bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diabetes, Glycated Hemoglobin, and Risk of Cancer in the UK Biobank Study
Authors: Peila Rita , Rohan Thomas E. 
Published: March 2020

Abstract

Background:
Evidence suggest that diabetes and glycated hemoglobin (HbA1c) levels are associated with cancer risk. However, previous studies have been limited variably by failure to adjust for cancer-specific risk factors (e.g., body mass index), inattention to diabetes duration and use of antidiabetic medications, and failure to stratify by obesity.

Methods:
We examined the association between diabetes, HbA1c, and cancer risk in the UK Biobank, using data from 476,517 participants (54% women), followed for an average period of 7.1 years. Diabetes was defined on the basis of baseline self-reported diagnosis of diabetes and/or use of diabetes medication, while HbA1c measured at baseline was categorized as low (&lt;31 mmol/mol), normal (31–&lt;39 mmol/mol), increased risk (39–&lt;48 mmol/mol), and high risk for diabetes (≥48 mmol/mol). Multivariable Cox proportional hazards models were used to estimate the association of diabetes and cancer at different anatomical sites, with adjustment for cancer-specific risk factors.

Results:
Diabetes was associated with increased risk of cancers of the stomach, liver, bladder, endometrium, and lung among smokers, and with decreased risk of prostate cancer. Compared with the normal HbA1c category, the increased risk category was positively associated with risk of cancers of the colon, liver, bladder, and lung among smokers, and the high-risk category was associated with increased risk of cancers of the esophagus, liver, pancreas, and bladder, and with decreased risk of prostate cancer.

Conclusions:
These results suggest that both diabetes and/or elevated HbA1c are associated with risk of cancer at several anatomic sites.

Impact:
The associations of diabetes and HbA1c levels with cancer suggest their importance in cancer prevention.
DIY (Do-It-Yourself) Electronics, Coin-Operated Relic Boxes and Techno-Animist Shrines
Authors: Snake-Beings Emit 
Published: March 2020

Abstract
The author uses creative practice and DIY electronics as the vehicle for a practice-led inquiry into the similarities between techno-animism and material agency. Combining technology with aspects of magic and religion, techno-animism is an emerging concept in postmodern anthropology used to discuss the sentient agency of objects and materials within the context of modern technological societies. This combination of seemingly disparate fields of knowledge is the basis of a postdisciplinary research into creative practices, attitudes and ethos using a series of artifacts that visualize the ideas of techno-animism, made by the author over a period of 30 years.
The Impact of Elevation Sidelobe Contamination on Radar Data Quality for Operational Interpretation
Authors: Nai Feng , Boettcher Jami , Curtis Christopher , Schvartzman David , Torres Sebastián 
Published: March 2020

AbstractTo fulfill the evolving observational needs of the National Weather Service (NWS), future weather radar systems will have to meet demanding requirements. Designing such systems will likely involve trade-offs between system cost and operational performance. A potential cost driver for future weather radars that could cause significant data-quality impacts on forecasters is the required angular resolution and sidelobe performance, which are mainly dictated by the antenna radiation pattern. Typical antenna radiation patterns can be characterized by the width of the main lobe and their sidelobe levels, which are traditionally measured across the azimuthal and elevation dimensions. In this work, we study the impact of increasing sidelobe levels on NWS forecasters’ data interpretation during warning operations. The resulting impact model can be used by decision-makers to better understand the cost–benefit trade-offs inherent in any radar system design.
A 33-yr Mei-Yu-Season Climatology of Shear Lines over the Yangtze–Huai River Basin in Eastern China
Authors: Yao Xiuping , Ma Jiali , Zhang Da-Lin , Yan Lizhu 
Published: March 2020

AbstractA 33-yr climatology of shear lines occurring over the Yangtze–Huai River basin (YHSLs) of eastern China during the mei-yu season (i.e., June and July) of 1981–2013 is examined using the daily ERA-Interim reanalysis data and daily rain gauge observations. Results show that (i) nearly 75% of the heavy-rainfall days (i.e., >50 mm day−1) are accompanied by YHSLs, (ii) about 66% of YHSLs can produce heavy rainfall over the Yangtze–Huai River basin, and (iii) YHSL-related heavy rainfall occurs frequently in the south-central basin. The statistical properties of YHSLs are investigated by classifying them into warm, cold, quasi-stationary, and vortex types based on their distinct flow and thermal patterns as well as orientations and movements. Although the warm-type rainfall intensity is the weakest among the four, it has the highest number of heavy-rainfall days, making it the largest contributor (33%) to the total mei-yu rainfall amounts associated with YHSLs. By comparison, the quasi-stationary type has the smallest number of heavy-rainfall days, contributing about 19% to the total rainfall, whereas the vortex type is the more frequent extreme-rain producer (i.e., >100 mm day−1). The four types of YHSLs are closely related to various synoptic-scale low-to-midtropospheric disturbances—such as the southwest vortex, low-level jets, and midlatitude traveling perturbations that interact with mei-yu fronts over the basin and a subtropical high to the south—that provide favorable lifting and the needed moisture supply for heavy-rainfall production. The results have important implications for the operational rainfall forecasts associated with YHSLs through analog pattern recognition.
Consumer Acceptance and Willingness to Pay for Instant Cereal Products With Food-to-Food Fortification in Eldoret, Kenya
Authors: De Groote Hugo , Mugalavai Violet , Ferruzzi Mario , Onkware Augustino , Ayua Emmanuel , Duodu Kwaku G. , Ndegwa Michael , Hamaker Bruce R. 
Published: March 2020

Background: Maize is the major food staple in East and Southern Africa, where food-processing industries are emerging fast. New low-cost extrusion cookers allow small enterprises to enter the market for processed cereals, including instant, fortified, and flavored products. Objective: Assess consumers’ interest and preferences for the new products. Methods: Consumers (n = 220) in Eldoret, Kenya, were invited to evaluate 4 new cereal products: (1) sifted maize flour mixed with sorghum, (2) instant sifted mixed flour, (3) instant whole flour, and (4) instant whole flour fortified with natural ingredients and to compare them to conventional sifted maize flour, using 2 preparations: stiff porridge ( ugali) and soft porridge ( uji). These were followed by economic experiments to estimate consumers’ willingness to pay (WTP) for the new products and traits. Results: For ugali, consumers preferred conventional sifted maize flour, while for uji, they appreciated the new products, especially sifted mixed flour (with sorghum) and instant whole mixed flour. Fortification with food-to-food sources was not appreciated, especially for ugali. Comparing WTP for the traits with their production cost showed that mixed, whole, and instant flours were economical, but not fortification. Maize/sorghum mixtures realized a benefit of 24% over conventional maize flour, whole meal 11%, and instant mixtures 5%. Conclusions: There is a potential market for improved cereal products in Kenya, but more for uji than for ugali, especially with instant, mixed, and whole flour. Acceptable and affordable products, fortified with other foods that are locally available, however, still need to be developed, especially for ugali.
State-Mandated Coverage of Cleft Lip and Cleft Palate Treatment
Authors: Wanchek Tanya , Wehby George 
Published: March 2020

Objective: We conducted a comprehensive review of state laws and regulations that require private health insurance plans to cover the services needed by children born with cleft lip and/or cleft palate (CL/P). The goal is to better understand how states are reducing the barriers children with CL/P face when seeking recommended health care services. Design: We identified all state laws and regulations mandating insurance coverage of services for children with CL/P by private insurance carriers from 1999 through 2017 using Westlaw legal database. We categorized laws and regulations into ten services: facial surgery (facial, corrective, reconstructive), oral surgery, orthodontics, dental care, habilitation/rehabilitation/speech therapy, prosthetic treatment, audiology, nutrition counseling, genetic testing, and psychological counseling. We also captured broad mandates indicating coverage for all necessary treatments. Results: There was a trend toward increased coverage of services for CL/P over time. In 1999, 27 states and Washington, DC did not have relevant laws or regulations. By 2017, there were 19 states without laws or regulations mandating services. The most common mandated service was facial surgery followed by habilitation/rehabilitation/speech therapy, orthodontics, dental care, and oral surgery. Nutrition, audiology, genetic testing and psychological counseling were rarely included in mandated services. Conclusions: States vary widely in their requirements for coverage of services needed by children with CL/P in private health insurance plans. There has been an increase in mandates over the past two decades to cover services, although significant variation continues to exist across states.
High Prevalence of Degenerative Changes at the Metatarsal Head Sesamoid Articulation Found During Hallux Valgus Correction Surgery
Authors: Tsai Justin , Daniel Joseph N. , McDonald Elizabeth L. , Pedowitz David I. , Rogero Ryan G. , Shakked Rachel J. , Nicholson Kristen J. , Raikin Steven M. 
Published: March 2020

Background. Despite the absence of complications and a restoration of normal hallux alignment, some patients have suboptimal outcomes from hallux valgus correction surgery. One risk factor for persistent pain may be the presence of arthritic changes at the metatarsal head articulation with the sesamoids, an area not easily assessed with standard radiographs unless dedicated sesamoid views are obtained. In this study, we prospectively evaluated the metatarsal head for degenerative changes during hallux valgus correction surgery and identified preoperative risk factors associated with these changes. Methods. We prospectively evaluated 200 feet in 196 patients who underwent hallux valgus surgery intraoperatively for the pattern and severity of arthritic changes at the metatarsal head. Mann-Whitney U testing was implemented to compare differences in arthritic scores between preoperative deformity groups. The Spearman correlation test was used to determine the association between age and preoperative deformity with the severity of degenerative changes. Results. More than half of all feet assessed had severe arthritic changes at the plantar medial aspect of the metatarsal head and 40% of feet at the plantar lateral aspect. Age and intermetatarsal angle were found to be positively correlated with arthritis in this area. Conclusion. Our prospective study has demonstrated the high prevalence of arthritic changes at the metatarsal head sesamoid articulation and the positive influence of age and severity of deformity on metatarsal head arthritic changes seen during hallux valgus correction surgery. Furthermore, these arthritic changes were found to have no significant influence on preoperative functional and pain levels. Levels of Evidence: Level IV: Case series
Validation of the “Wisconsin Criteria” for Obtaining Dedicated Facial Imaging and Its Financial Impact at a Level 1 Trauma Center
Authors: Stewart Christopher N. , Wood Lily , Barta Ruth Jo 
Published: March 2020

Introduction:According to national trauma databases, 25% of all people injured have some type of facial injury. The gold standard for diagnosing bony trauma of the facial skeleton has been computed tomography (CT) scan. In 2011, the “Wisconsin criteria” were established and subsequently validated as a method to predict which patients truly have a facial fracture and warrant further imaging. The purpose of this study is to externally validate these criteria and determine the economic impact they might have on avoiding unnecessary CT scans.Methods:This was a retrospective chart review. We collected 1000 patients who had undergone facial CT related to trauma and retrospectively applied the “Wisconsin criteria” based on physical exam documentation.Results:Of the 1000 facial CT scans obtained, we identified 408 fractures, 12% of which required operative intervention. The “Wisconsin criteria” applied to our patient population had a sensitivity of 90% and a negative predictive value of 93%. Using these criteria resulted in a missed fracture rate of 2.8%. Finally, had these criteria been used to determine when a facial CT scan was indicated, our institution could be saving over US$300 000 annually.Conclusion:The “Wisconsin criteria” are a reliable method to screen for facial fracture in trauma patients. Using a validated instrument tool to guide decision-making, we can avoid obtaining low-value imaging studies. This can have a large economic impact while maintaining safety and reliability in accurate diagnosis.
Comorbidity of HIV, hypertension, and diabetes and associated factors among people receiving antiretroviral therapy in Bahir Dar city, Ethiopia
Authors: Getahun Zenebework , Azage Muluken , Abuhay Taye , Abebe Fantu 
Published: March 2020

Background:People living with human immunodeficiency virus (HIV) are facing an increased burden of noncommunicable diseases (NCDs) comorbidity. There is, however, paucity of information on the magnitude of HIV-NCDs comorbidity, its associated factors, and how the health system is responding to the double burden in Ethiopia.Objective:To determine the magnitude of comorbidity between HIV and hypertension or diabetes and associated factors among HIV-positive adults receiving antiretroviral therapy (ART) in Bahir Dar city, Ethiopia.Methods:A facility-based cross-sectional study was conducted among 560 randomly selected HIV-positive adults taking ART. Data were collected using a structured questionnaire and analyzed using SPSS version 23. Descriptive statistics were used to describe the data. A logistic regression model was fit to identify associated factors with comorbidity of HIV and NCDs.Results:The magnitude of comorbidity was 19.6% (95% confidence interval (CI): 16.0–23.0). Being older (55 and above years) adjusted odds ratio (AOR: 8.5; 95% CI: 3.2–15.1), taking second-line ART regimen containing tenofovir (AOR: 2.7; 95% CI: 1.3–5.6), and increased body mass index (BMI) ≥25 (AOR: 2.7; 95% CI: 1.2–6.5) were the factors associated with comorbidity. Participants reported that they were not managed in an integrated and coordinated manner.Conclusions:The magnitude of comorbidity among adults was high in the study area. Being older, second-line ART regimen and high BMI ≥25 increased the odds of having NCDs among HIV-positive adults. Targeted screening for the incidences of NCDs, addressing modifiable risk factors, and providing integrated care would help to improve the quality of life comorbid patients.
Automatic quantification of left ventricular function by medical students using ultrasound
Authors: Grue Jahn Frederik , Storve Sigurd , Dalen Håvard , Mjølstad Ole Christian , Samstad Stein O. , Eriksen-Volnes Torfinn , Torp Hans , Haugen Bjørn Olav 
Published: March 2020

Abstract
Background
Automatic analyses of echocardiograms may support inexperienced users in quantifying left ventricular (LV) function. We have developed an algorithm for fully automatic measurements of mitral annular plane systolic excursion (MAPSE) and mitral annular systolic (S′) and early diastolic (e′) peak velocities. We aimed to study the influence of user experience of automatic measurements of these indices in echocardiographic recordings acquired by medical students and clinicians.

Methods
We included 75 consecutive patients referred for echocardiography at a university hospital. The patients underwent echocardiography by clinicians (cardiologists, cardiology residents and sonographers), who obtained manual reference measurements of MAPSE by M-mode and of S′ and e′ by colour tissue Doppler imaging (cTDI). Immediately after, each patient was examined by 1 of 39 medical students who were instructed in image acquisition on the day of participation. Each student acquired cTDI recordings from 1 to 4 patients. All cTDI recordings by students and clinicians were analysed for MAPSE, S′ and e′ using a fully automatic algorithm. The automatic measurements were compared to the manual reference measurements.

Results
Correct tracking of the mitral annulus was feasible in 50 (67%) and 63 (84%) of the students’ and clinicians’ recordings, respectively (p = 0.007). Image quality was highest in the clinicians’ recordings. Mean difference ± standard deviation of the automatic measurements of the students’ recordings compared to the manual reference was − 0.0 ± 2.0 mm for MAPSE, 0.3 ± 1.1 cm/s for S′ and 0.6 ± 1.4 cm/s for e′. The corresponding intraclass correlation coefficients for MAPSE, S′ and e′ were 0.85 (good), 0.89 (good) and 0.92 (excellent), respectively. Automatic measurements from the students’ and clinicians’ recordings were in similar agreement with the reference when mitral annular tracking was correct.

Conclusions
In case of correct tracking of the mitral annulus, the agreement with reference for the automatic measurements was overall good. Low image quality reduced feasibility. Adequate image acquisition is essential for automatic analyses of LV function indices, and thus, appropriate education of the operators is mandatory. Automatic measurements may help inexperienced users of ultrasound, but do not remove the need for dedicated education and training.
Uptake of intermittent preventive treatment for malaria during pregnancy with Sulphadoxine-Pyrimethamine in Malawi after adoption of updated World Health Organization policy: an analysis of demographic and health survey 2015–2016
Authors: Azizi Steven Chifundo 
Published: March 2020

Abstract
Background
Malawi adopted the 2012 updated Word Health Organization (WHO) Intermittent preventive treatment of malaria during pregnancy with sulphadoxine-pyrimethamine (IPTp-SP) policy in 2013. This study aimed to estimate the proportion of and identify factors associated with the uptake of at least three doses of IPTp with SP among pregnant women in Malawi after the adoption and operationalisation of updated WHO IPTp-SP policy.

Methods
The 2015–16 Malawi Demographic and Health Survey dataset was analysed. Of 1219 women aged 15–49 years who had live births and the children were born after the date of July 2015, 1069 women were included in the analysis. Bivariate and multiple logistic regression were used in data analysis. The statistical analysis took into account a complex survey sample design.

Results
Of the 1069 women, 447 (42, 95% CI: 38.1–45.6) received three (optimal) or more doses of IPTp-SP. Less than half (47%) managed to attend at least four antenatal care (ANC) clinics. Only 52% received optimal SP doses among those who made at least four ANC visits. Only the number of ANC visits was associated with the optimal uptake of SP. Women who attended ANC three times only and those who visited ANC once or twice only were less likely to receive at least three doses of SP than those who managed to attend ANC at least four times during pregnancy (AOR = 0.71, 95% CI 0.49–1.02) and (AOR = 0.12, 95% CI 0.06–0.21) respectively.

Conclusions
To achieve effective malaria prevention in pregnancy, IPTP-SP is used alongside other interventions. However, there is low uptake of optimal SP doses in Malawi, and this seems to be associated with the number of ANC visits. Moreover, there is limited effectiveness of an increased number of ANC visits on the uptake of optimal SP doses. Further research should be done to explore health systems factors affecting uptake of optimal IPTp with SP doses during pregnancy.
Graded response model fit, measurement invariance and (comparative) precision of the Dutch-Flemish PROMIS® Upper Extremity V2.0 item bank in patients with upper extremity disorders
Authors: Lameijer C. M. , van Bruggen S. G. J. , Haan E. J. A. , Van Deurzen D. F. P. , Van der Elst K. , Stouten V. , Kaat A. J. , Roorda L. D. , Terwee C. B. 
Published: March 2020

AbstractBackgroundThe Dutch-Flemish PROMIS® Upper Extremity (DF-PROMIS-UE) V2.0 item bank was recently developed using Item Response Theory (IRT). Unknown for this bank are: (1) if it is legitimate to calculate IRT-based scores for short forms and Computerized Adaptive Tests (CATs), which requires that the items meet the assumptions of and fit the IRT-model (Graded Response Model [GRM]);(2) if it is legitimate to compare (sub) groups of patients using this measure, which requires measurement invariance; and (3) the precision of the estimated patients’ scores for patients with different levels of functioning and compared to legacy measures. Aims were to evaluate (1) the assumptions of and fit to the GRM, (2) measurement invariance and (3) (comparative) precision of the DF-PROMIS-UE v2.0.MethodsCross-sectional data were collected in Dutch patients with upper extremity disorders. Assessed were IRT-assumptions (unidimensionality [bi-factor analysis], local independence [residual correlations], monotonicity [coefficient H]), GRM item fit, measurement invariance (absence of Differential Item Functioning [DIF] due to age, gender, center, duration, and location of complaints) and precision (standard error of IRT-based scores across levels of functioning). To study measurement invariance for language [Dutch vs. English], additional US data were used. Legacy instruments were the Disability of the Arm, Shoulder and Hand (DASH), the QuickDASH and the Michigan Hand Questionnaire (MHQ).ResultsIn total 521 Dutch (mean age ± SD = 51 ± 17 years, 49% female) and 246 US patients (mean age ± SD = 48 ± 14 years, 69% female) participated. The DF-PROMIS-UE v2.0 item bank was sufficiently unidimensional (Omega-H = 0.80, Explained Common Variance = 0.68), had negligible local dependence (four out of 1035 correlations > 0.20), good monotonicity (H = 0.63), good GRM fit (no misfitting items) and demonstrated sufficient measurement invariance. Precise estimates (Standard Error < 3.2) were obtained for most patients (7-item short form, 88.5%; standard CAT, 91.3%; and, fixed 7-item CAT, 87.6%).The DASH displayed better reliability than the DF-PROMIS-UE short form and standard CAT, the QuickDASH displayed comparable reliability. The MHQ-ADL displayed better reliability than the DF-PROMIS-UE short form and standard CAT for T-scores between 28 and 50. For patients with low function, the DF-PROMIS-UE measures performed better.ConclusionsThe DF-PROMIS-UE v2.0 item bank showed sufficient psychometric properties in Dutch patients with UE disorders.