bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology and risk factors of pesticide poisoning in Malaysia: a retrospective analysis by the National Poison Centre (NPC) from 2006 to 2015
Authors: Kamaruzaman Nur Azzalia , Leong Yin-Hui , Jaafar Mohd Hafiidz , Mohamed Khan Halilol Rahman , Abdul Rani Noor Afiza , Razali Mohd Fadhli , Abdul Majid Mohamed Isa 
Published: June 2020

ObjectivePesticide poisoning is a global health problem, and its progressive deterioration is a major cause of concern. The objective of this study is to assess epidemiological characteristics and identify risk factors of pesticide poisoning in Malaysia.SettingPesticide poisoning database of Malaysia National Poison Centre (NPC) from 2006 to 2015.ParticipantsTelephone enquiries regarding pesticide poisoning were made by healthcare professionals. Information received by the NPC was entered into a retrievable database of standardised Poison Case Report Form, as adapted from the World Health Organization (WHO).OutcomesThe outcome of the study is to provide an overview of national epidemiological profile of pesticide poisoning. High-risk groups of people and their circumstances were also identified to ensure that appropriate measures are strategised.ResultsWithin the study period, a total of 11 087 pesticide poisoning cases were recorded. Sixty per cent of these cases were intentional in nature and most were found among male individuals (57%) of the Indian race (36.4%) aged between 20 and 29 years (25.5%), which occurred at home (90%) through the route of ingestion (94%). The highest number of poisoning was due to herbicides (44%) followed by agricultural insecticides (34%), rodenticides (9.9%), household insecticides (9.5%) and fungicides (0.5%). In addition, 93.6% of intentional pesticide poisoning cases were caused by suicide attempts. The results of this study show that there was an increasing trend in pesticide poisoning incidents over the 10-year duration. This indicates that pesticide poisoning is a prevalent public health problem in Malaysia, resulting in an average incidence rate of 3.8 per 100 000 population.ConclusionsDeliberate pesticide ingestion as a method of suicide has become a disturbing trend among Malaysians. Therefore, regulation of highly hazardous pesticides must be enforced to ensure controlled and limited access to these chemicals by the public.
Variations in antibiotic prescribing among village doctors in a rural region of Shandong province, China: a cross-sectional analysis of prescriptions
Authors: Dyar Oliver James , Yang Ding , Yin Jia , Sun Qiang , Stålsby Lundborg Cecilia 
Published: June 2020

ObjectivesTo assess variation in antibiotic prescribing practices among village doctors in a rural region of Shandong province, China.Design, setting and participantsAlmost all outpatient encounters at village clinics result in a prescription being issued. Prescriptions were collected over a 2.5-year period from 8 primary care village clinics staffed by 24 doctors located around a town in rural Shandong province. A target of 60 prescriptions per clinic per month was sampled from an average total of around 300. Prescriptions were analysed at both aggregate and individual-prescriber levels, with a focus on diagnoses of likely viral acute upper respiratory tract infections (AURIs), defined as International Classification of Diseases, 10th Revision codes J00 and J06.9.Main outcome measuresProportions of prescriptions for AURIs containing (1) at least one antibiotic, (2) multiple antibiotics, (3) at least one parenteral antibiotic; classes and agents of antibiotics prescribed.ResultsIn total, 14 471 prescriptions from 23 prescribers were ultimately included, of which 5833 (40.3%) contained at least 1 antibiotic. Nearly two-thirds 62.5% (3237/5177) of likely viral AURI prescriptions contained an antibiotic, accounting for 55.5% (3237/5833) of all antibiotic-containing prescriptions. For AURIs, there was wide variation at the individual level in antibiotic prescribing rates (33.1%–88.0%), as well multiple antibiotic prescribing rates (1.3%–60.2%) and parenteral antibiotic prescribing rates (3.2%–62.1%). Each village doctor prescribed between 11 and 21 unique agents for AURIs, including many broad-spectrum antibiotics. Doctors in the highest quartile for antibiotic prescribing rates for AURI also had higher antibiotic prescribing rates than doctors in the lowest quartile for potentially bacterial upper respiratory tract infections (pharyngitis, tonsillitis, laryngopharyngitis; 89.1% vs 72.4%, p=0.002).ConclusionsAll village doctors overused antibiotics for respiratory tract infections. Variations in individual prescriber practices are significant even in a small homogenous setting and should be accounted for when developing targets and interventions to improve antibiotic use.
Attitudes of rural communities towards the use of technology for health purposes in New Zealand: a focus group study
Authors: Babbage Duncan R , van Kessel Kirsten , Terraschke Agnes , Drown Juliet , Elder Hinemoa 
Published: June 2020

ObjectivesExamine attitudes to using online health and wellness services, and determine what barriers may exist to this in two rural communities in New Zealand.DesignA thematic analysis informed by a social constructivist paradigm explored the attitudes of youth and adults to give voice to these communities. Eighteen focus groups—nine in each region—were held for an hour each, with between three and nine participants in each group.SettingTwo rural areas at the Northern and Southern ends of New Zealand were chosen. In each area, we partnered with a local health centre providing primary care services. Three localities were identified within each region where we conducted the data collection.ParticipantsParticipants were youth aged 12–15 years, aged 16–20 years and adults over 21 years. Overall, 74 females and 40 males were recruited. Recruitment occurred through schools, community organisations or personal contacts of the facilitators, who were youth workers in their respective communities. Ethnicity of the participants was representative of each area, with a higher percentage of Māori participants in Northland.ResultsEight themes were identified which described participants’ attitudes to technology use in healthcare. Themes covered accessibility, cost, independence, anonymity and awareness issues: technology makes health information easily accessible; access to technology can be limited in rural communities; technology can reduce the cost of healthcare but it is too expensive for some; technology increases independence and autonomy of people’s own health; independent healthcare decisions come with risks; anonymity encourages people to seek help online; technology can help raise awareness and provide peer-support for people with health issues; technology impacts on social relationships.ConclusionsParticipants—particularly youth—were generally positive about the role of technology in healthcare delivery, and interested in ways technology could improve autonomy and access to health and wellness services.
Protocol for a mixed-method analysis of implementation of case management in primary care for frequent users of healthcare services with chronic diseases and complex care needs
Authors: Danish Alya , Chouinard Maud-Christine , Aubrey-Bassler Kris , Burge Fred , Doucet Shelley , Ramsden Vivian R , Bisson Mathieu , Cassidy Monique , Condran Brian , Lambert Mireille , Penney Carla , Sabourin Véronique , Warren Mike , Hudon Catherine 
Published: June 2020

IntroductionCase management (CM) in a primary care setting is a promising approach to integrating and improving healthcare services and outcomes for patients with chronic conditions and complex care needs who frequently use healthcare services. Despite evidence supporting CM and interest in implementing it in Canada, little is known about how to do this. This research aims to identify the barriers and facilitators to the implementation of a CM intervention in different primary care contexts (objective 1) and to explain the influence of the clinical context on the degree of implementation (objective 2) and on the outcomes of the intervention (objective 3).Methods and analysisA multiple-case embedded mixed-methods study will be conducted on CM implemented in ten primary care clinics across five Canadian provinces. Each clinic will represent a subunit of analysis, detailed through a case history. Cases will be compared and contrasted using multiple analytical approaches. Qualitative data (objectives 1 and 2) from individual semistructured interviews (n=130), focus group discussions (n=20) and participant observation of each clinic (36 hours) will be compared and integrated with quantitative (objective 3) clinical data on services use (n=300) and patient questionnaires (n=300). An evaluation of intervention fidelity will be integrated into the data analysis.Ethics and disseminationThis project received approval from the CIUSSS de l'Estrie – CHUS Research Ethic Board (project number MP-31-2019-2830). Results will provide the opportunity to refine the CM intervention and to facilitate effective evaluation, replication and scale-up. This research provides knowledge on how to resp ond to the needs of individuals with chronic conditions and complex care needs in a cost-effective way that improves patient-reported outcomes and healthcare use, while ensuring care team well-being. Dissemination of results is planned and executed based on the needs of various stakeholders involved in the research.
TMEM16A deficiency: a potentially fatal neonatal disease resulting from impaired chloride currents
Authors: Park Julien H , Ousingsawat Jiraporn , Cabrita Inês , Bettels Ruth E , Große-Onnebrink Jörg , Schmalstieg Christian , Biskup Saskia , Reunert Janine , Rust Stephan , Schreiber Rainer , Kunzelmann Karl , Marquardt Thorsten 
Published: June 2020

IntroductionTMEM16A is a calcium-activated chloride channel expressed in various secretory epithelia. Two siblings presented in early infancy with reduced intestinal peristalsis and recurrent episodes of haemorrhagic diarrhoea. In one of them, the episodes were characterised by hepatic pneumatosis with gas bubbles in the portal vein similar to necrotising enterocolitis of the newborn.MethodsExome sequencing identified a homozygous truncating pathogenic variant in ANO1. Expression analysis was performed using reverse transcription PCR, western blot and immunohistochemistry. Electrophysiological and cell biological studies were employed to characterise the effects on ion transport both in patient respiratory epithelial cells and in transfected HEK293 cells.ResultsThe identified variant led to TMEM16A dysfunction, which resulted in abolished calcium-activated Cl− currents. Secondarily, CFTR function is affected due to the close interplay between both channels without inducing cystic fibrosis (CF).ConclusionTMEM16A deficiency is a potentially fatal disorder caused by abolished calcium-activated Cl− currents in secretory epithelia. Secondary impairment of CFTR function did not cause a CF phenotyp, which may have implications for CF treatment.
Experimental investigation of the internal tube flow effect on the vibration response of tubes in a shell and tube heat exchanger
Authors: Ali Nouman , Khushnood Shahab , Nizam Luqman Ahmad , Bashir Shahid , Hafeez Akmal 
Published: June 2020

In shell and tube heat exchangers, tube bundles often fail due to flow-induced vibrations. In the current study, the vibration response of tubes, placed in the first and third rows of the tube bundle, has been examined having a normal triangular arrangement with a pitch-to-diameter (P/D) ratio of 1.44. Each tube was tested at three different internal flow velocities of 0.85, 0.9, and 1 m/s and five shell-side velocities ranging from 0.9 to 1.3 m/s with an increment of 0.1 m/s. This is the first experiment of its kind that offers insight into the vibration behavior of the glass tubes of a shell and tube heat exchanger. Experimental analysis shows that tubes with internal flow vibrate with higher amplitudes than tubes without internal flow. Furthermore, the vibration amplitude of the tube tends to rise with increasing internal tube velocity, even for the same shell-side velocity. For the current range of shell- and tube-side velocities, with the internal flow from the tube, the hydrodynamic mass of the tube increases significantly with enhanced damping and contributes toward the stability of the tubes in cross-flow, the stability threshold is delayed and higher shell-side velocities are allowed to enhance the heat transfer rate.
Production of gravitational waves during preheating in the Starobinsky inflationary model
Authors: Jin Guoqiang , Fu Chengjie , Wu Puxun , Yu Hongwei 
Published: June 2020

AbstractThe production of GWs during preheating in the Starobinsky model with a nonminimally coupled auxiliary scalar field is studied through the lattice simulation in this paper. We find that the GW spectrum $$\Omega _{\mathrm{gw}}$$Ωgw grows fast with the increase of the absolute value of coupling parameter $$\xi $$ξ. This is because the resonant bands become broad with the increase of $$|\xi |$$|ξ|. When $$\xi <0$$ξ<0, $$\Omega _{\mathrm{gw}}$$Ωgw begins to grow once the inflation ends and grows faster than the case of $$\xi >0$$ξ>0. $$\Omega _{\mathrm{gw}}$$Ωgw reaches the maximum at $$\xi =-20$$ξ=-20 ($$\xi =42$$ξ=42 for the case $$\xi >0$$ξ>0) and then decreases with slight oscillation. Furthermore we find that the GWs produced in the era of preheating satisfy the limits from the Planck and next-generation CMB experiments.
Associations between Proton Pump Inhibitor and Histamine-2 Receptor Antagonist and Bone Mineral Density among Kidney Transplant Recipients
Authors: Lyu Beini , Hansen Karen E. , Jorgenson Margaret R. , Astor Brad C. 
Published: June 2020

<b><i>Background:</i></b> In the general population, use of proton pump inhibitor (PPI) has been linked to higher risk of osteoporotic fractures. PPI is commonly prescribed in kidney transplant recipients (KTRs). However, the effect of PPI on osteoporosis in KTRs is largely unstudied. <b><i>Methods:</i></b> A total of 1,774 adult KTRs in the Wisconsin Allograft Recipient Database with at least one eligible bone mineral density (BMD) measurement at least 3 months after transplantation were included in the analyses. Associations between use of PPI and histamine-2 receptor antagonist (H2RA) at 3 months after transplantation and subsequent slope of T-score were assessed. <b><i>Results:</i></b> A total of 1,478 (83.3%) participants were using a PPI at 3 months after transplantation. Compared to the use of H2RA, use of PPI was not significantly associated with annualized slope of hip T-score (β = –0.0039, 95% CI –0.00497 to 0.0021) or annualized slope of spine T-score (β = –0.017, 95% CI –0.049 to 0.083) after adjustment for potential confounders. Similarly, no significant association between use of PPI and slope of T-score was observed when defining PPI/H2RA exposure as use within 6 months of the initial BMD measurement, or only including participants with at least 2 BMD measurements, or stratified by different age and sex. <b><i>Conclusions:</i></b> Use of PPI was not associated with an increased rate of BMD loss in KTRs. Our results support previous findings that PPI use does not have a significant effect on bone mineral loss.
Review of fast square root calculation methods for fixed point microcontroller-based control systems of power electronics
Authors: Dianov Anton , Anuchin Aleksey 
Published: June 2020

<span lang="EN-US">Square root calculation is a widely used task in real-time control systems especially in those, which control power electronics: motors drives, power converters, power factor correctors, etc. At the same time calculation of square roots is a bottle-neck in the optimization of code execution time. Taking into account that for many applications approximate calculation of a square root is enough, calculation time can be decreased with the price of precision of calculation. This paper analyses existing methods for fast square root calculation, which can be implemented for fixed point microcontrollers. It discusses algorithms’ pros and cons, analyses calculation errors and gives some recommendations on their use. The paper also proposes an original method for fast square root calculation, which does not use hardware acceleration and therefore, is suitable for implementation at a variety of modern Digital Signal Processors, which have high-speed hardware multipliers, but do not have effective dividers. The maximum relative error of the proposed method is 3.36% for calculation without division, and can be decreased to 0.055% using one division operation. Finally, the most promising methods are compared and results of their performance comparisons are depicted in tables. </span>
Comparison of Frenotomy Techniques for the Treatment of Ankyloglossia in Children: A Systematic Review
Authors: Khan Usman , MacPherson Jake , Bezuhly Michael , Hong Paul 
Published: June 2020

ObjectiveTo compare the effectiveness of conventional (CF), laser (LF), and Z‐plasty (ZF) frenotomies for the treatment of ankyloglossia in the pediatric population.Data SourcesA comprehensive search of PUBMED, EMBASE, and COCHRANE databases was performed.Review MethodsRelevant articles were independently assessed by 2 reviewers according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis (PRISMA) guidelines.ResultsThirty‐five articles assessing CF (27 articles), LF (4 articles), ZF (3 articles), and/or rhomboid plasty frenotomy (1 article) were included. A high level of outcome heterogeneity prevented pooling of data. All 7 randomized controlled trials (RCTs) were of low quality. Both CF (5 articles with 589 patients) and LF (2 articles with 78 patients) were independently shown to reduce maternal nipple pain on a visual analog or numeric rating scale. There were reports of improvement with breastfeeding outcomes as assessed on validated assessment tools for 88% (7/8) of CF articles (588 patients) and 2 LF articles (78 patients). ZF improved breastfeeding outcomes on subjective maternal reports (1 article with 18 infants) only. One RCT with a high risk of bias concluded greater speech articulation improvements with ZF compared to CF. Only minor adverse events were reported for all frenotomy techniques.ConclusionsCurrent literature does not demonstrate a clear advantage for one frenotomy technique when managing children with ankyloglossia. Recommendations for future research are provided to overcome the methodological shortcomings in the literature. We conclude that all frenotomy techniques are safe and effective for treating symptomatic ankyloglossia.
Validation of a Novel, Multidomain Head and Neck Cancer Appearance‐ and Function‐Distress Patient‐Reported Outcome Measure
Authors: Graboyes Evan M. , Hand Brittany N. , Ellis Mark A. , Huang Andrew T. , Nilsen Marci L. , Pipkorn Patrik , Marsh Courtney H. , Maurer Stacey , Day Terry A. , Sterba Katherine R. 
Published: June 2020

ObjectivesDistress with self‐perceived changes in appearance and function can result in body image disturbance (BID), which is common in head and neck cancer (HNC) survivors and a major source of psychosocial morbidity. To address the lack of psychometrically sound patient‐reported outcome measures (PROMs) of HNC‐related BID, we aim to create and validate the Inventory to Measure and Assess imaGe disturbancE–Head & Neck (IMAGE‐HN).Study DesignSurvey study.SettingMultiple academic centers.Subjects and MethodsFollowing item development, HNC survivors from 4 academic centers completed the IMAGE‐HN. Item responses were psychometrically analyzed using confirmatory factor analysis (CFA) and Rasch analysis.ResultsItem development resulted in a 31‐item PROM consisting of 5 individual domains and a global domain. In total, 305 HNC survivors of diverse ages, HNC subsites, and reconstructive paradigms completed the initial items. After removal of 3 items for local dependence, CFA confirmed the unidimensionality and local independence (item residual correlations <|0.20|) for each domain. Rasch analysis indicated acceptable fit (infit and outfit mean squares <2.0), monotonicity of all rating scale categories, and low person misfit (<4%). Person separation indices and person reliability were adequate for each domain except appearance concealment, which was removed (4 items). This resulted in the IMAGE‐HN, a psychometrically acceptable 24‐item PROM of HNC‐related BID consisting of a global scale and 4 subscales measuring unique constructs and comprised independent items.ConclusionsIMAGE‐HN is a novel, psychometrically sound, multidomain PROM of HNC‐related BID for use in clinical and research settings.
Implantable Drug Reservoir Devices for Inner Ear Delivery of Pharmacotherapeutics
Authors: Kita Ashley , Saldate Johnny , Chang Courtney , Chellappa Nitika , Jong Jeremy , Matsuda Riley , Schmidt Andrew , Shih Brandon , Shafqat Iram , Schoettler Kari , Acharya Shiv , Seidlits Stephanie , Hoffman Larry 
Published: June 2020

ObjectiveCisplatin is a platinum‐based chemotherapeutic drug that secondarily induces toxicity in inner ear sensory epithelia, contributing to auditory and vestibular dysfunction. We describe the creation of a drug reservoir device (DRD) to combat this ototoxicity for the duration of chemotherapy. As ototoxic side effects of chemotherapy may limit an oncologist’s ability to prescribe first‐line agents such as cisplatin, mitigating such devastating effects through prolonged topical therapy would be tremendously valuable.Study DesignWe investigated (1) the ability of an electrospun polylactic acid DRD to provide prolonged delivery of the posited otoprotectant metformin and (2) the development of an in vitro model utilizing Sh‐Sy5y human neuroblastoma cells to assess the efficacy of metformin in reducing cisplatin‐induced toxicity.SettingNeurophysiology laboratory.MethodsBasic science experiments were performed to assess DRD properties and metformin’s effects on cisplatin toxicity in culture.ResultsWe found that DRDs with increasing polylactic acid concentrations exhibited metformin release for up to 8 weeks. In modeling elution across the round window in vitro, continued elution of metformin was observed for at least 6 weeks, as quantified by spectrophotometry. Unfortunately, metformin did not exhibit protective efficacy in this model using Sh‐Sy5y cells.ConclusionWhile metformin was not found to be protective in Sh‐Sy5y cells, these results suggest that an electrospun DRD can provide a tailorable drug delivery system providing medication for the duration of chemotherapy treatment. This represents a novel drug delivery system and efficacy screening assay with broad clinical applications in personalized delivery of inner ear therapies.
SARS‐CoV‐2 Infection in Health Care Workers: Cross‐sectional Analysis of an Otolaryngology Unit
Authors: Paderno Alberto , Fior Milena , Berretti Giulia , Schreiber Alberto , Grammatica Alberto , Mattavelli Davide , Deganello Alberto 
Published: June 2020

The restart of routine in‐ and outpatient activity in the COVID‐19 postepidemic peak needs to be carefully planned in light of specific patterns of viral diffusion. We evaluated SARS‐CoV‐2 serology in the entire personnel of a COVID‐19‐free otolaryngology department in a highly affected area. The aim was to determine the prevalence of SARS‐CoV‐2 positivity among staff to clarify the impact of different risk factors for infection. The entire staff of the otolaryngology unit was tested for SARS‐CoV‐2 serology. Symptomatic staff members were tested with nasal/pharyngeal swabs. All answered a survey focused on the number of in‐ and extrahospital positive contacts and type of activities in the unit. Five (9%) were positive for SARS‐CoV‐2 infection. The only variable associated with a higher risk of infection was the number of extrahospital contacts without personal protective equipment (P =. 008). Our study shows that in non‐COVID‐19 departments, the use of adequate personal protective equipment leads to low rates of infection among health care workers. The prevalent risk of infection was related to extrahospital contact.