birth-year ±5 years to each case. In a case–control design, we analysed lupus manifestations, cardiovascular risk factors and immunosuppressive therapies. We collected Systemic Lupus Erythematosus Disease Activity Index 2000 disease activity index during the cardiovascular event.ResultsWe identified 308 patients with lupus from among all University of Kentucky Health System patients. 20 (6.5%) of such patients with lupus were confirmed to cardiovascular complication. Of those 20, 7 (35%) had experienced myocardial infarction, 10 (50%) had experienced stroke and 4 (20%) had peripheral ischaemia. Tobacco use and male gender were the only traditional cardiovascular risk factors higher in the cases group. Hydroxychloroquine and steroids were less utilised in the cases than in the controls (70% vs 100% in hydroxychloroquine, 30% vs 82% in steroids). Venous thrombosis was found to be significantly higher in the cases. On multivariate analysis, venous thrombosis remained significant.ConclusionDespite tobacco use partially explaining the increased risk of cardiovascular disease among the cases group, the higher prevalence of venous thrombosis in the cases group suggests lupus as a potential additional risk factor of cardiovascular morbidity among patients with lupus in this Appalachian community.
Treatment of Dangling-Type Thumb Polydactyly: Suture Ligation vs. Surgical Excision
Authors: Chow Esther Ching San , Chan Yi Lok Charis , Ko Choi Wah , Ho Pak Cheong 
Published: May 2021

Background: To review the cases of dangling-type thumb polydactyly treated with suture ligation vs surgical excision. Methods: Cases of dangling-type thumb polydactyly treated in 2 different hospitals from 1994 to 2014 were recruited. Group 1 includes cases treated with suture ligation in hospital 1; Group 2 includes cases treated with surgical excision in hospital 2. The demographics data, early clinical outcomes and early complications were retrieved from clinical notes. All cases were contacted for a final assessment. Results: There were 23 cases recruited in group 1 and 26 cases recruited in group 2. The mean age at the time of procedure was 15.9 days (group 1) vs. 14 months (group 2). The infection rate was comparable in both groups (4.35% vs. 3.85%). 12 cases in group 1 and 14 cases in group 2 completed a final assessment. Residual tissue is common in group 1 (58.5%) and 4 cases (33.3%) required revision surgery. No case in group 2 had residual tissue and none require revision surgery. There was no painful neuroma in both groups and all patients achieved normal thumb and hand functions. The parental satisfaction score was 7.8 (group 1) and 8.8 (group 2) with no statistical difference (p = 0.061). Conclusions: Suture ligation and surgical excision are safe and effective treatment options for dangling-type thumb polydactyly. Both methods received comparable parental satisfaction. However, residual tissue is common after suture ligation while this problem is not observed after surgical excision.
The Quantum Symmetry in Nonbalanced Hopf Spin Models Determined by a Normal Coideal Subalgebra
Authors: Qiaoling Xin , Tianqing Cao 
Published: May 2021

For a finite-dimensional cocommutative semisimple Hopf

C

∗

-algebra

H

and a normal coideal

∗

-subalgebra

H

1

, we define the nonbalanced quantum double

D

H

1

;
H

as the crossed product of

H

with

H
1

o
p

^

, with respect to the left coadjoint representation of the first algebra acting on the second one, and then construct the infinite crossed product

A

H

1

=
⋯
⋊
H
⋊

H

1

^

⋊
H
⋊

H

1

^

⋊
H
⋊
⋯

as the observable algebra of nonbalanced Hopf spin models. Under a right comodule algebra action of

D

H

1

;
H

on

A

H

1

, the field algebra can be obtained as the crossed product

C

∗

-algebra. Moreover, we prove there exists a duality between the nonbalanced quantum double

D

H

1

;
H

and the observable algebra

A

H

1

.
The male of an unknown species of Pennellidae (Copepoda, Siphonostomatoida) parasitic on the branchial lamellae of the limpid-wing flyingfish Cheilopogon unicolor (Valenciennes, 1847) (Pisces, Exocoetidae)
Authors: Izawa Kunihiko 
Published: May 2021

Abstract
The male of an unknown species of Pennellidae is described based on a single specimen parasitic on the branchial lamellae of the limpid-wing flyingfish Cheilopogon unicolor (Valenciennes, 1847) (Pisces, Exocoetidae). The male has a 1-segmented abdomen and biramous legs 1 and 2, as well as uniramous legs 3 and 4; the rami of all legs are 2-segmented.
Performing Exoticism and the Transnational Reception of World Cinema
Authors: Berghahn Daniela 
Published: May 2021

Abstract
This article examines why exoticism is central to thinking about the global dynamics of world cinema and its transnational reception. Offering a theoretical discussion of exoticism, alongside the closely related concepts of autoethnography and cultural translation, it proposes that the exotic gaze is a particular mode of aesthetic perception that is simultaneously anchored in the filmic text and elicited in the spectator in the process of transnational reception. Like world cinema, exoticism is a travelling concept that depends on mobility and the crossing of cultural boundaries to come into existence. The visual pleasure afforded by exotic cinema’s sumptuous style is arguably the chief vehicle that allows world cinema to travel and be understood, or misunderstood, as the case may be, by transnational audiences who are potentially disadvantaged by a hermeneutic deficit of culturally specific knowledge when trying to understand films from outside their own cultural sphere.
The influence of surface heat fluxes on the growth of idealized monsoon
Authors: Diaz Michael , Boos William R. 
Published: May 2021

AbstractThis study explores the effect of surface sensible and latent heat fluxes on monsoon depressions using a series of idealized convection-permitting simulations. Each experiment is initialized with a small amplitude wave that is allowed to grow within an environment representative of the South Asian monsoon. Comparing experiments with and without interactive surface heat fluxes, it is found that these fluxes enhance the growth of the simulated vortices. Without interactive surface fluxes, the strengthening period is short and the vortices fail to reach intensities characteristic of stronger monsoon depressions. Using a large set of experiments in which the vertical and meridional shear are systematically varied, it is found that surface heat fluxes enhance intensity the most when the upper-level shear is weak, the lower-level shear and associated moist static energy (MSE) gradient are sufficiently steep, and the lower-level meridional shear is strong. These experiments reveal two different regimes of convection-coupled monsoon depression growth: one in which convection is driven by MSE advection and one in which it is driven by surface heat fluxes and quasi-geostrophic forcing for ascent. Both regimes require sufficiently strong meridional shear to achieve initial growth by barotropic instability.
Deforestation strengthens atmospheric transport of mineral dust and phosphorus from North Africa to the Amazon
Authors: Li Yue , Randerson James T. , Mahowald Natalie M. , Lawrence Peter J. 
Published: May 2021

AbstractPhosphorus contained in atmospheric mineral dust aerosol originating from Africa fertilizes tropical forests in Amazonia. However, the mechanisms influencing this nutrient transport pathway remain poorly understood. Here we use the Community Earth System Model to investigate how large-scale deforestation affects mineral dust aerosol transport and deposition in the tropics. We find that the surface biophysical changes that accompany deforestation produce a warmer, drier and windier surface environment that perturbs atmospheric circulation and enhances long-range dust transport from North Africa to the Amazon. Tropics-wide deforestation weakens the Hadley circulation, which in turn, leads to a northward expansion of the Hadley cell and increases surface air pressure over the Sahara Desert. The high pressure anomaly over the Sahara, in turn, increases northeasterly winds across North Africa and the tropical North Atlantic Ocean, which subsequently increases dust transport to the South America continent. We estimate that the annual atmospheric phosphorus deposition from dust significantly increases by 27% (P < 0.01) in the Amazon under a scenario of complete deforestation. These interactions exemplify how land surface changes can modify tropical nutrient cycling, which in turn, may have consequences for long-term changes in tropical ecosystem productivity and biodiversity.
Developments in radiation techniques for thoracic malignancies
Authors: Finazzi Tobias , Schneiders Famke L. , Senan Suresh 
Published: May 2021

Radiation therapy is a cornerstone of modern lung cancer treatment alongside surgery, chemotherapy, immunotherapy and targeted therapies. Advances in radiotherapy techniques have enhanced the accuracy of radiation delivery, which has contributed to the evolution of radiation therapy into a guideline-recommended treatment in both early-stage and locally advanced nonsmall cell lung cancer. Furthermore, although radiotherapy has long been used for palliation of disease in advanced lung cancer, it is increasingly having a role as a locally ablative treatment in patients with oligometastatic disease.This review provides an overview of recent developments in radiation techniques, particularly for non-radiation oncologists who are involved in the care of lung cancer patients. Technical advances are discussed, and findings of recent clinical trials are highlighted, all of which have led to a changing perception of the role of radiation therapy in multidisciplinary care.
The relationship between financial hardship and incident diabetic kidney disease in older US adults – a longitudinal study
Authors: Corwin Timothy R. , Ozieh Mukoso N. , Garacci Emma , Palatnik Anna , Egede Leonard E. 
Published: May 2021

Abstract
Background
Financial hardship is associated with poor health, however the association of financial hardship and incident diabetic kidney disease (DKD) is unknown. This study aimed to examine the longitudinal relationship between financial hardship and incident DKD among older adults with diabetes.

Methods
Analyses were conducted in 2735 adults age 50 or older with diabetes and no DKD using four waves of data (2006–2012) from the Health and Retirement Study, a national longitudinal cohort. The primary outcome was incident DKD. Financial hardship was based on three measures: 1) difficulty paying bills; 2) food insecurity; and 3) cost-related medication non-adherence using validated surveys. A dichotomous financial hardship variable (0 vs 1 or more) was constructed based on all three measures. Cox regression models were used to estimate the association between financial hardship, change in financial hardship experience and incident DKD adjusting for demographics, socioeconomic status, and comorbidities.

Results
During the median follow-up period of 4.1 years, incident DKD rate was higher in individuals with versus without financial hardship (41.2 versus 27/1000 person years). After adjustment, individuals with financial hardship (HR 1.32, 95% CI 1.04–1.68) had significantly increased likelihood of developing DKD compared to individuals without financial hardship. Persistent financial hardship (adjusted HR 1.52 95% CI 1.06–2.18) and negative financial hardship (adjusted HR 1.54 95% CI 1.02–2.33) were associated with incident DKD compared with no financial hardship experience. However, positive financial hardship was not statistically significant in unadjusted and adjusted (adjusted HR 0.89 95% CI 0.55–1.46) models. Cost-related medication non-adherence (adjusted HR 1.43 95% CI 1.07–1.93) was associated with incident DKD independent of other financial hardship measures.

Conclusions
Financial hardship experience is associated with a higher likelihood of incident DKD in older adults with diabetes. Future studies investigating factors that explain the relationship between financial hardship and incident DKD are needed.