bluuebunny/crossref_metadata_2025_split huggingface dataset:
Methods of competing risks flexible parametric modeling for estimation of the risk of the first disease among HIV infected men
Authors: Nouri Sahar , Mahmoudi Mahmood , Mohammad Kazem , Mansournia Mohammad Ali , Yaseri Mahdi , Akhtar-Danesh Noori 
Published: January 2020

Abstract
Background
Patients infected with the Human Immunodeficiency Virus (HIV) are susceptible to many diseases. In these patients, the occurrence of one disease alters the chance of contracting another. Under such circumstances, methods for competing risks are required. Recently, competing risks analyses in the scope of flexible parametric models have risen to address this requirement. These lesser-known analyses have considerable advantages over conventional methods.

Methods
Using data from Multi Centre AIDS Cohort Study (MACS), this paper reviews and applies methods of competing risks flexible parametric models to analyze the risk of the first disease (AIDS or non-AIDS) among HIV-infected patients. We compared two alternative subdistribution hazard flexible parametric models (SDHFPM1 and SDHFPM2) with the Fine & Gray model. To make a complete inference, we performed cause-specific hazard flexible parametric models for each event separately as well.

Results
Both SDHFPM1 and SDHFPM2 provided consistent results regarding the magnitude of coefficients and risk estimations compared with estimations obtained from the Fine & Gray model, However, competing risks flexible parametric models provided more efficient and smoother estimations for the baseline risks of the first disease. We found that age at HIV diagnosis indirectly affected the risk of AIDS as the first event by increasing the number of patients who experience a non-AIDS disease prior to AIDS among > 40 years. Other significant covariates had direct effects on the risks of AIDS and non-AIDS.

Discussion
The choice of an appropriate model depends on the research goals and computational challenges. The SDHFPM1 models each event separately and requires calculating censoring weights which is time-consuming. In contrast, SDHFPM2 models all events simultaneously and is more appropriate for large datasets, however, when the focus is on one particular event SDHFPM1 is more preferable.
Flexible age-period-cohort modelling illustrated using obesity prevalence data
Authors: Dobson Annette , Hockey Richard , Chan Hsiu-Wen , Mishra Gita 
Published: January 2020

Abstract
Background
Use of generalized linear models with continuous, non-linear functions for age, period and cohort makes it possible to estimate these effects so they are interpretable, reliable and easily displayed graphically. To demonstrate the methods we use data on the prevalence of obesity among Australian women from two independent data sources obtained using different study designs.

Methods
We used data from two long-running nationally representative studies: seven cross-sectional Australian National Health Surveys conducted between 1995 and 2017–18, each involving 6000–8000 women; and the Australian Longitudinal Study on Women’s Health which started in 1996 and involves more than 57,000 women in four age cohorts who are re-surveyed at three-yearly intervals or annually. Age-period-cohort analysis was conducted using generalized linear models with splines to describe non-linear continuous effects.

Results
When analysed in the same way both data sets showed similar patterns. Prevalence of obesity increased with age until late middle age and then declined; increased only slightly across surveys; but increased steadily with birth year until the 1960s and then accelerated.

Conclusions
The methods illustrated here make the estimation and visualisation of age, period and cohort effects accessible and interpretable. Regardless of how the data are collected (from repeated cross-sectional surveys or longitudinal cohort studies), it is clear that younger generations of Australian women are becoming heavier at younger ages. Analyses of trends in obesity should include cohort, in addition to age and period, effects in order to focus preventive strategies appropriately.
Enabling good outcomes in older adults on dialysis: a qualitative study
Authors: Raj Rajesh , Brown Bridget , Ahuja Kiran , Frandsen Mai , Jose Matthew 
Published: January 2020

Abstract
Background
Older patients on dialysis may not have optimal outcomes, particularly with regards to quality of life. Existing research is focused mainly on survival, with limited information about other outcomes. Such information can help in shared decision-making around dialysis initiation; it can also be used to improve outcomes in patients established on dialysis. We used qualitative research methods to explore patient perspectives regarding their experience and outcomes with dialysis.

Methods
Semi-structured interviews with participants aged ≥70, receiving dialysis at a regional Australian hospital, were recorded and transcribed. From participants’ responses, we identified descriptive themes using a phenomenological approach, with verification by two researchers. Factors affecting outcomes were derived reflexively from these themes.

Results
Seventeen interviews were analysed prior to saturation of themes. Participants (12 on haemodialysis, 5 on peritoneal dialysis) had spent an average of 4.3 years on dialysis. There were 11 males and 6 females, with mean age 76.2 years (range 70 to 83). Experiences of dialysis were described across four domains - the self, the body, effects on daily life and the influences of others; yielding themes of (i) responses to loss (of time, autonomy, previous life), (ii) responses to uncertainty (variable symptoms; unpredictable future; dependence on others), (iii) acceptance / adaptation (to life on dialysis; to ageing) and (iv) the role of relationships / support (family, friends and clinicians).

Conclusions
Older patients experience the effects of dialysis across multiple domains in their lives. They endure feelings of loss and persistent uncertainty, but may also adapt successfully to their new circumstances, aided by the support they receive from family, health professionals and institutions. From these insights, we have suggested practical measures to improve outcomes in older patients.
Unexpected presentation and surgical salvage of transplant renal artery dissection caused by vascular clamping: a case report
Authors: Hori Shunta , Yoneda Tatsuo , Tomizawa Mitsuru , Ichikawa Kazuki , Morizawa Yosuke , Nakai Yasushi , Miyake Makito , Fujimoto Kiyohide 
Published: January 2020

Abstract
Background
Transplant renal artery dissection is a rare and serious event that can cause allograft dysfunction and activation of the renin–mediated renovascular hypertension. Most cases are induced by percutaneous transluminal angioplasty, arteriosclerotic disease, or fibromuscular dysplasia. We observed a case of transplant renal artery dissection induced by unusual causes during kidney transplantation.

Case presentation
A 35-year-old woman, whose mother donated a kidney to her, underwent ABO-incompatible living kidney transplantation. The allograft had one renal artery and vein that were anastomosed to the internal iliac artery and external iliac vein, respectively. Although careful handling was performed in all procedures including vascular clamping, Doppler ultrasonography (US) immediately after reperfusion showed an increase in the systolic blood velocity and urine output was not observed. Arterial anastomotic stenosis was suspected, but upon exploration, a renal artery dissection was detected in the middle portion of the donor artery. The part of the transplant renal artery was resected, and cold reflux was started again. At the resected part of transplant renal artery, dissection was identified. After re-anastomosis, Doppler US revealed that the blood flow of the renal artery was adequate without an increase in the systolic blood velocity, and sufficient blood flow was observed throughout the allograft. Urine output was also observed as soon as blood flow returned, and serum creatinine level decreased to 0.95 mg/dL after surgery. The cause of injury might have been vascular clamping in order to drain the air and check bleeding at the anastomosis.

Conclusions
Our case reaffirmed that careful handling is needed in all procedures, including donor nephrectomy, cannulation for transplant perfusion, vascular clamping, and anastomosis, even without any evidence of arteriosclerosis. Kidney transplant recipients commonly have atherosclerosis and hypertension, which are risk factors for arterial dissection. Early diagnosis and intervention can lead to the prevention of allograft dysfunction. Therefore, close monitoring of allograft blood flow by Doppler US during surgery should be considered.
Retinal tear formation after whole-body vibration training exercise
Authors: Maggiano John , Yu Mei-Chuan Margret , Chen Sanford , You Timothy , Rathod Rajiv 
Published: January 2020

Abstract
Background
The purpose of this report is to describe the occurrence of a retinal tear, pre-retinal and vitreous hemorrhages after completing a session of whole-body vibration training. Though our patient is the third documented case of vitreous hemorrhage following whole-body vibration training, he is the first to show a close association of a retinal tear and vitreous hemorrhage with whole-body vibration training.

Case presentation
This case report describes a 59-year-old male who had acute onset of floaters and shadows in the left eye. The results of the examination revealed a temporal retinal tear, inferior pre-retinal hemorrhage, and mild vitreous hemorrhage. He was successfully treated using laser photocoagulation with resolution of vitreous and pre-retinal hemorrhages on 4-month follow up.

Conclusions
With the rise in popularity of whole-body vibration training exercise, it is important for the medical and athletic community to be aware of possible associated ocular complications. We believe that high-force vibration training may cause retinal tears in susceptible persons.
Pigmented paravenous retinochoroidal atrophy associated with Vogt-Koyanagi-Harada disease: a case report
Authors: Ramtohul Prithvi , Comet Alban , Gascon Pierre , Denis Danièle 
Published: January 2020

Abstract
Background
To describe a unique case of pigmented paravenous retinochoroidal atrophy that developed several years after Vogt-Koyanagi-Harada disease.

Case presentation
A 28-year-old woman presented with gradual vision loss in both eyes and nyctalopia for 2 years. Past medical history was relevant for Vogt-Koyanagi-Harada disease since the age of 19 and positive HLA-DR4. Funduscopic examination revealed perivascular pigmentary clumping and atrophic changes radiating from the optic disks. Spectral domain optical coherence tomography through the macula demonstrated perifoveal outer retinal layers loss with cystic degeneration. Fundus autofluorescence showed zonal areas of hypoautofluorescence corresponding to the areas of atrophy. Full-field electroretinogram identified mildly reduced scotopic and photopic responses. The patient was diagnosed with pigmented paravenous retinochoroidal atrophy.

Conclusions
Pigmented paravenous retinochoroidal atrophy may be acquired after Vogt-Koyanagi-Harada disease. Pathogenesis of pigmented paravenous retinochoroidal atrophy may involve inflammatory-related precursors on a background of genetic predisposition.
Helping people with psychosis to expand their social networks: the stakeholders’ views
Authors: Tee Helena , Priebe Stefan , Santos Carlos , Xanthopoulou Penny , Webber Martin , Giacco Domenico 
Published: January 2020

Abstract
Background
People with psychosis experience more social isolation than any other diagnostic group and have smaller social networks than the general population. This isolation can have a detrimental effect on quality of life. No direct, standardised interventions have been developed to specifically target this issue. Stakeholders input appears crucial in the process of developing such an intervention. This study aimed to identify the main considerations when developing an intervention aiming to reduce social isolation in people with psychosis.

Methods
Focus groups and individual interviews were conducted with patients, carers and mental health staff. Data was thematically analysed.

Results
Thirty four patients with psychosis, 26 carers of people experiencing psychosis and 22 mental health professionals participated in the study. Suggested aspects to be considered in a novel intervention were: i) finding and training the right staff member; ii) discussing negative social attitudes and patients’ previous negative experiences, iii) addressing personal ambivalence; iv) establishing how best to provide information about social activities; v) facilitating access to social activities, vi) striking a balance between support and independence.

Conclusion
The suggestions identified can help to develop more targeted approaches to reduce social isolation within this patient group. A patient-centred approach and generic communication skills appear to be underpinning most of the helpful elements identified, whilst specific techniques and skills can help to overcome negative past experiences and motivational barriers.
Carpal tunnel surgery: predictors of clinical outcomes and patients’ satisfaction
Authors: Alimohammadi Ehsan , Bagheri Seyed Reza , Hadidi Homa , Rizevandi Parisa , Abdi Alireza 
Published: January 2020

Abstract
Background
Carpal tunnel syndrome (CTS) is the most common peripheral neuropathy. Moreover, carpal tunnel release (CTR) surgery generally has excellent results. The present study aimed to investigate the predictors of clinical outcomes and satisfaction in patients with CTR.

Methods
In this observational prospective cohort study, 152 patients with open carpal tunnel release surgery were investigated. Complete clinical examinations were performed and recorded before the surgery, two weeks after the surgery and 6 months after the surgery. The Boston Carpal Tunnel Questionnaire (BCTQ) were assessed on admission and at last follow-up visits to evaluate clinical outcomes. Patients’ satisfaction was determined by a 10-point verbal descriptor nominal scale (1 = very poor, 5 = fair and 10 = excellent) and recorded during the last follow -up visits.

Results
Among 152 patients who were investigated, there were 118 (77.6%) females and 34 (22.36%) males. Overall, surgery improved the outcomes based on Symptom Severity Scale (SSS) and Functional Status Scale (FSS) (P < 0.05). Most of the considered variables did not show significant effects on clinical outcomes and patients’ satisfaction. However, duration of symptoms and electrophysiological severity were the predictors of the change score in SSS(P < 0.05). As well as, age was the only predictor of the change score in FSS (P < 0.05). Finally, according to the linear regression model, the pre-operative grip strength and age were the independent predictors of post-operative satisfaction (P < 0.05).

Conclusions
Results of the present study revealed that there was a significant improvement in clinical outcomes after CTS surgery. Stronger pre-operative grip strength and younger age were independent predictors of higher post-operative satisfaction. These results can be used in pre-operative counseling and management of post-operative expectations.
Comparison of score-based prediction of 90-day mortality after liver resection
Authors: Knoblich Tanja , Hinz Ulf , Stravodimos Christos , Schön Michael R. , Mehrabi Arianeb , Büchler Markus W. , Hoffmann Katrin 
Published: January 2020

Abstract
Background
Indications for liver surgery are expanding fast and complexity of procedures increases. Preoperative mortality risk assessment by scoring systems is debatable. A previously published externally validated Mortality Risk Score allowed easy applicable and precise prediction of postoperative mortality. Aim of the study was to compare the performance of the Mortality Risk Score with the standard scores MELD and P-POSSUM.

Methods
Data of 529 patients undergoing liver resection were analysed. Mortality Risk Score, the labMELD Score and the P-POSSUM Scores (PS, OS, P-POSSUM mortality %) were calculated. The ROC curves of the three scoring systems were computed and the areas under the curve (C-index) were calculated using logistic regression models. Comparisons between the ROC curves were performed using the corresponding Wald tests.

Results
Internal validation confirmed that the risk model was predictive for a 90-day mortality rate with a C-index of 0.8421. The labMELD Score had a C-index of 0.7352 and the P-POSSUM system 0.6795 (PS 0.6953, OS 0.5413). The 90-day mortality rate increased with increasing labMELD values (p < 0.0001). Categorized according to the Mortality Risk Score Groups the labMELD Score showed a linear increase while the POSSUM Scores showed variable results.

Conclusions
By accurately predicting the risk of postoperative mortality after liver surgery the Mortality Risk Score should be useful at the selection stage. Prediction can be adjusted by use of the well-established labMELD Score. In contrast, the performance of standard P-POSSUM Scores is limited.
Low priority of obesity education leads to lack of medical students’ preparedness to effectively treat patients with obesity: results from the U.S. medical school obesity education curriculum benchmark study
Authors: Butsch W. Scott , Kushner Robert F. , Alford Susan , Smolarz B. Gabriel 
Published: January 2020

Abstract
Background
Physicians are currently unprepared to treat patients with obesity, which is of great concern given the obesity epidemic in the United States. This study sought to evaluate the current status of obesity education among U.S. medical schools, benchmarking the degree to which medical school curricula address competencies proposed by the Obesity Medicine Education Collaborative (OMEC).

Methods
Invitations to complete an online survey were sent via postal mail to 141 U.S. medical schools compiled from Association of American Medical Colleges. Medical school deans and curriculum staff knowledgeable about their medical school curriculum completed online surveys in the summer of 2018. Descriptive analyses were performed.

Results
Forty of 141 medical schools responded (28.4%) and completed the survey. Only 10.0% of respondents believe their students were “very prepared” to manage patients with obesity and one-third reported that their medical school had no obesity education program in place and no plans to develop one. Half of the medical schools surveyed reported that expanding obesity education was a low priority or not a priority. An average of 10 h was reported as dedicated to obesity education, but less than 40% of schools reported that any obesity-related topic was well covered (i.e., to a “great extent”). Medical students received an adequate education (defined as covered to at least “some extent”) on the topics of biology, physiology, epidemiology of obesity, obesity-related comorbidities, and evidence-based behavior change models to assess patient readiness for counseling (range: 79.5 to 94.9%). However, in approximately 30% of the schools surveyed, there was little or no education in nutrition and behavioral obesity interventions, on appropriate communication with patients with obesity, or pharmacotherapy. Lack of room in the curriculum was reported as the greatest barrier to incorporating obesity education.

Conclusions
Currently, U.S. medical schools are not adequately preparing their students to manage patients with obesity. Despite the obesity epidemic and high cost burden, medical schools are not prioritizing obesity in their curricula.
Exploring the views of successful applicants for medical school about gender medicine using a gender-sensitive video assignment
Authors: Scholte Joni K. , van der Meulen Francisca W. M. , Teunissen Theodora A. M. , Albers Mieke , Laan Roland F. J. M. , Fluit Cornelia R. M. G. , Lagro-Janssen Antoine L. M. 
Published: January 2020

Abstract
Background
Sex and gender influence health and disease outcomes, therefore, doctors should be able to deliver gender-sensitive care. To train gender-sensitive doctors, relevant sex and gender differences have to be included in medical education. In order to develop appealing, relevant, and effective education for undergraduate medical students, education should be tailored to students’ level and anticipated on their ideas and assumptions. Therefore, we wanted to answer the following research questions: 1. What do aspiring medical students want to learn about gender medicine?; 2. How would they like to learn about gender medicine?; and 3. What are their ideas and assumptions about sex and gender differences in health and disease?

Methods
We performed an explorative thematic document analysis of educational assignments made by successful applicants (n = 50) during the selection procedure of their entry into medical school. To test aspirants’ capacity for self-directed learning, students were asked to formulate their own study plan after they watched a video that resembled a future practical experience (a consultation with a patient). As the content of this video was gender-sensitive, the assignments of the successful applicants gave us the unique opportunity to examine aspiring medical students’ views about gender medicine.

Results
Aspiring medical students were eager to start their training to become gender-sensitive doctors. They believed in better care for all patients and thought doctors should obtain gender competences during their medical training. Students preferred to start with acquiring basic biomedical knowledge about differences between men and women and continue their training by developing gender-sensitive communication skills in (simulated) practical settings. Students differed in their interpretation of the gender-sensitive video, some generalized potential differences to all men and all women. Teachers were considered as important role models in learning about gender medicine.

Conclusions
We advise medical schools to teach gender medicine from the beginning of medical school, by focusing on sex differences first and adding gender related themes later on in the curriculum. As students may interpret gender-sensitive information differently, structurally embedding reflection on gender medicine with gender competent teachers is necessary.
A mobile app implementing the international classification of functioning, disability and health rehabilitation set
Authors: Zhang Malan , Yu Jiani , Shen Wei , Zhang Yun , Xiang Yun , Zhang Xinting , Lin Ziling , Yan Tiebin 
Published: January 2020

AbstractBackgroundThe Chinese assessment standards of the International Classification of Functioning, Disability and Health Rehabilitation Set is available now. It is coming to be used as a basic functional evaluation tool in China. With data accumulating, a mobile application is needed to eliminate the extra cost of data entry, storage, and graphical presentation of trends. This study aimed to design, develop and test a mobile app based on the International Classification of Functioning, Disability and Health Rehabilitation Set Rehabilitation Set.MethodsThe study had three phases. The first involved specifying the functional requirements of the app. Then an app was designed and refined to meet those requirements. In a pilot test, the app was used by rehabilitation professionals in clinical practice and their comments were collected for its further modification in one-on-one interviews.ResultsThe app met the initial requirements, and the pilot study showed it worked as designed. The pilot study also showed that the app is user-friendly and convenient to use in rehabilitation practice. Some feedback was given to improve the app.ConclusionAn Android mobile app implementing the International Classification of Functioning, Disability and Health Rehabilitation Set was successfully developed.