bluuebunny/crossref_metadata_2025_split huggingface dataset:
“They heard our voice!” patient engagement councils in community-based primary care practices: a participatory action research pilot study
Authors: Haesebaert Julie , Samson Isabelle , Lee-Gosselin Hélène , Guay-Bélanger Sabrina , Proteau Jean-François , Drouin Guy , Guimont Chantal , Vigneault Luc , Poirier Annie , Sanon Priscille-Nice , Roch Geneviève , Poitras Marie-Ève , LeBlanc Annie , Légaré France 
Published: September 2020

Abstract
Background
Patient engagement could improve the quality of primary care practices. However, we know little about effective patient engagement strategies. We aimed to assess the acceptability and feasibility of embedding advisory councils of clinicians, managers, patients and caregivers to conduct patient-oriented quality improvement projects in primary care practices.

Methods
Using a participatory action research approach, we conducted our study in two non-academic primary care practices in Quebec City (Canada). Patient-experts (patients trained in research) were involved in study design, council recruitment and meeting facilitation. Advisory councils were each to include patients and/or caregivers, clinicians and managers. Over six meetings, councils would identify quality improvement priorities and plan projects accordingly. We assessed acceptability and feasibility of the councils using non-participant observations, audio-recordings and self-administered questionnaires. We used descriptive analyses, triangulated qualitative data and performed inductive thematic analysis.

Results
Between December 2017 and June 2018, two advisory councils were formed, each with 11 patients (36% male, mean age 53.8 years), a nurse and a manager practising as a family physician (25% male, mean age 45 years). The six meetings per practice occurred within the study period with a mean of eight patients per meeting. Councils worked on two projects each: the first council on a new information leaflet about clinic organization and operation, and on communications about local public health programs; the second on methods to further engage patients in the practice, and on improving the appointment scheduling system. Median patient satisfaction was 8/10, and 66.7% perceived councils had an impact on practice operations. They considered involvement of a manager, facilitation by patient-experts, and the fostering of mutual respect as key to this impact. Clinicians and managers liked having patients as facilitators and the respect among members. Limiting factors were difficulty focusing on a single feasible project and time constraints. Managers in both practices were committed to pursuing the councils post-study.

Conclusion
Our results indicated that embedding advisory councils of clinicians, managers, patients and caregivers to conduct patient-oriented quality improvement projects in primary care practices is both acceptable and feasible. Future research should assess its transferability to other clinical contexts.
Population aging and the historical development of intergenerational transfer systems
Authors: Lee Ronald 
Published: September 2020

AbstractFrom our evolutionary past, humans inherited a long period of child dependency, extensive intergenerational transfers to children, cooperative breeding, and social sharing of food. Older people continued to transfer a surplus to the young. After the agricultural revolution, population densities grew making land and residences valuable assets controlled by older people, leading to their reduced labor supply which made them net consumers. In some East Asian societies today, elders are supported by adult children but in most societies the elderly continue to make private net transfers to their children out of asset income or public pensions. Growing public intergenerational transfers have crowded out private transfers. In some high-income countries, the direction of intergenerational flows has reversed from downward to upwards, from young to old. Nonetheless, net private transfers remain strongly downward, from older to younger, everywhere in the world. For many but not all countries, projected population aging will bring fiscal instability unless there are major program reforms. However, in many countries population aging will reduce the net cost to adults of private transfers to children, partially offsetting the increased net costs to working age adults for public transfers to the elderly.
Long-fibre reinforced polymer composites by 3D printing: influence of nature of reinforcement and processing parameters on mechanical performance
Authors: Dantas Francis , Couling Kevin , Gibbons Gregory J. 
Published: September 2020

AbstractThe aim of this study was to identify the effect of material type (matrix and reinforcement) and process parameters, on the mechanical properties of 3D Printed long-fibre reinforced polymer composites manufactured using a commercial 3D Printer (Mark Two). The effect of matrix material (Onyx or polyamide), reinforcement type (Carbon, Kevlar®, and HSHT glass), volume of reinforcement, and reinforcement lay-up orientation on both Ultimate Tensile Strength (UTS) and Flexural Modulus were investigated.For Onyx, carbon fibre reinforcement offered the largest increase in both UTS and Flexural Modulus over unreinforced material (1228 ± 19% and 1114 ± 6% respectively). Kevlar® and HSHT also provided improvements but these were less significant. Similarly, for Nylon, the UTS and Flexural Modulus were increased by 1431 ± 56% and 1924 ± 5% by the addition of carbon fibre reinforcement. Statistical analysis indicated that changing the number of layers of reinforcement had the largest impact on both UTS and Flexural Strength, and all parameters were statistically significant.
Albizia chinensis bark extract ameliorates the genotoxic effect of cyclophosphamide
Authors: Nabil Marian , Hassan Entesar E. , Ghaly Neven S. , Aly Fawzia A. , Melek Farouk R. , Hassan Zeinab M. , Fahmy Maha A. , Farghaly Ayman A. 
Published: September 2020

Abstract
Background
The genus Albizia (Leguminoseae) is used in folk medicine for the treatment of a wide range of ailments. Recently, saponins from plant origin have attracted much attention. Saponins are recorded to have a broad range of biological and pharmacological activities. This study was performed to evaluate the protective role of Albizia chinensis bark methanolic extract (MEAC) against the genotoxicity induced by cyclophosphamide (CP) using different mutagenic parameters.

Results
The results showed that MEAC induced an inhibitory effect against chromosomal aberrations of CP in mouse bone marrow and spermatocytes. Such effect was found to be significant (p < 0.01) with a dose of 100 mg/kg treated once for 24 h and also after repeated treatment at a dose of 25 mg/kg for 7 days. In sperm abnormalities, the protective effect of Albizia extract showed a dose-related relationship. Different doses of MEAC (25, 50, and 100 mg/kg) significantly (p < 0.01) ameliorated sperm abnormalities induced by CP dose-dependently. The percentage of sperm abnormalities was decreased to 5.14 ± 0.72 in the group of animals treated with CP plus MEAC (100 mg/kg) indicating an inhibitory effect of about 50%.

Conclusion
MEAC at the doses examined was non-genotoxic compared to control (negative) and exhibited a protective role against CP genotoxicity.
Durometry as an alternative tool to the modified Rodnan’s skin score in the assessment of diffuse systemic sclerosis patients: a cross-sectional study
Authors: de Oliveira Marília de Fátima Cirioli , Leopoldo Vanessa Cristina , Pereira Karla Ribeiro Costa , de Moraes Daniela Aparecida , Dias Juliana Bernardes Elias , Gonçalves Maynara Santana , Ramalho Leandra Naíra Zambelli , dos Santos Bruna Nogueira , de Oliveira Maria Carolina , Silveira Renata Cristina Campos Pereira 
Published: September 2020

Abstract
Background
The reproducibility and reliability of the modified Rodnan’s Skin Score (mRSS) are debated due to investigator-related subjectivity. Here, we evaluate if durometry correlates with mRSS in patients with diffuse systemic sclerosis (SSc).

Methods
This cross-sectional study was conducted from December 2018 to June 2019, including 58 diffuse SSc patients. Two certified researchers, blind to each other’s scores, performed the mRSS, followed by durometry at 17 predefined skin sites. For durometry and mRSS, individual scores per skin site were registered. Durometry and mRSS results measured by each researcher, as well as scores from different researchers, were compared. Skin thickness measurements from forearm skin biopsies were available in a subset of the patients, for comparisons. Statistical analyses included Cohen’s Kappa Coefficient, Intraclass Correlation Coefficient, Kendall’s Coefficient and Spearman’s test.

Results
Mean (standard deviation, SD) patient age was 44.8 (12.9) years, and 88% were female. Inter-rater agreement varied from 0.88 to 0.99 (Intraclass correlation coefficient) for durometry, and 0.54 to 0.79 (Cohen’s Kappa coefficient) for mRSS, according to the specific evaluated sites. When data were compared with skin thickness assessed in forearm biopsies, durometry correlated better with skin thickness than mRSS.

Conclusion
Durometry may be considered as an alternative method to quantify skin involvement in patients with diffuse SSc. The strong inter-rater agreement suggests that the method may be useful for the assessment of patients by multiple researchers, as in clinical trials.
A predictive model of the sunscreen use in the paddy workers based on the health action process approach model: a path analysis
Authors: Panahi Hadiseh , Salehi Leili , Mahmoodi Zohreh 
Published: September 2020

Abstract
Background
Skin cancer is considered as one of the most common cancers in the world. There is little information about identifying factors affecting sunscreen use among paddy workers and their protective behavior. The present study aimed to determine a predictive model of the sunscreen use in the paddy workers based on the health action process approach model (HAPA).

Methods
This cross-sectional study was conducted on 177 paddy workers who engaged in agricultural work in the north of Iran in 2018. Convenience sampling methods was used. Inclusion criteria were being a farmer for 5 years, working under the sunshine more than 2 h per day, and above the age of 30 years. A multi-sectional questionnaire (intention, risk perception (RP), outcome expectation (OE), action self-efficacy (ASE), action planning (AP), coping planning (CP), coping SE (CSE), self-monitoring (SM), and sunscreen use) was used for data collection. Data were analyzed with SPSS-21 and Lisrel-8.8 software.

Results
The mean age of participants was 47.78 ± 12.66 years. The final path model fitted well (comparative fit index (CFI) = 0.98, RMSEA = 0.000), only coping self-efficacy (CSE) from both direct and indirect paths had an impact on sunscreen use (B = 0.73). Among the variables which are influenced only in one direction, coping planning (CP) had the most direct influence (B = 0.30) on behavior, and action planning had the lowest influence (B = 0.24).

Conclusion
Coping self-efficacy was the most important factor which had influence on the use of sunscreen, and it should be considered when designing interventional programs related to sunscreen use among paddy workers.
DNA integrity index as a potential molecular biomarker in colorectal cancer
Authors: Salem Ramy , Ahmed Rasha , Shaheen Karim , Abdalmegeed Mohammed , Hassan Heba 
Published: September 2020

Abstract
Background
Efficient approaches for early detection of colorectal cancer offer opportunities to gain better treatment outcomes. Blood-based molecular biomarkers as DNA integrity index (DII) might represent a promising tumor marker in the future. The purpose of this study was to assess the clinical utility of the DII as a potential biomarker for colorectal cancer in 90 colorectal cancer patients, 30 patients with benign colorectal mass, and 30 age- and sex-matched healthy control subjects. PCR was used to assess the concentration of both ALU115 and ALU247. DII was calculated as the ratio of Q247/Q115.

Results
DII was significantly higher in colorectal cancer patients than both patients with benign colorectal mass and healthy controls. ROC curve was plotted using DII and the best cut-off was ≥ 0.60 with diagnostic sensitivity 93.0%, specificity 65.0%, PPV 80.0%, NPV 86.0%, and efficiency 82% with AUC (0.872) while the best cut-off for CEA was ≥ 1.4 ng/mL with diagnostic sensitivity 87.0%, specificity 60.0%, PPV 76%, NPV 75%, and efficiency 76% with AUC (0.79).

Conclusions
Our results suggest that DII is better than CEA as an early marker for colorectal cancer detection and may be used as a candidate biomarker for malignancy.
Anticancer potential of Chenopodium album leaf extract against Ehrlich ascites carcinoma cells in Swiss albino mice
Authors: Rana Sohel , Rahman Shakila , Sana Samiron , Biswas Tonmoy Kumar , Hashem Abu Kayes Md. , Parvin Shahnaz , Mazumder Kishor 
Published: September 2020

Abstract
Background
Chenopodium album (Family: Amaranthaceae) is a nutritive herb mainly found in Bangladesh and had reported that it is having different bioactive phytochemicals including polyphenols. It has a great popularity for it is traditionally used as a medicine against microorganisms, inflammation, and cancer. We designed this experiment to explore the in vivo anticancer effects of C. album leaf extract against Ehrlich ascites carcinoma (EAC) cells in Swiss albino mice.

Results
Administration of C. album leaf extract at concentration 200 (mg/kg) and 400 (mg/kg) showed 30.60% and 41.80% cell growth inhibition respectively that were statistically significant (***P < 0.001) and may lead to apoptosis, and the number of apoptotic cells were 37.5 ± 6.22, 54.67 ± 4.76 respectively (***P < 0.001). Plant extract at concentration 200 (mg/kg) and 400 (mg/kg) increased life span 22.27% and 51.07% respectively. Tumor weight decreased 18.50 ± 2.59 g, 13.67 ± 2.25 g respectively compared to the control group, and results were statistically significant (***P < 0.001). Treatment with plant extract 200 (mg/kg) and 400 (mg/kg) restored all biochemical parameters including hemoglobin content, white blood cell (WBC) count, and red blood cell (RBC) count of EAC cells bearing Swiss albino mice.

Conclusion
Our current findings may suggest that C. album leaf extract showed potent anticancer activity through cell growth inhibition and apoptosis, increased mean survival time, decreased tumor weight, and restored all the biochemical parameters and stimulation of host immunity. As a result, the C. album leaf has taken into consideration as a potent source of bioactive compounds in cancer chemotherapy.
Developing a test battery for diagnosis of childhood apraxia of speech in Arabic speakers
Authors: Abdou Dalia , Afsah Omayma , Baz Hemmat , Abou-Elsaad Tamer 
Published: September 2020

Abstract
Background
Childhood apraxia of speech (CAS) is a speech sound disorder in which the precision and consistency of movements underlying speech are impaired in absence of neuromuscular deficits. It is important to differentiate between language disorders and CAS to avoid misdiagnosis. The objective of this study was to develop a test battery for CAS in order to identify its possible presence in Arabic-speaking children, thus allowing the planning of appropriate therapy programs. The constructed test battery for CAS was administered to 70 monolingual Arabic-speaking Egyptian children including 10 children with suspected CAS, 20 children with phonological disorders, and 40 typically developing children. Participants’ responses were statistically analyzed to assess the validity and reliability, and to evaluate sensitivity and specificity of the test battery.

Results
Statistically significant differences were found between the three groups as regard all subtotal and total scores of CAS test battery with good validity and reliability of the test.

Conclusions
The constructed test battery for diagnosis of CAS is a reliable, valid, and sensitive tool that can be used to detect the presence of CAS in Arabic-speaking children and differentiate between it and phonological disorders.
Dualism and the ‘difficult patient’: why integrating neuroscience matters
Authors: Novick Andrew M. , Ross David A. 
Published: September 2020

SUMMARYPatients with psychiatric illness present a unique challenge to clinicians: in contrast to the traditional medical model, in which patients are conceptualised as being stricken by a disease, patients with certain psychiatric illnesses may seem complicit in the illness. Questions of free will, choice and the role of the physician can cause clinicians to feel helpless, disinterested or even resentful. These tensions are a lasting legacy of centuries of mind–body dualism. Over the past several decades, modern tools have finally allowed us to break down this false dichotomy. Integrating a modern neuroscience perspective into practice allows clinicians to conceptualise individuals with psychiatric illness in a way that promotes empathy and enhances patient care. Specifically, a strong grasp of neuroscience prevents clinicians from falling into the trap in which behavioural aspects of a patient's presentation are perceived as being separate from the disease process. We demonstrate the value of incorporating neuroscience into a biopsychosocial formulation through the example of a ‘difficult patient’.
Implications of Incidental Germline Findings Identified In the Context of Clinical Whole Exome Sequencing for Guiding Cancer Therapy
Authors: Schneider Bryan P. , Stout Leigh Anne , Philips Santosh , Schroeder Courtney , Scott Susanna F. , Hunter Cynthia , Kassem Nawal , Kiel Patrick J. , Radovich Milan 
Published: September 2020

PURPOSE Identification of incidental germline mutations in the context of next-generation sequencing is an unintended consequence of advancing technologies. These data are critical for family members to understand disease risks and take action. PATIENTS AND METHODS A retrospective cohort analysis was conducted of 1,028 adult patients with metastatic cancer who were sequenced with tumor and germline whole exome sequencing (WES). Germline variant call files were mined for pathogenic/likely pathogenic (P/LP) variants using the ClinVar database and narrowed to high-quality submitters. RESULTS Median age was 59 years, with 16% of patients ≤ 45 years old. The most common tumor types were breast cancer (12.5%), colorectal cancer (11.5%), sarcoma (9.3%), prostate cancer (8.4%), and lung cancer (6.6%). We identified 3,427 P/LP variants in 471 genes, and 84% of patients harbored one or more variant. One hundred thirty-two patients (12.8%) carried a P/LP variant in a cancer predisposition gene, with BRCA2 being the most common (1.6%). Patients with breast cancer were most likely to carry a P/LP variant (19.2%). One hundred ten patients (10.7%) carried a P/LP variant in a gene that would be recommended by the American College of Medical Genetics and Genomics to be reported as a result of clinical actionability, with the most common being ATP7B (2.7%), BRCA2 (1.6%), MUTYH (1.4%), and BRCA1 (1%). Of patients who carried a P/LP variant in a cancer predisposition gene, only 53% would have been offered correct testing based on current clinical practice guidelines. Of 471 mutated genes, 231 genes had a P/LP variant identified in one patient, demonstrating significant genetic heterogeneity. CONCLUSION The majority of patients undergoing clinical cancer WES harbor a pathogenic germline variation. Identification of clinically actionable germline findings will create additional burden on oncology clinics as broader WES becomes common.
Affordable but Inaccessible? Contraception Deserts in the US States
Authors: Kreitzer Rebecca J. , Smith Candis Watts , Kane Kellen A. , Saunders Tracee M. 
Published: September 2020

Abstract
Context: This article focuses on whether, and the extent to which, the resources made available by Title X—the only federal policy aimed specifically at reproductive health care—are equitably accessible. Here, equitable means that barriers to accessing services are lowest for those people who need them most.
Methods: The authors use geographic information systems (GIS) and statistical/spatial analysis (specifically the integrated two-step floating catchment area [I2SFCA] method) to study the spatial and nonspatial accessibility of Title X clinics in 2018.
Findings: The authors find that contraception deserts vary across the states, with between 17% and 53% of the state population living in a desert. Furthermore, they find that low-income people and people of color are more likely to live in certain types of contraception deserts.
Conclusions: The analyses reveal not only a wide range of sizes and shapes of contraception deserts across the US states but also a range of severity of inequity.
Fibrodysplasia ossificans progressiva: current concepts from bench to bedside
Authors: Kaliya-Perumal Arun-Kumar , Carney Tom J. , Ingham Philip W. 
Published: September 2020

ABSTRACT
Heterotopic ossification (HO) is a disorder characterised by the formation of ectopic bone in soft tissue. Acquired HO typically occurs in response to trauma and is relatively common, yet its aetiology remains poorly understood. Genetic forms, by contrast, are very rare, but provide insights into the mechanisms of HO pathobiology. Fibrodysplasia ossificans progressiva (FOP) is the most debilitating form of HO. All patients reported to date carry heterozygous gain-of-function mutations in the gene encoding activin A receptor type I (ACVR1). These mutations cause dysregulated bone morphogenetic protein (BMP) signalling, leading to HO at extraskeletal sites including, but not limited to, muscles, ligaments, tendons and fascia. Ever since the identification of the causative gene, developing a cure for FOP has been a focus of investigation, and studies have decoded the pathophysiology at the molecular and cellular levels, and explored novel management strategies. Based on the established role of BMP signalling throughout HO in FOP, therapeutic modalities that target multiple levels of the signalling cascade have been designed, and some drugs have entered clinical trials, holding out hope of a cure. A potential role of other signalling pathways that could influence the dysregulated BMP signalling and present alternative therapeutic targets remains a matter of debate. Here, we review the recent FOP literature, including pathophysiology, clinical aspects, animal models and current management strategies. We also consider how this research can inform our understanding of other types of HO and highlight some of the remaining knowledge gaps.