bluuebunny/crossref_metadata_2025_split huggingface dataset:
“Kind of blurry”: Deciphering clues to prevent, investigate and manage prescribing cascades
Authors: Farrell Barbara , Galley Emily , Jeffs Lianne , Howell Pam , McCarthy Lisa M. 
Published: August 2022

Background
Prescribing cascades, where a medication is used to treat the side effect of another medication, contribute to polypharmacy and related morbidity. Little is known about clinicians’ and patients’ experiences with prescribing cascades. In this study, we explored why and how prescribing cascades occur across a variety of care settings and how they are managed.

Methods and findings
This descriptive qualitative study employed semi-structured interviews with older adults who may have experienced a prescribing cascade(s), their caregivers, and healthcare providers. Interviewees were recruited through physician referral from a Geriatric Day Hospital, two long-term care homes in Ottawa, Ontario, and through self-referral across Ontario, Canada. An inductive approach was used to code data and determine themes. Thirty-one interviews were conducted for ten unique patient cases. Some interviewees were involved in more than one case, resulting in 22 unique interviewees. Three themes were identified. First, recognition of prescribing cascades is linked to awareness of medication side effects. Second, investigation and management of prescribing cascades is simultaneous and iterative (rather than linear and sequential). Third, prevention of prescribing cascades requires intentional strategies to help people anticipate and recognize medication side effects. Difficulty with recruitment from both long-term care homes and through self-referral was the central limitation. This exemplifies challenges associated with studying a poorly recognized and underexplored phenomenon.

Conclusions
In order to better recognize, investigate and manage prescribing cascades, clinicians and patients need to know more about medication side effects; they need to ask ‘can this be caused by a drug?’ when signs and symptoms arise or worsen; and they need access to information about medication experiences to have benefit-risk discussions and make decisions about deprescribing. Approaches for raising public awareness of prescribing cascades should be trialed to raise the profile of this issue and facilitate continued exploration of the phenomenon.
Cortisol response under low intensity exercise during cognitive-behavioral therapy is associated with therapeutic outcome in panic disorder–an exploratory study
Authors: Wintermann Gloria-Beatrice , Noack René , Steudte-Schmiedgen Susann , Weidner Kerstin 
Published: September 2022

Objectives
Patients with Panic Disorder (PD) show an abnormal stress-induced functioning of the Hypothalamic-Pituitary-adrenal (HPA)-axis. Different protocols for stress induction are of rather low relevance for the psychotherapeutic treatment. In practice, interoceptive exposure is often realized as Low Intensity Exercise (LIE), as compared to an incremental cycle exercise test to exhaustion. Currently, it is not known, whether LIE displays an effective interoceptive stressor 1.) leading to a significant anxiety induction; 2.) a comparable HPA- and Sympathetic-Adreno-Medullar (SAM)-axis response in both patients and healthy controls; 3.) stress responses under LIE are associated with treatment outcomes.

Patients and methods
N = 20 patients with PD and n = 20 healthy controls were exposed to ten minutes of LIE on an exercise bike. LIE was applied as part of the interoceptive exposure, during an intensive Cognitive-Behavioral Therapy (CBT) in a day clinic. Heart rate was monitored and salivary cortisol samples collected. Before and after the LIE, state anxiety/ arousal were assessed. In order to evaluate psychopathology, the Panic and Agoraphobia Scale, Mobility Inventory, Agoraphobic Cognitions Questionnaire and Body Sensations Questionnaire were applied, before (T1) and after five weeks (T2) of an intensive CBT.

Results
LIE led to a significant and similar heart rate increase in both groups. Cortisol decreased over time in both groups, especially in male patients. A higher psychopathology before, and after CBT, was associated with a significantly lower cortisol response under LIE.

Conclusions
In the present study, LIE led to a divergent stress response: while there was a significant heart rate increase, cortisol decreased over time, particularly in male patients. A lower reactivity of the HPA-axis seems to be associated with a lower treatment outcome, which may affect extinction based learning. The findings suggest, that interoceptive stimuli should be designed carefully in order to be potent stressors.
Toward elimination of mother-to-child transmission of HIV in Malawi: Findings from the Malawi Population-based HIV Impact Assessment (2015–2016)
Authors: Kim Evelyn , Jonnalagadda Sasi , Cuervo-Rojas Juliana , Jahn Andreas , Payne Danielle , West Christine , Ogollah Francis , Maida Alice , Kayira Dumbani , Nyirenda Rose , Dobbs Trudy , Patel Hetal , Radin Elizabeth , Voetsch Andrew , Auld Andrew 
Published: September 2022

Background
Malawi spearheaded the development and implementation of Option B+ for prevention of mother-to-child transmission of HIV (PMTCT), providing life-long ART for all HIV-positive pregnant and breastfeeding women. We used data from the 2015–2016 Malawi Population-based HIV Impact Assessment (MPHIA) to estimate progress toward 90-90-90 targets (90% of those with HIV know their HIV-positive status; of these, 90% are receiving ART; and of these, 90% have viral load suppression [VLS]) for HIV-positive women reporting a live birth in the previous 3 years.

Methods
MPHIA was a nationally representative household survey; consenting eligible women aged 15–64 years were interviewed on pregnancies and outcomes, including HIV status during their most recent pregnancy, PMTCT uptake, and early infant diagnosis (EID) testing. Descriptive analyses were weighted to account for the complex survey design. Viral load (VL) results were categorized by VLS (<1,000 copies/mL) and undetectable VL (target not detected/below the limit of detection).

Results
Of the 3,153 women included in our analysis, 371 (10.1%, 95% confidence interval [CI]: 8.8%–11.3%) tested HIV positive in the survey. Most HIV-positive women (84.2%, 95% CI: 79.9%–88.6%) reported knowing their HIV-positive status; of these, 94.9% (95% CI: 91.7%–98.2%) were receiving ART; and of these, 91.2% (95% CI: 87.4%–95.0%) had VLS. Among the 371 HIV-positive women, 76.0% (95% CI: 70.4%–81.7%) had VLS and 66.5% (95% CI: 59.8%–73.2%) had undetectable VL. Among 262 HIV-exposed children, 50.8% (95% CI: 42.8%–58.8%) received EID testing within 2 months of birth, whereas 17.9% (95% CI: 11.9%–23.8%) did not receive EID testing. Of 190 HIV-exposed children with a reported HIV test result, 2.1% (95% CI: 0.0%–4.6%) had positive results.

Conclusions
MPHIA data demonstrate high PMTCT uptake at a population level. However, our results identify some gaps in VLS in postpartum women and EID testing.
Meals, Microbiota and Mental Health in Children and Adolescents (MMM-Study): A protocol for an observational longitudinal case-control study
Authors: Asbjornsdottir Birna , Lauth Bertrand , Fasano Alessio , Thorsdottir Inga , Karlsdottir Ingibjorg , Gudmundsson Larus S. , Gottfredsson Magnus , Smarason Orri , Sigurdardottir Sigurveig , Halldorsson Thorhallur I. , Marteinsson Viggo Thor , Gudmundsdottir Valborg , Birgisdottir Bryndis Eva 
Published: September 2022

Recent studies indicate that the interplay between diet, intestinal microbiota composition, and intestinal permeability can impact mental health. More than 10% of children and adolescents in Iceland suffer from mental disorders, and rates of psychotropics use are very high. The aim of this novel observational longitudinal case-control study, “Meals, Microbiota and Mental Health in Children and Adolescents (MMM-Study)” is to contribute to the promotion of treatment options for children and adolescents diagnosed with mental disorders through identification of patterns that may affect the symptoms. All children and adolescents, 5–15 years referred to the outpatient clinic of the Child and Adolescent Psychiatry Department at The National University Hospital in Reykjavik, Iceland, for one year (n≈150) will be invited to participate. There are two control groups, i.e., sex-matched children from the same postal area (n≈150) and same parent siblings (full siblings) in the same household close in age +/- 3 years (n<150). A three-day food diary, rating scales for mental health, and multiple questionnaires will be completed. Biosamples (fecal-, urine-, saliva-, blood samples, and buccal swab) will be collected and used for 16S rRNA gene amplicon sequencing of the oral and gut microbiome, measurements of serum factors, quantification of urine metabolites and host genotype, respectively. For longitudinal follow-up, data collection will be repeated after three years in the same groups. Integrative analysis of diet, gut microbiota, intestinal permeability, serum metabolites, and mental health will be conducted applying bioinformatics and systems biology approaches. Extensive population-based data of this quality has not been collected before, with collection repeated in three years’ time, contributing to the high scientific value. The MMM-study follows the “Strengthening the Reporting of Observational Studies in Epidemiology” (STROBE) guidelines. Approval has been obtained from the Icelandic National Bioethics Committee, and the study is registered with Clinicaltrials.gov. The study will contribute to an improved understanding of the links between diet, gut microbiota and mental health in children through good quality study design by collecting information on multiple components, and a longitudinal approach. Furthermore, the study creates knowledge on possibilities for targeted and more personalized dietary and lifestyle interventions in subgroups.
Trial registration numbers: VSN-19-225 & NCT04330703.
Views of advance care planning in older hospitalized patients following an emergency admission: A qualitative study
Authors: Bielinska Anna-Maria , Soosaipillai Gehan , Riley Julia , Darzi Ara , Urch Catherine , Archer Stephanie 
Published: September 2022

Background
There is increasing evidence of the need to consider advance care planning (ACP) for older adults who have been recently admitted to hospital as an emergency. However, there is a gap in knowledge regarding how to facilitate ACP following acute illness in later life.

Aim/Objectives
To explore the perceived impact of ACP on the lives of older persons aged 70+ who have been acutely admitted to hospital.

Method
Semi-structured qualitative interviews were conducted with older adults aged 70+ who were admitted to hospital as an emergency. Thematic analysis was enhanced by dual coding and exploration of divergent views within an interdisciplinary team.

Results
Twenty participants were interviewed. Thematic analysis generated the following themes: (1) Bespoke planning to holistically support a sense of self, (2) ACP as a socio-cultural phenomenon advocating for older persons rights, (3) The role of personal relationships, (4) Navigating unfamiliar territory and (5) Harnessing resources.

Conclusion
These findings indicate that maintaining a sense of personal identity and protecting individuals’ wishes and rights during ACP is important to older adults who have been acutely unwell. Following emergency hospitalization, older persons believe that ACP must be supported by a network of relationships and resources, improving the likelihood of adequate preparation to navigate the uncertainties of future care in later life. Therefore, emergency hospitalization in later life, and the uncertainty that may follow, may provide a catalyst for patients, carers and healthcare professionals to leverage existing or create new relationships and target resources to enable ACP, in order to uphold older persons’ identity, rights and wishes following acute illness.
A rapid RT-LAMP SARS-CoV-2 screening assay for collapsing asymptomatic COVID-19 transmission
Authors: Allsopp Rebecca C. , Cowley Caroline M. , Barber Ruth C. , Jones Carolyn , Holmes Christopher W. , Bird Paul W. , Gohil Shailesh G. , Blackmore Claire , Tobin Martin D. , Brunskill Nigel , Baker Philip N. , Shaw Jacqui A. 
Published: September 2022

Purpose
To demonstrate the diagnostic performance of rapid SARS-CoV-2 RT-LAMP assays, comparing the performance of genomic versus sub-genomic sequence target with subsequent application in an asymptomatic screening population.

Methods
RT-LAMP diagnostic specificity (DSe) and sensitivity (DSe) was determined using 114 RT-PCR clinically positive and 88 RT-PCR clinically negative swab samples processed through the diagnostic RT-PCR service within the University Hospitals of Leicester NHS Trust. A swab-based RT-LAMP SARS-CoV-2 screening programme was subsequently made available to all staff and students at the University of Leicester (Autumn 2020), implemented to ISO 15189:2012 standards using NHS IT infrastructure and supported by University Hospital Leicester via confirmatory NHS diagnostic laboratory testing of RT-LAMP ‘positive’ samples.

Results
Validation samples reporting a Ct < 20 were detected at 100% DSe and DSp, reducing to 95% DSe (100% DSp) for all samples reporting a Ct < 30 (both genomic dual sub-genomic assays). Advisory screening identified nine positive cases in 1680 symptom free individuals (equivalent to 540 cases per 100,000) with results reported back to participants and feed into national statistics within 48 hours.

Conclusion
This work demonstrates the utility of a rapid RT-LAMP assay for collapsing transmission of SARS-CoV-2 in an asymptomatic screening population.
Impact of Belgian COVID-19 lockdown restrictions on autistic individuals’ socio-communicative behaviors and their parents’ quality of life
Authors: Weyland Marielle , Maes Pauline , Kissine Mikhail , Defresne Pierre 
Published: August 2022

Background
In the spring of 2020, Belgian authorities enforced a full lockdown period to contain the spread of the SARS-CoV-2 virus. This lockdown drastically disrupted the daily life of autistic individuals’ and that of their families. In the midst of these extraordinary circumstances, we assessed the impact of social restrictions on autistic individuals’ behavior and their parents’ or caregivers’ quality of life; we also sought to identify individual characteristics that may influence such changes.

Methods
We designed an online survey targeting caregivers living with an autistic child or adult. The questionnaire included 125 five-point Likert questions which targeted changes in families’ quality of life and in autistic individuals’ behavior, as well as factors likely to influence the extent and direction of these changes.

Results
We collected data from 209 French-speaking Belgian respondents. Respondents reported that the lockdown brought about a higher frequency of nonfunctional socio-communicative behaviors, as well as a decrease in families’ quality of life. Parents who had less access to respite care experienced a steeper decrease in their quality of life. Autistic individuals with comorbidities, and whose parents had less access to respite care and implemented fewer rules at home during lockdown were more likely to display nonfunctional socio-communicative behaviors.

Conclusion
COVID-19 lockdown restrictions had a negative impact on both autistic individuals and their parents.
Glycemic index, glycemic load, and lung cancer risk: A meta-analysis of cohort and case-control studies
Authors: Du Hongzhen , Zhang Tianfeng , Lu Xuning , Chen Meicui , Li Xiaoling , Li Zengning 
Published: September 2022

ObjectiveGlycemic index (GI) or glycemic load (GL) has been investigated in the field of cancer research for several years. However, the relationship between GI or GL and lung cancer risk remains inconsistent. Therefore, this study aimed to summarize previous findings on this relationship.MethodsPubMed, Embase, Scopus, Web of Science databases, and Cochrane Library were searched by July 2021. This review was conducted in accordance with the PRISMA guidelines. A fixed or random-effects model was adopted for meta-analysis to compute the pooled relative risks (RR) and their corresponding 95% confidence intervals (CIs). Subgroup analyses, sensitivity analyses, and publication bias analyses were also performed.ResultsIn total, nine articles were included, with four case-control studies and five cohort studies, including 17,019 cases and 786,479 controls. After merging the studies, pooled multivariable RRs of lung cancer based on the highest versus the lowest intake were 1.14 (95%CI: 1.03–1.26) and 0.93 (95%CI: 0.84–1.02) for GI and GL. Results persisted in most stratifications after stratifying by potential confounders in the relationship between GI and lung cancer risk. There was a non-linear dose response relation for GI with lung caner risk.ConclusionGI typically has a positive relationship with lung cancer risk. However, no associations between GL and lung cancer risk were observed based on current evidence, suggesting that this issue should be studied and verified further to substantiate these findings.
Associations of trait emotional intelligence and stress with anxiety in Chinese medical students
Authors: Shi Meng , Lu XiaoShi , Du TianJiao 
Published: September 2022

Background
Medical students are vulnerable to anxiety. Identifying its key influencing factors can potentially benefit both students and their future patients. Trait emotional intelligence (EI) and perceived stress may play important roles in anxiety. The main objective of this study was to examine the associations between trait EI, perceived stress and anxiety among Chinese medical students.

Materials and methods
Self-report questionnaires, consisting of the Chinese versions of the Trait Emotional Intelligence Questionnaire-Short Form, the 10-item Perceived Stress Scale, the 7-item Generalized Anxiety Disorder Scale, and demographic section were distributed to 1500 students at three medical universities in China. Hierarchical regression analyses were performed to examine the associations between trait EI, perceived stress and anxiety. Asymptotic and resampling strategies were utilized to examine the mediating effect of perceived stress.

Results
A total number of 1388 medical students became final participants. After adjustment for demographics, while trait EI was strongly and negatively associated with anxiety, accounting for 21.1% of its variance, perceived stress was strongly and positively related to anxiety, explaining an additional 10.0% of the variance. Stress appeared to have a mediating effect on the association between trait EI and anxiety in students with high and moderate levels of stress, but not in low stress group.

Conclusions
Both constructs of trait EI and perceived stress could be of vital importance to understand anxiety in medical students. Evidence-based strategies to enhance trait EI and reduce perceived stress might be undertaken to prevent and treat anxiety in the students.
Content of some heavy metals in plants of Artemisia gmelinii Web. et Stechm (Transbaikal Territory)
Authors: Leskova O. A. , Bondarevich E. A. , Kotsyurzhinskaya N. N. , Leskov А. P. 
Published: August 2022

The paper presents research data on the content of chemical elements (Fe, Mn, Ti, Zn, Cu, Pb, Cr, Ni) in a plant Artemisia gmelinii Web. eх Stechm, growing on the territory of the Transbaikal Territory. It has been established that most of the studied elements are concentrated in the aboveground phytomass of the plant. The maximum average concentrations are recorded for iron, manganese and titanium. Only zinc accumulates in the leaves of the studied species. Nutrients chemical elements as copper and nickel are evenly distributed throughout the plant. For copper, zinc and lead, exceed-ances of the maximum permissible concentrations were recorded (for dry vegetables).
The current state of Ulmus pumila L. in shelterbelts dry steppe zone of the Republic of Khakassia
Authors: Lobanov A. I. , Kravtsova L. P. , Gordeeva G. N. , Kut’kina N. V. 
Published: August 2022

One of the most effective and cheapest ways to reduce environmental stress on arable land is forest shelterbelts. Elm (Ulmus pumila L.) is the main tree species used in field-protective afforestation in the dry steppe zone of the Republic of Khakassia. The studies were carried out in field-protective forest belts of different planting methods, consisting of Ulmus pumila, growing in the Koibal steppe of the Beisky district of the Republic of Khakassia. Here, using modern techniques, temporary trial plots were laid. The aim of the study was to study the current state of life of elm shelterbelts in the dry steppe zone of the Republic of Khakassia. The features of growth, preservation, natural regeneration and sanitary condition of elm forests on trial plots are analyzed depending on the planting methods and the design of forest plantations growing on underdeveloped chestnut sandy loamy soil. It has been established that the best condition of elm trees (1.7-2.2 points) 31 years after planting is noted in forest belts with a checkerboard arrangement of trees, and the worst (2.8-3.2 points) is in forest belts with row plant placement, which is necessary take into account when creating a new generation of shelterbelts.
Ecologo-geographical research of Poa botryoides (Trin. ex Griseb.) Kom. (Poaceae)
Authors: Olonova M. V. 
Published: August 2022

Poa botryoides (Trin. ex Griseb.) Kom. is a predominantly Siberian mountain-steppe species, occupying an intermediate position between P stepposa (Kryl.) Roshev. and P attenuata Trin., from which it is poorly isolated morphologically. A digital map of P botryoides distribution was compiled, based on 143 localities, revealed from herbarium materials and reliable literary sources; the ecologo-climatic niche of this species was constructed on the basis of 19 climatic parameters. The histograms revealed similarities between the precipitation plots of the driest quarter and the coldest quarters, as well as the wettest and warmest quarters. This can be explained by the high correlation between the season and the amount of precipitation. Two-dimensional “climatic envelopes” constructed both for the average annual values of temperature and precipitation, and for the values of temperature and precipitation during the growing season, showed the spread of values, as well as the number of individuals in atypical climatic conditions. Maps reflecting the spatial location of these “atypical” points showed that most of them are located in the humid regions of the Far East, which makes us pay more attention to the P. botryoides samples collected in these territories.
Proposal to include Cosmarium striolatum in the Red Books of the Sverdlovsk and Chelyabinsk Regions
Authors: Shakhmatov A. S. 
Published: August 2022

The paper contains a proposal to include Cosmarium striolatum (Nageli) W. Archer 1861 in the Red Books of the Sverdlovsk and Chelyabinsk regions of the Russian Federation in the category of a rare species (category 3), or as a species with an uncertain status (category 4). Information about the distribution of C. striolatum in the world, as well as data on the finding of the species in the Middle Urals were given.