bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ultra-processed food advertisements dominate the food advertising landscape in two Stockholm areas with low vs high socioeconomic status. Is it time for regulatory action?
Authors: Fagerberg Petter , Langlet Billy , Oravsky Aleksandra , Sandborg Johanna , Löf Marie , Ioakimidis Ioannis 
Published: December 2019

Abstract
Background
Ultra-processed food consumption is a risk factor for obesity and has a negative environmental impact. Food companies spend billions of dollars on advertisements each year to increase the consumption of ultra-processed food. In Australia, USA, and New Zealand, most food advertisements around schools and in train stations promote ultra-processed food, but no similar studies have been conducted in Sweden. The aim of this study was to explore the proportion of ultra-processed food advertisements in two districts of Stockholm, Sweden with low vs. high socioeconomic status (SES).

Methods
Two independent researchers (per area) mapped all advertisements, including storefronts, in two Stockholm districts. During consecutive days, all advertisements were photographed in Skärholmen (low SES district), and Östermalmstorg (high SES district), on the streets inside and outside the subway stations, as well as inside and outside of local shopping malls. Advertisements promoting food products were identified and a trained dietician categorized whether they promoted ultra-processed foods. Chi-Square test was conducted to test for differences in the proportion of ultra-processed food advertisements between the two study areas.

Results
In total, 4092 advertisements were photographed in Skärholmen (n = 1935) and Östermalm (n = 2157). 32.8% of all advertisements promoted food, while 65.4% of food advertisements promoted ultra-processed foods. A significantly higher proportion of ultra-processed food advertisements out of total food advertisements was identified in the low SES area, irrespective of the researcher taking the pictures (74.6% vs. 61.8%, p < 0.001 and 70.4% vs. 54.8%, p = 0.001). There was no significant difference in the proportion of food advertisements out of total advertisements between the two areas.

Conclusions
This study provides initial evidence about the scale and the differences in exposure to food advertisements across areas in Stockholm. The observed high proportion of ultra-processed food advertisements is concerning and is in sharp contrast to the Swedish dietary guidelines that recommend reduced consumption of such foods. Based on our results, residents in low SES areas might be more exposed to ultra-processed food advertisements than those in high SES areas in Stockholm. If such findings are confirmed in additional areas, they should be considered during the deployment of food advertisement regulatory actions.
Complementary medicine use among Australian patients in an acute hospital setting: an exploratory, cross sectional study
Authors: Waddington Freya , Lee Jenny , Naunton Mark , Kyle Greg , Thomas Jackson , O’Kane Gabrielle 
Published: December 2019

Abstract
Background
The use of Complementary Medicines (CMs) has significantly increased in Australia over the last decade. This study attempts to determine the extent to which complementary and alternative medicines are recorded, ceased or initiated in the acute hospital setting and investigate which health professionals have a role in this process.

Methods
A cross-sectional study of inpatients was conducted at a major tertiary teaching hospital. Patient’s medical records were examined to determine the rates of complementary medicine (CM) use and recording on medication charts and discharge prescriptions. Patient progress notes were audited to determine which health professionals were involved with the initiation or cessation of CMs during the inpatient stay.

Results
Three hundred and forty-one patients were included for analysis of which 44.3% (n = 151) participants were recorded as utilizing a CM. Patients were admitted on a mean of 2 (±1.4[Sd]; 0–9[range]) CMs and discharged on a mean of 1.7 CMs (±1.3[Sd]; 0–5[range]). 274 individual CMs were recorded on inpatient medication reconciliation forms with multivitamins, magnesium, fish oil and cholecalciferol recorded the most frequently. One hundred and fifty-eight changes to patient CM usage were recorded during the patient hospitalisation. One hundred and seven of these changes (68%) were not accounted for in the patient progress notes.

Conclusion
Patients use of CM in this hospital setting do not reflect the national estimated usage. On the occasions that CM products are included in patient records, they are subsequently deprescribed following patient examination in hospital. It is currently unclear which health professionals have a role in this deprescribing process.
Impact of faculty development programme on self-efficacy, competency and attitude towards medical education in Bhutan: a mixed-methods study
Authors: Tenzin Karma , Dorji Thinley , Choeda Tshering , Pongpirul Krit 
Published: December 2019

AbstractBackgroundSoon after Bhutan’s first medical university was established in 2012, Faculty Development Programmes (FDPs) were adopted for efficient delivery of postgraduate medical curriculum. Medical education was an additional responsibility for the clinicians who already had multi-dimensional roles in the healthcare system where there is acute shortage of healthcare professionals. We studied the impact of FDPs on postgraduate medical education in Bhutan.MethodsThis was a mixed-methods study with a quantitative (cohort study – quasi-experimental with 18 participants) and concurrent explanatory qualitative component (focused group discussion (FGD) with 11 teaching faculty members). The 18 participants were given a structured FDP designed by the University. The FGD assessed teacher self-efficacy and competency using standard tools before and after the FDP. Thematic analysis of the FGD explored the impact of FDPs in the delivery of postgraduate residency programmes.ResultsThere were significant increase in the teacher self-efficacy (31 vs 34,p = 0.009) and competency scores (56 vs 64,p = 0.011). There were significant improvements in self-efficacy in the domain of the teaching relevant subject contents and developing creative ways to cope with system constraints. In teaching-learning assessments, there was a significant appreciation of the effectiveness of lectures and tutorials and the use of essay questions. The FGD demonstrated the acceptance of FDPs and its importance in quality improvement of postgraduate medical education, professional development of teachers and improvement of their communication skills. The teachers have now migrated from the conventional methods of teaching to workplace-based teaching and assessment. The FDPs also resulted in review and revision of postgraduate medical curriculum soon after the first batch graduated in 2018. Lack of adequate support from relevant stakeholders and lack of a medical education centre in the University were seen as major challenges.ConclusionsThe FDPs have brought tangible professionalization of postgraduate medical education at an early stage of the medical university. There is a need for continued efforts to strengthen, sustain and consolidate the gains made thus far.
Comparing different supervised machine learning algorithms for disease prediction
Authors: Uddin Shahadat , Khan Arif , Hossain Md Ekramul , Moni Mohammad Ali 
Published: December 2019

AbstractBackgroundSupervised machine learning algorithms have been a dominant method in the data mining field. Disease prediction using health data has recently shown a potential application area for these methods. This study aims to identify the key trends among different types of supervised machine learning algorithms, and their performance and usage for disease risk prediction.MethodsIn this study, extensive research efforts were made to identify those studies that applied more than one supervised machine learning algorithm on single disease prediction. Two databases (i.e., Scopus and PubMed) were searched for different types of search items. Thus, we selected 48 articles in total for the comparison among variants supervised machine learning algorithms for disease prediction.ResultsWe found that the Support Vector Machine (SVM) algorithm is applied most frequently (in 29 studies) followed by the Naïve Bayes algorithm (in 23 studies). However, the Random Forest (RF) algorithm showed superior accuracy comparatively. Of the 17 studies where it was applied, RF showed the highest accuracy in 9 of them, i.e., 53%. This was followed by SVM which topped in 41% of the studies it was considered.ConclusionThis study provides a wide overview of the relative performance of different variants of supervised machine learning algorithms for disease prediction. This important information of relative performance can be used to aid researchers in the selection of an appropriate supervised machine learning algorithm for their studies.
Factors associated with contracted services of Chinese family doctors from the perspective of medical staff and consumers: a cross-sectional study
Authors: Wang Huanyan , Shi Lei , Han Xuanye , Zhang Jinchan , Ma Yuanshuo , Yang Xi , Liu Ming , Fan Lihua , Lou Fengge 
Published: December 2019

Abstract
Background
The family doctor system has developed rapidly all over the world, and in the past few years, China has actively explored family doctor-type contracted services. This study aimed to explore the related factors of Contracted Family Doctors Services (CFDS) from the perspectives of medical staff and consumers, and to provide a stronger basis for the development and promotion of CFDS.

Methods
A combination of quantitative and qualitative methods were used in this study. A self-reported questionnaire was designed through a literature analysis, group discussions, expert consultations and a pre-investigation, and conducted among community health service providers in 12 community health service centres across four provinces of China. A total of 389 participants participated, and 320 valid questionnaires were obtained, with an effective response rate of 82.3%. A total of 36 consumers participated in in-depth interviews, and the effective rate was 100.0%. An exploratory factor analysis, a confirmatory factor analysis, inductive methods, and expert consultations were used to analyse the related factors of CFDS.

Results
The related factors of CFDS from the perspectives of medical staff were divided into four dimensions, with the following weighting coefficients: national government factors (31.9%), community health service agency factors (24.7%), consumer-related factors (22.6%), and contracted doctor-related factors (20.8%). The related factors of CFDS from the perspectives of consumers were divided into four dimensions, with the following frequency sequence: national government factors, contract doctor-related factors, community health service agency factors, and consumers-related factors. National government factors played an important role in CFDS from the perspectives of medical staff and consumers.

Conclusions
The related factors of CFDS were the same from the perspective of medical staff and consumers, but the weight of each factor was different. The development of CFDS is inseparable from the support of policies. It is suggested that the government should strengthen the publicity of CFDS, expand the coverage, introduce personalised contract programs that meet the needs of different groups, and promote the rapid development of CFDS.
Different expression of Defensin-B gene in the endometrium of mares of different age during the breeding season
Authors: Crociati M. , Capomaccio S. , Mandara M. T. , Stradaioli G. , Sylla L. , Monaci M. , Cappelli K. 
Published: December 2019

Abstract
Background
Despite being one of the major causes of infertility in mares, the mechanisms responsible for equine endometrosis are still unclear and controversial. In the last few years, many investigations focused on local immune response modulation. Since it is generally accepted that endometrial fibrosis increases with age, we hypothesize that older mares could show altered local immune modulation, initiating a pro-inflammatory and tissue remodeling cascade of events that could lead to endometrosis. The aim of this study, indeed, is to evaluate and describe the local gene expression of genes involved in acute inflammatory response and fibrosis (COL1A1, COL3A1, TNFA, MMP9, IL6, TGFB1 and TGFBR1), together with others associated to immune modulation (DEFB4B, IDO1 and FOXP3), in uterine specimens from mares of different age.

Results
Twenty-five Standardbred mares were involved in the study with age ranging from 7 to 19 years (mean 10.40 ± 4.42). They were divided by age into two groups: G1 (n = 15, less than 10 years old) and G2 (N = 10, greater than 11 years old). Specimens from the uterus’ right horn-body junction were collected and processed for histology evaluation and RT-qPCR assay.Gene expression of DEFB4B, MMP9 and TNFA was higher in younger mares, suggesting a balance in immune modulation and tissue remodeling. Interleukin-6 and COL3A1 gene expressions were greater in older animals, probably indicating inflammatory pathways activation and fibrosis increase. Although no differences in fibrosis and inflammation distribution could be found with histological examination among G1 and G2, our results suggest a possible involvement of DEF4BB in regulating the local immune response in younger mare’s uterus (G1); age may contribute to the dis-regulation of DEFB4B transcription and, indirectly, influence the extracellular matrix homeostasis. Transcription of IDO1 and FOXP3 genes, instead, does not seem to be age related, or to be involved in local immune-response and tissue remodeling functions.

Conclusions
Further investigations are needed in order to clarify the interactions between the expression of DEFB4B, IL6, TNFA, COL3A1 and MMP9 and other local signals of immune-modulation and tissue remodeling, in mares in a prospective study design.
Vaccine strain Listeria monocytogenes abscess in a dog: a case report
Authors: Musser Margaret L. , Berger Erika P. , Parsons Cameron , Kathariou Sophia , Johannes Chad M. 
Published: December 2019

Abstract
Background
Listeria monocytogenes is a promising therapeutic vaccine vector for cancer immunotherapy. Although highly attenuated, three cases of systemic listeriosis have been reported in people following treatment with Listeria-based therapeutic vaccines. This complication has thus far not been reported in canine patients.

Case presentation
A dog previously diagnosed with osteoblastic osteosarcoma was presented for care following administration of three doses of the Canine Osteosarcoma Vaccine-Live Listeria Vector. On routine staging chest radiographs, mild sternal lymphadenopathy and a right caudoventral thoracic mass effect were noted. Further evaluation of the mass effect with computed tomography and ultrasound revealed a cavitated mass associated with the 7th right rib. Aspirates of the mass cultured positive for Listeria monocytogenes. The mass and associated ribs were surgically removed. Histopathology was consistent with metastatic osteoblastic osteosarcoma. Treatment was continued with doxorubicin chemotherapy and at the time of publication, the dog was alive over 1 year following diagnosis with no evidence of further disease progression. Genotyping of the abscess-derived L. monocytogenes was consistent with the vaccine strain.

Conclusions
This case represents the first veterinary case to describe development of a Listeria abscess following administration of a Listeria-based therapeutic vaccine.
Karyotyping and prenatal diagnosis of 47,XX,+ 8[67]/46,XX [13] Mosaicism: case report and literature review
Authors: Sun Shaohua , Zhan Fang , Jiang Jiusheng , Zhang Xuerui , Yan Lei , Cai Weiyi , Liu Hailiang , Cao Donghua 
Published: December 2019

Abstract
Background
Trisomy 8 mosaicism has a wide phenotypic variability, ranging from mild dysmorphic features to severe malformations. This report concluded a female pregnant woman with trisomy 8 mosaicism, and carefully cytogenetic diagnoses were performed to give her prenatal diagnostic information. This report also provides more knowledge about trisomy 8 mosaicism and the prenatal diagnostic for clinicians.

Case presentation
In this present study, we reported one case of pregnancy woman with trisomy 8 mosaicism. Noninvasive prenatal testing prompted an abnormal Z-score, but further three dimension color ultrasound result suggested a single live fetus with no abnormality. The phenotypic of the pregnant woman was normal. Based on our results, there were no abnormal initial myeloid cells (< 10− 4), which suggested that the patient had no blood diseases. The peripheral blood karyotype of the patient was 47,XX,+ 8[67]/46,XX [13], and karyotype of amniotic fluid was 46, XX. The next generation sequencing (NGS) result suggested that the proportions of trisomy 8 in different tissues were obviously different; and 0% in amniotic fluid. Last, the chromosomes of the patient and her baby were confirmed using chromosome microarray analysis (CMA), and the results were arr[GRCh37](8) × 3,11p15.5p13(230750–33,455,733) × 2 hmz and normal.

Conclusions
This pregnancy woman was trisomy 8 mosaicism, but the phenotypic was normal, and also the fetus was normal. Carefully cytogenetic diagnoses should be performed for prenatal diagnose.
Effectiveness of plant-based repellents against different Anopheles species: a systematic review
Authors: Asadollahi Amin , Khoobdel Mehdi , Zahraei-Ramazani Alireza , Azarmi Sahar , Mosawi Sayed Hussain 
Published: December 2019

AbstractPlant-based repellents have been applied for generations in traditional practice as a personal protection approach against different species ofAnopheles. Knowledge of traditional repellent plants is a significant resource for the development of new natural products as an alternative to chemical repellents. Many studies have reported evidence of repellant activities of plant extracts or essential oils against malaria vectors worldwide. This systematic review aimed to assess the effectiveness of plant-based repellents againstAnophelesmosquitoes. All eligible studies on the repellency effects of plants againstAnophelesmosquitoes published up to July 2018 were systematically searched through PubMed/Medline, Scopus and Google scholar databases. Outcomes measures were percentage repellency and protection time. A total of 62 trials met the inclusion criteria. The highest repellency effect was identified fromLigusticum sinenseextract, followed by citronella, pine,Dalbergia sissoo, peppermint andRhizophora mucronataoils with complete protection time ranging from 9.1 to 11.5 h. Furthermore, essential oils from plants such as lavender, camphor, catnip, geranium, jasmine, broad-leaved eucalyptus, lemongrass, lemon-scented eucalyptus, amyris, narrow-leaved eucalyptus, carotin, cedarwood, chamomile, cinnamon oil, juniper, cajeput, soya bean, rosemary, niaouli, olive, tagetes, violet, sandalwood, litsea, galbanum, andCurcuma longaalso showed good repellency with 8 h complete repellency against different species ofAnopheles. Essential oils and extracts of some plants could be formulated for the development of eco-friendly repellents againstAnophelesspecies. Plant oils may serve as suitable alternatives to synthetic repellents in the future as they are relatively safe, inexpensive, and are readily available in many parts of the world.
Doses of chloroquine in the treatment of malaria by Plasmodium vivax in patients between 2 and 14 years of age from the Brazilian Amazon basin
Authors: de Sena Luann Wendel Pereira , Mello Amanda Gabryelle Nunes Cardoso , Ferreira Michelle Valéria Dias , de Ataide Marcieni Andrade , Dias Rosa Maria , Vieira José Luiz Fernandes 
Published: December 2019

Abstract
Background
A total dose of chloroquine of 25 mg/kg is recommended by the World Health Organization (WHO) to treat malaria by Plasmodium vivax. In several endemic areas, including the Brazilian Amazon basin, anti-malarial drugs are dispensed in small plastic bags at a dosing regimen based on age. This practice can lead to suboptimal dosing of the drug, which can impact treatment outcomes. The aim of the present study was to estimate the extent of sub-dosing of chloroquine in children and adolescents with vivax malaria using an age-based dose regimen, in addition to investigating the influence of age on the plasma concentrations of chloroquine and desethylchloroquine.

Methods
A study of cases was conducted with male patients with a confirmed infection by P. vivax, ages 2 to 14 years, using a combined regimen of chloroquine and primaquine. Height, weight and body surface area were determined at admission on the study. The total dose of chloroquine administered was estimated based on the weight and on the body surface area of the study patients. Chloroquine and desethylchloroquine were measured on Day 7 in each patient included in the study by a high-performance liquid chromatographic method with fluorescence detection.

Results
A total of 81 patients were enrolled and completed the study. The median age was 9 years (2–14 years). All patients presented negative blood smears at 42 days follow-up. The total dose of chloroquine ranged from 13.1 to 38.1 mg/kg. The percentage of patients with a total dose of the drug below 25 mg/kg ranged from 29.4 to 63.6%. The total dose of chloroquine administered based on BSA ranged from 387 to 1079 mg/m2, increasing with age. Plasma chloroquine concentrations ranged from 107 to 420 ng/ml, increasing with age. For desethylchloroquine, the plasma concentrations ranged from 167 to 390 ng/ml, with similar values among age-groups.

Conclusion
The data demonstrated the widespread exposure of children and adolescents to suboptimal doses of chloroquine in the endemic area investigated.
Understanding challenges to malaria elimination in Nepal: a qualitative study with an embedded capacity-building exercise
Authors: Adhikari Shiva Raj , Sapkota Vishnu P. , Thapa Arjun K. , Acharya Yubraj 
Published: December 2019

Abstract
Background
The Nepalese Government has made significant progress toward the elimination of malaria. However, given the surge in the prevalence of non-communicable diseases, such as diabetes and hypertension, and the localized nature of malaria prevalence, malaria elimination will remain a challenge. In the current study, the authors sought to understand local perceptions on threats to malaria elimination in three endemic districts.

Methods
The authors conducted a capacity-building exercise embedded within a qualitative study. The study component aimed to understand how local policymakers and actors perceive challenges in malaria elimination. For them to be able to articulate the challenges, however, an understanding of malaria elimination in the context of a broader health system in Nepal would be required. The capacity-building component, thus, involved providing that knowledge.

Results
Although the prevalence of malaria is high in the three districts where the study was conducted, there are significant gaps in human resources, diagnosis and treatment, and the provision of indoor residual spraying and long-lasting insecticide treated nets. More importantly, the authors’ experience suggests that it may be possible to capitalize on local expertise in order to identify gaps in malaria elimination at a sub-national level by building in a capacity-building exercise within a study.

Conclusions
Locals in three malaria-endemic districts of Nepal perceive that there are significant gaps in human resources, diagnosis and treatment, the provision of insecticide treated nets, and indoor residual spraying.