bluuebunny/crossref_metadata_2025_split huggingface dataset:
Opportunities for the development of drowning interventions in West Bengal, India: A review of policy and government programs
Authors: Gupta Medhavi , Zwi Anthony B , Jagnoor Jagnoor 
Published: April 2020

Abstract
Background: Four million people living in the Indian Sundarbans region in the state of West Bengal face a particularly high risk of drowning due to rurality, presence of open water, lack of accessible health systems and poor infrastructure. Although the World Health Organization has identified several interventions that may prevent drowning in rural low-and middle-income country contexts, no drowning interventions are currently implemented in this region. This study aims to conduct contextual policy analysis for the development of a drowning program. Implementation of a drowning program should consider leveraging existing structures and resources, as interventions that build on existing policy targets or government programs are more likely to be sustainable and scalable.Methods: A detailed content review of national and state policy (West Bengal) was conducted to identify policy principles and/or specific government programs that may be leveraged for drowning interventions. The enablers and barriers of these programs as well as their implementation reach were assessed through a systematic literature review. Identified policies and programs were also assessed to understand how they catered for underserved groups and their implications for equity.Results: Three programs were identified that may be leveraged for the implementation of drowning interventions such as supervised childcare, provision of home-based barriers, swim and rescue skills training and community first responder training: the Integrated Child Development Scheme (ICDS), Self-Help Group (SHG) and Accredited Social Health Activist (ASHA) programs. All three had high coverage in West Bengal and considered underserved groups such as women and rural populations. Possible barriers to using these programs were poor government monitoring and resource provision and overburdening of community-based workers. Conclusions: This is the first systematic analysis of both policy content and execution of government programs to provide comprehensive insights into possible implementation strategies for a health intervention, in this case drowning. Programs targeting specific health outcomes should consider interventions outside of the health sector that address social determinants of health. This may enable the program to better align with relevant government agendas and increase sustainability.
Prevalence of positive TST among Healthcare workers in a high-burden TB setting in Peru
Authors: Sedamano Juana , Schwalb Alvaro , Cachay Rodrigo , Zamudio Carlos , Ugarte-Gil Cesar , Soto-Cabezas Gabriela , Munayco César V. , Seas Carlos 
Published: April 2020

Abstract
Background: Tuberculosis (TB) transmission has long been recognized as an important occupational hazard for healthcare workers (HCWs). HCWs have a 5.8% annual risk of exposure and three times greater risk of developing active TB than the general population.Methods: We conducted an observational cross-sectional study between September 2014 and March 2015 among HCWs in a high-burden TB setting in Lima to estimate the prevalence of positive Tuberculin Skin Test (TST) and to investigate factors associated with a positive TST.Results: 240 participants were included in the analysis; TST was administered to 190 (79.2%) while the rest were exempt due to a previous positive TST result, history of TB, or test refusal. A positive TST result was found among 56.2% of participants to whom the TST was applied (95% CI: 49.22% - 63.55%). When considering those who had a previous positive TST result and those with a history of TB, the prevalence of a positive TST result was 64.3% (95% CI: 57.8% - 70.3%). No significant differences were observed between clinical/paramedical and administrative staff in the health center. The use of N95 masks during work hours was reported by 142 (69.9%) participants. Prevalence ratios (PR) show that workers with more than 120 months as a HCW were 1.44 times more likely to be TST positive. The multivariate analysis found that HCWs with over 10 years of service were 1.52 times more likely to be TST positive.Conclusion: This study supports previous reports that TB infection is an occupational hazard for HCWs. Prevention of TB transmission through control measures, as well as timely diagnosis of LTBI in this particular high-risk group, is critical for individual and public health.
Neutrophil: lymphocyte ratio is positively associated with subclinical diabetic cardiomyopathy
Authors: Huang Xiaoli , Qin Zihan , Xu Min , Zhang Feifei , Jiang Xiaohong , Hua Fei , Tao Lichan 
Published: April 2020

Abstract
Background: Subclinical diabetic cardiomyopathy (DCM) occurs frequently in asymptomatic subjects with Type 2 diabetes mellitus (T2DM). Previous studies have shown a direct relationship between the immune system and DCM using reliable biomarkers.Methods: 507 subjects with T2DM were recruited from April 2018 to October 2019 and divided into T2DM with cardiac dysfunction (DCM) group and T2DM without cardiac dysfunction (non-DCM) group. Adjusted logistic regression models were used to evaluate relationship between the quartiles of Neutrophil: lymphocyte ratio (NLR) and subclinical DCM (covariates: age, sex, BMI, duration of diabetes, and hyperlipidemia). Results: Blood NLR was significantly upregulated in DCM group compared to non-DCM group (P = 0.05). Then the adjusted odds ratio (95% CI) of the highest NLR quartile was 14.32 (2.92-70.31) compared to the lowest quartile of NLR after multiple adjusted (P < 0.001). However, neutrophil and lymphocyte counts did not significantly relate to the incidence of DCM in T2DM patients. Conclusions: The present study demonstrated that NLR was related to the incidence of subclinical DCM, suggesting that NLR may be an efficient and accurate prognostic biomarker for DCM. Trial registration: Chinese Clinical Trial Registry (ChiCTR1900027080). Registered 30 October 2019. Retrospectively registered: www.medresman.org
Development of a standardized method to evaluate the protective efficiency of cosmetic packaging against microbial contamination
Authors: Catovic Chloe , Martin Sylvia , Desaint Sephane , Borges Christine , Lesouhaitier Helene , Roullet Florence , Bresciani Nadine , Jouault Anne-Marie , Poulet Valerie , Luc Joelle , Joulia Valérie , Jupin Alain , Masson Christophe , Crozier Alain , Feuilloley Marc G.J. 
Published: April 2020

Abstract
Doubts surrounding the potential adverse effects of antimicrobial preservatives have modified the demand of consumers, who increasingly insist on the production of low-level and even preservative-free cosmetics. Protection of the product against microbial contamination is therefore focused on the packaging. This has prompted the emergence of a highly diverse array of so-called “protective”, “overprotective”, and “barrier” packaging. However, these designations are not normalized and the choice of the right packaging adapted to each cosmetic product is still essentially empirical, hazardous, and time consuming. The Cosmetic Valleys cluster has launched a commission to define a complete and experimentally-validated method to classify the level of protection of cosmetic packaging against microbial contamination. As reported herein, this required the development a specific bacteriostatic medium that can be used for seven days and an in vitro procedure that reproduces in-use contamination and consumer practices. Based on tests performed on over 800 packages of different origin and performance characteristics, we propose a classification, divided into six grades, to differentiate the protective efficiency of cosmetic packaging. This work can be considered as a first step towards a regulatory text.
Effect of exercise training on body temperature in the elderly: a retrospective cohort study
Authors: Matsumura Koichiro , Iwasaka Toshiji , Mizuno Satoshi , Mizuno Ikuko , Hayanami Hikaru , Sawada Kiyoshi , Iwasaka Junji , Takeuchi Kotaro , Suga Toshimitsu , Sugiura Tetsuro , Shiojima Icihro 
Published: April 2020

Abstract
Background
Although rise in body temperature in the elderly has clinical benefits such as activating immune system, little is known regarding the mediator related to the elevation of body temperature. This study evaluated the effect of exercise training on body temperature and clarified the relationship between body temperature and body composition in the elderly.
Methods
In this retrospective cohort study, a total of 91 elderly participants performed aerobic and anaerobic exercise training twice a week for 2-year. Non-contact infrared thermometer and bioelectrical impedance analysis were performed at baseline and at 2-year. The participants were divided into 2 groups by baseline body temperature of 36.3℃; lower body temperature group (n = 67) and normal body temperature group (n = 24).
Results
Body temperature rose significantly after exercise training (36.04 ± 0.01 °C to 36.30 ± 0.02 °C, p < 0.0001) in the lower body temperature group, whereas there was no significant difference (36.35 ± 0.02 °C to 36.36 ± 0.03 °C, p = 0.39) in the normal body temperature group. A positive correlation was observed between the amount of change in body temperature and baseline body temperature (r = -0.68, p < 0.0001). Increase in skeletal muscle mass was an independent variable related to the rise in body temperature by the multivariate logistic regression analysis (odds ratio: 4.77, 95% confidence interval: 1.29–17.70, p = 0.02).
Conclusions
Exercise training raised body temperature in the elderly, especially those with lower baseline body temperature.
Advanced oxidation processes for the removal of cyanobacterial toxins from drinking water
Authors: Schneider Marcel , Bláha Luděk 
Published: April 2020

Abstract
Drinking water production faces many different challenges with one of them being naturally produced cyanobacterial toxins. Since pollutants become more abundant and persistent today, conventional water treatment is often no longer sufficient to provide adequate removal. Amongst other emerging technologies, advanced oxidation processes (AOPs) have a great potential to appropriately tackle this issue. This review addresses the economic and health risks posed by cyanotoxins and discusses their removal from drinking water by AOPs. The current state of knowledge on AOPs and their application for cyanotoxin degradation is synthesized to provide an overview on available techniques and effects of water quality, toxin- and technique-specific parameters on their degradation efficacy. The different AOPs are compared based on their efficiency and applicability, considering economic, practical and environmental aspects and their potential to generate toxic disinfection byproducts. For future research, more relevant studies to include the degradation of less explored cyanotoxins, toxin mixtures in actual surface water, assessment of residual toxicity and scale-up are recommended. Since actual surface water most likely contains more than just cyanotoxins, a multi-barrier approach consisting of a series of different physical, biological and chemical – especially oxidative – treatment steps is inevitable to ensure safe and high quality drinking water.
Functional analyses of chitinolytic enzymes in the formation of calcite prisms in Pinctada fucata.
Authors: Kintsu Hiroyuki , Pérez-Huerta Alberto , Ohtsuka Shigeru , Okumura Taiga , Ifuku Shinsuke , Nagata Koji , Kogure Toshihiro , Suzuki Michio 
Published: April 2020

Abstract
Background
The mollusk shells present distinctive microstructures that are formed by small amounts of organic matrices controlling the crystal growth of calcium carbonate. These microstructures show superior mechanical properties such as strength or flexibility. The shell of Pinctada fucata has the prismatic layer consisting of prisms of single calcite crystals. These crystals contain small angle grain boundaries caused by a dense intracrystalline organic matrix network to improve mechanical strength. Previously, we identified chitin and chitinolytic enzymes as components of this intracrystalline organic matrix. In this study, we analyzed the function of those organic matrices in calcium carbonate crystallization by in vitro and in vivo experiments.
Results
We analyzed calcites synthesized in chitin gel with or without chitinolytic enzymes by using transmission electron microscope (TEM) and atom probe tomography (APT). TEM observations showed that grain boundary was more induced as concentration of chitinolytic enzymes increased and thus, chitin became thinner. In an optimal concentration of chitinolytic enzymes, small angle grain boundaries were observed. APT analysis showed that ion clusters derived from chitin were detected. In order to clarify the importance of chitinolytic enzymes on the formation of the prismatic layer in vivo, we performed the experiment in which chitinase inhibitor was injected into a living Pinctada fucata and then analyzed the change of mechanical properties of the prismatic layer. The hardness and elastic modulus increased after injection of chitinase inhibitor. Electron back scattered diffraction (EBSD) mapping data showed that the spread of crystal orientations in whole single crystal also increased by the effect of inhibitor injections.
Conclusion
Our results suggested that chitinolytic enzymes may function cooperatively with chitin to regulate the crystal growth and mechanical properties of the prismatic layer, and chitinolytic enzymes are essential for the formation of the normal prismatic layer of P. fucata.
A Systematic Review and Meta-analysis of Alcohol Use Disorders and Its determinants in People Living with HIV in Africa: A Continent based Review and Meta-analysis study.
Authors: Necho Mogesie , Belete Asmare , Getachew Yibeltal 
Published: April 2020

Abstract
Background
Alcohol use disorder among people living with HIV/AIDS contributes to decreased adherence and effectiveness of antiretroviral medication, decreased help-seeking to HIV/AIDS care and treatment, increased load of the virus in the blood, and development of drug-resistant HIV strains. This study therefore aimed and assessed the pooled evidence on prevalence and associated factors of alcohol use disorder in retroviral infected patients in Africa.
Methods
We implemented our electronic data base search on PubMed, Scopus, EMBASE, and Psych-INFO libraries. In addition, WHO websites and Google scholar were also investigated for grey literatures. Moreover, we further investigated the reference lists of published articles. Stata-11meta-prop package with 95% confidence interval was used. Subgroup and sensitivity analysis were also performed. Cochran's Q- and the I2 test were used to check heterogeneity. Publication bias was evaluated with Egger's test and funnel plots.
Results
In this meta-analysis, we included 22 studies with a total of 16774 patients and the pooled prevalence of alcohol use disorder was 22.03%( 95% CI: 17.18, 28.67). The average prevalence of AUD in South Africa (28.77%) was higher than in Uganda (16.61%) and Nigeria (22.8%). Besides, the average prevalence of AUD in studies published before 2011, 2011–2015, and after 2015 was found to be 13.47%, 24.93% and 22.88% respectively. Moreover, the pooled magnitude of AUD among studies which utilized a sample size > 450 was 16.71% whereas it was 26.46% among studies that utilized sample size < 450. Furthermore, the pooled estimated prevalence of hazardous, harmful and dependent drinking was 10.87%, 8.1%, and 3.12% respectively. Being male was an associated factor for alcohol use disorder (AOR = 5.5%; 95% CI: 1.10, 9.98). Moreover, the average odds ratio of cigarette smoking and chat chewing were found to be 3.95% (95% CI: 3.00, 4.89) and 3.34% (95% CI: 1.71, 4.96) respectively.
Conclusion
The average estimated prevalence of AUD in HIV/AIDs patients was high and factors such as being Male, cigarette smoking and chat chewing were associated with it. Early detection and appropriate management of AUD and the mentioned associated factors have to be a routine practice.
Readmission Risk Factors in Patients after myocardial infarction using the minimum data set
Authors: Abooali Sara , Aslani Azam , Bayati Mohsen 
Published: April 2020

Abstract
Background

- Readmission is important not only as a representation factor of quality, but also because of its high cost and taking up an inconsistent share of hospital care costs. The purpose of this study was to determine the affecting factors of readmission of patients after myocardial infarction using the minimum data set.
Methods

- This is a descriptive cross-sectional and retrospective study. The research environment was hospitals affiliated with Shiraz University of Medical Sciences. A total of 320 hospitalized patient files with myocardial infarction with the code I21, admitted between April 2011 and October 2019 were reviewed. After comprehensive review of the literature and sources, 55 criteria were extracted and two expert panel sessions were held. Univariate and multivariate analysis were used to investigate the relationships between different factors and readmission. Next, variables that were significant in univariate analysis were entered into the regression model.
Results

- After convening the expert panel, 32 criteria were finally approved. The highest rate of readmission occurred in the first 30 days after first admission with 84 cases (24%) and according to the present study the most common clinical (cardiovascular) factors affecting readmission were acute coronary syndrome with 104 cases (59.43%), atherosclerosis with 92 cases (52.57%), infarction in other areas with 89 cases (50.86%), anterior myocardial infarction with 88 cases (50.29%), congestive heart failure with 18 cases (10.29%).
Conclusions-

This study showed that underlying and clinical factors affecting readmissions in a developing country include acute coronary syndrome, anterior myocardial infarction, coronary artery stenosis/chronic ischemic heart disease, chronic obstructive pulmonary disease, hypertension at first admission and high amount of sodium in the first admission.
Qualitative analysis of clinicians’ perspectives on the use of a computerized decision aid in the treatment of psychotic disorders
Authors: Roebroek Lukas , Bruins Jojanneke , Delespaul Philippe A. , Boonstra Albert , Castelein Stynke 
Published: April 2020

Abstract
Background Clinical decision aids are used in various medical fields to support patients and clinicians when making healthcare decisions. Few attempts have been made to implement such tools in psychiatry. We developed Treatment E-Assist (TREAT); a routine outcome monitoring based computerized clinical decision aid, which generates personalized treatment recommendations in the care of people with psychotic disorders. The aim of this study is to investigate how TREAT is used and evaluated by clinicians and how this tool can be improved.Methods Clinicians working with TREAT during a clinical trial were asked to participate in semi-structured interviews. The unified theory of acceptance and use of technology (UTAUT) was adopted to structure the interview questions. The transcripts were coded. An inductive thematic analysis was followed to identify the main themes.Results 13 clinicians (mean age: 49) of which eight psychiatrists and five nurse practitioners, participated in this study. Eight clinicians experienced TREAT as beneficial, whereas five experienced no additional benefits. Thematic analysis revealed five themes about how TREAT was used and evaluated by clinicians, views on TREAT’s visual structuring of routine outcome monitoring results, guideline based treatment recommendations, contextual factors, effects on patients and effects on shared decision-making. Performance and effort expectancy were perceived as high by clinicians. The facilitating conditions were optimal and perceived social influence was low.Conclusion This article presents a qualitative evaluation by clinicians of a computerized clinical decision aid in psychosis care. TREAT was viewed by most clinicians as beneficial during their consultations. The visual representation of routine outcome monitoring results was well-appreciated and provided input to discuss treatment planning with patients. The treatment recommendations did not change most treatment decisions but supported clinical reasoning. However, some clinicians were unconvinced about TREAT’s benefits. The delivery, applicability and the availability of resources require improvement to increase TREAT’s efficacy. Not all patients responded well to TREAT but the observed facilitation of shared decision-making is promising. All four predictors of the unified theory of acceptance and use of technology were positively evaluated by the majority of clinicians. Clinicians behavioral intentions are expected to be high when implementing TREAT into organizations.
Systematic analysis of rare variants in mitochondrial function-associated genes for autosomal-dominant Parkinson’s disease in a Chinese population
Authors: Chen Yongping , Gu Xiaojing , Ou Ruwei , Zhang Lingyu , Hou Yanbing , Liu Kuncheng , Cao Bei , Wei Qianqian , Song Wei , Zhao Bi , Wu Ying , Cheng Jingqiu , shang huifang 
Published: April 2020

Abstract
Background

Mitochondrial dysfunction is involved in the pathogenicity of Parkinson’s disease (PD). However, the genetic roles of mitochondrial function-associated genes responsible for PD need to be replicated in different cohorts.
Methods

Whole-exome and Sanger sequencing were used to identify the genetic etiology of 400 autosomal dominant-inherited PD (ADPD) patients. Variants in six dominant inherited mitochondrial function-associated genes, including HTRA2, CHCHD2, CHCHD10, TRAP1, HSPA9 and RHOT1, were analyzed.
Results

A total of 12 rare variants identified in the five genes accounted for 3% of ADPD cases, including 0.5% in HTRA2, 0.8% in CHCHD2, 1% in TRAP1, 0.3% in RHOT1 and 0.5% in HSPA9. Among them, five novel variants, p.E4A, p.R13Cfs*107 and p.R449X in TRAP1, p.S95N in RHOT1 and p.N180I in HSPA9, were identified in ADPD patients. Evidence of a founder event that occurred exclusively in Asia was identified in two probands with p.P53Afs*37 in CHCHD2, which was further observed in one patient from 300 sporadic cases. Based on burden analysis, CHCHD2 tended to be slightly enriched in ADPD. Clinically, all patients carrying mutations in the genes presented typical motor symptoms and a good response to L-DOPA. Most of them had slower disease progression (8/12) and mild cognitive impairment (9/12), but the age of onset varied. No rare variant was detected in CHCHD10.
Conclusion

Our study expands the mutation spectra and enhances the understanding of the clinical phenotype of PD patients with mitochondrial function-related gene variants. Additionally, the CHCHD2 gene should be given more attention in PD originating in the Chinese population.