bluuebunny/crossref_metadata_2025_split huggingface dataset:
Interpreter proxy versus healthcare interpreter for administration of patient surveys following arthroplasty: a pilot study
Authors: Xue Daniel , Churches Timothy , Armstrong Elizabeth , Mittal Rajat , Naylor Justine M. , Harris Ian A. 
Published: October 2019

Abstract
Purpose: Clinical quality registries and other systems that conduct routine post-discharge surveillance of patient outcomes following surgery may have difficulty surveying patients who have limited proficiency in the language of the healthcare provider. Interpreter proxies (family and carers) are often used due to limited access to certified healthcare interpreters (due to cost or availability). The aim of this study was to assess the reliability of engaging interpreter proxies compared with certified healthcare interpreters for the administration of patient-reported health-related surveys for people with limited English proficiency (LEP).
Methods: People with LEP and due for a routine 6-month telephone follow-up post knee or hip arthroplasty were invited to participate. Participants were randomly allocated to having their first interview with an interpreter proxy or a certified healthcare interpreter followed by the second (crossover) interview within 2 weeks (range: 4 to 12 days) after the first interview using the alternative method. Agreement between the two methods was assessed using quadratic weighted Cohen's kappa, intraclass correlation and concordance correlation co-efficient where appropriate for EQ-5D health domains, total Oxford hip and knee scores, patient satisfaction, operation success, readmission, reoperation, and post-surgical complication responses. The mean of the differences between the same data items collected by each of the two methods was also calculated.
Results: 85 participants (96%) completed the study. There was substantial to excellent inter-rater agreement (kappa=0.69-0.87 and ICCs above 0.74) for all but one measure. The mean differences between family proxy and healthcare interpreter scores for each participant were small, ranging from 0.01 (score range of 1-5) to 0.72 (score range of 0-100).
Conclusion: These results suggest that using interpreter proxies is a reliable alternative to certified healthcare interpreters in conducting patient-reported health surveys, potentially making this process easier and cost effective for researchers and registries.
A Comparative Analysis of Diffusion-weighted Imaging and Ultrasound in Thyroid Nodules
Authors: Kong Weidan , Yue Xiuhui , Ren Jiliang , tao xiaofeng 
Published: October 2019

Abstract
Background: Diffusion-weighted imaging (DWI) and ultrasound are commonly used methods to examine thyroid nodules, but their comparative value is rarely studied. We evaluated the utility of DWI and ultrasound in differentiating benign and malignant thyroid nodules.
Methods: A total of 100 patients with 137 nodules who underwent both DWI and ultrasound before operation were enrolled. The T1 and T2 signal intensity ratio (SIR) of each thyroid nodule was calculated by measuring the mean signal intensity divided by that of paraspinal muscle. The apparent diffusion coefficient (ADC) value and the SIR of benign and malignant thyroid nodules were analyzed by two-sample independent t tests. The sensitivity, specificity, and accuracy of DWI and ultrasound were compared with chi-square tests.
Results: There was no significant difference in the SIR between benign and malignant thyroid nodules. The ADC value was significantly different. At the threshold value was 1.12 × 10 -3 mm 2 /s, the maximum area under the curve was 0.944. The sensitivity, specificity, and accuracy were 84.9%, 92.2%, and 87.6% respectively. The corresponding values of ultrasound diagnosis were 90.1%, 80.4%, and 86.9%.
Conclusions: Ultrasound has high sensitivity in differentiating benign and malignant thyroid nodules, and the ADC value has high specificity, but there is no statistical difference in sensitivity or specificity between the two modalities. DWI and ultrasound each have their own advantages in differentiating benign and malignant thyroid nodules.
Keywords
Thyroid nodules, Ultrasound, Diffusion-weighted imaging
Protocol for a phase III wait-listed cluster randomised controlled trial of an intervention for mental wellbeing through enhancing mental health literacy and improving work friendliness in Hong Kong
Authors: Lam Lawrence T. , Wong Prudence , Lam Mary K 
Published: October 2019

Abstract
Background Mental health has long been recognised as a major global health issue. Some work-related characteristics have been identified to be associated with common mental health problems, thus the workplace is an important venue for the prevention of mental health problems and promoting mental wellness. Burnout is one of the important aspects of workplace organisational stressor and, in recent years, the lack of Mental Health Literacy has also been identified as a fundamental issue. Studies have demonstrated that an improvement in Mental Health Literacy is an effective measure for enhancing mental wellbeing. It would be prudent to combine an organisation-directed component and the enhancement of mental health literacy in an intervention program. This trial is to examine the novel approach of an intervention aiming to provide an evidence-based prevention program. Methods This study utilised a wait-listed cluster randomised control trial design. Using the branch offices as the primary sampling units, employees from three large companies in different industries will be recruited. Upon enrolment and after the baseline assessment of the outcome measures, participants nested in the branch offices will be allocated to the intervention or wait-listed arms. The intervention program comprises of two main elements: an organisation-directed component and an individual-directed psychoeducation training. This intervention will be delivered by a senior social worker well-versed in workplace issues over a period of three months. The trail will determine if an integrated workplace mental health literacy and wellbeing program is effective in increasing the mental health literacy scores and reducing burnout and stress scores, as measured by standardised and validated scales. Discussion If the trial results are in line with the hypothesis that support the efficacy of the intervention program, it will provide an evidence-based approach for an effective Workplace Mental Wellbeing intervention program that could, not only enhance the understanding of mental health issues, but also reduce work-related burnout and stress as well as increase workers’ quality of life.
The effects of occupational pollutants on the reproductive health of female informal street traders in Warwick Junction, Durban, South Africa – a cross-sectional study
Authors: Hariparsad Sujatha , Naidoo Rajen 
Published: October 2019

Abstract
Background: Informal street traders are exposed on a daily basis to traffic emissions and biomass fuel smoke containing a variety of pollutants. These exposures are likely to place the female traders at increased risk for adverse reproductive outcomes. Aim The aim of this study was to compare the reproductive outcomes among street traders exposed to pollutants from their work-related activities and traders without such exposure. Methods: A cross-sectional study was conducted among 305 female traders selected from exposed and non-exposed areas within the Warwick Junction trading hub, located in Durban, South Africa. Validated reproductive questionnaires and clinical assessments were conducted on all participants. Adverse reproductive outcomes such as low birth weight, spontaneous abortions and infertility were assessed Results: The mean age of the traders was 43.6 years (SD:12.1), mostly single (63%) and worked in trading hub for an average of 14 years. There were 876 pregnancies reported in the total sample. Traders pregnant while working in in this location accounted for 120 pregnancies There was an increased risk of exposed traders having a low birth weight infant as compared to non-exposed traders (OR=3.7; CI: 1.8, 7.6). Exposed traders were also almost 3 times more likely to be infertile as compared to non-exposed traders (OR=2.6; CI: 1.6, 4.3). Conclusions: Working as a street trader may have a causal association with developing adverse reproductive outcomes in females. Recommendations to mitigate adverse exposures have been suggested which include short term safety interventions and better cooking practices and future long term policy interventions.
The effects of oral vitamin D supplementation on the prevention of peritoneal dialysis-related peritonitis: study protocol for a randomized controlled clinical trial
Authors: Zhang Yuhui , Xu Xiao , Pi Haichen , Yang Zhikai , Johnson David W , Dong Jie 
Published: October 2019

Abstract
Background: Vitamin D deficiency has been shown to be closely associated with peritoneal dialysis (PD)-related peritonitis. The aim of this study is to examine the feasibility of conducting a large, powered randomized controlled trial to determine the effects of vitamin D supplementation on the risk of PD-related peritonitis in patients who have already experienced an episode of peritonitis.
Methods: This prospective, open-label randomized controlled pilot trial with blinded end-points (PROBE) aims to determine the feasibility of oral vitamin D supplementation and to explore its effects on the risk of subsequent PD-related peritonitis among PD patients who have recovered from a recent episode of peritonitis. Eligible patients will be randomized 1:1 to either oral vitamin D supplementation (2000 IU per day; intervention group) or no vitamin D supplementation (control group) in addition to usual care according to International Society for Peritoneal Dialysis (ISPD) Guidelines. The sample size will be 30 for both groups. All participants will be followed for 12 months. The primary outcome is the assessment of feasibility (recruitment success, retention, adherence, safety) and fidelity (change in serum 25-hydroxy vitamin D level during follow-up) for a large, powered randomized controlled trial to determine the effects of vitamin D on the risk of PD-related peritonitis in the future. Secondary outcomes include time to peritonitis occurrence, recovery of peritonitis, peritonitis-related transition to hemodialysis, and peritonitis-related death (defined as death within 30 days of peritonitis onset).
Discussion: This is the first randomized controlled trail investigating the effects of vitamin D supplementation on the risk of subsequent PD-related peritonitis among patients on PD. The findings for this pilot study will determine the feasibility of conducting a full-scale randomized controlled trail, which may provide a new strategy for preventing PD-related peritonitis among PD patients.
Trial registration: Clinicaltrails.gov, NCT03264625, registered on 29 August 2017. https://www.clinicaltrials.gov/ct2/show/NCT03264625?term=NCT 03264625&rank=1, assessed on 1 July 2019.
Aromatase inhibitors and risk of cardiovascular events in breast cancer patients: A systematic review and meta-analysis
Authors: He Yang , Zhang Jianhua , Shen Guofang , Liu Lin , Zhao Qingwei , Lu Xiaoyang , Yang Hongyu , Hong Dongsheng 
Published: October 2019

Abstract
Background : Cardiovascular events (CVEs) was considered as one of the primary cause to reduce the quality of life in breast cancer patients with aromatase inhibitors (AIs) treatment, which has not been sufficiently addressed. The aim of this study was to assess the correlation between risk of CVEs and AIs in patients with breast cancer.
Methods: Included studies were obtained from the databases of Embase, Pubmed, Cochrane Library, Clinical Trials.gov, and reference lists. The main outcome measures were overall incidence, odds ratios (ORs), and 95% confidence intervals (CIs). Furthermore, the association and the risk differences among different tumor types, AIs ,ages,or treatment regimens were conducted. Fixed-effect or random-effect models were applied in the statistical analyses according to the heterogeneity. Our analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.
Results: Seventeen studies, which included 44411 subjects, were included in our analyses.The overall incidence of CVEs in AIs group was 13.02% (95% CI: 8.15%–20.17%) and almost all of the high-grade CVEs occurred in patients treated with AIs . The pooled ORs of CVEs was 0.9940 (95% CI: 0.8545 -1.1562 ). Under sub-gro up analysis, the incidence of CVEs related to exemestane was high er than that of controls (OR=1.1564, 95% CI: 1.0656-1.2549) , but no statistical differences in risk of CVEs were found in other sub-group analysis. No evidence of publication bias was found for incidence of CVEs in our meta-analysis by a funnel plot.
Conclusions: These results suggest that p atients with breast cancer treated with AIs do not have a significant risk of developing CVEs in comparison with the controls, and exemestane might not be considered as the alternative AI to the breast cancer patients from the perspective of CVEs . Further studies are recommended to investigate this association and the risk differences among different tumor types, AIs or treatment regimens.
Change in treatment coverage and barriers to mental health care among adults with depression and alcohol use disorder: a repeat cross sectional community survey in Nepal
Authors: Luitel Nagendra Prasad , Garman Emily C , Jord Mark JD , Lund Crick 
Published: October 2019

Abstract
Background: Despite the availability of evidence-based treatment, there is a substantial gap between the number of individuals in need of mental health care and those who receive treatment. The aim of this study was to assess changes in treatment coverage and barriers to mental health care among adults with depression and alcohol use disorder (AUD) before and after implementation of a district mental health care plan (MHCP) in Nepal. Methods: The repeat population-based cross-sectional community survey was conducted with randomly selected adults in the baseline (N=1983) and the follow-up (N=1499) surveys, 3 years and 6 months apart. The Patient Health Questionnaire and Alcohol Use Disorder Identification Test were used to screen people with probable depression and AUD. Barriers to seeking mental health care were assessed by using a standardized tool, the Barriers to Care Evaluation Scale (BACE). Results: The proportion of the participants receiving treatment for depression increased by 3.7 points (from 8.1% in the baseline to 11.8% in the follow-up) and for AUD by 5.2 points (from 5.1% in the baseline to 10.3% in the follow-up study), however, these changes were not statistically significant. There was no significant reduction in the overall BACE score in both unadjusted and adjusted models for both depression and AUD. The possible reasons for non-significant changes in treatment coverage and barriers to care could be that (i) the method of repeat population level surveys with a random sample was too distal to the intervention to be able to register a change and (ii) the study was underpowered to detect such changes. Conclusion: The study found non-significant trends for improvements in treatment coverage and barriers to mental health care following implementation of the district mental health care plan. The key areas for improvement in the current strategy to improve treatment coverage and barriers to mental health care included change in the content of the existing community sensitization program, particularly for changing attitude and intention of people with mental illness for seeking care.
A Longitudinal Analysis of Mental and General Health Status of Informal Carers in Australia
Authors: Mohanty Itismita , Niyonsenga Theo 
Published: October 2019

Abstract
Background: The study investigated the self-assessed mental and general health status of informal carers in Australia. It evaluated the influence of carer’s health behaviours, namely: physical activity, smoking and drinking status; along with their social connectedness and workforce engagement on their health status.
Methods: The study used a retrospective longitudinal design using data from the Household Income and Labour Dynamics of Australia survey, waves 5-15 (2005-2015). It included individuals aged 15 years and older from Australian households surveyed over a period of 11 years. The sample consisted of 23,251 individuals. The outcome measures included: Mental health, general health and physical functioning, domains of the Short Form 36 Questionnaire, a widely used multi-dimensional measure of health-related quality of life. Using fixed effects regression and following individuals over time, the analysis took care of the issue of individuals self-selecting themselves as carers due to some predisposing factors such as age, poor health, socioeconomic status and sedentary behaviour.
Results: There were statistically significant carer-noncarer status differences in mental (Beta = -0.587, p=0.003) and general health (Beta = -0.670, p=0.001) outcomes. Aging had a modifying impact on carers’ mental and general health outcomes. Older carers coped better with their caregiving responsibilities than younger ones. Moreover, while physical activities had a positive influence on both mental and general health for non-carers, with more activities generating better health outcomes, it only had a modifying impact on carers’ mental health. Furthermore, the study found that moderate levels of social drinking had beneficial modifying impact on carers’ mental and general health.
Conclusion: This study added value to the literature on informal carers’ mental and general health in Australia by identifying some of the protective and risk factors. The study found the modifying effects of carers’ age, health behaviours such as physical activity, smoking and drinking status on their health. Finally, the study identified an apparent beneficial link between moderate levels of social drinking and carer health that needs to be further explored with more targeted future research.
Silicon application and related changes in soil bacterial community dynamics reduced ginseng black spot incidence in Panax ginseng in a short-term study
Authors: Li Meijia , Wang Qiuxia , Liu Zhengbo , Pan Xiaoxi , Zhang Yayu 
Published: October 2019

Abstract
Background This study analyzed the effect of silicon (Si) application on the occurrence of ginseng black spot caused by Alternaria panax . We explored the differences in soil physical and chemical factors and microbial community structure following Si application as well as the key factors that affected the occurrence of ginseng black spot in soil. Potted Panax ginseng plants were used to assess the effect of Si treatment on ginseng black spot. Soil physical and chemical properties were comprehensively analyzed. Bacterial communities were analyzed using Illumina HiSeq sequencing targeting the 16S rRNA gene.
Results After inoculation with A. panax , the morbidity (and morbidity index) of ginseng with and without Si was 52% (46) and 83% (77), respectively. Soil physical and chemical analysis showed that under the ginseng black spot inoculation, bacterial communities were mainly affected by pH and available potassium, followed by ammonium nitrogen and available Si. NMDS and PLS-DA analyses and the heat maps of relative abundance revealed that Si application elevated the resistance of ginseng black spot as regulated by the abundance and diversity of bacterial flora in rhizosphere soils. Heatmap analysis at the genus level revealed that A. panax + Si inoculations significantly increased the soil community abundance of Sandaracinus , Polycyclovorans , Hirschia , Haliangium , Nitrospira , Saccharothrix , Aeromicrobium , Luteimonas , and Rubellimicrobium and led to a bacterial community structure with relative abundances that were significantly similar to that of untreated soil.
Conclusions Short-term Si application also significantly regulated the structural impact on soil microorganisms caused by ginseng black spot. Our findings indicated that Si applications may possibly be used in the prevention and treatment of ginseng black spot.
Exosomal Bta-miR-185 and Bta-miR-378 Are Potential Markers for Quality Control of Milk Infected by Staphylococcus aureus
Authors: Ma Shaoyang , Tong Chao , Ibeagha-Awemu Eveline M. , Zhao Xin 
Published: October 2019

Abstract
MicroRNAs (miRNA) in milk-derived exosomes may reflect pathophysiological changes caused by mastitis. This study profiled miRNAs in milk exosomes and potential markers for quality control of milk infected by Staphylococcus aureus (S. aureus). Total RNA from milk exosomes was collected from healthy cows (n=3) and S. aureus infected cows (n=6). Two hundred ninety miRNAs (221 known and 69 novel ones) were identified. Among them, 22 known and 15 novel miRNAs were differentially expressed (DE). Target genes of DE miRNAs were significantly enriched in intracellular protein transport, endoplasmic reticulum and identical protein binding. Two miRNAs (bta-miR-378 and bta-miR-185) with high read counts and log2 fold changes (>3.5) were considered as potential milk exosome biomarker miRNAs for S. aureus mastitis and milk quality. One target gene (VAT1L) of bta-miR-378 and five target genes (DYRK1B, MLLT3, HP1BP3, NPR2 and PGM1) of bta-miR-185 were validated. DE miRNAs in exosomes from normal and S. aureus infected milk were identified. Two DE miRNAs could be used as potential biomarkers for the infection. The linkage between the validated target genes and diseases suggest that we should pay particular attention to exosome miRNAs from mastitic milk in terms of milk safety.
Mass screening for hepatitis B and C in the Southern Upper Egypt
Authors: Soliman Gamal , Elzalabany Mahmoud S. , Hassanein Tarek , Miller F. DeWolfe 
Published: October 2019

Abstract
Background : It is well documented that Egypt has the highest prevalence of hepatitis C virus (HCV) in the world. The recent development of fast acting, highly effective direct acting antiviral drugs (DAAs), has opened the possibility of treating and curing HCV infection in the Egyptian population on large scale.
Methods : A screening demonstration project was implemented in southern Egypt in and around the city of Luxor. Free screening and if indicated, treatment, was offered to those 16 years or older for anti-HCV antibody (anti-HCV) and hepatitis B virus surface antigen (HBsAg) using third generation enzyme immunoassays (Enzygnost® Anti-HCV and HbsAg). Statistical methods included estimation of odds ratios (OR) and 95% confidence intervals (95% CI).
Results: There was a large turnout of 67,042 persons who were screened in a 12-month period starting in June 2106. 31,965 males (47.7%) and 35,077 females (52.3%) were screened with a mean age of 43.6±14.3 years. 9,701 patients (14.5%) were positive for anti-HCV and 2,950 (4.4%) for HBsAg. Prevalence of anti-HCV was significantly higher in males than females (19.67% vs.9.73% OR=2.27; CI 2.2 to 2.4; p<0.001) and the same for HBsAg (6.2% vs. 2.8% OR=2.3; CI 2.2 to 2.5; p<0.001). The prevalence of anti-HCV was significantly associated with age (p<0.001), ranging from between 1-4% in individuals below the age of 40 years, then increased steadily to 42% at age 60 followed by a precipitous decline in age specific prevalence.
Conclusions: The results showed unanticipated patterns of anti-HCV and HBsAg by age and gender in contrast to previous reports on this unique HCV epidemic in Egypt. Moreover, the results provide essential information for effective planning, design, and evaluation for future Egyptian national mass screen and treatment programs.