bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chronic Exposure to Waterpipe Smoke Elicits Immunomodulatory and Carcinogenic Effects in the Lung
Authors: Hassane Maya , Rahal Zahraa , Karaoghlanian Nareg , Zhang Jiexin , Sinjab Ansam , Wong Justin W. , Lu Wei , Scheet Paul , Lee J. Jack , Raso Maria Gabriela , Solis Luisa M. , Fujimoto Junya , Chami Hassan , Shihadeh Alan L. , Kadara Humam 
Published: April 2022

Abstract

Effects of waterpipe smoking on lung pathobiology and carcinogenesis remain sparse despite the worldwide emergence of this tobacco vector. To address this gap, we investigated the effects of chronic waterpipe smoke (WPS) exposure on lung pathobiology, host immunity, and tumorigenesis using an experimental animal model that is prone to tobacco carcinogens and an exploratory observational analysis of human waterpipe smokers and nonsmokers. Mice exhibited elevated incidence of lung tumors following heavy WPS exposure (5 days/week for 20 weeks) compared to littermates with light WPS (once/week for 20 weeks) or control air. Lungs of mice exposed to heavy WPS showed augmented CD8+ and CD4+ T cell counts along with elevated protumor immune phenotypes including increased IL17A in T/B cells, PD-L1 on tumor and immune cells, and the proinflammatory cytokine IL1β in myeloid cells. RNA-sequencing (RNA-seq) analysis showed reduced antitumor immune gene signatures in animals exposed to heavy WPS relative to control air. We also performed RNA-seq analysis of airway epithelia from bronchial brushings of cancer-free waterpipe smokers and nonsmokers undergoing diagnostic bronchoscopy. Transcriptomes of normal airway cells in waterpipe smokers, relative to waterpipe nonsmokers, harbored gene programs that were associated with poor clinical outcomes in patients with lung adenocarcinoma, alluding to a WPS-associated molecular injury, like that established in response to cigarette smoking. Our findings support the notion that WPS exhibits carcinogenic effects and constitutes a possible risk factor for lung cancer as well as warrant future studies that can guide evidence-based policies for mitigating waterpipe smoking.

Prevention Relevance:
Potential carcinogenic effects of waterpipe smoking are very poorly understood despite its emergence as a socially acceptable form of smoking. Our work highlights carcinogenic effects of waterpipe smoking in the lung and, thus, accentuate the need for inclusion of individuals with exclusive waterpipe smoking in prevention and smoking cessation studies.
Comparing Post-Operative Outcomes of Pancreaticoduodenectomy for Pancreatic Ductal Adenocarcinoma: Neoadjuvant Therapy Versus Surgery First Approach
Authors: Hyman David W. , Almerey Tariq , Mujkanovic Amer , Hammons Isaac , Tice Mary , Stauffer John A. 
Published: April 2022

Objectives Optimal use of surgery first (SF) vs neoadjuvant therapy (NAT) for localized pancreatic ductal adenocarcinoma (PDAC) is still unclear. There is concern that NAT may result in worsened post-operative outcomes. Our study objectives were to show the impact of NAT on post-operative morbidity and mortality. Methods All patients undergoing resection for PDAC between 1/1/2010 and 12/31/2020 were reviewed and those who underwent pancreaticoduodenectomy (PD) were included. Demographics, perioperative details, and pathology details were gathered. Data pertaining to 90-day complications were obtained and graded according to international consensus guidelines. Those undergoing SF were compared to those who had NAT. Categorical variables were compared by Fisher’s exact test and continuous variables by Student’s t-test. Results Two hundred and forty-one subjects who underwent PD for PDAC were included in this review. There was no significant difference in the rate of major morbidity between subjects who received NAT vs SF (19.4 vs 20.3%, P = 1.0). Similarly, there were no significant differences in the rates of mortality (3.1 vs 4.2%, P = .742), post-operative pancreatic fistula (8.2 vs 10.5%, P = .658), or post-pancreatectomy hemorrhage (7.1 vs 7.7%, P = 1.0), respectively. Conclusion Post-operative outcomes are not worsened by the use of the NAT approach prior to PD for PDAC. Further investigation is needed to reveal which patient subgroups may benefit from the use of NAT, especially regarding survival.
Ground Level Falls in Patients Over 60, Do Race and Socioeconomic Status Affect Outcome?
Authors: Jones Da’keesha M. , Connelly Daniel W. , Burgess Jessica R. 
Published: April 2022

Background Falls are a significant source of morbidity, mortality, and health care spending in the elderly. The objective was to identify whether race, insurance status, and median income by zip code were associated with discharge disposition, readmission within 90 days, or mortality within 1 year of ground-level falls in patients aged 60-90. Materials and Methods We conducted a retrospective chart review of 926 patients aged 60-90 treated for ground-level falls. We created a binomial linear regression model to identify predictors of discharge disposition, 90-day readmission, and mortality within 1 year of discharge. Results Length of stay (P < .01), having orthopedic surgery (P < .01), score on Charlson Comorbidity Index (CCI) (P < .01), increasing age (P = .014), female sex (P = .05), and admission to the ICU (P = .05) were associated with discharge to a secondary facility. Readmission within 90 days was only associated with higher scores on the CCI (P < .01). Charlson Comorbidity Index (P < .0001), hospital length of stay (P < .001), and admission to the ICU (P = .015) were associated with increased mortality at 1 year. Discussion Predictors of discharge to another facility included hospital length of stay, having orthopedic surgery, CCI scores, increasing age, female sex, and admission to the ICU. Charlson Comorbidity Index score was the only significant predictor of readmission. Predictors of mortality at 1-year post-fall included CCI score, hospital length of stay, and admission to the ICU. Race, median income by zip code, and insurance provider were not statistically significant.
The Effectiveness of a Counselling Program in Reducing the Death Anxiety and Improving Self-Efficacy Among a Sample of Female Middle-Aged Teachers Recovered from COVID-19 Virus
Authors: AlZaben Mamduh , Al Adwan Fatima 
Published: April 2022

This study explored the effectiveness of a counselling program in reducing the death anxiety and improving self-efficacy among a sample of female middle-aged teachers recovered from COVID-19 virus in Jordan. The latter program is based on cognitive behavioural therapy. The sample consists from 22 female middle-aged teachers recovered from COVID-19 virus. The ages of those children range between 35 and 50 years. The study was carried out during the year 2020–2021. The chosen teachers were divided into two groups randomly (i.e. control and experimental groups). The experimental group consists from 11 teachers who were enrolled in the proposed counselling program that is based on cognitive behavioural therapy. This program consists from 16 sessions. The control group consists from 11 teachers who were not enrolled in the proposed counselling program. The death anxiety and self-efficacy scales were used before and after implementing the program. They were used after 4 weeks since the date of finishing the implementation of the program. The researchers found that there are significant differences – at the significance level of (a ≤ 0.05) – between the control and experimental groups in terms of the death anxiety and self-efficacy levels for the favour of the experimental group. The researchers found that there is a need to use this program due to the impact of this program on the experimental group after 1 month since the date of finishing the implementation of the program.
Characteristics of People With and Without Laboratory-Confirmed SARS-CoV-2 Infection During Pregnancy, Massachusetts, March 2020–March 2021
Authors: Shephard Hanna M. , Manning Susan E. , Nestoridi Eirini , Brown Catherine , Yazdy Mahsa M. 
Published: April 2022

Objectives: Pregnant people infected with SARS-CoV-2, the virus that causes COVID-19, are at increased risk for severe illness and death compared with nonpregnant people. However, population-based information comparing characteristics of people with and without laboratory-confirmed SARS-CoV-2 infection during pregnancy is limited. We compared the characteristics of people with and without SARS-CoV-2 infection during pregnancy in Massachusetts. Methods: We compared maternal demographic characteristics, pre-pregnancy conditions, and pregnancy complications of people with and without SARS-CoV-2 infection during pregnancy with completed pregnancies resulting in a live birth in Massachusetts during March 1, 2020–March 31, 2021. We tested for significant differences in the distribution of characteristics of pregnant people by SARS-CoV-2 infection status overall and stratified by race and ethnicity. We used modified Poisson regression analyses to examine the association between race and ethnicity and SARS-CoV-2 infection during pregnancy. Results: Of 69 960 completed pregnancies identified during the study period, 3119 (4.5%) had laboratory-confirmed SARS-CoV-2 infection during pregnancy. Risk for SARS-CoV-2 infection was higher among Hispanic (adjusted risk ratio [aRR] = 2.3; 95% CI, 2.1-2.6) and non-Hispanic Black (aRR = 1.9; 95% CI, 1.7-2.1) pregnant people compared with non-Hispanic White pregnant people. Conclusions: This study demonstrates the disproportionate impact of SARS-CoV-2 infection on Hispanic and non-Hispanic Black pregnant people in Massachusetts, which may widen existent inequities in maternal morbidity and mortality. Future research is needed to elucidate the structural factors leading to these inequities.
Patients’ Perspectives on Emergency Department COVID-19 Vaccination and Vaccination Messaging Through Randomized Vignettes
Authors: Waxman Michael J. , Ray Maile , Schechter-Perkins Elissa M. , Faryar Kiran , Flynn Karen Coen , Breen Mandi , Wojcik Susan M. , Berry Fiona , Zheng Amy , Ata Ashar , Lerner E. Brooke , Lyons Michael S. , McGinnis Sandra 
Published: April 2022

Objectives: Emergency departments (EDs) could play an important role in the COVID-19 pandemic response by reaching patients who would otherwise not seek vaccination in the community. Prior to expanding COVID-19 vaccination to the acute care setting, we assessed ED patients’ COVID-19 vaccine status, perspectives, and hypothetical receptivity to ED-based vaccination. Methods: From January 11 through March 31, 2021, we conducted a multisite (Albany Medical Center, Boston Medical Center, Buffalo General Hospital, University of Cincinnati Medical Center, and Upstate Medical Center), cross-sectional survey of ED patients, with embedded randomization for participants to receive 1 of 4 vignette vaccination messages (simple opt-in message, recommendation by the hospital, community-oriented message, and acknowledgment of vaccine hesitancy). Main outcomes included COVID-19 vaccination status, prior intention to be vaccinated, and receptivity to randomized hypothetical vignette messages. Results: Of 610 participants, 122 (20.0%) were vaccinated, 234 (38.4%) had prior intent to be vaccinated, 111 (18.2%) were unsure as to prior intent, and 143 (23.4%) had no prior intent to be vaccinated. Vaccine hesitancy (participants who were vaccine unsure or did not intend to receive the vaccine) was associated with the following: age <45 years, female, non-Hispanic Black, no primary health care, and no prior influenza vaccination. Overall, 364 of 565 (64.4%; 95% CI, 60.3%-68.4%) were willing to accept a hypothetical vaccination in the ED. Among participants with prior vaccine hesitancy, a simple opt-in message resulted in the highest acceptance rates to hypothetical vaccination (39.7%; 95% CI, 27.6%-52.8%). Conclusions: EDs have appropriate patient populations to initiate COVID-19 vaccination programs as a supplement to community efforts. A simple opt-in approach may offer the best messaging to reach vaccine-hesitant ED patients.
The Reformulated Contextual Truth Defence: More Radical That First Appears
Authors: Collins Matthew 
Published: April 2022

AbstractDefamatory publications may carry any number of related or distinct imputations. Complexities arise where a plaintiff selects one or more imputations for complaint, but ignores other imputations carried by the same publication. In England and Wales, the so-called Polly Peck principle permits defendants to plead and justify an imputation other than one complained of by the plaintiff but bearing a common sting with such an imputation. The Polly Peck principle has not been good law in Australia for more than 20 years. The statutory defence of contextual truth in Australia’s uniform defamation laws, however, permits a defendant to plead and justify imputations that are ‘in addition to’ those complained of by the plaintiff and affords a complete defence where, having regard to the substantial truth of those contextual imputations, the imputations complained of by the plaintiff do not further harm the reputation of the plaintiff. As enacted, the defence was infected with a serious drafting error. This article looks at the implications of the reformulation of the contextual truth defence effected by the recent amendments to Australia’s uniform defamation laws. It posits that those implications are considerably broader than have been recognised to date. It argues that the reformulated defence not only corrects the drafting error in the original defence of contextual truth but also resurrects the Polly Peck principle in Australia and substantially neuters 20 years of confused jurisprudence concerning the extent to which a defendant is or should be constrained by the imputations pleaded by the plaintiff.
Site-specific mechanical properties of the human great saphenous vein: Cadaveric comparisons among the thigh, knee, and lower leg harvest sites
Authors: Arima Takahiro , Otsuka Shun , Mitsuoka Hiroki , Nakano Takashi , Naito Munekazu , Ishibashi Hiroyuki 
Published: April 2022

Background This study aimed to determine site-specific mechanical properties of the great saphenous vein (GSV) harvested from various sites in the same cadaver. Methods GSV samples were harvested from three sites: the thigh, knee, and lower leg. The thickness and diameter of the samples were measured, and the tensile test was performed to measure stiffness and Young’s modulus. Results The stiffness of the GSV harvested from knees in the longitudinal direction was lower than those from other sites, whereas the stiffness of the GSV harvested from the lower leg in the circumferential direction was lower than that from the thigh. Conclusions The GSV has site-specific mechanical properties. Thus, in addition to morphological evaluations such as echo and computed tomography in preoperative graft surgical evaluations, knowledge of the mechanical properties at each site can improve the patency rate and prevent aneurysmal expansion.
Health and social care services for people with dementia at home at the end of life: A qualitative study of bereaved informal caregivers’ experiences
Authors: Mogan Caroline , Harrison Dening Karen , Dowrick Christopher , Lloyd-Williams Mari 
Published: April 2022

Background: More people are dying at home with dementia and Alzheimer’s disease. While informal caregivers are the main providers of care for people with dementia dying at home, they require support from health and social care services. However, little is known about how they experience these services. Aim: To explore informal caregivers’ views and experiences of health and social care services when looking after a person with dementia at home at the end-of-life. Design: A qualitative interview study. Data were analysed using thematic analysis. Setting/Participants: Twenty-nine bereaved informal caregivers who had looked after a person with dementia at home during the last 6 months of life. Results: Specialist palliative care for people with dementia dying at home is rare and care is mostly managed by General Practitioners and domiciliary care workers. Four overarching themes were identified: Poor continuity of care; Lack of expertise; Limited advance care planning; and Loss of autonomy. Conclusions: End-of-life care at home for people with dementia must be proactively planned with an emphasis on advance care planning. Policy makers should recognise the critical role of domiciliary care services in end-of-life care and ensure that they are adequately qualified and trained.
En bloc resection, is this the future of non-muscle invasive bladder cancer management? Presentation of our technique and brief review of the literature
Authors: Symeonidis Evangelos N , Baniotis Panagiotis , Langas Georgios , Stefanidis Panagiotis , Tsiakaras Stavros , Stratis Michail , Savvides Eliophotos , Bouchalakis Athanasios , Petras Stefanos , Memmos Dimitrios , Anastasiadis Anastasios , Mykoniatis Ioannis , Vakalopoulos Ioannis , Toutziaris Chrysovalantis , Dimitriadis Georgios , Sountoulides Petros 
Published: April 2022

Introduction: The quality of the initial transurethral resection of bladder tumors (TURBT) plays a key role in accurate local staging thus affecting treatment decision-making and disease prognosis. TURBT is still the gold standard for non-muscle invasive bladder cancer (NMIBC). However, en bloc resection of bladder tumors (ERBT) gradually expanded as a promising alternative to TURBT, aiming to overcome certain inherent limitations of conventional resection. We hereby describe a step-by-step bipolar ERBT technique and briefly review the current trends surrounding the role of various en bloc techniques in the field. Case presentation: We present the case of a 65-year old patient undergoing bipolar ERBT for a single, approximately 2 cm, papillary bladder mass. An experienced urologist completed the procedure within 17 min and without any intra- or postoperative complications. No conversion to TURBT was needed, and an adequate specimen for histological assessment was obtained. The patient made an uneventful recovery, and no recurrence was noted at 12-months. Conclusion: Our initial experience demonstrates that ERBT via bipolar current is relatively quick, safe, and reliable. Prospective comparative clinical trials will examine its efficacy, and long-term oncological superiority in managing NMIBC.
A vaincre sans péril, on triomphe sans gloire ! L’effet de l’incertitude de gagner sur la qualité de l’expérience client durant les interactions gamifiées
Authors: Leclercq Thomas 
Published: April 2022

Résumé Offrir aux clients une expérience de qualité est devenu un enjeu critique pour les entreprises. A cette fin, les chercheurs ont mis en évidence l’opportunité d’utiliser la gamification. Cependant, et malgré la popularité grandissante de cette stratégie, les études rapportent des résultats divergents. Cette recherche vise à réconcilier les résultats antérieurs en identifiant les conditions dans lesquelles la gamification permet d’aboutir à une meilleure expérience. Sur base de la théorie de la résolution de l’incertitude, nous examinons comment l’incertitude de gagner affecte la qualité de l’expérience client. Les résultats de six études, combinant une enquête sur le terrain et des expérimentations, démontrent les bénéfices associés à l’incertitude de gagner en termes de qualité de l’expérience client. Nous montrons que cet effet existe pendant et après l’activité gamifiée, quand les participants sont informés de leur succès ou de leur échec. Par ailleurs, nous mettons en évidence que le fait de perdre le concours renforce l’impact positif de l’incertitude de gagner, ce qui suggère que l’incertitude de gagner permet de contrer l’effet négatif de l’aversion à l’échec lors d’un concours. A l’inverse, nous suggérons que la valeur de la récompense proposée atténue l’impact positif de l’incertitude de gagner en attirant l’attention du client sur l’enjeu plutôt que l’expérience vécue. Nos résultats contribuent à la littérature existante en soulignant le rôle de l’incertitude de gagner comme condition déterminante à la capacité de la gamification à délivrer une expérience de qualité.
Factors Associated With COVID-19 Behavioral Intentions: Findings From an Online Survey
Authors: Lama Yuki , Budenz Alex , Gaysynsky Anna , Iles Irina A. , Sylvia Chou Wen-Ying 
Published: April 2022

Purpose The COVID-19 pandemic provides a novel context through which to evaluate salient factors for promoting behavioral change. We examined how attitudes, perceived community behaviors, and prior related behaviors predict intentions to (1) receive COVID-19 vaccination and (2) practice social distancing. Design Cross-sectional online survey administered through Amazon’s Mechanical Turk in September 2020. Subjects A convenience sample of US adults (N = 1804). Measures COVID-19 vaccination and social distancing intentions were measured on a 7-point Likert scale. Predictor variables included general vaccination and social distancing attitudes, perceived community mask-wearing, prior influenza vaccination, prior social distancing, and socio-demographics. Analysis Descriptive statistics and linear regressions. Results Thirty percent of respondents reported a strong willingness to receive COVID-19 vaccination, while 67% strongly intended to engage in social distancing. In regression analyses, vaccination intention was predicted by positive vaccine attitudes (b = .84; 95%CI: .78, .90; P < .001), prior influenza vaccination (b = −.47; 95%CI: −.63, −.32; P < .001), and perceived community mask-wearing (b = −.28; 95%CI: −.56, −.01; P=.049). Intention to practice social distancing was predicted by positive attitudes (b = .65; 95%CI: .61, .69; P < .001), prior social distancing (b = −.49; 95%CI: −.59, −.39; P < .001), and perceived community mask-wearing (b = −.28; 95%CI: −.46, −.09; P = .003). Conclusion Findings have implications for health promotion efforts. Messages that are targeted and tailored on pre-existing attitudes may be more effective. Additionally, leveraging prior behaviors and perceived community behavior may improve communication strategies.
Association Between the Serum Iron and Acute Cognitive Impairment After Stroke: A Cross-Sectional Study
Authors: Xu Minjie , Hu Yaoyao , Wu Junxin , Wu Zijing , Yang Shuang , He Jincai , Ren Wenwei 
Published: April 2022

Background Complications such as cognitive impairment are common in stroke victims. The goal of this study was to see if there was a link between blood iron levels and post-stroke cognitive impairment (PSCI) within 2 weeks after stroke. Methods A total of 313 patients with ischemic stroke were recruited and separated into two groups: PSCI (n = 202) and non-PSCI (n = 111). The Mini-mental state examination scale was used to evaluate the cognitive status within 2 weeks after stroke (acute phase). The serum iron levels were divided into 4 layers: Q1 ≤ 11.7 μmol/L, Q2 11.8-15.1 μmol/, Q3 15.2-19.3 μmol/L, Q4 ≥ 19.4 μmol/L, respectively. The connection between serum iron and PSCI was then investigated further using binary logistic regression, which was adjusted for confounders. Results The difference in serum iron levels between the PSCI and non-PSCI group was initially conducted by the Mann-Whitney test, and a significant difference was found (14.5 (11.0-17.8) vs. 16.9 (13.7-21.8), p < .001), with no confounders being adjusted. After adjusting for confounding factors, the binary regression analysis showed that the Q4 layer showed the lowest risk of PSCI, with the Q1 layer being the reference. (odds ratio (OR) = 0.297, 95% confidence interval (CI) = 0.136-0.649, p = 0.002). Conclusion A decreased risk of early-onset PSCI was linked to high serum iron levels. Low serum iron levels were found to be a risk factor for acute cognitive impairment following stroke, which could help physicians identify and take intervention measures early to reduce the risk of cognitive impairment after stroke.