bluuebunny/crossref_metadata_2025_split huggingface dataset:
Una revisión temática de las expectativas de los pacientes frente a las conductas del médico
Authors: Marroquín Arturo , Gómez-Restrepo Carlos , Botero-Bermúdez Mónica 
Published: May 2020

Introducción: Actualmente, la medicina enfatiza en una atención centrada en el paciente. No solo la naturaleza de la profesión demanda perpetuar estas intenciones, sino que, inmersos en un sistema de salud en crisis, la satisfacción del paciente como marcador de la calidad de la atención puede traducirse en mejores desenlaces en salud y por ende en ahorros enormes a largo plazo. Objetivo: En este orden de ideas nos propusimos realizar una revisión temática con búsqueda sistemática de la literatura sobre las expectativas del paciente frente al comportamiento del médico durante la atención. Métodos y materiales: Se realizó una búsqueda en las bases de datos Pubmed, Lilacs y Embase con términos específicos y libres. Resultados: Se filtraron 46 artículos para realizar la revisión según criterios de inclusión previamente establecidos. De acuerdo con la información, se crearon 4 dimensiones alrededor del constructo de las expectativas; Confianza, respeto (autonomía), empatía y comunicación. Se extrajo posteriormente la información tanto cuantitativa como cualitativa. Conclusiones: Aunque pareciera existir numerosas investigaciones al respecto, también existe divergencia. Aunque la mayoría de las veces, los individuos parecieran concordar frente a las dimensiones encontradas, s, diferentes grupos culturales y de diferentes características discrepan frente a las expectativas. Teniendo en cuenta esta heterogeneidad, investigación local es requerida para aproximarse a las expectativas de la población colombiana.
Accelerometer-Assessed Prolonged Sitting During Work and Leisure Time and Associations With Age, Body Mass Index, and Health: A Cross-Sectional Study
Authors: Mechlenburg Inger , Tjur Marianne , Overgaard Kristian 
Published: May 2020

Background: High levels of sitting may have a negative impact on health. The aim of this study was to examine how sitting time varies between work and leisure time and to identify parameters associated with overall sitting time and prolonged sitting. Methods: In a total of 189 persons ≥18 years randomly selected from the Danish Civil Registration System, sitting time was monitored with an accelerometer-based sensor mounted at the mid-thigh. Moreover, participants completed a questionnaire including data on demographics, work schedule, and general health. Data were processed using a custom built algorithm. Overall sitting was parametrized as mean % of time spent sitting and prolonged sitting as s (periods exceeding 30 minutes). Results: During working hours, the mean overall sitting time (49.2%) was significantly lower than during leisure time on both working days (60.6%, p < .0001) and on days off work (58.9%, p < .0001). For men, prolonged sitting was positively associated with age, while corresponding associations were negative among female participants (p = .01). Body mass index (BMI) increased by 0.06 kg/m2 for every % increase in prolonged sitting (p = .005). The odds ratio of reporting poor health was 1.05 for every % increase in overall sitting during leisure time on workdays (p = .005). Conclusions: Overall sitting time varies between work and leisure time. Prolonged sitting is positively associated with age for men and with BMI for both men and women.
Persistence of Grenvillian dominance in Laurentian detrital zircon age systematics explained by sedimentary recycling: Evidence from detrital zircon double dating and detrital monazite textures and geochronology
Authors: Zotto S.C. , Moecher D.P. , Niemi N.A. , Thigpen J.R. , Samson S.D. 
Published: May 2020

AbstractGrenvillian ages dominate Neoproterozoic to Paleozoic detrital zircon (DZ) populations across eastern Laurentia and persist through the present. The persistence of this dominance is inferred to result from recycling of DZ grains ultimately sourced from exceptionally Zr-rich and zircon-fertile Grenvillian granitoids. Pennsylvanian arenites of the Appalachian Basin (eastern United States) exhibit DZ U-Pb age distributions that are nearly identical to those of Neoproterozoic to Cambrian strata, and contain detrital diagenetic monazite grains formed via metamorphism or diagenesis of sedimentary rocks in the source region. Detrital zircon (U-Th)/He ages are mostly 475–300 Ma, yielding lag times [Δt = U-Pb age − (U-Th)/He age] of 500–1000 m.y. and 1200–2400 m.y. for Grenvillian and Paleoproterozoic to Archean DZ grains, respectively. Detrital monazite Th-Pb ages are comparable to (U-Th)/He cooling ages, reflecting formation of monazite during Paleozoic regional metamorphism of Neoproterozoic to Cambrian strata that reset the (U-Th)/He systematics of Grenvillian DZ grains within those metasediments. These results are either consistent with or prove recycling. Incorporation of other geological constraints permits definition of at least three (and potentially five) recycling events and their timing following initial post-Grenvillian exhumation and erosion (the “great Grenvillian sedimentation episode”). Recycling events include dispersal of post-Grenvillian sediment during deposition of Neoproterozoic to Cambrian strata (formation of the “Great Unconformity”: cycle 1), subsequent erosion of metamorphosed Neoproterozoic to Cambrian strata generating detritus for the Pennsylvanian arenites sampled here (cycle 2), and modern erosion of those arenites (cycle 3). Pancontinental river systems facilitated dispersal of sediment of ultimate Grenvillian age during or after each cycle.
Primary care faecal calprotectin testing in children with suspected inflammatory bowel disease: a diagnostic accuracy study
Authors: Walker Gareth J , Chanchlani Neil , Thomas Amanda , Lin Simeng , Moore Lucy , Heerasing Neel M , Hendy Peter , Abdelrahim Mohamed , Mole Sean , Perry Mandy H , Mcdonald Timothy J , Bewshea Claire M , Hart James W , Russell Richard K , Ahmad Tariq , Goodhand James R , Kennedy Nicholas A 
Published: May 2020

ObjectiveTo determine the diagnostic accuracy of calprotectin to diagnose inflammatory bowel disease (IBD) in children in whom general practitioners (GPs) suspected IBD.DesignProspective observational cohort study of a new calprotectin-based primary care referral pathway.Setting48 GP practices and gastroenterology secondary care services at the Royal Devon and Exeter NHS Foundation Trust in the South-West of England, UK.Patients195 children aged between 4 and 18 years referred on the pathway between January 2014 and August 2017 for investigation of gastrointestinal symptoms were included.InterventionsPrimary-care-driven faecal calprotectin testing. Primary and secondary care records over 12 months from the point of calprotectin testing were used as the reference standard.Main outcome measuresDiagnostic accuracy of calprotectin testing to detect IBD.Results7% (13/195) tested patients were diagnosed with IBD. Using our prespecified cut-off of 100 µg/g, calprotectin had a diagnostic accuracy of 91% (95% CI 86% to 95%) with a sensitivity for distinguishing IBD from non-IBD of 100% (95% CI 75% to 100%), a specificity of 91% (95% CI 85% to 94%), a positive predictive value of 43% (95% CI 25% to 63%) and a negative predictive value of 100% (95% CI 98% to 100%). Calprotectin testing had no effect on the time to diagnosis, but a negative test contributed to saved referrals and was associated with fewer diagnostic tests in secondary care.ConclusionsCalprotectin testing of children with suspected IBD in primary care accurately distinguishes IBD from a functional gut disorder, reduces secondary care referrals and associated diagnostic healthcare utilisation.
Insulin enhances renal glucose excretion: relation to insulin sensitivity and sodium-glucose cotransport
Authors: Ferrannini Ele , Pereira-Moreira Ricardo , Seghieri Marta , Rebelos Eleni , Souza Aglécio L , Chueire Valeria B , Arvia Caterina , Muscelli Elza 
Published: May 2020

IntroductionInsulin regulates renal glucose production and utilization; both these fluxes are increased in type 2 diabetes (T2D). Whether insulin also controls urinary glucose excretion is not known.MethodsWe applied the pancreatic clamp technique in 12 healthy subjects and 13 T2D subjects. Each participant received a somatostatin infusion and a variable glucose infusion to achieve (within 1 hour) and maintain glycemia at 22 mmol/L for 3 hours; next, a constant insulin infusion (240 pmol/min/kg) was added for another 3 hours. Urine was collected separately in each period for glucose and creatinine determination.ResultsDuring saline, glucose excretion was lower in T2D than controls in absolute terms (0.49 (0.32) vs 0.69 (0.18) mmol/min, median (IQR), p=0.01) and as a fraction of filtered glucose (16.2 (6.4) vs 19.9 (7.5)%, p<0.001). With insulin, whole-body glucose disposal rose more in controls than T2D (183 (48) vs 101 (48) µmol/kgFFM/min, p<0.0003). Insulin stimulated absolute and fractional glucose excretion in controls (p<0.01) but not in T2D. Sodium excretion paralleled glucose excretion. In the pooled data, fractional glucose excretion was directly related to whole-body glucose disposal and to fractional sodium excretion (r=0.52 and 0.54, both p<0.01). In another group of healthy controls, empagliflozin was administered before starting the pancreatic clamp to block sodium-glucose cotransporter 2 (SGLT2). Under these conditions, insulin still enhanced both glucose and sodium excretion.ConclusionsAcute exogenous insulin infusion jointly stimulates renal glucose and sodium excretion, indicating that the effect may be mediated by SGLTs. This action is resistant in patients with diabetes, accounting for their increased retention of glucose and sodium, and is not abolished by partial SGLT2 inhibition by empagliflozin.
Beyond HOSPEX: what is the additional training value of military hospital exercises (HOSPEX)?
Authors: Gimzewska Madelaine , Hunter K , Al Azzawi S , Boreham A 
Published: May 2020

BackgroundThe use of simulation in clinical environments is a frequently used adjunct to training individuals and teams. The military uses clinical simulation to train large numbers of personnel, standardise patient pathways and sustain specific skills to ensure medical personnel are prepared to deploy in their clinical roles.MethodsAs part of a North Atlantic Treaty Organization (NATO) exercise, 256 Field Hospital (Reserves) deployed a team of clinicians to simulate a role 2 basic field hospital. This hospital exercise (HOSPEX) involved training, and a 4-day real-time exercise with casualty simulation. A retrospective survey of all clinical personnel was conducted to analyse the utility of the exercise on their understanding of their job role, the workings of the field hospital and their confidence in deploying on operations.Results39 personnel were surveyed, with questions graded on a modified Likert scale. 41% had previous operational experience in their current job role. A significantly higher proportion of respondents graded their understanding of their job role, and the field hospital overall, as good or excellent having completed the exercise (p<0.01), and 90% felt more confident in fulfilling their operational role postexercise. 90% of respondents had previous experience of simulation, and 94% of these rated the military simulation as being more beneficial than civilian equivalents.DiscussionWith a shift towards simulation in medical training, opportunities have arisen within HOSPEX to develop additional skills for teams and individuals. Simulation is especially important in personnel who have not had previous operational experience, who may deploy on first time operations in senior clinical and leadership roles.ConclusionHOSPEXs are perceived as being extremely useful by clinical personnel preparing for future operational deployment. HOSPEX simulation has prepared the military for varied operations since its inception, and the paradigm has potential for extension into civilian training for high intensity medical responses.
Effectiveness of psychological, psychoeducational and psychosocial interventions to prevent postpartum depression in adolescent and adult mothers: study protocol for a systematic review and meta-analysis of randomised controlled trials
Authors: Martín-Gómez Carmen , Moreno-Peral Patricia , Bellón Juan A , Conejo Cerón Sonia , Campos-Paino Henar , Gómez-Gómez Irene , Rigabert Alina , Benítez Isabel , Motrico Emma 
Published: May 2020

IntroductionThe prevalence of postpartum depression (PPD) is 17%, and the incidence is 12% worldwide. Adverse consequences for mothers and babies have been associated with this disease. To assess the effectiveness of psychological, psychoeducational and psychosocial interventions in preventing PPD, a systematic review and meta-analysis (SR/MA) will be conducted.Methods and analysisA SR/MA will be performed following the indications of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies will be identified through MEDLINE (Ovid and PubMed), PsycINFO, Web of Science, Scopus, CINAHL, Cochrane Central Register of Controlled Trials, OpenGrey, Australian New Zealand Clinical Trial Registry, ClinicalTrials.gov and evidencebasedtherapy.org from inception until 31 January 2020. Bridging searches will be also conducted until the review is completed. The selection criteria will be as follows: (1) subjects will be pregnant females or females who have given birth in the last 12 months and who were non-depressive at baseline; (2) psychological, psychoeducational and psychosocial interventions; (3) comparator will be usual care, attention control, waiting list or no intervention; (4) outcomes will be specific results on PPD; and (5) the design of the studies will be randomised controlled trials. No restrictions regarding the year of publication, the setting of the intervention or the language of publication will be considered. Pooled standardised mean differences and 95% CIs will be calculated. The risk of bias of the studies will be assessed through the Cochrane Collaboration risk of bias tool. Heterogeneity between the studies will be determined by the I2 and Cochran’s Q statistics. Sensitivity and subgroup analyses will also be performed. Publication bias will be checked with funnel plots and Egger’s test. Heterogeneity will be explored by random-effects meta-regression analysis.Ethics and disseminationThe ethical assessment was not required. The results will be presented at conferences and disseminated through publications.PROSPERO registration numberCRD42018109981.
Efficacy and safety of xuezhikang once per day versus two times per day in patients with mild to moderate hypercholesterolaemia (APEX study): a protocol for a multicentre, prospective randomised controlled, open-label, non-inferiority study
Authors: Wu Zexuan , Wu Dexi , Jiang Jingzhou , Chen Ailan , Zheng Dong-Dan , Li Jianhao , Dong Yugang , Chen Yili 
Published: May 2020

IntroductionReduction in low-density lipoprotein cholesterol (LDL-C) improves clinical outcomes in patients with coronary artery disease. However, rates of lipid-lowering medication adherence are far from ideal. Reducing dosage frequency from multiple dosing to once-daily dosing may improve patients’ medication adherence. Xuezhikang (XZK), an extract of Chinese red yeast rice, contains a family of naturally occurring statins and is traditionally prescribed as 600 mg two times per day. A comParative Efficacy study of XZK (APEX study) is designed to test the hypothesis that XZK prescribed 1200 mg once per day (OD group) is non-inferior to 600 mg two times per day (TD group) in patients with hypercholesterolaemia.Methods and analysisThe APEX study is a multicentre, prospective randomised controlled, open-label, non-inferiority study. We plan to recruit 316 patients aged ≥18 years with a diagnosis of mild to moderate hypercholesterolaemia for primary prevention. Patients will be randomised (1:1) to OD group and TD group. The OD group take XZK 1200 mg once per day after dinner while TD group take a traditional dose of 600 mg, two times per day after meals. Participants will have an 8-week medication period and be followed up at weeks 0, 4 and 8. The primary end point is the mean percentage change from baseline to week 8 in serum LDL-C. Secondary end points are safety and lipid-lowering effect on other lipoproteins and compliance. Data analyses will be on the intention-to-treat principle using non-inferiority analysis.Ethics and disseminationThe research had been approved by the Clinical Research and Laboratory Animal Ethics Committee of the First Affiliated Hospital, Sun Yat-sen University ((2017)286). The results will be reported through peer-reviewed journals, seminars and conference presentations.Trial registration numberChiCTR-IIR-17013660.
The comparative effectiveness of physical exercise interventions in individuals with chronic non-specific neck pain: protocol for a network meta-analysis
Authors: de Zoete Rutger MJ , McAuley James H , Armfield Nigel R , Sterling Michele 
Published: May 2020

IntroductionNeck pain is a global burdensome problem, with a large proportion of neck pain cases becoming chronic. Although physical exercise is a commonly prescribed treatment, the evidence on the effectiveness of isolated exercise interventions remains limited. Traditional pairwise randomised controlled trials (RCTs) and meta-analyses are limited in only comparing two interventions. This protocol describes the design of a network meta-analysis, which enables a comparative investigation of all physical exercise interventions for which RCTs are available. We aim to systematically compare the effectiveness of different types of physical exercise in people with chronic non-specific neck pain.Methods and analysisNine electronic databases (AMED, CINAHL, Cochrane Central Register of Controlled Trials, Embase, MEDLINE, Physiotherapy Evidence Database, PsycINFO, Scopus and SPORTDiscus) were searched for RCTs from inception to 12 March 2019. Titles and abstract firstly, and full-text papers secondly, will be screened by two reviewers. Data will be extracted by two reviewers. The primary outcome measure is effectiveness of the intervention. Methodological quality of included studies will be assessed by two reviewers using the PEDro scale. The overall quality of evidence will be assessed with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework, which has been adapted for network meta-analyses. The available evidence will be summarised using a network diagram. A contribution matrix will be presented to allow assessment of direct and indirect evidence. Forest plots will be constructed to visualise effects of all included exercise interventions. Pairwise effect sizes will be calculated by including all evidence available in the network. Effect measures for treatments that have not been compared in a pairwise RCT can be compared indirectly by contrasting effect sizes of comparisons with a common comparator.Ethics and disseminationThis work synthesises evidence from previously published studies and does not require ethics review or approval. A manuscript describing the findings will be submitted for publication in a peer-reviewed scientific journal.PROSPERO registration numberCRD42019126523.
Availability and prices of medicines for non-communicable diseases at health facilities and retail drug outlets in Kenya: a cross-sectional survey in eight counties
Authors: Ashigbie Paul G , Rockers Peter C , Laing Richard O , Cabral Howard J , Onyango Monica A , Buleti John Paul Likalamu , Wirtz Veronika J 
Published: May 2020

ObjectivesThe objective of this study was to determine the availability and prices of medicines for non-communicable diseases (NCDs) in health facilities and private for-profit drug outlets in Kenya.DesignCross-sectional study.MethodsAll public and non-profit health facilities in eight counties (Embu, Kakamega, Kwale, Makueni, Narok, Nyeri, Samburu and West Pokot) that purchased medicines from the Mission for Essential Drugs and Supplies, a major wholesaler, were surveyed in September 2016. For each health facility, one nearby private for-profit drug outlet was also surveyed. Data on availability and price were analysed for 24 NCD and 8 acute medicine formulations. Availability was analysed separately for medicines in the national Essential Medicines List (EML) and those in the Standard Treatment Guidelines (STGs). Median price ratios were estimated using the International Medical Products Price Guide as a reference.Results59 public and 78 non-profit facilities and 135 drug outlets were surveyed. Availability of NCD medicines was highest in private for-profit drug outlets (61.7% and 29.3% for medicines on the EML and STGs, respectively). Availability of STG medicines increased with increasing level of care of facilities: 16.1% at dispensaries to 31.7% at secondary referral facilities. The mean proportion of availability for NCD medicines listed in the STGs (0.25) was significantly lower than for acute medicines (0.61), p<0.0001. The proportion of public facilities giving medicines for free (0.47) was significantly higher than the proportion of private non-profit facilities giving medicines for free (0.09) (p<0.0001). The mean price ratio of NCD medicines was significantly higher than for acute medicines in non-profit facilities (4.1 vs 2.0, respectively; p=0.0076), and in private for-profit drug outlets (3.5 vs 1.7; p=0.0013).ConclusionPatients with NCDs in Kenya appear to have limited access to medicines. Increasing access should be a focus of efforts to achieve universal health coverage.
Characteristics of patients seeking outpatient smoking cessation treatment before and after the implementation of a smoke-free law in Valencia (Spain): a cross-sectional study
Authors: Wang Yang , Guadalupe-Fernández Víctor , Salamanca Ludwing Florez , Saiz Patricia Guillem , Saiz Javier Guillem , Sánchez Carmen Saiz 
Published: May 2020

ObjectiveExplore potential changes in the characteristics of patients requesting smoking cessation treatment at an outpatient setting in Spain before and after Law 42/2010 was enacted.DesignThis is a cross-sectional study with convenience sampling. The information was obtained from the medical records of patients receiving smoking cessation treatment from January 2008 to December 2014.SettingHospital Clinico Universitario de Valencia.Participants423 patients who sought smoking cessation treatment 36 months before or 48 months after the enactment of the law.ResultsAfter the enactment of a comprehensive smoke-free law in Spain, the patients seeking smoking cessation treatment were older (p=0.003), had lower values of exhaled CO (p<0.0001), lower number of previous attempts to quit (p=0.027) and more history of medical problems related to smoking (p=0.002).ConclusionOur findings support the idea that society–nation level interventions could have an impact at the individual level, reflected by the change of patients’ characteristics. It seems that the Law 42/2010 mobilised certain group of patients to seek treatment.