bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antibiotic Dispensing Before and After Primary and Revision Total Hip Replacement: An Australian Orthopaedic Association National Joint Replacement Registry Linkage Study
Authors: Gulyani Aarti , De Steiger Richard , Smith Paul , Pratt Nicole , Duszynski Katherine , Graves Stephen E , Inacio Maria , Harris Ian , Ackerman Ilana , Jorm Louisa , Lorimer Michelle 
Published: December 2020

IntroductionInfection is a major complication following joint replacement (JR) surgery. However, little data exist on baseline use of antibiotics following primary JR and how use changes with subsequent revision surgery.
Objectives & ApproachOur study objectives were to describe community use of antibiotics before and after primary total hip replacement (THR) and change in use pre and post revision procedure.
Registry data were linked with national medication dispensing data using probabilistic record linkage. Patients with THR for osteoarthritis in a private hospital between 1999 and 2017 were included. Three groups were analysed: patients with primary procedures revised for infection, revised for non-infection reasons and those not revised. Rate of antibiotic dispensing/month was calculated as number of patients dispensed at least one antibiotic in a given month divided by number of patients at-risk.
ResultsThere were 102,577 patients included in the non-revised group, 3,156 revised for non-infection and 520 revised for infection. Prior to primary THR, baseline antibiotic dispensing rate was 9-11%/month in all groups. Post-primary rates were similar (10-11%) for non-revised and revised non-infection patients but higher (16-17%) for revised-infection patients. In 1, 6 and 12 months preceding revision for infection, antibiotic use was 55%, 27% and 22%, respectively. For patients revised for non-infection, antibiotic use was 21%, 14%, 13%, respectively. One-month following revision for infection, 82% of patients were dispensed antibiotics, remaining high (38%) at 6-months and 28% at 12-months. In the revision non-infection group, antibiotic use was 48% first month post-surgery, reducing rapidly to 15% at 6-months.
Conclusion / ImplicationsNon-revision and revision non-infection patients had similar antibiotic dispensing before and after surgery. Revision infection patients however, maintained higher antibiotic dispensing post-primary, pre and post revision. This may reflect either ongoing infection, need for long-term suppressive therapy or reluctance of treating physicians to terminate treatment.
Outcomes of Indigenous Twin and Singleton Pregnancies: Complications, Medical Care, Birth Experience and Infant Health
Authors: Gibberd Alison , Tyler Jessica , Preen David , Falster Kathleen , Hanly Mark , Clarke Marilyn , McNamara Bridgette , Eades Sandra , Scurrah Katrina 
Published: December 2020

IntroductionMultifetal pregnancies and births tend to be more complicated and have poorer outcomes than singleton pregnancies. Singleton pregnancies and perinatal outcomes are worse, on average, for Indigenous people than non-Indigenous people, but little is known about Indigenous multifetal pregnancies.
Objectives and ApproachWe comprehensively describe and compare Indigenous twin and singleton pregnancies and births in Western Australia (WA) and New South Wales (NSW) and compare to NSW non-Indigenous pregnancies and births. Birth records and infant and maternal hospital records were linked for births during 2000-2013 (WA) and 2002-2008 (NSW). Time travelled for the birth was based on the distance from the hospital to the centroid of the mother’s geographical residential area.
ResultsIn the Indigenous populations, mothers of twins had poorer health than mothers of singletons (e.g. in WA, 19% of mothers of twins had hypertension/pre-eclampsia/eclampsia vs 9% of mothers of singletons). They were more likely to have antenatal care during the first trimester (e.g. 69% vs 64% in NSW), though less likely than non-Indigenous mothers of both twins (80%) and singletons (75%).The majority of Indigenous twins were born in a hospital with a neonatal intensive care unit (NICU) (e.g. 66% vs 26% in WA) and many mothers of twins travelled further for the birth (e.g. 8% of mothers of Indigenous twins in NSW travelled 3 hours or more vs 4% of mothers of singletons). In both jurisdictions, outcomes were worse for twins than singletons (e.g. 67% of twins in WA were preterm vs 13% of singletons and 30% of twins were admitted to a NICU vs 6% of singletons).
Conclusion / ImplicationsMothers of Indigenous twins faced significant challenges during the pregnancy, birth and the postnatal period in hospital and, in addition to accessible specialist medical care, these mothers may need practical and psychosocial support throughout their journey.
Using Coronial Records to Provide Novel In-Depth Insights into Work-Related Fatal Injury
Authors: Lilley Rebbecca , Davie Gabrielle , McNoe Bronwen , Driscoll Tim 
Published: December 2020

IntroductionNew Zealand’s (NZ) workplace fatality record is very poor compared to similar OECD countries. The reasons for NZ’s poor performance are highly debated yet inadequately informed due to a lack of high quality fatality data. Due to incomplete official data on work fatalities in NZ, it is not currently possible to use routine official data collections to reliably report: i) who is fatally injured due to work activities, and ii) what groups should be prioritised for action.
Objectives and ApproachThis study uses coronial records to overcome the limitations of existing official data collections to provide the most complete and detailed evidence platform for occupational safety policy and action in NZ. A work-related fatal injury dataset spanning the period 2005-2014 was created by: 1) identifying possible cases aged 0-84 years from the Mortality Collection using selected external cause of injury codes, 2) linking these to Coronial records and 3) identifying and coding work-related cases.
ResultsOf 7,730 injury fatalities with corresponding Coronial records retrieved and reviewed, 1,924 (24%) were work-related, of which 955 were workers. Fifty-nine per cent more worker deaths were identified compared to available official NZ Government estimates from notification and compensation data. Workers killed on public roads were the main additional group identified. Official data do not provide occupation-based fatality rates; our study found ‘Miners and drillers’, ‘deckhands and fishermen’ and ‘loggers’ had the highest rates of fatal injury.
Conclusion / ImplicationsCoronial records offer a rich source of population data on work-related fatal injury deaths, providing better estimates of work-traffic fatalities and high risk occupations than are otherwise available as well as evidence for establishing prevention strategies in NZ.
Consolidated Person Level Health Data Improve Tuberculosis Surveillance and Patient Care
Authors: Smith Mariette , Heekes Alexa , Von Delft Arne , Mutemaringa Themba , Tiffin Nicki , Boulle Andrew 
Published: December 2020

IntroductionElectronic tuberculosis (TB) register systems influence policy decisions, resource allocation and patient care in many ways, but their limitations have been demonstrated in many high-burden settings like South Africa. While digital health systems in the Western Cape, South Africa have improved over time and benefited from implementation of a unique patient identifier, questions about quality and completeness of register data remain. A Health Information Exchange (HIE), established in 2015, daily integrates routinely-collected person level health data from electronic sources in the Province, including laboratory, dispensing, clinical and encounter data, as well as disease register data for HIV and TB.
Objectives and ApproachUsing TB-related datapoints from various electronic platforms and resources, an algorithm was developed to infer cases, visit and treatment information, comorbidities and mortality - defined as a “cascade”. The cascade is recompiled daily incorporating new information added to the HIE, and presented to health care workers and managers as filterable, downloadable reports on an electronic platform. TB Register and inferred cascade data were compared for 2018.
ResultsThere were 40,227 cases in the register after 3,010 duplicate entries were eliminated by consolidating personal identifiers and duplicate entries across facilities into single TB episodes. 13,729 additional cases were identified in the HIE cascade. Of these, 6,984 had evidence of treatment; 4,143 were diagnosed and treated only in hospitals - thus less likely to be recorded in the registers. Updated patient contact details and allocation of a primary care facility based on patient visit history, aided in patient care.
Conclusion / ImplicationsLeveraging a consolidated environment for person-level health data can substantially enhance and verify disease registers. Appropriate tools can render these data accessible and actionable to improve patient care, minimise errors and missed opportunities to close treatment gaps, and increase accuracy of surveillance and reporting on a programmatic level.
Exploring the Effect of Nice Guidelines on Prescribing for Childhood Atopic Eczema in Primary Care with An Interrupted Time Series
Authors: Schreuders LIW , Ersser SJ , Thompson C 
Published: December 2020

IntroductionAtopic eczema (AE) is a chronic inflammatory skin condition affecting 20-32% of UK children, typically diagnosed and treated in primary care. National Institute of Health and Clinical Excellence (NICE, 2007) guidelines recommend all children presenting with AE in primary care are prescribed emollient; topical corticosteroids (TCS) are co-prescribed if indicated by severity. The proportion of children receiving recommended treatment and NICE guideline impact on prescribing practices is unknown. This study was the first to access population-level UK-wide primary care dermatology data from SystmOne.
Objectives and ApproachWe explored treatment patterns for childhood AE documented in primary care data from SystmOne.
Secondary analysis of retrospective, longitudinal primary care data for childhood (<12yo) AE-related consultations from 2002 to 2013. Four treatment scenarios were compared: 1) emollient and TCS co-prescribed (NICE-recommended for moderate-high severity presentation), 2) emollient only (NICE-recommended for mild severity presentation), 3) TCS only (not recommended), or 4) no topical treatment prescribed (not recommended). ARIMA used to examine step and trend-change in prescribing following guideline release.
ResultsNICE-recommended treatments were more common following guideline release: emollient+TCS increased 8% (95%CI 7.7,8.7%); emollient alone increased 8% (95%CI 7.8,8.8%); TCS alone decreased 5% (95%CI -4.2,-5.1%); and no treatment decreased 11% (95%CI -11.3,-12.3%).
Longitudinal analysis indicated increased NICE-recommended prescribing was due to pre-existing trends not significantly altered by the guideline release. By December 2013, ~334 children per month were still not receiving recommended AE treatment (37% of ~900 first-time consultations/month).
Conclusion / ImplicationsAdherence to best practice guidelines for treatment and management of childhood atopic eczema is currently sub-optimal. Significant barriers to optimal use of this data could be achieved by improving design of data input interfaces with secondary use for research in mind. As well as study findings, this presentation will share challenges associated with utilising routinely collected SystmOne data for research purposes for the first time in the UK.
NGLMS-CR: A Web-Based Clerical Review Tool
Authors: Farrow James , Palfy Miro 
Published: December 2020

Native applications often require special permissions to install and update which may not always be available in secure/controlled sensitive-data environments. Deploying new features can be time-consuming and introduce delays. The Next Generation Linkage System Clerical Review tool (NGLMS-CR) is a configurable web application which side-steps these issues. The NGLMS-CR allows rapid response to changing project requirements.
Objectives and ApproachWe wanted a lightweight platform-independent tool to run in any modern web-browser. This avoids a need for special administrative privileges and allows rapid deployment/update. The NGLMS-CR communicates via a simple RESTful protocol to a server managing user-permissions, workflows and review data. Data is stored in a relational or graph database. The NGLMS-CR does not require a graph database.
Users see various workpools (collections of records) and work through these at their own pace. Different workpools may be configured for different requirements, e.g. clusters requiring special expertise, clusters requiring higher data security, overly-large clusters &c. Custom workflows are built around workpools. Individual clusters can have customisable status indicators displayed to highlight integrity checks and other information, e.g. a cluster containing multiple birth records or containing records with inconsistent gender information.
The tool also promotes ergonomic and health objectives as well as collecting metrics about review activity. The review session tracks reviewer engagement and gives feedback on the situation so far: how long has been spent reviewing; how long activity has been undertaken without a break. The user is given visual warnings when sessions extend beyond a set time. Activity is logged and metrics regarding throughput/accuracy collated for analysis.ResultsIn real-time manual clerical review tasks the customisable nature of the NGLMS-CR has proven important. Changes are immediately visible to users and workflow and status icons changes available with no delay while software is ‘rolled out’.
Conclusion / ImplicationsUncoupling review from any particular linkage system enables flexibility in project administration. A web-based review application may run on any system and requires minimal administrative permissions. This facilitates deployment in sensitive environments. Customisable workflow allows quick creation of ad hoc projects/tasks, even mid-project as new situations are discovered. Customisable cluster integrity checks allows cluster- and project-sensitive feedback to be rapidly deployed to aid review. By being flexible and independent the NGLMS-CR can supplement and complement existing linkage and review processes.
Vaccine-Preventable Infections Among Solid Organ Transplant Recipients: A Data-Linked Cohort Study, Australia, 2000-2015
Authors: Waller Karen MJ , De La Mata Nicole L , Wyburn Kate R , Kelly Patrick J , Ramachandran Vidiya , Shah Karan , Morton Rachael , Rawlinson William D , Webster Angela C 
Published: December 2020

IntroductionRecipients of solid organ transplants are at risk of serious infection due to immunosuppression. Some infections are preventable with vaccination; infection rates vary with immunosuppression, vaccination rates and baseline disease prevalence. Both adherence with and response to vaccination in this population are variable, and optimum vaccination strategies continue to be refined.
Objectives and ApproachWe aimed to characterise the incidence and complications of vaccine-preventable infections in transplant recipients. Eligible participants received an organ transplant in New South Wales, Australia, in 2000-2015. Linkage was undertaken between transplant registries and the notifiable conditions information management system. Vaccine-preventable infections were diphtheria, Haemophilus influenzae type b, influenza, invasive pneumococcal disease, measles, mumps, pertussis, poliovirus, rubella and tetanus. Standardized incidence ratios (SIR) were calculated relative to Australian population notification rates, standardizing for gender, age and calendar year.
ResultsAmong 3,394 recipients, 399 vaccine-preventable infections affected 339 (10%) recipients. Influenza was the most common vaccine-preventable infection with 352 notifications among 305 recipients. Influenza cases were 8.9 times more common among transplant recipients than the general population (95%CI: 8.0-10.0). In 36 cases (10%), hospitalization was required, and 2 deaths due to influenza were reported.
There were 20 notifications of invasive pneumococcal disease (IPD) for 18 recipients. IPD occurred 10.2 times more often among transplant recipients than the general population (95%CI: 6.4-16.2). Most (n=13, 65%) cases were hospitalized, and one patient died from IPD.
Cases of pertussis occurred only slightly more often than in the general population (SIR 1.5, 95%CI: 1.0-2.3). Of 26 cases, there was one reported hospitalization and no deaths due to pertussis. Only one case of mumps, and no other vaccine-preventable infections, were reported.
ConclusionTransplant recipients have excess cases of influenza and IPD compared to the general population, although this has improved over time. The need for appropriate recipient vaccination is emphasized.
Spatial Linkage of Electronic Health Records and Census Data in A Children’s Hospital
Authors: Tan Jonathan M , Tam Vicky , Galvez Jorge A , Hsu Grace , Quarshie William , Wasey Jack O , Nelson Olivia , Simpao Allan F 
Published: December 2020

IntroductionSocial determinants of health (SDOH) has a significant impact on access to health. Risk stratification of patients who have difficulty accessing care could allow for triaging of peri-operative resources. Unfortunately, there is a limited amount of SES factors available to study in electronic health records (EHR).
Objectives and ApproachOur objective was to understand the SES and location risk factors that are associated with paediatric patients arriving late to the hospital for elective surgery. We conducted a retrospective study of paediatric patients requiring elective surgery from 2015-2019. Spatial linkage of EHR data with US Census–ACS 2017 data was conducted. Analysis was at patient and neighbourhood block group levels. Statistical analysis was conducted utilizing SAS, Python and ArcGIS.
ResultsOur study had 40,943 patients with 7,453 patients (18.2%) who arrived ≥15 minutes late from their scheduled arrival. Patient level risk factors for arriving late included younger age, Black and Indian patients, non-English speaking, government insurance, increased co-morbidities and earlier appointments. The median time of arrival for patients arriving late was 23.0 minutes (18.0-33.0 minutes IQR), versus the on-time group of 7 min (4-22 minutes IQR) early. Median drive time and distance, using network analysis was not a significant factor. Statistically significant neighbourhood risk factors for arriving late included block groups with high unemployment, households receiving public assistance, low income households, higher number of high-school drop outs, female-headed households, more renter-occupied houses, and areas with high turnover. Logistic regression demonstrated neighbourhoods with the lowest quintile SES were 30% more likely to be late than the areas with the highest SES (p<0.001).
Conclusion / ImplicationsWe successfully identified patient and neighbourhood socioeconomic risk factors for arriving late to the hospital leveraging geospatial methods and EHR data. Leveraging EHR data with geospatial analytics can augment our understanding of the SDOH that may impact the delivery of care.
Muslim Society Perception of The Unregistered Divorce
Authors: Lutfi Lutfi , Akbar Muhammad , Marzuki Marzuki 
Published: December 2020

The aim of this paper is to discuss the view of Muslim people in Marawola, district of Sigi, towards unregistered divorce. This study uses qualitative methods and data was gathered through observation, in-depth interviews, and written material. Data analysis was analyzed using grounded theory approach. The results showed that the understanding and view of the Marawola community towards unregistered divorce was that of divorce carried out outside a religious court involving only husband and wife and religious leaders. On other occasions, it also involved village officials, where the divorce was only confirmed by a letter of freedom signed by the husband and wife, two witnesses and sometimes also signed by the village head as the one who knew.
PLATELET DISTRIBUTION WIDTH VALUE AS A DIAGNOSTIC AND PROGNOSTIC MARKER IN ACUTE CORONARY SYNDROME
Authors: Latif Rahmi Rifany , Kurniawan Liong Boy , Rauf Darmawati 
Published: December 2020

An acute coronary syndrome is a form of clinical manifestation of coronary heart disease with atherosclerosis, and thrombosis processes. Platelets play an essential role in thrombosis. High PDW shows a variation of the morphology, and size of a platelet. This was a retrospective cross-sectional study comparing PDW, length of stay, and patient outcome in STEMI, NSTEMI, UAP, and control patients at the Dr.Wahidin Sudirohusodo Hospital Makassar during the period of January 2014 – December 2015. Data were analyzed using statistical software. One hundred, and seventy-two ACS patients were included; 65 patients had UAP, 48 patients had STEMI and 59 patients had NSTEMI. Sixty normal patients were included as a control. Kruskal-Wallis test showed a statistical difference in PDW between patients with STEMI, NSTEMI, UAP, and control (p=0.000). Post hoc test showed a significant difference between ACS, and control, STEMI, and control (p=0.000), NSTEMI and control (p=0.000), UAP, and control (p=0.000), but there no significant difference between STEMI, and NSTEMI (p=0.320), STEMI, and UAP (p=0.980), NSTEMI and UAP (p=0.435). There was no significant difference in PDW between patients who survived, and died (p=0.298), and also patients with a length of stay of â‰¤ 7 days, and > 7 days (p=0.293). Platelet distribution width was higher in ACS patients compared with control patients, but could not be used to predict the outcome, and length of stay of patients with ACS. It is advisable to do further research with a large sample size to avoid bias.
BALANCE OF PROINFLAMMATORY AND ANTI INFLAMMATORY MARKERS IN ROUTINE HEMODIALYZED PATIENTS (A STUDY OF END-STAGE RENAL FAILURE PATIENTS AT THE DR. SARDJITO HOSPITAL YOGYAKARTA)
Authors: Puspitawati Ira , P Purwanto A , Suromo Lisyani B. 
Published: December 2020

Patients with End-Stage Renal Disease (ESRD) tend to have immune imbalance triggered by uremia and Hemodialysis (HD) procedures. Contact between dialysis membrane and blood will cause bio-incompatibility reactions inducing complement activation and production of Reactive Oxygen Species (ROS) as well as proinflammatory cytokines and acute phase protein such as C-Reactive Protein (CRP). Those immune response imbalances will lead to an immunocompromised condition. The objective of this study was to prove the correlation between inflammatory markers (IL-1Î², IL-6 and C-reactive proteins) and its anti-inflammatory marker (IL-10) in routine hemodialyzed patients. This is a cross-sectional observational study involving 90 subjects conducted at the Hemodialysis Installation of the Dr. Sardjito Hospital. The inclusion criteria of this study were patients who underwent routine HD procedures, aged between 18 and 65 years-old, having leukocytes count and albumin level within normal limit. The exclusion criteria of this study were patients with Acute Coronary Syndrome (ACS) and malignancies. Levels of IL-1Î², IL-6 and IL-10 were measured using Enzyme-Linked Immunosorbent Assay (ELISA), while CRP was measured using highly-sensitive CRP immunoturbidimetry. Statistical analysis was performed by Spearman test. This study results showed correlations between IL-1Î²and IL-10 (p=0.001, r=0.302), IL-6 and IL-10 (p=0.001, r=0.418) and correlation between CRP and IL-10 (p=0.005, r=0.295). There were also correlations between IL-1Î² and IL-6 (p=0.029, r=0.232), IL-6 and CRP (p=0.001, r=0.534), but no correlation was found between IL- 1Î² and CRP (p=0.431, r=0.073). All factors that trigger the secretion of proinflammatory cytokines will trigger the release of anti-inflammatory cytokines, the consequences of anti-inflammatory cytokine secretion will happen minutes after the release of inflammatory cytokines. This study showed that there were correlations between proinflammatory and anti-inflammatory cytokines. Further studies of polymorphism-related cytokines secretion are warranted.