bluuebunny/crossref_metadata_2025_split huggingface dataset:
Self-care for anxiety and depression: a comparison of evidence from Cochrane reviews and practice to inform decision-making and priority-setting
Authors: Pilkington Karen , Wieland Lisa Susan 
Published: August 2020

Abstract
Background
Self-care refers to a range of activities and approaches undertaken by an individual to maintain health and manage ill-health which may include various complementary or alternative approaches. The purpose of this study was to identify the self-care approaches used by the general public for depression and anxiety, assess the usefulness of Cochrane reviews for informing decisions on self-care and highlight any gaps in the evidence.

Methods
Searches were carried out for surveys of self-care for anxiety and/or depression and for Cochrane reviews and protocols of interventions with potential for use in self-care. Data was extracted from each review and Plain Language Summaries assessed for content, consistency and readability. Interventions reported in surveys and in Cochrane reviews were compared and effectiveness of each assessed.

Results
Surveys from 10 countries reported a variety of self-care interventions, 17 of which appeared in 2 or more surveys and which included dietary supplements, herbal medicines, mind-body therapies and various forms of exercise. Twenty-two reviews and 5 protocols on potential self-care interventions were identified, the majority in depression. Twelve interventions were judged effective or promising, most with small effect sizes. Readability of summaries was highly variable: half were written at college/university level. Several commonly used approaches were not covered by Cochrane reviews.

Conclusions
This study has revealed the interventions currently used by the general public which are judged effective or promising based on Cochrane reviews. Some disparity is highlighted between interventions used in practice and the availability of reliable evidence, and in the presentation of effectiveness and safety. Being able to direct patients to reliable, accessible information is a positive step in ensuring effective patient-centered, evidence-informed care. Addressing gaps, ensuring consistency and increasing usability of evidence intended for the general public will support this goal.
Proficiency testing for identifying underperforming students before postgraduate education: a longitudinal study
Authors: Andreou Vasiliki , Eggermont Jan , Gielis Guy , Schoenmakers Birgitte 
Published: August 2020

Abstract
Background
Efficient selection of medical students in GP training plays an important role in improving healthcare quality. The aim of this study was to collect quantitative and qualitative validity evidence of a multicomponent proficiency-test for identifying underperforming students in cognitive and non-cognitive competencies, prior to entering postgraduate GP Training. From 2016 to 2018, 894 medical GP students in four Flemish universities in Belgium registered to take a multicomponent proficiency-test before admission to postgraduate GP Training. Data on students were obtained from the proficiency-test as a test-score and from traineeship mentors’ narrative reports.

Results
In total, 849 students took the multicomponent proficiency-test during 2016–2018. Test scores were normally distributed. Five different descriptive labels were extracted from mentors’ narrative reports based on thematic analysis, considering both cognitive and non-cognitive competences. Chi-square tests and odds ratio showed a significant association between students scoring low on the proficiency–test and having gaps in cognitive and non-cognitive competencies during GP traineeship.

Conclusion
A multicomponent proficiency-test could detect underperforming students prior to postgraduate GP Training. Students that ranked in the lowest score quartile had a higher likelihood of being labelled as underperforming than students in the highest score quartile. Therefore, a low score in the multicomponent proficiency-test could indicate the need for closer guidance and early remediating actions focusing on both cognitive and non-cognitive competencies.
Short-term outcomes and complications of 65 cases of porous TTA with flange: a prospective clinical study in dogs
Authors: Bernardi-Villavicencio Cristina , Jimenez-Socorro Antonio Nicolas , Rojo-Salvador Concepcion , Robles-Sanmartin Javier , Rodriguez-Quiros Jesus 
Published: August 2020

Abstract
Background
Cranial cruciate ligament rupture (CrCLR) is the most common orthopaedic cause of lameness in the hind limb in dogs. Many surgical treatments have been described, but tibial tuberosity advancement (TTA) is one of the most commonly used today. Since it was first described, TTA has evolved to reduce major complications and to arrest the progression of osteoarthrosis. The aim of this study was to assess a surgical technique called Porous TTA with flange prospectively. This study was performed in 61 dogs that underwent 65 Porous TTA with flange procedures, to validate it as an alternative CrCLR treatment. Complications and clinical outcomes (pain, lameness, weight bearing, flexion, extension, crepitation and atrophy) were reported over 3 months, i.e. at 3, 6 and 12 weeks postoperatively.

Results
The results showed a positive clinical outcome, a minor complication rate of 47.69% at the first review 3 weeks postoperatively, 10.77% at the second one (6 weeks after the surgery) and 4% at the third one (at 12 weeks). Major complications were observed only at the last review, with one case that had an infection requiring implant removal; this represented 1.5% of cases. Variables evaluated for a relationship with complication scores and improvement were body condition score, sex, age, breed, body weight, breed size, side of the affected limb, traumatic anamnesis and time of lameness before surgery. No relationship was detected.

Conclusions
Clinical outcomes and complications show that Porous TTA with flange is an efficient alternative for surgical treatment of CrCLR in dogs.
Progesterone-responsive vaginal leiomyoma and hyperprogesteronemia due to ovarian luteoma in an older bitch
Authors: Ferré-Dolcet L. , Romagnoli S. , Banzato T. , Cavicchioli L. , Di Maggio R. , Cattai A. , Berlanda M. , Schrank M. , Mollo A. 
Published: August 2020

AbstractBackgroundThis is the first report about a vaginal leiomyoma concomitant with an ovarian luteoma in a bitch.Case presentationA 11-year-old intact female Labrador retriever was referred because of anuria, constipation and protrusion of a vaginal mass through the vulvar commissure. The bitch had high serum progesterone concentration (4.94 ng/ml). Because of the possibility of progesterone responsiveness causing further increase of the vaginal mass and since the bitch was a poor surgical candidate a 10 mg/kg aglepristone treatment was started SC on referral day 1. A computerized tomography showed a 12.7 × 6.5 × 8.3 cm mass causing urethral and rectal compression, ureteral dilation and hydronephrosis. A vaginal leiomyoma was diagnosed on histology. As serum progesterone concentration kept increasing despite aglepristone treatment, a 0.02 ng/mL twice daily IM alfaprostol treatment was started on day 18. As neither treatment showed remission of clinical signs or luteolysis, ovariohysterectomy was performed on referral day 35. Multiple corpora lutea were found on both ovaries. On histology a luteoma was diagnosed on the left ovary. P4 levels were undetectable 7 days after surgery. Recovery was uneventful and 12 weeks after surgery tomography showed a reduction of 86.7% of the vaginal mass. The bitch has been in good health and able to urinate without any complication ever since.ConclusionsThis case demonstrates the importance of identifying progesterone related conditions as well as the importance of judiciously using a combined medical and surgical approach.
Efficient 2,3-butanediol production from whey powder using metabolically engineered Klebsiella oxytoca
Authors: Meng Wensi , Zhang Yongjia , Cao Menghao , Zhang Wen , Lü Chuanjuan , Yang Chunyu , Gao Chao , Xu Ping , Ma Cuiqing 
Published: August 2020

Abstract
Background
Whey is a major pollutant generated by the dairy industry. To decrease environmental pollution caused by the industrial release of whey, new prospects for its utilization need to be urgently explored. Here, we investigated the possibility of using whey powder to produce 2,3-butanediol (BDO), an important platform chemical.

Results
Klebsiella oxytoca strain PDL-0 was selected because of its ability to efficiently produce BDO from lactose, the major fermentable sugar in whey. After deleting genes pox, pta, frdA, ldhD, and pflB responding for the production of by-products acetate, succinate, lactate, and formate, a recombinant strain K. oxytoca PDL-K5 was constructed. Fed-batch fermentation using K. oxytoca PDL-K5 produced 74.9 g/L BDO with a productivity of 2.27 g/L/h and a yield of 0.43 g/g from lactose. In addition, when whey powder was used as the substrate, 65.5 g/L BDO was produced within 24 h with a productivity of 2.73 g/L/h and a yield of 0.44 g/g.

Conclusion
This study demonstrated the efficiency of K. oxytoca PDL-0 for BDO production from whey. Due to its non-pathogenicity and efficient lactose utilization, K. oxytoca PDL-0 might also be used in the production of other important chemicals using whey as the substrate.
Association between direct government subsidies and service scope of primary care facilities: a cross-sectional study in China
Authors: Li Zhong , Hung Peiyin , He Ruibo , Zhang Liang 
Published: August 2020

AbstractBackgroundComprehensive primary care practices, through preconception, preventive, curative, and rehabilitative care, have been a global priority in the promotion of health. However, the scope of primary care services has still been in decline in China. Studies on the factors for primary care service scope have centred on human resources and infrastructure; the role of direct government subsidies (DGS) on services scope of primary care facilities were left unanswered. This study aimed to explore the association between the DGS and services scope of primary care facilities in China.MethodsA multi-stage, clustered cross-sectional survey using self-administrated questionnaire was conducted among primary care facilities of 36 districts/counties in China. A total of 770 primary care facilities were surveyed with 757 (98.3%) valid respondents. Of the 757 primary care facilities, 469 (62.0%) provided us detailed information of financial revenue and DGS from 2009 to 2016. Therefore, 469 primary care facilities from 31 counties/districts were included in this study. Sasabuchi-Lind-Mehlum tests and multivariate regression models were used to examine the inverted U-shaped relationship between the DGS and service scope.ResultsOf 469 PCFs, 332 (70.8%) were township health centres. Proportion of annul DGS to FR arose from 26.5% in 2009 to 50.5% in 2016. At the low proportion of DGS to financial revenue, an increase in DGS was associated with an increased service scope of primary care facilities, whereas the proportion of DGS to financial revenue over 42.5% might cause narrowed service scope (P = 0.023, 95% CI 11.59–51.74%); for the basic medical care dimension, the cut point is 42.6%. However, association between DGS and service scope of public health by primary care facilities is statistically insignificant.ConclusionWhile the DGS successfully achieved equalization of basic preventive and public health services, the disproportionate proportion of DGS to financial revenue is associated with narrowed service scope, which might cause underutilization of primary care and distorted incentive structure of primary care. Future improvements of DGS should focus on the incentive of broader basic medical services provision, such as clarifying service scope of primary care facilities and strategic procurement with a performance-based subsidies system to determine resource allocation.
Simultaneous and sensitive determination of ascorbic acid, dopamine and uric acid via an electrochemical sensor based on PVP-graphene composite
Authors: Wu Yiyong , Deng Peihong , Tian Yaling , Feng Jinxia , Xiao Jingyun , Li Junhua , Liu Jun , Li Guangli , He Quanguo 
Published: August 2020

AbstractA method with high sensitivity, good accuracy and fast response is of ever increasing importance for the simultaneous detection of AA, DA and UA. In this paper, a simple and sensitive electrochemical sensor, which based on the polyvinylpyrrolidone (PVP)-graphene composite film modified glassy carbon electrode (PVP-GR/GCE), was presented for detecting ascorbic acid (AA), dopamine (DA) and uric acid (UA) simultaneously. The PVP-GR/GCE has excellent electrocatalytic activity for the oxidation of AA, DA and UA. The second-order derivative linear sweep voltammetry was used for the electrochemical measurements. The peak potential differences of DA-AA, DA-UA, and UA-AA (measured on the PVP-GR/GCE) were 212, 130 and 342 mV respectively. Besides, the over potential of AA, DA and UA reduced obviously, so did the peak current increase. Under the optimum conditions, the linear ranges of AA, DA and UA were 4.0 μM–1.0 mM, 0.02–100 μM, and 0.04–100 μM, respectively. The detection limits were 0.8 μM, 0.002 μM and 0.02 μM for AA, DA, and UA. The electrochemical sensor presented the advantages of high sensitivity and selectivity, excellent reproducibility and long-term stability. Furthermore, the sensor was successfully applied to the analysis of real samples.
Preferences of physicians for public and private sector work
Authors: Scott Anthony , Holte Jon Helgeim , Witt Julia 
Published: August 2020

Abstract
Background
The public-private mix of healthcare remains controversial. This paper examines physicians’ preferences for public sector work in the context of dual practice, whilst accounting for other differences in the characteristics of jobs.

Methods
A discrete choice experiment is conducted with data from 3422 non-GP specialists from the Medicine in Australia: Balancing Employment and Life (MABEL) panel survey of physicians.

Results
Physicians prefer to work in the public sector, though the value of working in the public sector is very small at 0.14% of their annual earnings to work an additional hour per week. These preferences are heterogeneous. Contrary to other studies that show risk averse individuals prefer public sector work, for physicians, we find that those averse to taking career or clinical risks prefer to work in the private sector. Those with relatively low earnings prefer public sector work and those with high earnings prefer private sector work, though these effects are small.

Conclusions
Other job characteristics are more important than the sector of work, suggesting that these should be the focus of policy to influence specialist’s allocation of time between sectors.
Capacity development in patient-oriented research: programme evaluation and impact analysis
Authors: Rosario Melanie King , Hebert Marilynne A. , Sahota Balreen Kaur , Eurich Dean 
Published: August 2020

Abstract
Background
National and provincial funding was invested to increase the quantity and quality of patient-oriented research (POR) across Canada. Capacity development became a priority to ensure all stakeholders were prepared to engage in POR. In part, this need was met through an annual Studentship competition in the province of Alberta, providing funding to students whose research incorporated principles of POR. However, despite efforts to build capacity in the health research trainee population, little is known about the outcomes of these programmes. This evaluation study examined the outcomes of a POR capacity development programme for health research trainees.

Methods
Final impact narrative reports were submitted by the 21 Studentship programme awardees for 2015 and 2016 who represent a variety of health disciplines across three major research universities. The reports describe the programme outcomes as well as the overall impact on individual, project and professional development as POR trainees. A synthesis of structured and categorised report data was conducted, along with additional qualitative analyses as new themes emerged that were not apparent in the competency framework utilised in the programme design.

Results
Awardee reports detailed the impact of the Studentship programme on the key themes of increased knowledge and skill, relationship building, confidence and leadership, as well as project and career impact. The impacts felt most profoundly by the awardees were not reflective of the competencies that guided programme design. The outcomes were then re-examined using a health research capacity development framework to gain a more comprehensive view of programme impact.

Conclusion
The Studentship programme narratives provided insight into the rarely tracked capacity development outcomes of POR research trainees. Awardee narratives indicated significant development beyond the intended competencies and suggested a need to revisit the competency framework for POR in Alberta. While competencies were useful in guiding the design of the initial programme, a more comprehensive capacity development framework was required to capture the broader impacts on trainee development. Future capacity development programmes may benefit from these early programme insights, specifically the need for more robust competencies for POR. Further exploration of evaluation methods for short-term awards and sustainability of capacity development programmes is warranted.
Twelve year trajectories of physical activity and health costs in mid-age Australian women
Authors: Gomes Grace A. O. , Brown Wendy J. , Codogno Jamile S. , Mielke Gregore I. 
Published: August 2020

Abstract
Background
Few studies have examined relationships between physical activity (PA) during mid-age and health costs in women. The aim of this study was to investigate associations between PA levels and trajectories over 12 years with medical and pharmaceutical costs in mid-age Australian women.

Methods
Data from 6953 participants in the Australian Longitudinal Study on Women’s Health (born in 1946–1951) were analysed in 2019. PA was self-reported in 2001 (50-55y), 2007 (56-61y) and 2013 (62-67y). PA data were linked with 2013–2015 data from the Medicare (MBS) and Pharmaceutical (PBS) Benefits Schemes. Quantile regression was used to examine associations between PA patterns [always active, increasers, decreasers, fluctuaters or always inactive (reference)] with these medical and pharmaceutical costs.

Results
Among women who were consistently inactive (< 500 MET.minutes/week) in 2001, 2007 and 2013, median MBS and PBS costs (2013 to 2015) were AUD4261 and AUD1850, respectively. Those costs were AUD1728 (95%CI: 443–3013) and AUD578 (95%CI: 426–729) lower among women who were consistently active in 2001, 2007 and 2013 than among those who were always inactive. PBS costs were also lower in women who were active at only one survey (AUD205; 95%CI: 49–360), and in those whose PA increased between 2001 and 2013 (AUD388; 95%CI: 232–545).

Conclusion
Maintaining ‘active’ PA status was associated with 40% lower MBS and 30% lower PBS costs over three years in Australian women. Helping women to remain active in mid-life could result in considerable savings for both women and the Australian government.
Recurrent synovitis of hip and MEFV gene related arthritis in children
Authors: Salehzadeh Farhad , Mirzarahimi Mehrdad 
Published: August 2020

Abstract
Background
Recurrent and relapsing arthritis has been proposed to describe a group of arthritis with recurring and periodic nature, in which the joints are intermittently involved.
This study reports three non-FMF patients with heterozygous MEFV gene mutations and an extraordinary arthritis as a recurrent synovitis of hip (RSH).

Methods
During 16-years from 2003 to 2019 at pediatric rheumatologic clinic among 195 recorded files with chronic oligoarthritis, 3 patients with diagnosis of recurrent synovitis of hip (RSH) were reviewed thoroughly. Peripheral blood was collected from patients and the samples were screened for the 12 common MEFV gene pathogenic variants.

Results
This study included three patients, two female and one male with relapsing idiopathic arthritis that has been located on hip joints as a sole manifestation and pathologic findings of MEFV mutations as follow: A744S, V726A, and R761H.

Conclusion
On the basis of possible role of MEFV gene in different rheumatic disease, MEFV gene related arthritis may be considered as a background of RSH particularly in Mediterranean area.
A familial case of Kikuchi-Fujimoto disease in dizygotic twins
Authors: Quadir Ashfaque , Peacock Ken , Hsu Peter , Singh-Grewal Davinder , Alexander Stephen 
Published: August 2020

Abstract
Background
Kikuchi-Fujimoto disease (KFD) or necrotizing histiocytic lymphadenitis, was described separately by both Kikuchi and Fujimoto in Japan in the early 1970’s. Despite its rarity in the pediatric population, it is an important differential in persistent lymphadenopathy. Familial cases of KFD in the literature are rare. Here we describe the first reported case of KFD in non-identical twin sisters.

Case presentation
Twin 1 presented with a 3-week history of worsening right-sided cervical lymphadenopathy, daily fevers, significant lethargy, weight loss and arthralgia of her knees and ankles at the age of 12 years in 2015. She had had an unremarkable medical history. A biopsy of her lymph nodes showed histiocytic necrosis consistent with KFD. Twin 2 presented with a three-week history of lethargy, fatigue, weight loss and left-sided posterior cervical chain lymphadenopathy at 16 years of age in 2018. She had a history of frequently relapsing nephrotic syndrome and celiac disease. A biopsy of her lymph nodes was undertaken and showed histiocytic necrosis consistent with KFD.

Conclusions
KFD is a rare but self-limiting pathological process of necrotizing histiocytic lymphadenitis. Although further research is needed, there is an increasing amount of evidence which suggests a multifactorial pathological basis of disease. The two cases we document here are the first reported cases of familial KFD in dizygotic HLA-identical twins which reinforces the likely HLA-linkage in the etiology of KFD.
Prognostic role of neutrophil-to-lymphocyte ratio in aortic disease: a meta-analysis of observational studies
Authors: Xu Yan , Fang Haiyang , Qiu Zhiqiang , Cheng Xiaoshu 
Published: August 2020

Abstract
Objective
Recent studies have reported that neutrophil-to-lymphocyte ratio (NLR) is associated with cardiovascular disease. The aim of the present study was to investigate the prognostic value of NLR in aortic disease.

Methods
We systematically searched electronic databases (Cochrane, PubMed, Elsevier, Medline, and Embase) from their inception to March 2020. Observational studies that evaluated the relationship between NLR and aortic disease were eligible for critical appraisal. Data were extracted from applicable articles, risk ratio (RR), weighted mean differences (MD) and 95% confidence intervals (CI) were calculated by RevMan 5.3, and statistical heterogeneity was assessed by the I2 statistic.

Results
Fourteen studies enrolling 4066 individuals were included in the meta-analysis. Compared with the control group, NLR was significantly higher in the aortic disease group (MD 3.44, 95%CI: 0.81–6.07, P = 0.01, I2 = 99%). The NLR was also significantly higher in non-survivors with aortic disease, compared to the survivors (MD 4.62, 95%CI: 2.75–6.50, P < 0.00001, I2 = 60%). Compared with the aortic disease patients with a low NLR, mortality was significantly higher in those with a high NLR (RR 2.63, 95%CI: 1.79–3.86, P < 0.00001, I2 = 67%).

Conclusion
Based on current evidence, an elevated NLR was associated with aortic disease and in-hospital mortality. Raised NLR also demonstrated a significantly increased the risk of mortality after surgical repair in aortic disease patients. NLR may be a good prognostic biomarker in aortic disease and deserve further research in this area.