bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of and factors associated with tobacco smoking in the Gambia: a national cross-sectional study
Authors: Shariful Islam Md , AlWajeah Haifaa , Rabbani Md Golam , Ferdous Md , Mahfuza Nusrat Sharmin , Konka Daniel , Silenga Eva , Zafar Ullah Abu Naser 
Published: June 2022

ObjectivesTo examine the prevalence of and risk factors associated with tobacco smoking in the Gambia.DesignA nationwide cross-sectional study.SettingThe Gambia.ParticipantsThe study participants were both women and men aged between 15 and 49 years old. We included 16,066 men and women in our final analysis.Data analysisWe analysed data from the Gambia Demographic and Health Survey (DHS), 2019–2020. DHS collected nationally stratified data from local government areas and rural–urban areas. The outcome variable was the prevalence of tobacco smoking. Descriptive analysis, prevalence and logistic regression methods were used to analyse data to identify the potential determinants of tobacco smoking.ResultsThe response rate was 93%. The prevalence of current tobacco smoking was 9.92% in the Gambia in 2019–2020, of which, 81% of the consumers smoked tobacco daily. Men (19.3%) smoked tobacco much higher than women (0.65%) (p<0.001). People aged 40–49 years, with lower education, and manual workers were the most prevalent group of smoking in the Gambia (p<0.001).Men were 33 times more likely to smoke tobacco than women. The chance of consuming smoked tobacco increased with the increase of age (adjusted OR (AOR) 9.08, 95% CI 5.08 to 16.22 among adults aged 40–49 years, p<0.001). The strength of association was the highest among primary educated individuals (AOR 5.35, 95% CI 3.35 to 8.54).Manual workers (AOR 2.73) and people from the poorest households (AOR 1.86) were the risk groups for smoking. However, place of residency and region were insignificantly associated with smoking in the Gambia.ConclusionsMen, older people, manual workers, individuals with lower education and lower wealth status were the vulnerable groups to tobacco smoking in the Gambia. Government should intensify awareness programmes on the harmful effects of smoking, and introduce proper cessation support services among tobacco smoking users prioritising these risk groups.
Chronic lung lesions in COVID-19 survivors: predictive clinical model
Authors: Carvalho Carlos Roberto Ribeiro , Chate Rodrigo Caruso , Sawamura Marcio Valente Yamada , Garcia Michelle Louvaes , Lamas Celina Almeida , Cardenas Diego Armando Cardona , Lima Daniel Mario , Scudeller Paula Gobi , Salge João Marcos , Nomura Cesar Higa , Gutierrez Marco Antonio 
Published: June 2022

ObjectiveThis study aimed to propose a simple, accessible and low-cost predictive clinical model to detect lung lesions due to COVID-19 infection.DesignThis prospective cohort study included COVID-19 survivors hospitalised between 30 March 2020 and 31 August 2020 followed-up 6 months after hospital discharge. The pulmonary function was assessed using the modified Medical Research Council (mMRC) dyspnoea scale, oximetry (SpO2), spirometry (forced vital capacity (FVC)) and chest X-ray (CXR) during an in-person consultation. Patients with abnormalities in at least one of these parameters underwent chest CT. mMRC scale, SpO2, FVC and CXR findings were used to build a machine learning model for lung lesion detection on CT.SettingA tertiary hospital in Sao Paulo, Brazil.Participants749 eligible RT-PCR-confirmed SARS-CoV-2-infected patients aged ≥18 years.Primary outcome measureA predictive clinical model for lung lesion detection on chest CT.ResultsThere were 470 patients (63%) that had at least one sign of pulmonary involvement and were eligible for CT. Almost half of them (48%) had significant pulmonary abnormalities, including ground-glass opacities, parenchymal bands, reticulation, traction bronchiectasis and architectural distortion. The machine learning model, including the results of 257 patients with complete data on mMRC, SpO2, FVC, CXR and CT, accurately detected pulmonary lesions by the joint data of CXR, mMRC scale, SpO2 and FVC (sensitivity, 0.85±0.08; specificity, 0.70±0.06; F1-score, 0.79±0.06 and area under the curve, 0.80±0.07).ConclusionA predictive clinical model based on CXR, mMRC, oximetry and spirometry data can accurately screen patients with lung lesions after SARS-CoV-2 infection. Given that these examinations are highly accessible and low cost, this protocol can be automated and implemented in different countries for early detection of COVID-19 sequelae.
Family-centred care for children with traumatic brain injury and/or spinal cord injury: a qualitative study of service provider perspectives during the COVID-19 pandemic
Authors: Pollock Anna , D’Cruz Kate , Scheinberg Adam , Botchway Edith , Harms Louise , Amor David J , Anderson Vicki , Bonyhady Bruce , Knight Sarah 
Published: June 2022

ObjectivesCOVID-19 has led to rapid changes in rehabilitation service provision for young people living with traumatic brain and/or spinal cord injury. The aim of this project was to understand the experiences of rehabilitation service providers during the acute response stage of the COVID-19 pandemic. Specifically, we aimed to identify innovative approaches to meeting the ongoing needs of young people with traumatic brain and/or spinal cord injury during this time.SettingThis study was conducted at a research institute and involved remote interviews with key informants around Australia and internationally.ParticipantsKey informants from 11 services supporting children and/or adolescents with traumatic brain injury and/or spinal cord injury were interviewed using a semistructured interview guide. Interviews were transcribed and analysed using inductive thematic analysis.ResultsThree key themes emerged: (1) recognising and responding to the experiences of families during the pandemic, (2) the impact of greater use of telehealth on care delivery, and (3) realising opportunities to enhance family-centred care.ConclusionsThese themes capture shifting perspectives and process changes relevant to longer term practice. Research findings suggest opportunities for future service development, enabling service delivery that is more family centred, flexible and efficient in meeting the needs of families. Understanding these experiences and the changed nature of service delivery provides important insights with implications for future service improvement.
AOZORA: long-term safety and joint health in paediatric persons with haemophilia A without factor VIII inhibitors receiving emicizumab – protocol for a multicentre, open-label, phase IV clinical study
Authors: Shima Midori , Takedani Hideyuki , Kitsukawa Kaoru , Taki Masashi , Ishiguro Akira , Nagao Azusa , Yamaguchi-Suita Haruko , Kyogoku Yui , Yoshida Seitaro , Nogami Keiji 
Published: June 2022

IntroductionPersons with haemophilia A (PwHA) commonly experience regular bleeding into joints, which may result in joint damage and complications such as degenerative arthritis. Emicizumab has previously demonstrated efficacy in reducing the occurrence of joint bleeds and target joints, along with having a favourable safety profile; however, data on the long-term effects on joint health are lacking. The AOZORA study will evaluate the long-term safety and joint health of paediatric PwHA without factor (F)VIII inhibitors taking emicizumab; here, we report the details of the study protocol and baseline data.Methods and analysisAOZORA is a multicentre, open-label, phase IV clinical study in Japan that aims to enrol approximately 30 PwHA aged <12 years without FVIII inhibitors. The primary endpoints include a long-term safety evaluation of adverse events, laboratory test abnormalities and FVIII inhibitor development; and a long-term joint health assessment using MRI and the Hemophilia Joint Health Score. Exploratory endpoints include characterising participants’ physical activities and the number of activity-related bleeds requiring coagulation factor treatment. Currently, 30 participants have been enrolled, including 20 emicizumab-naïve participants and 10 who transferred from HOHOEMI, a previous study in paediatric PwHA.Ethics and disseminationThe AOZORA study was approved by the Institutional Review Boards of Nara Medical University and the St Marianna University Group. The study will be conducted in compliance with the Declaration of Helsinki, the standards stipulated in paragraph 3 of Article 14 and Article 80-2 of the Pharmaceuticals, Medical Devices and Other Therapeutic Products Act, the Ministerial Ordinance on Good Clinical Practice and the Ministerial Ordinance on Good Post-marketing Study Practice. Data will be published in peer-reviewed journals and presented at Global congresses.Trial registration numberJapicCTI-194701.
Can electronic monitoring with a digital smart spacer support personalised medication adherence and inhaler technique education in patients with asthma?: Protocol of the randomised controlled OUTERSPACE trial
Authors: Dierick Boudewijn H.J. , Achterbosch Maria , Been-Buck Sandra , Klemmeier Titia , van de Hei Susanne J. , Hagedoorn Paul , Kerstjens Huib A.M. , Kocks Janwillem W.H. , van Boven Job F. M. 
Published: June 2022

IntroductionMedication adherence and inhaler technique in patients with asthma remain suboptimal. A digital, smart spacer may support personalised adherence and inhaler technique education. The aim of this study is to assess the feasibility of undertaking a definitive randomised controlled trial of personalised, smart spacer data-driven education and explore clinical benefits.Methods and analysisWe present the design of the multicentre, randomised controlled OUtcomes following Tailored Education and Retraining: Studying Performance and AdherenCE feasibility trial of 2 months. Patients will be recruited from four Dutch general practices. At t=−1, patients with asthma ≥18 years using inhaled corticosteroids±long-acting beta-agonists±short-acting beta-agonists administered with a pressurised-metered-dose-inhaler and spacer (n=40) will use a smart spacer for 1 month. The rechargeable CE-marked smart spacer (Aerochamber Plus with Flow Vu) includes a sensor that monitors adherence and inhalation technique to prescribed dosing regimen of both maintenance and reliever inhalers. After 1 month (t=0), patients are 1:1 randomised into two groups: control group (usual care) versus intervention group (personalised education). At t=-1, t=0 and t=1 month, the Asthma Control Questionnaire (ACQ), Work Productivity and Activity Impairment (WPAI) questionnaire and Test of Adherence to Inhalers (TAI) are administered and fractional exhaled nitric oxide (FeNO) is assessed. At t=0 and t=1, spirometry is performed. At t=1, usability and satisfaction will be analysed using the System Usability Scale and interviews with patients and healthcare providers. Primary outcome is the overall feasibility of a definitive trial assessed by patient recruitment speed, participation and drop-out rate. Secondary outcomes are patient and healthcare provider satisfaction and exploratory clinical outcomes are adherence, inhaler technique, TAI score, FeNO, lung function, ACQ and WPAI.Ethics and disseminationEthical approval was obtained from the RTPO in Leeuwarden, Netherlands (number: NL78361.099.21). Patients will provide written informed consent. Study findings will be disseminated through conferences and peer-reviewed scientific and professional journals.Trial registration numberNL9637.
Causes of admissions and in-hospital mortality among patients admitted to critical care units in primary and secondary hospitals in Vietnam in 2018: a multicentre retrospective study
Authors: Dat Vu Quoc , Linh Bui Thi Khanh , Kim Giang Bao 
Published: June 2022

ObjectiveThe goal of this study was to describe the burden of disease and in-hospital mortality among patients admitted to the critical care units (CCUs) in Vietnam.DesignRetrospective study.SettingThe whole 1-year data of admissions to CCUs were collected from 34 hospitals from January to December 2018.ParticipantsA total of 44 013 episodes of admission to CCUs were analysed.Primary outcomeWe used International Classification of Diseases-11 codes to assess the primary diagnosis associated with admissions and in-hospitals mortality. Years of life lost (YLL) measure was further used to estimate the burden of disease.ResultsThe 0–5 years and ≥70 years age groups accounted for 14.8% (6508/44 013) and 26.1% (11 480/44 013) of all admissions, respectively. The most common diagnoses were diseases of the respiratory system (27.8% or 12 255/44 013), followed by unclassified symptoms, signs or clinical findings (13% or 5712/44 013), and diseases of the circulatory system (12.2% or 5380/44 013). Among 28 311 patients with available outcome data, 1681 individuals (5.9%) died during the hospitalisation. The in-hospital mortality rate increased with age, from 2.8% (86/3105) in under 5 years old age group to 23.1% (297/1288) in over 90-year age group. Diseases of the respiratory system was the leading causes of death in term of number of deaths (21.8% or 367/1681 of all deaths). Diagnosis of sepsis was associated with the highest in-hospital mortality (36.8%). The overall YLL under the age of 75 were 1287 per 1000 patients.ConclusionsCCUs in Vietnam faced wide differences in the burden of diseases. Sufficient infrastructure and adequate multidisciplinary training are essential to ensure the appropriate response to the current needs of population.
‘I can’t understand why others don’t screen more’: a qualitative study exploring why Australian general practitioners screen for primary aldosteronism
Authors: Nainani Abhir Krishan , Yang Jun , Peters Sanne , Russell Grant 
Published: June 2022

ObjectiveWe sought to understand the factors that influence a general practitioner’s (GP’s) experience of screening for primary aldosteronism (PA) in hypertensive patients.DesignA qualitative study, framed by phenomenology, using semistructured interviews that were audiorecorded, transcribed verbatim, entered into NVivo V.12.0 for coding and analysed for emerging themes.SettingMelbourne, Australia.ParticipantsEligible GPs had received education on PA as part of a previous study. We recruited a purposive sample of 16 GPs (6 females, 10 males) who varied in practice location, clinical experience and the number of patients screened for PA.ResultsAlthough GPs had been educated about PA, they found it challenging to explain the condition to patients and were uncertain about how to screen patients who were already taking antihypertensive medications. Most viewed the screening process to be practical, inexpensive and, by and large, acceptable to their patients. However, they found it inconvenient to alter antihypertensive medications before screening to allow for easier interpretation of the aldosterone-renin ratio. They were also less enthused about screening patients whom they thought fitted a clinical picture of essential hypertension. Knowledge of the screening process, cost and convenience of performing the aldosterone–renin ratio, conceptualisation of risk related to PA, and a desire to improve clinical care were influencing factors that modified the GPs’ screening experience.ConclusionOur findings suggest that knowledge gaps, practical limitations of the aldosterone–renin ratio, and errors in diagnostic reasoning were challenges of routine PA screening. Most of these practical barriers could be addressed by relatively simple educational and practice modifications to increase PA screening rates and optimise detection for the most common cause of secondary hypertension in primary care.
6α-hydroxylated bile acids mediate TGR5 signalling to improve glucose metabolism upon dietary fiber supplementation in mice
Authors: Makki Kassem , Brolin Harald , Petersen Natalia , Henricsson Marcus , Christensen Dan Ploug , Khan Muhammad Tanweer , Wahlström Annika , Bergh Per-Olof , Tremaroli Valentina , Schoonjans Kristina , Marschall Hanns-Ulrich , Bäckhed Fredrik 
Published: June 2022

ObjectiveDietary fibres are essential for maintaining microbial diversity and the gut microbiota can modulate host physiology by metabolising the fibres. Here, we investigated whether the soluble dietary fibre oligofructose improves host metabolism by modulating bacterial transformation of secondary bile acids in mice fed western-style diet.DesignTo assess the impact of dietary fibre supplementation on bile acid transformation by gut bacteria, we fed conventional wild-type and TGR5 knockout mice western-style diet enriched or not with cellulose or oligofructose. In addition, we used germ-free mice and in vitro cultures to evaluate the activity of bacteria to transform bile acids in the caecal content of mice fed with western-style diet enriched with oligofructose. Finally, we treated wild-type and TGR5 knockout mice orally with hyodeoxycholic acid to assess its antidiabetic effects.ResultsWe show that oligofructose sustains the production of 6α-hydroxylated bile acids from primary bile acids by gut bacteria when fed western-style diet. Mechanistically, we demonstrated that the effects of oligofructose on 6α-hydroxylated bile acids were microbiota dependent and specifically required functional TGR5 signalling to reduce body weight gain and improve glucose metabolism. Furthermore, we show that the 6α-hydroxylated bile acid hyodeoxycholic acid stimulates TGR5 signalling, in vitro and in vivo, and increases GLP-1R activity to improve host glucose metabolism.ConclusionModulation of the gut microbiota with oligofructose enriches bacteria involved in 6α-hydroxylated bile acid production and leads to TGR5-GLP1R axis activation to improve body weight and metabolism under western-style diet feeding in mice.
Malignant lymphoma and occupational exposure to extremely low frequency magnetic fields and electrical shocks: a nested case-control study in a cohort of four Nordic countries
Authors: Jalilian Hamed , Guxens Mònica , Heikkinen Sanna , Pukkala Eero , Huss Anke , Eshagh Hossaini Seyed Kamal , Kjærheim Kristina , Vermeulen Roel 
Published: June 2022

BackgroundExposure to extremely low frequency magnetic fields (ELF-MFs) and electric shocks is a common occupational risk factor in many workplaces. Recent investigations have highlighted a possible association between such exposures and lymphoma risk. This study was carried out to further explore the association between occupational exposure to ELF-MFs and electric shocks and risk of lymphoma in a large Nordic census-based cohort.MethodsWe included cases of non-Hodgkin's lymphoma (NHL, n=68 978), chronic lymphocytic leukaemia (CLL, n=20 615) and multiple myeloma (MM, n=35 467) diagnosed between 1961 and 2005 in Finland, Iceland, Norway and Sweden. Cases were matched to five controls by year of birth, sex and country. Lifetime occupational ELF-MF and electric shock exposures were assigned to jobs reported in population censuses using job-exposure matrices. The risk of cancer was assessed based on cumulative exposure to ELF-MF and electric shocks. ORs with 95% CIs were estimated using logistic models adjusted for occupational co-exposures relevant to lymphomas.ResultsLess than 7% of the cases experienced high levels of ELF-MF. We observed no increased risks among workers exposed to high levels of ELF-MF for NHL (OR: 0.93; CI 0.90 to 0.97), CLL (OR: 0.98; CI 0.92 to 1.05) or MM (OR: 0.96; CI 0.90 to 1.01).ConclusionOur results do not provide support for an association between occupational exposure to ELF-MFs and electric shocks and lymphoma risk.
Photodissociation and X-Ray-Dominated Regions
Authors: Wolfire Mark G. , Vallini Livia , Chevance Mélanie 
Published: June 2022

The radiation from stars and active galactic nuclei (AGNs) creates photodissociation regions (PDRs) and X-ray-dominated regions (XDRs), where the chemistry or heating is dominated by far-ultraviolet (FUV) radiation or X-ray radiation, respectively. PDRs include a wide range of environments, from the diffuse interstellar medium (ISM) to dense star-forming regions. XDRs are found in the center of galaxies hosting AGNs, in protostellar disks, and in the vicinity of X-ray binaries. In this review, we describe the dominant thermal, chemical, and radiation transfer processes in PDRs and XDRs, as well as give a brief description of models and their use for analyzing observations. We then present recent results from Milky Way, nearby extragalactic, and high-redshift observations. Several important results include the following: ▪ Velocity-resolved PDR lines reveal the kinematics of the neutral atomic gas and provide constraints on the stellar feedback process. Their interpretation is, however, in dispute, as observations suggest a prominent role for stellar winds, whereas they are much less important in theoretical models. ▪ A significant fraction of molecular mass resides in CO-dark gas especially in low-metallicity and/or highly irradiated environments. ▪ The CO ladder and [Ci]/[Cii] ratios can determine if FUV or X rays dominate the ISM heating of extragalactic sources. ▪ With Atacama Large Millimeter/submillimeter Array, PDR and XDR tracers are now routinely detected on galactic scales over cosmic time. This makes it possible to link the star-formation history of the Universe to the evolution of the physical and chemical properties of the gas.
AMC-070: Lenalidomide Is Safe and Effective in HIV-Associated Kaposi Sarcoma
Authors: Reid Erin G. , Shimabukuro Kelly , Moore Page , Ambinder Richard F. , Bui Jack D. , Han Semi , Martínez-Maza Otoniel , Dittmer Dirk P. , Aboulafia David , Chiao Elizabeth Yu , Maurer Toby , Baiocchi Robert , Mitsuyasu Ronald , Wachsman William ,   for the AIDS Malignancy Consortium (AMC)
Published: June 2022

AbstractPurpose:Kaposi sarcoma (KS), an endothelial cell tumor associated with KS herpesvirus (KSHV), remains among the most common malignancies occurring with HIV infection (HIV-KS). As an oral anti-inflammatory, antiangiogenic, and immunomodulatory agent, lenalidomide is potentially an attractive alternative to standard chemotherapy for KS.Experimental Design:The primary objectives of this phase I/II trial were to determine the maximum tolerated dose (MTD) and response rates for lenalidomide in HIV-KS. Secondary objectives included correlating response with natural killer (NK) and T-cell subsets, plasma cytokines, viral copy number, and KSHV gene expression in biopsies. Four dose levels of oral lenalidomide taken 21 consecutive days of 28-day cycles were evaluated in adults with HIV-KS on antiretroviral therapy with controlled viremia.Results:Fifteen and 23 participants enrolled in phases I and II, respectively, 76% of whom had received prior KS therapy. The MTD was not reached, declaring 25 mg as the recommended phase II dose (RP2D). The most frequent adverse events were neutropenia, fatigue, leukopenia, and diarrhea. Of the 25 evaluable participants receiving RP2D, 60% responded. Correlative studies performed in a subset of participants demonstrated a significant increase in proportions of blood T cells with T-regulatory phenotype, and plasma cytokines trended toward a less inflammatory pattern. Clinical response was associated with loss of KSHV transcription.Conclusions:Lenalidomide is active in HIV-KS. The most common adverse events were manageable. With 60% of participants receiving RP2D obtaining a partial response and &lt;10% discontinuing due to adverse events, the response and tolerability to lenalidomide support its use in HIV-KS.See related commentary by Henry and Maki, p. 2485