bluuebunny/crossref_metadata_2025_split huggingface dataset:
Participation in faecal immunochemical testing-based colorectal cancer screening programmes in the northwest of Europe
Authors: Toes-Zoutendijk Esther , Portillo Isabel , Hoeck Sarah , de Brabander Isabel , Perrin Philippe , Dubois Catherine , van Leerdam Monique , Lansdorp-Vogelaar Iris , Bardou Marc 
Published: October 2019

Objective This study compared the participation in four faecal immunochemical testing-based screening programmes for colorectal cancer in Flanders, France, Basque country and the Netherlands, to identify factors to further optimize faecal immunochemical testing programmes. Method Background information and data on performance indicators were collected and compared for the four programmes. Results Invitation method, reminders, funding, faecal immunochemical testing cut-off and follow-up after positive faecal immunochemical testing differed in the four programmes. In France, only an invitation letter is sent by mail, while the sample kit must be collected from the general practitioner. In the other programmes, an invitation letter including the sample kit is sent by mail. Participation rates vary substantially according to the method of invitation, with the highest participation rates in the Netherlands (73.0%) and Basque country (72.4%), followed by Flanders (54.5%) and France (28.6%). Basque country (92.8%) and France (88.4%), the two programmes with most active involvement of general practitioners in referral for colonoscopy, had the highest participation rates for colonoscopy. Conclusions Large differences in screening participation observed between programmes according to the invitation method used suggest that changes to the design of the programme, such as including the sample kit with the invitation, or active involvement of GPs, might increase participation.
Application of a nonlocal grid model for analysis of the creep damage of metals
Authors: Nowak Krzysztof 
Published: October 2019

The paper presents a model of creep damage development in polycrystalline material. The model operates at two scales: micro and macro. The microscale is appropriate for simulation of the damage development phenomenon. Engineering structures operate and experimental tests are performed at the macroscale. For a polycrystalline material, damage development is strictly dependent on the structure of the material. At the microscale, the model uses a tool called cellular automata that enables the description of this dependence. The macroscopic results, required for comparison with the experimental results and for the analysis of engineering structures, are achieved by means of the finite element method. The model connects the cellular automata damage model with the deformation model implemented in the finite element system to realize the multiscale cellular automata finite element model. This connection is made using a nonlocal approach to avoid a solution dependence on the finite element mesh. The nonlocal grid method is considered the most suitable for the discrete cellular automata model. The model has been verified with the experimental results of a uniaxial tension test for copper at elevated temperature. The effectiveness and different variants of the nonlocal grid method for creep crack growth problems have been examined.
Improving geriatric care and reducing hospitalisations in regional and remote areas: The benefits of telehealth
Authors: Lillicrap Louise , Hunter Christine , Goldswain Peter 
Published: October 2019

Introduction The aim of this study was to compare the effectiveness of two geriatrician models of care, the telegeriatric service (TGS) and visiting geriatrician (VG), in regional and remote settings in terms of potential cost-savings to the health system and impact on health service use (HSU). Furthermore, to establish whether longer wait-times for clinic appointments led to increased HSU by study participants. Methods Trends in patient emergency department presentations, hospitalisations and bed-days (HSU) were compared from 18 months before to 12 months after geriatrician appointment for the two services in the Western Australian Midwest region. The relationships between wait times, patient triage level and HSU were modelled. The costs of providing the services were offset against reductions in HSU after appointments. Results The sample comprised consecutive patients using the TGS ( n = 84) and VG service ( n = 124). Patient characteristics were similar, although patients using the VG service had longer wait-times, were triaged as more urgent and demonstrated the highest levels of HSU. Both models were effective with similar rates of reduced HSU following appointments. Increased wait-times and higher patient triage urgency were associated with increased HSU. Discussion Although TGS and VG showed similar reduced rates of HSU, TGS had the capacity to see a higher volume of patients, a broader geographical reach and improved waitlist management. Consequently, TGS was more effective at reducing avoidable hospitalisations and subsequent health deterioration due to shorter wait-times. Whilst face-to-face consultations are recognised as ‘gold standard’ a combination of the two models is most efficient.
Mining Twitter to Inform the Design of Online Interventions for Hispanic Alzheimer’s Disease and Related Dementias Caregivers
Authors: Yoon Sunmoo , Lucero Robert , Mittelman Mary S. , Luchsinger José A. , Bakken Suzanne 
Published: October 2019

Background/Objective: Hispanics are about 1.5 times as likely as non-Hispanic Whites to experience Alzheimer’s disease and related dementias (AD/ADRD). Eight percent of AD/ADRD caregivers are Hispanics. The purpose of this article is to provide a methodological case study of using data mining methods and the Twitter platform to inform online self-management and social support intervention design and evaluation for Hispanic AD/ADRD caregivers. It will enable other researchers to replicate the methods for their phenomena of interest. Method: We extracted an analytic corpus of 317,658 English and Spanish tweets, applied content mining (topic models) and network structure analysis (macro-, meso-, and micro-levels) methods, and created visualizations of results. Results: The topic models showed differences in content between English and Spanish tweet corpora and between years analyzed. Our methods detected significant structural changes between years including increases in network size and subgroups, decrease in proportion of isolates, and increase in proportion of triads of the balanced communication type. Discussion/Conclusion: Each analysis revealed key lessons that informed the design and/or evaluation of online self-management and social support interventions for Hispanic AD/ADRD caregivers. These lessons are relevant to others wishing to use Twitter to characterize a particular phenomenon or as an intervention platform.
Contrast-induced nephropathy: A dilemma between loss of neurons or nephrons in the setting of endovascular treatment of acute ischemic stroke
Authors: Delgado Acosta Fernando , Jiménez Gómez Elvira , Bravo Rey Isabel , Valverde Moyano Roberto , de Asís Bravo-Rodriguez Francisco , Oteros Fernández Rafael 
Published: October 2019

Purpose The aim is to report the incidence and risk factors of contrast-induced nephropathy after the use of iodine-based contrast for the endovascular treatment of acute ischemic stroke. Methods Data from patients who underwent neuroendovascular procedures in a center over a period of 22 months were analysed retrospectively. Contrast-induced nephropathy was determined by an increase in serum creatinine level of >25% of baseline or an absolute increase in serum creatinine level of at least 44 µmol/L (0.50 mg/dL) occurring after intravascular administration of contrast media without alternative explanation. The primary outcome measure of this study was the presence of contrast-induced nephropathy in these treated patients. Continuous data were presented as mean ± standard deviation, and categorical data as frequencies or percentages. The comparison was made using Student's t-test or Fisher's test. Logistic regression was performed to find independent contrast-induced nephropathy predictors. All statistical analyses were performed using Microsoft Excel. A p value of less than 0.05 was considered statistically significant. Results One hundred and eighty-nine patients undergoing endovascular treatment for acute ischemic stroke. Twenty cases of the total cohort (n = 189) presented contrast-induced nephropathy (10.58%). Only diabetes and creatinine levels between 1.3 and 2.5 mg/dL were associated with contrast-induced nephropathy. No patient was treated with dialysis. Conclusion Contrast-induced nephropathy is a relatively common complication after endovascular treatment of acute ischemic stroke and is associated with worse outcome in patients with this condition. However, there is no increase in the frequency of hemodialysis after the use of iodinated contrast medium.
Feasibility Study to Determine if Microfracture Surgery Using Water Jet Drilling Is Potentially Safe for Talar Chondral Defects in a Caprine Model
Authors: Kok Aimee C. , den Dunnen Steven , Lambers Kaj T.A. , Kerkhoffs Gino M.M.J. , Tuijthof Gabrielle J.M. 
Published: October 2019

Objective Surgical microfracture is considered a first-line treatment for talar osteochondral defects. However, current rigid awls and drills limit access to all locations in human joints and increase risk of heat necrosis of bone. Using a flexible water jet instrument to drill holes can improve the reachability of the defect without inducing thermal damage. The aim of this feasibility study is to determine whether water jet drilling is potentially safe compared with conventional microfracture awls by studying side effects and perioperative complications, as well as the quality of cartilage repair tissue. Design Talar chondral defects with 6-mm diameter were created bilaterally in 6 goats (12 samples). One defect in each goat was treated with microfracture created with conventional awls, the contralateral defect was treated with holes created with 5-second water jet bursts at a pressure of 50 MPa. Postoperative complications were recorded and after 24 weeks analyses were performed using the ICRS (International Cartilage Repair Society) macroscopic score and modified O’Driscoll histological score. Results Several practical issues using the water jet in the operating theatre were noted. Water jet drilling resulted in fibrocartilage repair tissue similar to the repair tissue from conventional awls. Conclusions These results suggest that water jet drilling gives adequate fibrocartilage repair tissue. Furthermore, the results highlight essential prerequisites for safe application of surgical water jet drilling: stable water pressure, water jet beam coherence, stable positioning of the nozzle head when jetting, and minimizing excessive fluid extravasation.
Symptoms and exacerbations in asthma: an apparent paradox?
Authors: Morjaria Jaymin B. , Rigby Alan S. , Morice Alyn H. 
Published: October 2019

Background: There is a dearth of data on prospectively recorded symptoms in patients with uncontrolled asthma. Asthma symptoms and exacerbation rate are commonly thought to be associated. The aim of this study was to analyse asthma symptoms of cough, wheeze, chest tightness and breathlessness in an uncontrolled asthma cohort. We also examined the effect of maintenance and reliever therapy (MART) on these symptoms and its effect on exacerbation rate. Methods: Adults with uncontrolled asthma electronically recorded their asthma symptom severity scores twice-daily over a period of 48 weeks following randomisation to beclometasone/formoterol twice daily plus pro re nata (prn) salbutamol or MART. Subjects with symptom scores of ⩾2 (ranging from 0 to 3 for each symptom) were considered more symptomatic, whereas those below a score of 2 were considered less severe. The influence treatment on exacerbation frequency and symptom profiles were then correlated. Results: Of the 1701 subjects in the analyses, 1403 were symptomatic with ⩾100 symptom episodes for one symptom. The remaining 298 subjects were classified as pauci-symptomatic. There was poor association between the frequency and symptom severity score for each symptom. Surprisingly, wheeze was the least reported symptom. Females were more likely to be polysymptomatic. MART compared with prn salbutamol markedly attenuated severe asthma exacerbations. This effect was most notable in subjects with fewer symptoms. Conclusions: In uncontrolled asthma, there is a poor correlation between reported symptoms and exacerbation frequency. This post hoc analysis suggests that MART should not be reserved for symptomatic subjects but achieves the greatest benefit in pauci-symptomatic patients with asthma. Trial registration: ClinicalTrials.gov identifier: NCT00861926
Prevalence and patterns of cognitive impairment in acute coronary syndrome patients: A systematic review
Authors: Zhao Emma , Lowres Nicole , Woolaston Anna , Naismith Sharon L , Gallagher Robyn 
Published: October 2019

Background Minimising risk factors through secondary prevention behaviour is challenging for patients following an acute coronary syndrome. Cognitive impairment can potentially make these changes more difficult. However, cognitive impairment prevalence in acute coronary syndrome patients is poorly understood. Design This study was based on a systematic review. Methods A systematic review was conducted of PubMed, Medline, PsycINFO and Cochrane databases up to March 2019, to identify studies reporting the prevalence of cognitive impairment in acute coronary syndrome patients. Predefined inclusion criteria were specified, including use of a validated cognitive impairment screening tool. Studies were excluded if patients had diagnosed dementia or coronary artery bypass graft surgery. Strengthening The Reporting of Observational Studies in Epidemiology and Cochrane Risk of Bias tools were used to assess quality. Results From 747 potential studies, nine were included. The total sample size was 6457 (range 53–2174), mean age range was 51.3–77.4 years, and range of proportions of males was 57–100%. Reported cognitive impairment prevalence rates varied substantially (9–85%) with no clear pattern over time. From the two studies which examined domains, verbal fluency, memory and language were affected the most. Meta-analysis could not be undertaken due to diverse screening tools ( n = 9), cut-off scores and screening timepoints. Conclusions Cognitive impairment in acute coronary syndrome patients is currently poorly described, and likely affects a substantial number of acute coronary syndrome patients who remain undetected and have the potential to develop to dementia in the future. As domains are most affected, this could impact understanding and retention of health education. Research is needed to accurately determine the prevalence of cognitive impairment in acute coronary syndrome patients and create suitable standardised measures and thresholds.
HEART score improves efficiency of coronary computed tomography angiography in patients suspected of acute coronary syndrome in the emergency department
Authors: Arslan Murat , Schaap Jeroen , Rood Pleunie PM , Nieman Koen , Budde Ricardo PJ , Attrach Mohamed , Dubois Eric A , Dedic Admir 
Published: October 2019

Aims: Coronary computed tomography angiography is increasingly employed in the emergency department for suspected acute coronary syndrome patients. The HEART score has been proposed for initial risk stratification in these patients. The aim of this study was to investigate the diagnostic value and efficiency of the HEART score before coronary computed tomography angiography. Methods and results: We included patients suspected of acute coronary syndrome who underwent coronary computed tomography angiography in the emergency department. Based on the HEART score, patients were stratified as low-risk (HEART≤3), intermediate-risk (HEART4–6) and high-risk (HEART≥7). We assessed coronary computed tomography angiography for the presence of significant coronary artery disease (>50% stenosis). The primary outcome, the level of major adverse cardiac events, was a composite endpoint of all-cause mortality, acute coronary syndrome or coronary revascularisation within 30 days. The study population consisted of 340 patients (mean age: 55.6±10.1 years, 44.7% women), major adverse cardiac events occurred in 45 (13.2%) patients. The incidence of major adverse cardiac events in patients stratified as low-risk (35.0%), intermediate-risk (56.8%) and high-risk (8.2%) was 3.4%, 12.4% and 60.7%, respectively. All four low-risk patients with major adverse cardiac events had a HEART score of three. An algorithm where coronary computed tomography angiography is reserved for patients with HEART 3–6 resulted in a sensitivity of 97.8%, specificity of 84.1%, negative predictive value of 99.6% and positive predictive value of 48.4%, while reducing the need for coronary computed tomography angiography by 22% ( n=75). Conclusion: The predictive value of coronary computed tomography angiography for 30-day major adverse cardiac events in suspected acute coronary syndrome patients is good, and reserving coronary computed tomography angiography for HEART score 3–6 patients reduces the number of needed coronary computed tomography angiograms without affecting diagnostic accuracy.
Long-Term Impact of Bariatric Surgery on Renal Outcomes at a Community-Based Publicly Funded Bariatric Program: The Regina Bariatric Study
Authors: McIsaac Mark , Kaban Gordon , Clay Adam , Berry Warren , Prasad Bhanu 
Published: October 2019

Background: Obesity is recognized as an independent risk factor for chronic kidney disease through multiple direct and indirect biological pathways. Bariatric surgery is a proven, effective method for sustained weight loss. However, there is a relative paucity of data on the impact of bariatric surgery on renal outcomes. Objective: The primary objective was to evaluate the change in urine albumin/creatinine ratio (ACR) in patients undergoing bariatric surgery, at 12 months after the procedure. Secondary objectives were to determine the changes in ACR at (6 and 24 months), estimated glomerular filtration rate (eGFR; 6, 12, and 24 months), and hemoglobin A1c (HbA1c); 12 and 24 months) after the procedure. Design: This observational retrospective cohort study included consecutive obese patients who underwent bariatric surgery. Setting: Provincial Bariatric Surgery Clinic at the Regina General Hospital, Saskatchewan. Patients: This study includes 471 consecutive obese adult patients who underwent bariatric surgery between 2008 and 2015. Measurements: We studied the impact of bariatric surgery on body mass index (BMI), renal outcomes (urine ACR and eGFR) and metabolic outcomes (fasting glucose, total cholesterol, low-density lipoprotein, triglycerides, and HbA1c) in 471 patients. Methods: Patients were followed for 2 years postsurgery in the bariatric clinic. Mixed linear models that accounted for the repeated nature of the data were used to access changes in outcomes over time. Results: Patients were predominantly female (81%) with a mean age (±SD) of 46 ± 10 years. Most patients (87%) had a BMI > 40 kg/m2 and 81% of the patients underwent Roux-en-Y gastric bypass. The mean BMI decreased from 47.7 ± 7.8 kg/m2 at baseline to 37.1 ± 7.9 kg/m2 at 6 months and 34.8 ± 8.8 kg/m2 at 12 months. In a subcohort of patients with microalbuminuria, ACR showed an improvement from a median [interquartile] value of 5.1 [3.7-7.5] mg/mmol at baseline to 2.3 [1.2-3.6] mg/mmol at 6 months ( P = .007), to 1.4 [0.9-3.7] mg/mmol at 2-year follow-up ( P < .001). Similarly, eGFR increased in patients with microalbuminuria from 109 ± 10 mL/min/1.73 m2 at baseline to 120 ± 36 mL/min/1.73 m2 at 2-year follow-up ( P = .013). There were statistically significant reductions in triglycerides, fasting glucose, and HbA1c. Limitations: This was a retrospective chart review, with the lack of a control group. Patients with eGFR less than 60 mL/min/1.73 m2 were not considered for surgery, and we had to measure renal outcomes predominantly on the presence of proteinuria. Conclusions: Our results suggest bariatric surgery significantly decreased weight and consequently improved renal and metabolic outcomes (eGFR, ACR, fasting glucose, cholesterol, and triglycerides) in patients with elevated BMI.
Development of AOSpine BOnE (Bone Osteobiologics and Evidence) Classification
Authors: Wang Jeffrey C. , Yoon S. Tim , Brodke Darrel S. , Park Jong-Beom , Hsieh Patrick , Meisel Hans-Joerg , Buser Zorica 
Published: October 2019

Study Design: Classification development. Objectives: The aim of our study was to develop a 3-tier classification for the levels of evidence for osteobiologics and provide a description of the principles by which osteobiologics can be evaluated. BOnE (Bone Osteobiologics and Evidence) classification evaluates each osteobiologic based on the available evidence, and if the published evidence is based on clinical, in vivo or in vitro studies. Methods: The process of establishing the BOnE classification included 5 face-to-face meetings and 2 web calls among members of the AOSpine Knowledge Forum Degenerative. Results: The 3 levels of evidence were determined based on the type of data on osteobiologics: level A for human studies, level B for animal studies, and level C for in vitro studies, with level A being the highest level of evidence. Each level was organized into 4 subgroups (eg, A1, A2, A3, and A4). Conclusions: The use and the variety of osteobiologics for spine fusion has dramatically increased over the past few decades; however, literature on their effectiveness is inconclusive. Several prior systematic reviews developed by AOSpine Knowledge Forum Degenerative reported low level of evidence primarily due to the high risk of bias, small sample size, lack of control groups, and limited patient-reported outcomes. BOnE classification will provide a universal platform for research studies and journal publications to classify a new or an existing product and will allow for creating decision-making algorithms for surgical planning.