bluuebunny/crossref_metadata_2025_split huggingface dataset:
Contamination and washing of cloth masks and risk of infection among hospital health workers in Vietnam: a post hoc analysis of a randomised controlled trial
Authors: MacIntyre Chandini Raina , Dung Tham Chi , Chughtai Abrar Ahmad , Seale Holly , Rahman Bayzidur 
Published: September 2020

BackgroundIn a previous randomised controlled trial (RCT) in hospital healthcare workers (HCWs), cloth masks resulted in a higher risk of respiratory infections compared with medical masks. This was the only published RCT of cloth masks at the time of the COVID-19 pandemic.ObjectiveTo do a post hoc analysis of unpublished data on mask washing and mask contamination from the original RCT to further understand poor performance of the two-layered cotton cloth mask used by HCWs in that RCT.Setting14 secondary-level/tertiary-level hospitals in Hanoi, Vietnam.ParticipantsA subgroup of 607 HCWs aged ≥18 years working full time in selected high-risk wards, who used a two-layered cloth mask and were part of a randomised controlled clinical trial comparing medical masks and cloth masks.InterventionWashing method for cloth masks (self-washing or hospital laundry). A substudy of contamination of a sample of 15 cloth and medical masks was also conducted.Outcome measureInfection rate over 4 weeks of follow up and viral contamination of masks tested by multiplex PCR.ResultsViral contamination with rhinovirus was identified on both used medical and cloth masks. Most HCW (77% of daily washing) self-washed their masks by hand. The risk of infection was more than double among HCW self-washing their masks compared with the hospital laundry (HR 2.04 (95% CI 1.03 to 4.00); p=0.04). There was no significant difference in infection between HCW who wore cloth masks washed in the hospital laundry compared with medical masks (p=0.5).ConclusionsUsing self-reported method of washing, we showed double the risk of infection with seasonal respiratory viruses if masks were self-washed by hand by HCWs. The majority of HCWs in the study reported hand-washing their mask themselves. This could explain the poor performance of two layered cloth masks, if the self-washing was inadequate. Cloth masks washed in the hospital laundry were as protective as medical masks. Both cloth and medical masks were contaminated, but only cloth masks were reused in the study, reiterating the importance of daily washing of reusable cloth masks using proper method. A well-washed cloth mask can be as protective as a medical mask.Trial resgistration numberACTRN12610000887077.
Validation of the Sexual Knowledge Picture Instrument as a diagnostic instrument for child sexual abuse: study protocol
Authors: van Ham Kirsten , Brilleslijper-Kater Sonja , van der Lee Hanneke , van Rijn Rick , van Goudoever Hans , Teeuw Rian 
Published: September 2020

BackgroundThe consequences of child sexual abuse (CSA) can be significant and can affect short-term and long-term mental, sexual and physical health. In order to offer timely and appropriate care for the child, early recognition of CSA is necessary. The lack of specific physical and psychological signs and barriers to abuse disclosure that these young victims face makes it difficult for medical and psychological professionals to recognise and confirm CSA signs. We aimed to validate the Sexual Knowledge Picture Instrument (SKPI) as a diagnostic instrument for CSA.Methods and analysisAn observational study to quantify the intraobserver and interobserver reliability and diagnostic accuracy of the SKPI will be performed. A total of 250 subjects from three groups will be included in the study: (1) a group of suspected CSA victims, recruited from three academic paediatric hospitals; (2) a case group of (proven) victims of CSA, recruited in cooperation with the Dutch Police Vice Squad; and (3) a control group of children, recruited from preschools and primary schools. All children will be interviewed using the SKPI, and to investigate reliability, video recordings will be assessed and reassessed by the same and a different blinded rater, respectively. Within 1 year, the results of the SKPI will be compared with the conclusions from the independent child protective services or police reports. If necessary, the SKPI will be modified to improve its reliability and accuracy.Ethics and disseminationThis validation study of the SKPI is necessary for obtaining a reliable diagnostic tool, which will enable medical and psychological professionals to detect CSA in young victims at an early age and start intervention/treatment.Trial registration numberNL 50903.018.15.
Evaluating the impact of a multidisciplinary master programme in palliative care on professional learning outcomes: a cross-sectional study after 20 years of experience
Authors: Lasmarías Cristina , Guanter Lourdes , Turrillas Pamela , Peñafiel Judith , Gómez-Batiste Xavier 
Published: September 2020

ObjectiveTo assess the impact after 20 years of a Master’s degree in palliative care (MsPC) on the participants’ educational outcomes in terms of educational needs satisfaction, motivation, applicability and professional development (PD) in the palliative care (PC) field.MethodsA cross-sectional study was conducted between October 2016 and February 2017. Participants were students of the MsPC from 13 editions. An ad hoc survey comprising closed-end questions was provided. Variables such as sociodemographic and learning outcomes, based on Kirkpatrick’s model, were included.ResultsRespondents were 76.6% women, and 60% were between 30 and 50 years of age. Over half of participants were physicians (57.4%), with >15 years of experience (52%). 77% (n=152) reported previous work experience (PWE) in PC, and 23% (n=45) had no PWE. After completing the MsPC, 49% of those without PWE were hired to work in a PC unit, while 84,2% with PWE continued work in a PC-related position. 51.6% professionals with PWE were currently working in other PC areas, such as training or research. High scores were observed on expectations, training needs, motivation in professional practice, PD, applicability and satisfaction, in both groups. Data have shown statistically significant differences on the perceived value of the MsPC to obtain work in the PC field (p=0.006).ConclusionsThis MsPC training programme improves educational outcomes, and promotes PD, regardless of PWE in PC. Interdisciplinary training for all professionals who care for PC individuals is required. To ensure the quality of education in PC programmes, a systematic process of continuous evaluation is needed.
Small intestinal metabolism is central to whole-body insulin resistance
Authors: Angelini Giulia , Salinari Serenella , Castagneto-Gissey Lidia , Bertuzzi Alessandro , Casella-Mariolo James , Ahlin Sofie , Boskoski Ivo , Gaggini Melania , Raffaelli Marco , Costamagna Guido , Casella Giovanni , Marini Pier Luigi , Gastaldelli Amalia , Bornstein Stefan , Mingrone Geltrude 
Published: September 2020

ObjectiveTo assess the role of jejunum in insulin resistance in humans and in experimental animals.DesignTwenty-four subjects undergoing biliopancreatic diversion (BPD) or Roux-en-Y gastric bypass (RYGB) were enrolled. Insulin sensitivity was measured at baseline and at 1 week after surgery using oral glucose minimal model.We excluded the jejunum from intestinal continuity in pigs and created a jejunal loop with its vascular and nerve supply intact accessible from two cutaneous stomas, and reconnected the bowel with an end-to-end anastomosis. Glucose stable isotopes were given in the stomach or in the jejunal loop.In vitro studies using primary porcine and human hepatocytes or myoblasts tested the effects of plasma on gluconeogenesis or glucose uptake and insulin signalling.ResultsWhole-body insulin sensitivity (SI∙104: 0.54±0.12 before vs 0.82±0.11 after BPD, p=0.024 and 0.41±0.09 before vs 0.65±0.09/pM/min after RYGB, p=not significant) and Glucose Disposition Index increased only after BPD. In pigs, insulin sensitivity was significantly lower when glucose was administered in the jejunal loop than in the stomach (glucose rate of disappearance (Rd) area under the curve (AUC)/insulin AUC∙10: 1.82±0.31 vs 2.96±0.33 mmol/pM/min, p=0.0017).Metabolomics showed a similar pattern before surgery and during jejunal-loop stimulation, pointing to a higher expression of gluconeogenetic substrates, a metabolic signature of impaired insulin sensitivity.A greater hepatocyte phosphoenolpyruvate-carboxykinase and glucose-6-phosphatase gene expression was elicited with plasma from porcine jejunal loop or before surgery compared with plasma from jejunectomy in pigs or jejunal bypass in humans.Stimulation of myoblasts with plasma from porcine jejunal loop or before surgery reduced glucose uptake, Ser473-Akt phosphorylation and GLUT4 expression compared with plasma obtained during gastric glucose administration after jejunectomy in pigs or after jejunal bypass in humans.ConclusionProximal gut plays a crucial role in controlling insulin sensitivity through a distinctive metabolic signature involving hepatic gluconeogenesis and muscle insulin resistance. Bypassing the jejunum is beneficial in terms of insulin-mediated glucose disposal in obesity.Trial registration numberNCT03111953.
Regular use of proton pump inhibitors and risk of type 2 diabetes: results from three prospective cohort studies
Authors: Yuan Jinqiu , He Qiangsheng , Nguyen Long H , Wong Martin C S , Huang Junjie , Yu Yuanyuan , Xia Bin , Tang Yan , He Yulong , Zhang Changhua 
Published: September 2020

ObjectiveThe association between the regular use of proton pump inhibitors (PPIs) and the risk of type 2 diabetes remains unclear, although a recent randomised controlled trial showed a trend towards increased risk. This study was undertaken to evaluate the regular use of PPIs and risk of type 2 diabetes.MethodThis is a prospective analysis of 204 689 participants free of diabetes in the Nurses' Health Study (NHS), NHS II and Health Professionals Follow-up Study (HPFS). Type 2 diabetes was confirmed using American Diabetes Association (ADA) diagnostic criteria. We evaluated hazard ratios (HRs) adjusting for demographic factors, lifestyle habits, the presence of comorbidities, use of other medications and clinical indications.ResultsWe documented 10 105 incident cases of diabetes over 2 127 471 person-years of follow-up. Regular PPI users had a 24% higher risk of diabetes than non-users (HR 1.24, 95% CI 1.17 to 1.31). The risk of diabetes increased with duration of PPI use. Fully adjusted HRs were 1.05 (95% CI 0.93 to 1.19) for participants who used PPIs for >0–2 years and 1.26 (95% CI 1.18 to 1.35) for participants who used PPIs for >2 years compared with non-users.ConclusionsRegular use of PPIs was associated with a higher risk of type 2 diabetes and the risk increased with longer duration of use. Physicians should therefore exercise caution when prescribing PPIs, particularly for long-term use.
Molecular landscape of CAPN3 mutations in limb-girdle muscular dystrophy type R1: from a Chinese multicentre analysis to a worldwide perspective
Authors: Zhong Huahua , Zheng Yiming , Zhao Zhe , Lin Pengfei , Xi Jianying , Zhu Wenhua , Lin Jie , Lu Jun , Yu Meng , Zhang Wei , Lv He , Yan Chuanzhu , Hu Jing , Wang Zhaoxia , Lu Jiahong , Zhao Chongbo , Yuan Yun , Luo Sushan 
Published: September 2020

BackgroundLimb-girdle muscular dystrophy type R1 (LGMDR1) can be caused by recessive CAPN3 mutations accounting for the majority of LGMD. To date, no systemic evaluation has been performed to analyse the detrimental and normal mutations on CAPN3 and its hotspots.MethodsCAPN3 variants (n=112) from a total of 124 patients with LGMDR1 recruited in four centres in China were retrospectively analysed. Then external CAPN3 variants (n=2031) from online databases were integrated with our Chinese cohort data to achieve a worldwide perspective on CAPN3 mutations. According to their related phenotypes (LGMDR1 or normal), we analysed consequence, distribution, ethnicity and severity scores of CAPN3 mutations.ResultsTwo hotspot mutations were identified including c.2120A>G in Chinese population and c.550del in Europe. According to the integrated dataset, 521 mutations were classified as LGMDR1-related and converged on exons 1, 10, 5, 22 and 13 of CAPN3. The remaining 1585 variants were classified as normal-population related. The deleterious ratio of LGMDR1-relevant variants to total variants in each population was 0.26 on average with a maximum of 0.35 in Finns and a minimum of 0.21 in South Asians. Severity evaluation showed that Chinese LGMDR1-related variants exhibited a higher risk (Combined Annotation Dependent Depletion score +1.10) than that from database patients (p<0.001).ConclusionsThis study confirmed two hotspots and LGMDR1-related CAPN3 variants, highlighting the advantages in using a data-based comprehensive analysis to achieve a genetic landscape for patients with LGMDR1.
Evaluation of lamb colostrum supplements
Authors: Bond Cherry 
Published: September 2020

IntroductionHalf of UK lamb mortality occurs within the first 24 hours of life, with newborn lambs requiring adequate intake of colostrum as soon as possible after birth to combat disease and optimise health. Approximately 22 percent of ewes produce colostrum of inadequate quality; consequently, colostrum replacers and supplements can be offered. Colostrum replacers should fully replace maternal colostrum, whereas colostrum supplements have been developed to provide exogenous immunoglobulins to neonates when natural concentrations are low and should contain a minimum of 3 g IgG/feed.MethodsFifteen different colostrum supplements were evaluated. For each product, two different batches were analysed for IgG content.ResultsLevels of IgG/feed ranged from 0.4 to 3.5 g. Products with the highest IgG levels were Lamaid (VetPlus), Colostro+ Lamb (Greencoat), Ovicol (Farmsense) and Shepherdess Lamb Colostrum (Provimi) averaging ≥3.0 g/feed. The remaining 11 products had IgG levels below 3 g IgG/feed, hence could be providing inadequate levels of IgG and potentially impacting on neonatal health.ConclusionThis study has shown great variability between the quality of commercially available colostrum supplements, so care must be taken when selecting products.
Modeling and predicting evacuation flows during hurricane Irma
Authors: Hong Lingzi , Frias-Martinez Vanessa 
Published: September 2020

AbstractEvacuations are a common practice to mitigate the potential risks and damages made by natural disasters. However, without proper coordination and management, evacuations can be inefficient and cause negative impact. Local governments and organizations need to have a better understanding of how the population responds to disasters and evacuation recommendations so as to enhance their disaster management processes. Previous studies mostly examine responses to evacuations at the individual or household level by using survey methods. However, population flows during disasters are not just the aggregation of individuals’ decisions, but a result of complex interactions with other individuals and the environment. We propose a method to model evacuation flows and reveal the patterns of evacuation flows at different spatial scales. Specifically, we gathered large-scale geotagged tweets during Hurricane Irma to conduct an empirical study. First, we present a method to characterize evacuation flows at different geographic scales: the state level, considering evacuation flows across southern states affected by Irma; the urban/rural area level, and the county level. Then we demonstrate results on the predictability of evacuation flows in the most affected state, Florida, by using the following environmental factors: the destructive force of the hurricane, the socioeconomic context, and the evacuation policy issued for counties. Feature analyses show that distance is a dominant predictive factor with counties that are geographically closer generally having larger evacuation flows. Socioeconomic levels are positively related to evacuation flows, with popular destinations associated to higher socioeconomic levels. The results presented in this paper can help decision makers to better understand population evacuation behaviors given certain environmental features, which in turn will aid in the design of efficient and informed preparedness and response strategies.
Claims‐Based Algorithms for Identifying Patients With Pulmonary Hypertension: A Comparison of Decision Rules and Machine‐Learning Approaches
Authors: Ong Mei‐Sing , Klann Jeffrey G. , Lin Kueiyu Joshua , Maron Bradley A. , Murphy Shawn N. , Natter Marc D. , Mandl Kenneth D. 
Published: September 2020

Background
Real‐world healthcare data are an important resource for epidemiologic research. However, accurate identification of patient cohorts—a crucial first step underpinning the validity of research results—remains a challenge. We developed and evaluated claims‐based case ascertainment algorithms for pulmonary hypertension (PH), comparing conventional decision rules with state‐of‐the‐art machine‐learning approaches.

Methods and Results

We analyzed an electronic health record‐Medicare linked database from two large academic tertiary care hospitals (years 2007–2013). Electronic health record charts were reviewed to form a gold standard cohort of patients with (n=386) and without PH (n=164). Using health encounter data captured in Medicare claims (including patients’ demographics, diagnoses, medications, and procedures), we developed and compared 2 approaches for identifying patients with PH: decision rules and machine‐learning algorithms using penalized lasso regression, random forest, and gradient boosting machine. The most optimal rule‐based algorithm—having ≥3 PH‐related healthcare encounters and having undergone right heart catheterization—attained an area under the receiver operating characteristic curve of 0.64 (sensitivity, 0.75; specificity, 0.48). All 3 machine‐learning algorithms outperformed the most optimal rule‐based algorithm (
P
<0.001). A model derived from the random forest algorithm achieved an area under the receiver operating characteristic curve of 0.88 (sensitivity, 0.87; specificity, 0.70), and gradient boosting machine achieved comparable results (area under the receiver operating characteristic curve, 0.85; sensitivity, 0.87; specificity, 0.70). Penalized lasso regression achieved an area under the receiver operating characteristic curve of 0.73 (sensitivity, 0.70; specificity, 0.68).

Conclusions
Research‐grade case identification algorithms for PH can be derived and rigorously validated using machine‐learning algorithms. Simple decision rules commonly applied in published literature performed poorly; more complex rule‐based algorithms may potentially address the limitation of this approach. PH research using claims data would be considerably strengthened through the use of validated algorithms for cohort ascertainment.
Femoral Versus Nonfemoral Subclavian/Carotid Arterial Access Route for Transcatheter Aortic Valve Replacement: A Systematic Review and Meta‐Analysis
Authors: Faroux Laurent , Junquera Lucia , Mohammadi Siamak , Del Val David , Muntané‐Carol Guillem , Alperi Alberto , Kalavrouziotis Dimitri , Dumont Eric , Paradis Jean‐Michel , Delarochellière Robert , Rodés‐Cabau Josep 
Published: September 2020

Background
Some concerns remain regarding the safety of transcarotid and transsubclavian approaches for transcatheter aortic valve replacement. We aimed to compare the risk of 30‐day complications and death in transcarotid/transsubclavian versus transfemoral transcatheter aortic valve replacement recipients.

Methods and Results
Data from 20 studies, including 79 426 patients (16 studies) and 3992 patients (4 studies) for the evaluation of the unadjusted and adjusted impact of the arterial approach were sourced, respectively. The use of a transcarotid/transsubclavian approach was associated with an increased risk of stroke when using unadjusted data (risk ratio [RR], 2.28; 95% CI, 1.90–2.72) as well as adjusted data (odds ratio [OR], 1.53; 95% CI, 1.05–2.22). The pooled results deriving from unadjusted data showed an increased risk of 30‐day death (RR, 1.46; 95% CI, 1.22–1.74) and bleeding (RR, 1.53; 95% CI, 1.18–1.97) in patients receiving transcatheter aortic valve replacement through a transcarotid/transsubclavian access (compared with the transfemoral group), but the associations between the arterial access and death (OR, 1.22; 95% CI, 0.89–1.69), bleeding (OR, 1.05; 95% CI, 0.68–1.61) were no longer significant when using adjusted data. No significant effect of the arterial access on vascular complication was observed in unadjusted (RR, 0.84; 95% CI, 0.66–1.06) and adjusted (OR, 0.79; 95% CI, 0.53–1.17) analyses.

Conclusions
Transcarotid and transsubclavian approaches for transcatheter aortic valve replacement were associated with an increased risk of stroke compared with the transfemoral approach. However, these nonfemoral arterial alternative accesses were not associated with an increased risk of 30‐day death, bleeding, or vascular complication when taking into account the confounding factors.
<p><strong><em>Lepidagathis ananthapuramensis </em></strong><strong>(Acanthaceae): a new species from the lateritic plateaus of Kerala, India</strong></p>
Authors: VS ANILKUMAR , ARYA SINDHU , BIJU PUNNAKOT , JOSEKUTTY ELAYANITHOTTATHIL JOSEPH , AUGUSTINE JOMY 
Published: September 2020

A new species of Lepidagathis from the lateritic plateau of Kasaragod district of Kerala, India, is described and illustrated as Lepidagathis ananthapuramensis sp. nov. The new species resembles L.keralensis but differs in having erect habit, hairy stem, roots borne only on the basal root stock , hairy veins of leaves, early blooming period, one-sided purplish brown long inflorescence,14–30 flowers per spike, four ovules in the ovary and 1–4 seeded capsule.
Convective Coupling in Tropical-Depression-Type Waves. Part I: Rainfall Characteristics and Moisture Structure
Authors: Feng Tao , Yang Xiu-Qun , Yu Jia-Yuh , Huang Ronghui 
Published: September 2020

AbstractTropical-depression (TD)-type waves are synoptic-scale disturbances embedded with deep convection over the western North Pacific. Studies of these disturbances began over six decades ago; however, some properties of these disturbances remain vague, e.g., the coupling mechanism between the deep convection and the waves. This two-part study aims to examine the rainfall progression in TD-type disturbances and associated tropospheric moisture controlling convective rainfall. Part I investigates the rainfall and moisture characteristics of TD-type waves using TRMM-derived rainfall products and the ERA-Interim data during the period of June–October 1998–2013. The rainfall features a north–south asymmetrical pattern with respect to a TD-type disturbance, with enhanced convective and stratiform rainfall occurring in the southern portion. Along with the northwestward propagation, deep convective and stratiform rainfall occur in phase with the TD-type disturbance without significant preceding shallow convective rainfall. Following the deepest convection, shallow convective rainfall increases in the anomalous southerlies. Such a rainfall progression differs from the paradigm from shallow to deep convection, then to stratiform rainfall, which is suggested in other convectively coupled equatorial waves. The rainfall progression and the atmospheric moisture anomaly are phase locked to the TD-type disturbances such that the relative displacements change little when the disturbances propagate northwestward. The latent heat release in deep convection, which is obtained from the TRMM 3G25 dataset, superposes with a broad warm anomaly in the mid- to upper troposphere, suggesting wave growth through the generation of available potential energy from diabatic heating.