bluuebunny/crossref_metadata_2025_split huggingface dataset:
Raccoons (Procyon lotor) in the Madrid region of Spain are carriers of antimicrobial‐resistant Escherichia coli and enteropathogenic E. coli
Authors: Orden José A. , García‐Meniño Isidro , Flament‐Simon Saskia C. , Blanco Jorge , de la Fuente Ricardo , Martínez‐Rodrigo Abel , Mas Alicia , Carrión Javier , Sobrino Francisco , Domínguez‐Bernal Gustavo 
Published: November 2020

AbstractThe role of wildlife in the epidemiology of antimicrobial resistance is unclear. Raccoons in North America can carry a variety of enteric bacteria, with associated antimicrobial resistance, that could infect humans and livestock. The potential for raccoons to carry these bacteria in Europe, where they are an invasive species, has not been explored. Our objectives were to determine the prevalence of Escherichia coli with associated antimicrobial resistance in raccoons from the Madrid region of Spain and to determine whether they are carriers of potential human pathogens, including verotoxin‐producing E. coli (VTEC) and enteropathogenic E. coli (EPEC). In total, we tested 237 E. coli isolates from the faeces of 83 euthanized raccoons for susceptibility to 14 antimicrobial agents and the presence of VTEC and EPEC. Antimicrobial resistance to at least one antimicrobial was detected in the faeces of 51% (42/83; 95% CI, 40.1–61.1) of the raccoons tested. A high percentage of raccoons carried, in their faeces, E. coli isolates resistant to ampicillin (33%), streptomycin (33%), tetracycline (30%), sulphafurazole (31%) and trimethoprim‐sulphamethoxazole (23%). We detected one isolate of extended‐spectrum β‐lactamase‐producing E. coli from the faeces of one raccoon. We detected VTEC in the faeces of one raccoon, and EPEC in the faeces of 12% (10/83) of the raccoons. Of the raccoons that carried EPEC in their faeces, 60% (6/10) carried EPEC isolates that exhibited characteristics associated with pathogenicity in humans. Raccoons in Madrid can carry pathogenic and antimicrobial‐resistant E. coli in their faeces and may be a risk to public health because of their potential to contaminate food and the environment with their faeces.
Feasibility of developing children’s Pill School within a UK hospital
Authors: Rashed Asia N , Terry David , Fox Andy , Christiansen Nanna , Tomlin Stephen 
Published: November 2020

ObjectiveWe assessed the feasibility of introducing an intervention (children’s Pill School—PS) within a UK hospital to provide swallowing training for children, identified the proportion of children who can be switched from oral liquid medicines to pills and assessed children/parents’ opinions about the PS training.Methods30 inpatient children (aged 3–18 years; taking oral liquid medicines; their liquid medications assessed suitable for switching to pills; can (and their parents) speak/understand English were included. Training sessions were delivered using hard sweets of different sizes.Results87% (26) of children successfully learnt how to swallow pills after one training session (mean duration 14.5 min), and 92% (24) were discharged on pills. 75 prescribed oral liquid medications were deemed suitable for switching to pills. Of these, 89% (67) were switched successfully.ConclusionChildren as young as 3 years were successful in swallowing pills after training. Providing children PS training session within hospital is feasible and acceptable to children and their parents.
Microcephaly in Australian children, 2016–2018: national surveillance study
Authors: Nunez Carlos , Morris Anne , Jones Cheryl A , Badawi Nadia , Baynam Gareth , Hansen Michele , Elliott Elizabeth J 
Published: November 2020

ObjectiveTo describe infants aged <12 months reported with microcephaly to the Australian Paediatric Surveillance Unit (APSU) following emergence of Zika virus infection internationally.Design, setting and patientsNational, active, monthly surveillance for microcephaly using the APSU. Microcephaly was defined as occipitofrontal circumference (OFC) of more than 2 SDs below the mean for age, gender and gestation.Main outcome measuresClinical spectrum, aetiology and birth prevalence of microcephaly reported by paediatricians.ResultsBetween June 2016 and July 2018, 106 notifications were received, with clinical details provided for 96 (91%). After excluding ineligible notifications, 70 cases were confirmed, giving an annual birth prevalence of 1.12 (95% CI 0.88 to 1.42) per 10 000 live births. Of the total number of cases, 47 (67%) had primary microcephaly (at birth); and 25 (36%) had severe microcephaly (OFC >3 SDs). Birth defects were reported in 42 (60%). Of 49 infants with developmental assessment details available, 25 (51%) had failed to reach all milestones. Vision impairment was reported in 14 (26%). The cause of microcephaly was unknown in 60%: 13 (19%) had been diagnosed with genetic disorders; 22 (39%) had anomalies on neuroimaging. No congenital or probable Zika infection was identified. Severe microcephaly was more often associated with hearing impairment than microcephaly of >2 SDs but ≤3 SDs below the mean (p<0.007). Indigenous children and children with socioeconomic advantage were over-represented among children with microcephaly.ConclusionNovel national data on microcephaly highlight the high proportion of idiopathic cases. This has implications for prevention and management and suggests the need for a standardised diagnostic approach and ongoing surveillance mechanism in Australia.
Outcomes and risk factors for failure after trabeculectomy in Taiwanese patients: medical chart reviews from 2006 to 2017
Authors: Chiu Hsun-I , Su Huan-I , Ko Yu-Chieh , Liu Catherine Jui-Ling 
Published: November 2020

AimsTo determine long-term outcomes and risk factors for failure after mitomycin C (MMC)-augmented initial trabeculectomy (IT) in Taiwanese patients.MethodsWe reviewed medical records of patients with glaucoma undergoing IT during December 2006–December 2016. We defined complete success as an intraocular pressure (IOP) of >5 or ≤21 mm Hg or IOP reduction of ≥20% from baseline without supplemental medications and qualified success as the aforementioned IOP levels with or without supplemental medications. Kaplan-Meier survival and Cox proportional analyses evaluated success rates and risk factors for failure, respectively.ResultsWe enrolled 190 patients (237 eyes; mean age: 54.0±15.3 years; mean postoperative follow-up period: 68.4±35.1 months). Mean IOP and glaucoma medications decreased from 22.2±10.8 to 14.4±5.2 mm Hg (p<0.001) and 3.0±0.7 to 1.8±1.2 (p=0.015), respectively, at the last visit. Cumulative qualified success rates were 93.9%, 93.0%, 86.5% and 67.1% at the 1, 2, 5 and 10 years follow-up, respectively; however, only 7.7% of the eyes reached complete success at the last visit. Eyes with poor preoperative visual acuity were associated with low qualified success rates (HR=1.689, p=0.027); patients aged >70 years had higher complete success rates than did those aged ≤70 years. Five cases (2.11%) exhibited bleb-associated complications.ConclusionDespite satisfactory long-term success rates, most eyes needed medication for IOP control, supporting the notion of predisposed scarring vitality in patients of Chinese ethnicity following MMC-augmented trabeculectomy.
Epidemic keratoconjunctivitis in India: electronic medical records-driven big data analytics report IV
Authors: Das Anthony Vipin , Basu Sayan 
Published: November 2020

AimsTo describe the clinical profile of epidemic keratoconjunctivitis (EKC) in patients presenting to a multitier ophthalmology hospital network in India.MethodsThis retrospective hospital-based study included 2 408 819 patients presenting between August 2010 and February 2020. Patients with a clinical diagnosis of EKC in at least one eye with a recent onset (≤1 week) were included as cases. The data were collected using the eyeSmart electronic medical record system.ResultsOverall, 21 196 (0.9%) new patients were diagnosed with EKC, of which 19 203 (90.6%) patients reported a recent onset (≤1 week) and were included for analysis. The median age was 32 (IQR: 22–45) years and adults (84.5%) were commonly affected. Most of the patients were male (62.1%) and unilateral (53.4%) affliction was commoner. The most common presenting symptom was redness (63.7%), followed by watering (42.1%). Preauricular lymphadenopathy or tenderness was documented in 1406 (7.3%) cases at presentation. A minority of the eyes had visual impairment worse than 20/200 (7.8%) due to associated ocular comorbidities. The involvement of the cornea was seen in 7338 (38.2%) patients and corneal signs included subepithelial infiltrates (26.3%), epithelial defect (1.4%), corneal oedema (0.9%) and filaments (0.4%). Of the patients who had corneal involvement, 496 (2.6%) patients had a chronic course beyond 1 month of which 105 (0.5%) had a course beyond 1 year.ConclusionEKC is a self-limiting condition that is commonly unilateral and predominantly affects males. About one-third of the patients have corneal involvement which rarely has a chronic course.
Anterior chamber depth, lens thickness and intraocular lens calculation formula accuracy: nine formulas comparison
Authors: Hipólito-Fernandes Diogo , Luís Maria Elisa , Serras-Pereira Rita , Gil Pedro , Maduro Vitor , Feijão João , Alves Nuno 
Published: November 2020

Background/AimsTo investigate the influence of anterior chamber depth (ACD) and lens thickness (LT) on 9 intraocular lens (IOL) power calculation formulas accuracy, in patients with normal axial lengths.MethodsRetrospective case series, including patients having uncomplicated cataract surgery with insertion of a single IOL model, divided into three groups according to preoperative ACD. Each group was further subdivided into three subgroups, according to the LT. Using optimised constants, refraction prediction error was calculated for Barrett Universal II, Emmetropia Verifying Optical (EVO) V.2.0, Haigis, Hill-RBF V.2.0, Hoffer Q, Holladay 1, Kane, PEARL-DGS and SRK/T formulas. Mean prediction error, mean and median absolute error (MedAE) and the percentage of eyes within ±0.25D, ±0.50D and ±1.00D were also calculated.ResultsThe study included 695 eyes from 695 patients. For ACD ≤3.0 mm and ≥3.5 mm, mean prediction error of SRK/T, Hoffer Q and Holladay 1 was significantly different from 0 (p<0.05). PEARL-DGS, Kane, EVO V.2.0 and Barrett Universal II were more accurate than the Hoffer Q in ACD ≤3.0 mm (p<0.05). Kane, PEARL-DGS, EVO V.2.0 and Barrett Universal II revealed the lowest variance of mean and MedAE by ACD and LT subgroup. Haigis and Hill-RBF V.2.0 were significantly influenced by LT, independently of the ACD, with a myopic shift with thin lenses and a hyperopic shift with thick lenses (p<0.05).ConclusionNew generation formulas, particularly Kane, PEARL-DGS and EVO V.2.0, seem to be more reliable and stable even in eyes with extreme ACD-LT combinations.
Prevalence and incidence of injuries in para athletes: a systematic review with meta-analysis and GRADE recommendations
Authors: Pinheiro Larissa Santos Pinto , Ocarino Juliana Melo , Madaleno Fernanda Oliveira , Verhagen Evert , de Mello Marco Túlio , Albuquerque Maicon Rodrigues , Andrade André Gustavo Pereira , da Mata Carla Patrícia , Pinto Rafael Zambelli , Silva Andressa , Resende Renan Alves 
Published: November 2020

ObjectiveTo investigate prevalence, incidence and profile of musculoskeletal injuries in para athletes.DesignSystematic review.Data sourcesSearches were conducted in MEDLINE, EMBASE, AMED, SPORTSDiscus, CINAHL and hand searching.Eligibility criteriaStudies were considered if they reported prevalence or incidence of musculoskeletal injuries in para athletes. Study selection, data extraction and analysis followed the protocol. Meta-analyses were conducted to estimate the prevalence and incidence rate among studies and subgroup analyses investigated whether methodological quality and sample size of the studies influenced on the estimated injury prevalence and incidence. The Grading of Recommendations Assessment, Development and Evaluation system determined the strength of evidence.ResultsForty-two studies were included. The prevalence of musculoskeletal injuries was 40.8% (95% CI 32.5% to 49.8%). Because of imprecision, indirectness and inconsistency, the strength of evidence was very low quality. The incidence of musculoskeletal injuries was 14.3 injuries per 1000 athlete-days (95% CI 11.9 to 16.8). The strength of evidence was low quality because of imprecision and indirectness. The subgroup analyses revealed that the sample size influenced on estimated injury prevalence and methodological quality influenced on estimated incidence. Injuries were more prevalent in the shoulder, for non-ambulant para athletes, and in the lower limbs, for ambulant para athletes.Summary/conclusionPara athletes show high prevalence and incidence of musculoskeletal injuries. Current very low-quality and low-quality evidence suggests that future high-quality studies with systematic data collection, larger sample size and specificities of para athletes are likely to change estimates of injury prevalence and incidence in para athletes.PROSPERO registration numberCRD42020147982.
Patient and nurse perceptions of an innovative TV wellness channel in an acute medical ward: a feasibility study
Authors: Russell Suzy , Ripley Vanya , Elliott Rosalind , Barnes Caryl 
Published: November 2020

Background
The Consultation Liaison Psychiatry service attends to the mental health needs of patients treated in a general hospital setting after referral by the treating team. Interventions may include psychoeducation and psychological treatment.
A mindfulness focused ‘TV wellness’ channel was conceptualised as an innovative method of providing psychoeducation and mindfulness/relaxation. The objective was to explore the acceptability of a TV wellness channel to nurses and patients in an acute care inpatient setting and its effect on patient anxiety.

Methods
This was a before and after prospective feasibility study. The intervention was a 30 min audio–visual television programme containing activities designed to reduce anxiety such as breathing and mindfulness exercises, nature film clips and short videos of clinical staff providing well-being tips during hospitalisation. Adult medical patients were requested to report their state anxiety using the Faces Anxiety Scale (1, low to 5 high anxiety) before and after viewing the channel. Patients and nurses reported on the acceptability of the content.

Results
There was a trend to lower state anxiety after patients (n=61) watched the TV wellness channel but this was not clinically significant (mean difference (95 CI) 0.60 (0.36 to 0.87)). The patients and nurses’ evaluations were positive with few areas for improvement.

Conclusion
Pilot evaluation of this innovative adjunct to Consultant Liaison Psychiatry provides evidence of its acceptability and potential to reduce anxiety for medical inpatients. This evaluation confirmed the feasibility of the TV wellness channel and has informed continued development and subsequent clinical research.
Path ahead for ‘low risk’ adolescents living with a Fontan circulation
Authors: Baker David W , Dennis Mark R , Zannino Diana , Schilling Chris , Moreno Patricia D , Bullock Andrew , Disney Patrick , Radford Dorothy J , Hornung Tim , Grigg Leeanne , d'Udekem Yves , Ayer Julian , Celermajer David S , Cordina Rachael 
Published: November 2020

ObjectiveA high risk of morbidity and mortality is well documented in adults with a Fontan circulation. The difference in outcomes between those with and without significant morbidity at the time of transition to adult care has not been well characterised.MethodsWe analysed clinical outcomes in patients enrolled in the Australian and New Zealand Fontan Registry ≥16 years of age. Low risk (LR) Fontan patients were defined as those without history of sustained arrhythmia, thromboembolic event, transplantation, Fontan conversion, protein-losing enteropathy, plastic bronchitis, New York Heart Association class III/IV and/or moderate/severe atrioventricular valve regurgitation or ventricular dysfunction. Increased risk (IR) patients had one or more risk factor.ResultsInclusion criteria were met in 822 patients; mean age 26±8 years, median follow-up from age 16 was 9 years, 203 had atriopulmonary connection (APC) and 619 had total cavopulmonary connection (TCPC). Survival at 30 years was higher in the LR versus IR; 94% versus 82% (p=0.005), 89% versus 77% (p=0.07) for APC and 96% versus 89% (p=0.05) for TCPC. LR patients experienced less Fontan failure (HR 0.34, 95% CI 0.23 to 0.49, p<0.001) and ventricular dysfunction (HR 0.46, 95% CI 0.29 to 0.71, p=0.001) compared with IR patients. For LR TCPC patients, modelled survival projections at 60 years were 49%–67%.ConclusionsClinical outcomes for adolescents LR at transition to adult care are markedly superior to those who have established risk factors for Fontan failure, which is an important consideration when formulating individualised long-term risk estimates and counselling patients.
Plasma cutting and exposure to PM2.5metal aerosol in metalworking, Almaty, Kazakhstan, 2020
Authors: Vinnikov Denis , Tulekov Zhangir 
Published: November 2020

ObjectivesLittle is known regarding the metal working subprocesses that determine exposures in the workplace primarily because their segregation from the main process is rather difficult in real-life occupational settings. The present study aimed to identify the subprocesses in a metalworks plant with high personal exposure to particulate matter (PM2.5)metal aerosol in order to plan future risk reduction interventions.MethodsA total of eighty 8-hour PM2.5metal aerosol samples from the breathing zone of four workers in each of four major operations (plasma cutting, machine operating, assembling and welding) were collected in a metalwork plant in Almaty in January to June 2020. Minimal, maximal, time-weighted average PM2.5metal aerosol mass concentrations were recorded with TSI SidePak AM520 personal aerosol and analysed using analysis of variance (ANOVA) after normalisation.ResultsThe overall sampling time was 640 hours. Maximal 1 min and geometric mean PM2.5concentrations were 8.551 and 1.7268 mg/m3in plasma cutting; 4.844 and 0.9343 mg/m3in machine operating; 2.993 and 0.6898 mg/m3in assembling; and 2.848 and 0.4903 mg/m3in welding. Using a Tukey-Kramer test after a one-way ANOVA, plasma cutting concentrations were significantly higher compared with all other operations (F-ratio 29.6, p<0.001). The fold-range containing 95% of the total variability (R0.95) from all samples was 12.5.ConclusionsThe highest PM2.5concentrations were found in plasma cutting, potentially elevating the risk of systemic inflammatory effects.
Coronary artery disease in patients hospitalised with Coronavirus disease 2019 (COVID-19) infection
Authors: Loffi Marco , Piccolo Raffaele , Regazzoni Valentina , Di Tano Giuseppe , Moschini Luigi , Robba Debora , Quinzani Filippo , Esposito Giovanni , Franzone Anna , Danzi Gian Battista 
Published: November 2020

ObjectiveAmong patients with Coronavirus disease 2019 (COVID-19), coronary artery disease (CAD) has been identified as a high-risk condition. We aimed to assess the clinical outcomes and mortality among patients with COVID-19 according to CAD status.MethodsWe retrospectively analysed data from patients with COVID-19 admitted to the Cremona Hospital (Lombardy region, Italy) between February and March 2020. The primary outcome was all-cause mortality. CAD was defined as a history of prior myocardial infarction (MI), prior percutaneous coronary intervention (PCI), prior coronary artery bypass grafting (CABG) or CAD that was being medically treated.ResultsOf 1252 consecutive patients with COVID-19, 124 (9.9%) had concomitant CAD. Patients with CAD were older and had a higher prevalence of comorbidities compared with those without CAD. Although patients with CAD had a higher risk of all-cause mortality than patients without CAD (HR 3.01, 95% CI 2.27 to 3.99), this difference was no longer significant in the adjusted model (HR 1.14, 95% CI 0.79 to 1.63). Results were consistent among patients with prior MI (adjusted HR (aHR) 0.87, 95% CI 0.54 to 1.41), prior PCI (aHR 1.10, 95% CI 0.75 to 1.62), prior CABG (aHR 0.91, 95% CI 0.45 to 1.82), or CAD medically treated (aHR 0.84, 95% CI 0.29 to 2.44). Multivariable analysis showed that age (aHR per 5 year increase 1.62, 95% CI 1.53 to 1.72) and female sex (aHR 0.63, 95% CI 0.49 to 0.82) were the only two independent correlates of mortality.ConclusionPatients with COVID-19 and CAD have an exceedingly higher risk of mortality, which is mainly attributable to the burden of comorbidities rather than to a direct effect of CAD per se.
Successful countering of tobacco industry efforts to overturn Thailand's ENDS ban
Authors: Patanavanich Roengrudee , Glantz Stanton 
Published: November 2020

BackgroundAfter Thailand enacted laws to ban the import and sale of all types of electronic nicotine delivery systems (ENDS, including e-cigarettes and heated tobacco products (HTPs)) in 2015, pro-ENDS advocacy groups pressured the government to lift the ban, particularly after Philip Morris International (PMI) started promoting its HTP IQOS in 2017.MethodsWe reviewed information related to ENDS in Thailand between 2014 and 2019 from Thai newspaper articles, meeting minutes and letters submitted to government agencies, websites and social media platforms of pro-ENDS networks and Thai tobacco control organisations.ResultsThe tobacco industry and the pro-ENDS groups used five tactics to try to reverse the Thai ban on ENDS: creating front groups, lobbying decision-makers, running public relations campaigns, seeking to discredit tobacco control advocates and funding pro-tobacco harm reduction research. ENDS Cigarette Smoking Thailand (ECST), a pro-ENDS group in Thailand, worked in parallel to Philip Morris Thailand Limited (PMTL) to oppose the ban. The group connected with international coalitions that promote harm reduction through the PMI-funded Foundation for a Smoke-Free World.ConclusionAlthough ECST and PMTL continuously worked to revoke the ban since 2017, the government still kept ENDS illegal as of October 2020. This decision resulted from the strong commitment and collaboration among Thai tobacco control organisations and their shared vision to protect the public’s health from harmful tobacco products. The similar strategies used by the pro-ENDS movement in Thailand and the tobacco companies could inform health advocates and policy-makers in other low and middle income countries facing pressure to market ENDS.