bluuebunny/crossref_metadata_2025_split huggingface dataset:
Awareness of Changes in E-cigarette Regulations and Behavior Before and After Implementation: A Longitudinal Survey of Smokers, Ex-smokers, and Vapers in the United Kingdom
Authors: Lee Hyun S , Wilson Samara , Partos Timea , McNeill Ann , Brose Leonie S 
Published: January 2019

Abstract

Introduction
In line with the European Union’s Tobacco Products Directive (TPD), new regulations for electronic cigarettes implemented in the United Kingdom between May 2016 and May 2017 included limiting refills to 10 mL, tank and cartridge sizes to 2 mL, and nicotine concentrations to 20 mg/mL.

Aims
To investigate the (1) awareness of new regulations, (2) product use before and after implementation, and (3) association between use of compliant products and subsequent smoking.

Methods
A UK online longitudinal survey of smokers, ex-smokers, and vapers was conducted between May and June 2016 (wave 4) and September 2017 (wave 5).The following methods were used: (1) to assess awareness of changes, proportions were calculated by smoking and vaping status (n = 1606). (2) Comparison of refill volume, tank and cartridge volumes, nicotine concentration at waves 4 and 5 (n = 199–388) was conducted. (3) Association was studied between number of TPD-compliant products used at wave 4 and smoking at wave 5, adjusted for wave 4 vaping status, age, gender, income, urges to smoke, and device type (n = 480).

Results
Awareness of regulations was highest for refill volume (10.1%; 37.4% among exclusive vapers) and nicotine concentration (9.5%; 27.3%). Higher proportions used TPD-compliant refill volumes (60.0%–73.7%, χ2(1) = 10.9, p = .001) and nicotine concentrations (89.2%–93.9%, χ2(1) = 7.41, p = .007) in wave 5 than wave 4, with little change for tank or cartridge volumes (77.1–75.5%, χ2(1) = 0.38, p = .540). The likelihood of smoking was similar for those using no or one TPD-compliant products as it was for those using two (OR = 1.10, 95% CI = 0.47–2.59) or three (OR = 1.56, 95% CI = 0.69–3.55).

Conclusion
Several months after full implementation, awareness of new regulations was low and most vapers used TPD-compliant products. Use of compliant products was not associated with subsequent smoking.

Implications
Using a longitudinal survey at the beginning and a few months after the end of the transition period for implementation of new regulation on electronic cigarettes, this is the first study to assess awareness of regulation and use of compliant products. After full implementation, awareness of changes was low overall (smokers, ex-smokers, and vapers combined) although higher among those who vaped. Nevertheless, most vapers (74%–94%) used products that were compliant with the new regulations and the use of products compliant with incoming regulations did not predict whether they were smoking cigarettes after implementation.
Smoking Cessation Pharmacotherapy Based on Genetically-Informed Biomarkers: What is the Evidence?
Authors: Panagiotou Orestis A , Schuit Ewoud , Munafò Marcus R , Bennett Derrick A , Bergen Andrew W , David Sean P 
Published: January 2019

Abstract

Introduction
Pharmacogenomic studies have used genetic variants to identify smokers likely to respond to pharmacological treatments for smoking cessation.

Methods
We performed a systematic review and meta-analysis of primary and secondary analyses of trials of smoking cessation pharmacotherapies. Eligible were trials with data on a priori selected single nucleotide polymorphisms, replicated non-single nucleotide polymorphisms, and/or the nicotine metabolite ratio. We estimated the genotype × treatment interaction as the ratio of risk ratios (RRR) for treatment effects across genotype groups.

Results
We identified 18 trials (N = 9017 participants), including 40 active (bupropion, nicotine replacement therapy [NRT], varenicline, or combination therapies) versus placebo comparisons and 16 active versus active comparisons. There was statistical evidence of heterogeneity across rs16969968 genotypes in CHRNA5 with regard to both 6-month abstinence and end-of-treatment abstinence in non-Hispanic black smokers and end-of-treatment abstinence in non-Hispanic white smokers. There was also heterogeneity across rs1051730 genotypes in CHRNA3 with regard to end-of-treatment abstinence in non-Hispanic white smokers. There was no clear statistical evidence for other genotype-by-treatment combinations. Compared with placebo, NRT was more effective among non-Hispanic black smokers with rs16969968-GG with regard to both 6-month abstinence (RRR for GG vs. GA or AA, 3.51; 95% confidence interval [CI] = 1.19 to 10.30) and end-of-treatment abstinence (RRR for GG vs. GA or AA, 5.84; 95% CI = 1.89 to 18.10). Among non-Hispanic white smokers, NRT effectiveness relative to placebo was comparable across rs1051730 and rs169969960 genotypes.

Conclusions
We did not identify widespread differential effects of smoking cessation pharmacotherapies based on genotype. The quality of the evidence is generally moderate.

Implications
Although we identified some evidence of genotype × treatment interactions, the vast majority of analyses did not provide evidence of differential treatment response by genotype. Where we find some evidence, these results should be considered preliminary and interpreted with caution because of the small number of contributing trials per genotype comparison, the wide confidence intervals, and the moderate quality of evidence. Prospective trials and individual-patient data meta-analyses accounting for heterogeneity of treatment effects through modeling are needed to assess the clinical utility of genetically informed biomarkers to guide pharmacotherapy choice for smoking cessation.
Neglected tropical diseases and disability—what is the link?
Authors: Kuper Hannah 
Published: January 2019

AbstractNeglected tropical diseases (NTDs) are a diverse group of infectious conditions that vary in their epidemiology, impact and control. They are among the most common conditions globally, affecting approximately one billion people. Many NTDs have long-term consequences, such as visual and physical impairments. As a result, people with NTDs may have difficulties in carrying out activities or participating in society—in other words, NTDs can cause disabilities. Additionally, NTDs are often strongly linked to stigma and can have mental health consequences. It is therefore important to incorporate rehabilitation within NTD programmes. Rehabilitation can be conceptualized narrowly in terms of the provision of clinical services (e.g. physiotherapy and assistive devices) or, more broadly, including efforts to improve employment, overcome stigma and enhance social participation of people with disabilities. Approximately 15% of the global population has a disability, and this large group must be considered when designing NTD programmes. Improving the inclusion of people with disabilities may require adaptations to NTD programmes, such as making them physically accessible or training staff about disability awareness. Without incorporating disability within NTD programmes, the quality of life of people with NTDs will suffer and global targets for elimination and management of NTDs will not be met.
Plantar Ulcers and Neuropathic Arthropathies: Associated Diseases, Polyneuropathy Correlates, and Risk Covariates
Authors: Andrews Karen L. , Dyck Peter J. , Kavros Steven J. , Vella Adrian , Kazamel Mohamed , Clark Vicki , Litchy William J. , Dyck P. James B. , Lodermeier Karen A. , Davies Jenny L. , Carter Rickey E. , Klein Christopher J. 
Published: January 2019

ABSTRACT

OBJECTIVE:
To evaluate the associated diseases, polyneuropathy correlates, and risk covariates of neuropathic plantar ulcers (PUs) and neuropathic arthropathies (NAs).

DESIGN:
The authors conducted a retrospective, observational study over 3.5 years of 69 patients with neuropathy, NA, or PU seen in a wound clinic who also had a comprehensive neurologic evaluation and neurophysiologic testing. Comparisons were made to a population representative cohort of patients with diabetes mellitus (DM; n = 259).

RESULTS:
Of the 69 wound clinic patients, 32 had PUs, 14 had NAs, and 23 had both. Of the 61 adequately assessed patients, 37 (61%) had DM, 22 (36%) had no known associated disease, and 2 (3%) had hereditary sensory and autonomic neuropathy. Of the 37 patients with DM, 35 had distal polyneuropathy, and 2 did not. In 22 patients with chronic idiopathic axonal polyneuropathy, 20 had distal polyneuropathy.

CONCLUSIONS:
Although DM was the disease most commonly associated with PUs and NAs, chronic hyperglycemia may not have been the major underlying risk factor. The major risk covariates are sensation loss from polyneuropathy, old age, obesity, repetitive foot injury, and inadequate foot care or treatment. Physicians and other healthcare providers can help by identifying patients at risk and instituting measures such as adequate foot care to decrease these risks.
Recovery Goals and Long-term Treatment Preference in Persons Who Engage in Nonmedical Opioid Use
Authors: Hay Kaitlyn R. , Huhn Andrew S. , Tompkins David Andrew , Dunn Kelly E. 
Published: January 2019

Background:While most opioid use disorder (OUD) treatment providers consider opioid abstinence to be the preferred outcome, little is known about the treatment preferences of the larger population of individuals who engage in nonmedical opioid use and have not yet sought treatment. This study sought to descriptively quantify the proportion of out-of-treatment individuals with nonmedical opioid use that have abstinent and nonabstinent recovery goals.Methods:Participants (N = 235) who engage in nonmedical opioid use and met self-reported criteria for OUD were recruited online and participated in a cross-sectional survey on recovery goals and treatment perceptions. Participants were dichotomized as having either abstinent (70.6%) or nonabstinent (29.4%) recovery goals. Participants were presented with 13 treatment options and asked which treatment they would “try first” and which treatment they thought would be the best option for long-term recovery.Results:Persons in the nonabstinent group were more likely to want to continue use of prescription opioids as prescribed by a physician compared with the abstinent group (χ2[1] = 9.71,P = 0.002). There were no group differences regarding preference for individual OUD treatments. The most frequently endorsed treatments that participants would “try first” were physician visits (23.4%), one-on-one counseling (18.7%), and 12-step groups (13.2%), whereas the most frequently endorsed treatments for long-term recovery were one-on-one counseling (17.4%), residential treatment (16.7%), and buprenorphine (15.3%).Conclusion:Public health initiatives to engage out-of-treatment individuals should take into account recovery goals and treatment preferences to maximize treatment initiation and retention.
The Effect of Therapeutic IOP-lowering Interventions on the 24-hour Ocular Dimensional Profile Recorded With a Sensing Contact Lens
Authors: Cutolo Carlo A. , De Moraes Carlos G. , Liebmann Jeffrey M. , Mansouri Kaweh , Traverso Carlo E. , Ritch Robert 
Published: January 2019

Précis:
The 24-hour ocular dimensional profile recorded by a contact lens sensor was affected by intraocular pressure lowering interventions. Among different treatments, incisional surgery had the most significant effect.

Purpose:
We investigated the effect of different intraocular pressure (IOP)-lowering interventions on contact lens sensor (CLS) parameters and their relationship with Goldmann applanation tonometry (GAT)-measured IOP reduction.

Methods:
Data from reliable CLS recordings performed before and after IOP-lowering interventions were analyzed. Three interventions were evaluated: topical medications, laser trabeculoplasty, and incisional surgery. A set of 115 different CLS parameters were derived from 24-hour curves. We compared before versus after values for each parameter. In addition, linear regression was performed using the percentage change of each CLS parameter as the outcome variable and the type of IOP-lowering procedure as the predictor after adjusting age and race. Finally, we investigated the relationship between changes in CLS parameters and GAT IOP with the Spearman rank correlation coefficient.

Results:
A total of 182 eyes of 182 patients were included in the analyses: 60 (33%) topical medications, 69 (38%) laser, and 53 (29%) surgery. The mean GAT IOP change was 3.6±6.5 mm Hg (P<0.001). Overall, more CLS parameters had a significant change after surgery than in the other groups (surgery>laser=drug). Linear regression showed that, for 20 CLS parameters, surgery was the most predictive of greatest percentage change in CLS signals. In all, 11 (9.5%) of the CLS parameters were significantly correlated with GAT changes.

Conclusions:
Incisional glaucoma surgery had a more pronounced effect on GAT and CLS parameters than laser and drugs. The CLS can detect changes in patterns resulting from IOP-lowering interventions beyond daytime GAT IOP. This device could potentially be used to assess treatment efficacy in glaucoma.
Nursing Staff Talk: Resource or Obstacle for Forensic Psychiatric Patient Care?
Authors: Kumpula Esa , Gustafsson Lena-Karin , Ekstrand Per 
Published: January 2019

ABSTRACT
Although forensic psychiatric care is located at the intersection of health care and the Swedish legal system, nursing research has not yet evaluated how language is context bound or its consequences for understanding patient care. The aim of this study was to explore how nursing staff talk about patient care in Swedish forensic psychiatric care and the implications for the care given to patients. The theoretical framework is based on social constructionism and sheds light on how language use can be understood as a social action. Twelve interviews were conducted with nursing staff working in forensic psychiatric settings. The questions focused on patient care in relation to activities, security, relationships with patients, and rules and routines. The results show that nursing staff assignments are encouraging them to use various interpretative repertoires to make meaning about their practice. The three interpretative repertoires were “taking responsibility for correcting patients' behavior,” “justifying patient care as contradictory practice,” and “patients as unpredictable.” However, although forensic psychiatric care emphasizes both security and care, nursing staff's use of these interpretative repertoires provided multiple interpretations that lead to contradictory ways of understanding patient care. These findings show that talk itself can be understood as problematic in various situations. A possible implication for clinical forensic nursing practice might be that the nurse–patient relationship does not support patients' best interests. For example, when language endows the patient with certain characteristics, this talk is justified and given meaning by its context and thus has an influence on a patient's individual need for care.
Effects of selenium supplementation on pregnancy outcome and disease progression in HIV-infected pregnant women in Lagos, Nigeria
Authors: Okunade Kehinde S. , John-Olabode Sarah , Akinsola Oluwatosin J. , Akinajo Opeyemi , Akanmu Sulaimon A. , Kanki Phyllis J. 
Published: January 2019

AbstractBackground:Micronutrient deficiencies are common during pregnancy, especially in pregnant women from economically disadvantaged settings where diets with low content of minerals and vitamins are consumed. Selenium is a non-metallic chemical element of great importance to human health. This study will assess the effect of selenium supplementation on major pregnancy outcomes and disease progression among HIV-infected pregnant women in Lagos, Nigeria.Methods:A randomized, double-blind, placebo-controlled trial involving confirmed HIV-positive pregnant women at the Lagos University Teaching Hospital (LUTH) between September 2018 and February 2019. Eligible participants are HIV-infected pregnant women aged 15 to 49 years and have a singleton gestation at 14 to 27 weeks’ gestation. At enrolment, 90 women will be randomly assigned into each intervention arm to receive either a daily tablet of 200 μg elemental selenium or placebo. Relevant participants’ data will be collected at enrolment and at delivery. Statistical analyses will be carried out using SPSS version 23.0 for Windows. The associations between any 2 groups of continuous variables will be tested using thettest or the Mann-WhitneyUtest and that of 2 groups of categorical variables with chi-square or Fishers exact test where appropriate. A series of multivariable analyses will also be carried out to identify and control for several possible confounders of the major pregnancy outcomes and HIV disease progression. Statistical significance will be defined asP < .05. Ethical approval for the study was obtained from the LUTH's Health Research and Ethics Committee (Approval number: ADM/DCST/HREC/APP/2438; 30th August 2018).Discussion:This trial will assess the effect of selenium supplementation on pregnancy outcome and HIV disease progression among HIV-infected pregnant women in Lagos. This will help to determine if routine selenium supplementation in HIV-infected pregnant women will contribute to the improvement in the major adverse pregnancy outcomes such as preterm birth and low birth weight and the HIV disease surrogate markers such as CD4+ cells count and viral load.Trial registration:PACTR, PACTR201809756724274. Registered on 3rd September 2018, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=3571.
The Nuss procedure for pectus excavatum during atrial septal defect closure through a minimal right oblique infra-axillary thoracotomy
Authors: Yang Guangxian , Deng Xicheng , Yang Yifeng , Wang Jinhua 
Published: January 2019

Abstract

Rationale:
Pectus excavatum (PE) is normally an isolated congenital disorder, but it can also occur with congenital heart defect (CHD). The optimal strategy for the management of children with PE and concurrent CHD remains under debate. The surgical strategy has evolved over the last 20 years from staged repair to simultaneous repair of both defects. We present a case of using the Nuss procedure for PE during atrial septal defect (ASD) closure through a minimal right oblique infra-axillary thoracotomy. To our knowledge, this is the first report to describe the correction of PE and CHD by this approach.

Patient concerns:
A 3.6-year-old patient weighing 13 kg was admitted for elective repair of PE and an ASD.

Diagnoses:
Clinically, the patient had typical features of PE with chest computed tomography (CT) revealing a Haller index of 4.4 and a grade 2 systolic murmur being heard the loudest at the 2nd−3rd intercostal space, abutting the left sternal border. Echocardiography confirmed a 2-hole secundum ASD with the upper defect being 8 mm, the lower defect 5 mm, and the 2 holes being 5-mm apart, which was deemed unsuitable for interventional closure.

Interventions:
After discussion with and consent from the family, the child underwent concomitant surgery for both defects. We performed an ASD repair under cardiopulmonary bypass (CPB) on the beating heart through the right oblique infra-axillary thoracotomy, and then, the standard Nuss procedure was performed using a 9-inch bar.

Outcomes:
Satisfactory ASD closure was confirmed by postoperative echocardiography. Satisfactory PE correction was confirmed by physical examination and postoperative chest radiography. The postoperative recovery process was uneventful, and the patient was discharged 6 days postoperatively.

Lessons:
This case shows that in carefully selected cases with concomitant PE and ASD, a combination of the Nuss procedure and ASD repair by CPB through infra-axillary thoracotomy can be safely performed, avoiding sternal incision, which leads to bleeding and sternal dehiscence, and results in better aesthetic and surgical outcomes.
Decreased liver stiffness by transient elastography indicates lower incidence of hepatocellular carcinoma in patients with chronic hepatitis B
Authors: Zhang Yinghua , Wang Chuanfang , Li Hui , Ding Yuanyuan 
Published: January 2019

Abstract
The prognositc value of dynamic liver stiffness (LS) variation on hepatocellular carcinoma (HCC) incidence in patients with chronic hepatitis B (CHB) remains to be explored. We aim to compare HCC incidence in patients with compensated CHB-related cirrhosis with increased and decreased LS after nucleos(t)ide analog (NA) regimens.
A total of 168 patients with CHB-related compensated cirrhosis were divided into groups according to LS variation post to NA treatment. The laboratory results of 2 groups were reviewed and investigated. The probability of HCC development among each group was analyzed and compared.
A total of 168 patients with CHB with compensated cirrhosis received NA treatment and Fibroscan. Child–Pugh score, alanine aminotransferase, total bilirubin level, status of hepatitis B e antigen, and serum hepatitis B virus DNA level were compared between groups. The cumulative probability of HCC development in patients with decreased LS was significantly lower than in patients with increased LS (P < .05). Multi-variant analysis indicated that decreased LS was significantly associated with lower probability of HCC development (hazard ratio, 0.65; 95% confidence interval range, 0.33–0.84, P < .05).
Decreased LS after NA treatment indicates a lower HCC incidence in patients with CHB with compensated cirrhosis.
Evaluation of myocardial viability in patients with acute myocardial infarction
Authors: Liu Kun , Wang Yan , Hao Qiongyu , Li Gonghao , Chen Peng , Li Dongye 
Published: January 2019

Abstract

Background:
The value of layer-specific two-dimensional speckle tracking echocardiography (LS2D-STE) for evaluating viable myocardium (VM) in patients with acute myocardial infarction (AMI) was unclear, this study provides new insights into it and to make a comparison with dualisotope simultaneous acquisition single photon emission computed tomography ( DISA-SPECT).

Methods:
Forty hospitalized patients with AMI and left ventricular systolic dysfunction (left ventricular ejection fraction <50%) underwent LS2D-STE and DISA-SPECT before percutaneous coronary intervention (PCI). The longitudinal, circumferential, and radial peak systolic strains and the peak systolic strain rates of 3 myocardiallayers (endocardium, mid-myocardium, and epicardium), as well as the total wall thickness, were determined by LS2D-STE. Routine echocardiography was followedup at 1, 3, 6 months after PCI, with the improvement of the wall motion as the goldenstandard for evaluating VM.

Results:
The sensitivity, specificity and accuracy of DISA-SPECT for evaluating VM were 82.1%, 74.3%, and 79.3%, respectively. Among the layer-specific parameters, only endocardial (endo-) longitudinal strain (LS) and endo- longitudinal strain rate (LSr) were used as independent parameters for evaluating VM (P < .05), and the sensitivity, specificity and accuracy of endo-LS and endo-LSr in evaluation of VM were 77.1%, 65.4%, and 72.9% vs 72.9%, 65.4%, and 69.7%. Endo-LS and endo-LSr were superior to total wall thickness LS and LSr (AUC endo-LS 0.767 vs total-LS 0.669; endo-LSr 0.743 vs total-LSr 0.682). The parallel test and the serial test of combination of endo-LS and endo-LSr showed similar sensitivity, specificity and accuracy to DISA-SPECT (P > .05).

Conclusion:
The endo-LS and endo-LSr analysis of LS2D-STE can evaluate the VM well, and its sensitivity, specificity and accuracy in detection of VM are similar to those of DISA-SPECT, resulting in LS2D-STE being a good option for the assessment of VM.