bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term colorectal cancer incidence after adenoma removal and the effects of surveillance on incidence: a multicentre, retrospective, cohort study
Authors: Cross Amanda J , Robbins Emma C , Pack Kevin , Stenson Iain , Kirby Paula L , Patel Bhavita , Rutter Matthew D , Veitch Andrew M , Saunders Brian P , Duffy Stephen W , Wooldrage Kate 
Published: January 2020

ObjectivePostpolypectomy colonoscopy surveillance aims to prevent colorectal cancer (CRC). The 2002 UK surveillance guidelines define low-risk, intermediate-risk and high-risk groups, recommending different strategies for each. Evidence supporting the guidelines is limited. We examined CRC incidence and effects of surveillance on incidence among each risk group.DesignRetrospective study of 33 011 patients who underwent colonoscopy with adenoma removal at 17 UK hospitals, mostly (87%) from 2000 to 2010. Patients were followed up through 2016. Cox regression with time-varying covariates was used to estimate effects of surveillance on CRC incidence adjusted for patient, procedural and polyp characteristics. Standardised incidence ratios (SIRs) compared incidence with that in the general population.ResultsAfter exclusions, 28 972 patients were available for analysis; 14 401 (50%) were classed as low-risk, 11 852 (41%) as intermediate-risk and 2719 (9%) as high-risk. Median follow-up was 9.3 years. In the low-risk, intermediate-risk and high-risk groups, CRC incidence per 100 000 person-years was 140 (95% CI 122 to 162), 221 (195 to 251) and 366 (295 to 453), respectively. CRC incidence was 40%–50% lower with a single surveillance visit than with none: hazard ratios (HRs) were 0.56 (95% CI 0.39 to 0.80), 0.59 (0.43 to 0.81) and 0.49 (0.29 to 0.82) in the low-risk, intermediate-risk and high-risk groups, respectively. Compared with the general population, CRC incidence without surveillance was similar among low-risk (SIR 0.86, 95% CI 0.73 to 1.02) and intermediate-risk (1.16, 0.97 to 1.37) patients, but higher among high-risk patients (1.91, 1.39 to 2.56).ConclusionPostpolypectomy surveillance reduces CRC risk. However, even without surveillance, CRC risk in some low-risk and intermediate-risk patients is no higher than in the general population. These patients could be managed by screening rather than surveillance.
Medication Errors and Blood Pressure Control Among Patients Managed for Hypertension in Public Ambulatory Care Clinics in Botswana
Authors: Gala Pooja , Moshokgo Veronica , Seth Bhavna , Ramasuana Kegomoditswe , Kazadi Emmanuel , M'buse Rudy , Pharithi Solomon , Gobotsamang Kabelo , Szymanowski Paige , Kerobale Ruth Olyn , Balekile Kelennetse , Tshimbalanga Jacques , Tieng'o Jane , Tapela Neo , Barak Tomer 
Published: January 2020

Background
The prevalence of hypertension in low‐ and middle‐income countries is rapidly increasing, with most cases undiagnosed and many poorly controlled among those diagnosed. Medication reconciliation studies from high‐income countries have demonstrated a high occurrence of antihypertensive medication errors and a strong association between medication errors and inadequate blood pressure control, but data from low‐ and middle‐income countries are lacking.

Methods and Results

We conducted a cross‐sectional study from April to October 2018 of adult patients on pharmacologic management for known hypertension at 7 public health facilities in Kweneng East District, Botswana. Our aims included to evaluate the frequency of uncontrolled hypertension, the frequency and type of medication errors causing discrepancies between patient‐reported and prescribed antihypertensive medications, and the association between medication errors and uncontrolled hypertension. Descriptive analyses and multivariable logistic regression were used. The prevalence of uncontrolled hypertension was 55% among 280 enrolled adult patients, and 95 (34%) had ≥1 medication error. The most common errors included patients taking medications incorrectly (11.1%; 31/280), patients omitting medications (7.9%; 22/280), and unfilled prescriptions caused by pharmacy stock outs (7.5%%; 21/280). Uncontrolled hypertension was significantly associated with having ≥1 medication error compared with no errors (adjusted odds ratio, 3.26; 95% CI, 1.75–6.06;
P
<0.001).

Conclusions
Medication errors are strongly associated with poor blood pressure control in this setting. Further research is warranted to assess whether medication reconciliation and other low‐cost interventions addressing root causes of medication errors can improve the control of hypertension and other chronic conditions in low‐ and middle‐income countries.
Regulating water reuse for agricultural irrigation: risks related to organic micro-contaminants
Authors: Helmecke Manuela , Fries Elke , Schulte Christoph 
Published: January 2020

AbstractIn recent years, more and more countries see irrigation using reclaimed water as an opportunity to secure and enhance agricultural production. Despite the benefits of water reuse, the scientific community raised several concerns and challenges for human health and the environment. This includes chemical risks. Effluents from urban wastewater treatment plants usually contain a wide range of organic chemicals. Such chemicals remaining in the water after the treatment process may cause hazards for human health, contaminate surrounding soil and water resources, and even compromise drinking water sources. Once crops on irrigated sites are exposed to chemicals, the potential transport to and accumulation in the edible parts of fruits and vegetables need to be controlled to rule out their introduction into the food chain. Finally, problems concerning the release of wastewater-borne antibiotics into the environment are starting to gain attention. For these reasons, agricultural irrigation should face more stringent quality requirements in order to minimize chemical risks. Combinations of measures reducing chemicals at the source, technical and natural water treatment processes especially to remove chemicals with persistent, bioaccumulative and toxic (PBT), or persistent, mobile and toxic (PMT) properties, good agricultural practices, and supplementary preventive measures (e.g. knowledge transfer to the stakeholders involved) will be necessary to bring about and ensure safe irrigation in the future. While internationally many regulations and guidelines for water reuse have successfully been implemented, questions remain whether the current knowledge regarding chemical risks is sufficiently considered in the regulatory context. The introduction of a new regulation for water reuse, as attempted in the European Union, poses a good opportunity to better take chemicals risks into account.
Persistent, mobile and toxic substances in the environment: a spotlight on current research and regulatory activities
Authors: Rüdel Heinz , Körner Wolfgang , Letzel Thomas , Neumann Michael , Nödler Karsten , Reemtsma Thorsten 
Published: January 2020

AbstractCertain persistent and polar substances may pose a hazard to drinking water resources. To foster the knowledge exchange in this field the Working Group Environmental Monitoring of the German Chemical Society (GDCh) Division Environmental Chemistry and Ecotoxicology discussed at their meeting in December 2018 the significance and relevance of persistent, mobile and toxic chemicals (PMT substances) in the environment. Five oral contributions highlighted not only various aspects such as the identification of potential PMT substances based on certain properties and their possible regulation under the European REACH regulation, but also current developments in the analysis of PMT substances and results from environmental monitoring. The data presented prove that many persistent and mobile substances can be detected in surface waters. Once detected, it can be complex and costly to identify sources and reduce inputs, as a case study on 1,4-dioxane in Bavarian surface waters shows. The same applies to the removal of polar substances from raw water for drinking water production. Today, scientific advances in analytical methods make it easier to identify and quantify even very polar substances in water samples. In addition to the targeted analysis of critical chemicals, non-target screening is playing an increasingly important role. This opens up the possibility of detecting substances in water samples that have not previously been investigated in routine monitoring and testing their relevance for humans and the environment. However, the list of potentially occurring PM substances that have not yet been investigated is still very long. Further methodological improvements seem necessary here. In view of the evidence for the presence of PMT substances in the environment (e.g., trifluoroacetic acid and 1,4-dioxane) and the potential risks for drinking water abstraction, it seems important under consideration of the precautionary principle to identify and prioritise relevant REACH-registered substances. The assessment should be based on the intrinsic properties and the emission potential of the compounds. The implementation of a detailed proposal made at European level to regulate PMT and very persistent and very mobile (vPvM) substances in the context of REACH would ensure that chemicals identified as being substances of very high concern according to the PMT and vPvM criteria are subject to authorisation in future.
Study protocol for an evaluation of ASDetect - a Mobile application for the early detection of autism
Authors: Barbaro Josephine , Yaari Maya 
Published: January 2020

Abstract
Background
Autism Spectrum Conditions (ASC) can be reliably diagnosed by 24 months of age. However, despite the well-known benefits of early intervention, there is still a research-practice gap in the timely identification of ASC, particularly in low-resourced settings. The Social Attention and Communication Surveillance (SACS) tool, which assesses behavioural markers of autism between 12 to 24 months of age, has been implemented in Maternal and Child Health (MCH) settings, with excellent psychometric properties. ASDetect is a free mobile application based on the SACS, which is designed to meet the need for an effective, evidence-based tool for parents, to learn about children’s early social-communication development and assess their child’s ‘likelihood’ for ASC.

Study aims
The primary aim of this study is to evaluate the psychometric properties of ASDetect in the early detection of children with ASC. A secondary aim is to assess ASDetect’s acceptability and parental user experience with the application.

Methods
Families are recruited to download the application and participate in the study via social media, health professionals (e.g., MCH nurses, paediatricians) and word of mouth. All participating caregivers complete a demographic questionnaire, survey regarding their user experience, and the Social Responsiveness Scale-2 (SRS-2), an autism screening questionnaire; they are also invited to participate in focus groups. Children identified at ‘high likelihood’ for ASC based on the ASDetect results, the SRS-2 or parental and/or professional concerns undergo a formal, gold-standard, diagnostic assessment. Receiver Operating Characteristic analyses will be used to assess psychometric properties of ASDetect. Thematic analyses will be used to explore themes arising in the focus groups to provide insights regarding user experiences with the app. Multiple regression analyses will be carried out to determine the extent to which demographic factors, parental stress and beliefs on health surveillance and child results on ASDetect are associated with the parental user-experience of the application.

Discussion
With a strong evidence-base and global access, ASDetect has the potential to empower parents by providing them with knowledge of their child’s social-communication development, validating and reassuring any parental concerns, and supporting them in communicating with other health professionals, ultimately enhancing child and family outcomes and well-being.
Relationship between characteristics of spinopelvic alignment and quality of life in Japanese patients with ankylosing spondylitis: a cross-sectional study
Authors:   Juntendo AS Research Group, Sato Tatsuya , Yonezawa Ikuho , Inoue Hisashi , Tada Kurisu , Kobayashi Shigeto , Hayashi Eri , Tamura Naoto , Kaneko Kazuo 
Published: January 2020

Abstract
Background
Studies on characteristic spinal deformities in Japanese patients with ankylosing spondylitis (AS) and data demonstrating a relationship between health-related quality of life (HRQOL) and spinopelvic alignment in these patients are lacking.

Methods
In this cross-sectional study, 50 patients with AS and without a surgical history, vertebral body fracture, or scoliosis as well as 30 control patients with degenerative lumbar kyphoscoliosis (DLKS) were included. Data collected included patient sex, age, spinopelvic parameters on sagittal full-spine standing radiographs, and HRQOL questionnaire responses. Student’s t-test was used to compare the characteristics of spinopelvic parameters between the groups. A multiple regression analysis was performed to analyze correlations between spinopelvic parameters and HRQOL in the AS group.

Results
Global kyphosis (GK; T1–12 angle) was significantly greater in the AS group than in the DLKS group (P < 0.001), whereas the pelvic tilt (PT; posterior PT angle) was smaller in the AS group (P = 0.006). Radiographic parameters correlated with HRQOL in the AS group. Multiple regression analysis identified the sagittal vertical axis (SVA) and sacral slope (SS) as factors influencing the SRS-22 total score and SVA and GK as factors influencing Japanese Orthopaedic Association Back Pain Evaluation Questionnaire mental health (subdomain).

Conclusions
Patients with AS did not use lumbar lordosis or posterior PT to compensate for their large thoracic kyphosis due to spinopelvic ankylosis. These patients showed a unique compensation pattern. The correlation/regression analysis revealed a correlation between radiographic parameters and HRQOL in patients with AS, with particular importance of SVA, SS, and GK for clinical results in AS.
Degeneration of three or more lumbar discs significantly decreases lumbar spine/hip ROM ratio during position change from standing to sitting in AVN patients before THA
Authors: Gu Jianming , Feng Huixiong , Feng Xiao , Zhou Yixin 
Published: January 2020

Abstract
Background
Limitations in the lumbar spine movement reduce lumbar vertebral motion and affect spinopelvic kinematics. We studied the influence of lumbar intervertebral disc degeneration on spinofemoral movement, from standing to sitting, in patients undergoing total hip arthroplasty (THA).

Methods
Of 138 consecutive patients scheduled for THA due to unilateral avascular necrosis (AVN) of the femoral head, those with ≥3 discs with University of California at Los Angeles (UCLA) disc degeneration score > 1 were defined as the lumbar degenerative disc disease (LDD) group, and the remaining patients constituted d the control group. Full body anteroposterior and lateral EOS images in the standing and sitting positions were obtained. Pelvic incidence (PI), L1 slope (L1 s), lumbar lordosis angle (LL), pelvic tilt (PT), sacral slope (SS), femoral slope (Fs), sagittal vertical axis (SVA), hip flexion, lumbar spine flexion, and total spinofemoral flexion were measured on the images and compared between groups.

Results
No significant between-group differences were observed in the height, weight, body mass index, AVN staging, or PI, SS, and Fs on standing. The LDD group included more females and older patients, had 5° lesser LL, 5° greater PT, and larger SVA. From standing to sitting, the PI remained constant in both groups. Total spinofemoral flexion was 7° less, lumbar spine flexion 16° less, L1 slope change 6° less, and SS change 8° less, and hip flexion was 7° more in the LDD than in the control group. The spine/hip flexion ratio was significantly lower in the LDD group (0.3 versus 0.7; p < 0.001). On regression analysis, the LDD group (p < 0.001) and older age (p = 0.048) but not sex, weight, or height were significant univariate predictors of decreased spine/hip ratio.

Conclusions
Patients with LDD leant more forward and had a larger pelvis posterior tilt angle on standing and a decreased lumbar spine/hip flexion ratio, with more hip joint flexion, on sitting, to compensate for reduced lumbar spine flexion. Surgeons should be aware that elderly patients with multiple LDD have significantly different spinofemoral movements and increased risk of posterior dislocation post-THA. Preoperative patient identification, intraoperative surgical technique modification, and individualized rehabilitation protocols are necessary.
Secondary purulent infections of the elbow joint: a retrospective, single-center study
Authors: Rausch Valentin , von Glinski Alexander , Rosteius Thomas , Königshausen Matthias , Schildhauer Thomas A. , Seybold Dominik , Gessmann Jan 
Published: January 2020

Abstract
Background
Septic arthritis of the elbow joint is a rare condition. Limited data is available on infections of the elbow joint following trauma or prior surgery on this joint. The aim of this study was to describe the etiology, comorbidities, bacterial spectrum and therapy of secondary purulent elbow infections.

Methods
Patients treated in our hospital were selected through retrospective chart review between 2006 and 2015. We included all patients with an empyema of the elbow after a trauma or surgical intervention on this joint. 30 patients between 26 and 82 years (mean: 52.47) were included.

Results
Seven patients (23.3%) were female, 23 (76.7%) male. 22 patients (73.3%) had a history of trauma, eight (26.7%) had prior elective surgeries on their elbow. Between one and 25 surgeries (mean: 5.77) were necessary for treatment. In nine patients, debridement and synovectomy were sufficient, eight patients (26.7%) received resection of the elbow joint. One patient was treated with a chronic fistula. In 18 patients (60%), cultures of aspiration/intraoperative swabs were positive for Staphylococcus aureus, four of these were methicillin-resistant. Four patients (13.3%) had positive cultures for Staphylococcus epidermidis, in five patients (16.7%) no bacteria could be cultured.

Conclusions
Secondary infections of the elbow joint are a rare disease with potentially severe courses, requiring aggressive surgical treatment and possibly severely impacting elbow function. Staphylococcus aureus was the most common bacteria in secondary infections and should be addressed by empiric antibiotic treatment when no suspicion for other participating organisms is present.
Higher preoperative pain catastrophizing increases the risk of low patient reported satisfaction after carpal tunnel release: a prospective study
Authors: Mosegaard Sebastian Breddam , Stilling Maiken , Hansen Torben Bæk 
Published: January 2020

AbstractBackgroundCarpal tunnel syndrome is a common upper-limb nerve compression disease. Carpal tunnel syndrome can lead to several symptoms such as tingling or numbness, pain in the hand or wrist, and reduced grip strength. Based on demographic characteristics, patient reported outcome measures, and with special attention to pain catastrophizing, the purpose of this study was to identify risk factors for low patient-reported satisfaction following surgical treatment of idiopathic carpal tunnel syndrome.MethodsA total of 417 hands from 417 patients (64. 5% females) with a mean age of 58. 0 years were included in this 1-year prospective follow-up study. We collected preoperative data on disability using the Disability of the Arm, Shoulder and Hand questionnaire (DASH), quality of life using the EuroQol-5D (EQ-5D), pain catastrophizing using the Pain Catastrophizing Scale (PCS) and distal motor latency. Data on DASH score, EQ-5D, and patient satisfaction was collected 12 months postoperatively. Wilcoxon matched-pairs signed-rank test was used to test for difference in preoperative and postoperative DASH and EQ-5D score. Risk factors for low postoperative patient reported satisfaction was examined using stepwise multiple logistic regression analysis.ResultsWe found a general improvement in patients’ DASH scores (12.29 [95% CI: 10.65–13.90],p < 0.001) and EQ-5D (0.14 [95% CI: 0.13–0.16],p < 0.001) from preoperative to 12 months postoperative. In the fully adjusted multiple regression analysis we found a statistically significant effect of preoperative PCS on patient reported satisfaction with OR = 1.05 (p = 0.022), for a one unit increase in preoperative PCS. There was no statistically significant predictive effect of preoperative EQ-5D (p = 0.869), DASH (p = 0.076), distal motor latency (p = 0.067), age (p = 0.505) or gender (p = 0.222).ConclusionsPatients improved in both DASH and EQ-5D from preoperative to 12 months postoperative. Higher preoperative PCS seems to have a negative effect on postoperative patient reported satisfaction after carpal tunnel release.
Risk of atrial fibrillation in persons with type 2 diabetes and the excess risk in relation to glycaemic control and renal function: a Swedish cohort study
Authors: Seyed Ahmadi Shilan , Svensson Ann-Marie , Pivodic Aldina , Rosengren Annika , Lind Marcus 
Published: January 2020

Abstract
Background
To examine the incidence of atrial fibrillation in individuals with type 2 diabetes compared with age- and sex-matched controls from the general population and its variation in relation to glycaemic control and renal function.

Methods
A total of 421,855 patients with type 2 diabetes from the Swedish National Diabetes Registry and 2,131,223 controls from the Swedish Population Registry, matched for age, sex and county, were included and followed from January 1, 2001 to December 31, 2013.

Results
Overall, 8.9% of individuals with type 2 diabetes and 7.0% of controls were diagnosed with atrial fibrillation during follow-up, unadjusted incidence risk ratio (IRR) 1.35 (95% 1.33–1.36). Women < 55 years old with type 2 diabetes had an IRR of 2.36 (95% CI 2.10–2.66), in relation to controls, whereas the corresponding value for men < 55 years old with type 2 diabetes was IRR 1.78 (95% CI 1.67–1.90). In the fully adjusted Cox regression, the risk of type 2 diabetes on incident atrial fibrillation was 28% greater vs controls, hazard ratio (HR) 1.28 (95% CI 1.26–1.30), p < 0.0001. The excess risk of atrial fibrillation in individuals with type 2 diabetes increased with worsening glycaemic control and renal complications. For individuals with HbA1c ≤ 6.9% (≤ 52 mmol/mol) and normoalbuminuria the excess risk vs controls was still increased, adjusted HR 1.16 (95% CI 1.14–1.19); p < 0.0001.

Conclusions
Individuals with type 2 diabetes had an overall 35% higher risk of atrial fibrillation compared to age- and sex-matched controls from the general population. The excess risk for atrial fibrillation increased with renal complications or with poor glycaemic control. Individuals with type 2 diabetes with good glycaemic control and normoalbuminuria had slightly increased risk.