bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reducing ultrasound in diagnosing deep vein thrombosis by using clinical scores and D-dimer testing
Authors: Zaid Nehad Abdou , El Desoky Mahmoud S. , F. Attia Seham 
Published: January 2020

Background: To reduce unnecessary venous ultrasound examination in cases suspected to have deep venous thrombosis (DVT) in emergency department by using D dimer and wells score. venous duplex is widely used to diagnose DVT increasing burden on ultrasound in overcrowded emergency department. Authors can decrease this burden by using clinical probability scores and D dimer.Methods: This is prospective study done on 50 consecutive patients suspected to have DVT represented to emergency department of Menoufia University Hospital during the period from June 2018 to June 2019. Full history, physical examination, assessment of clinical probability score, d dimer level and results of venous duplex collection.Results: According to wells score, the majority of cases diagnosed as DVT were of high probability group 13(68.4%), 5 patients with moderate probability and only one patient with low probability was diagnosed as DVT. The mean of D dimer level in cases diagnosed as DVT is (4173.6±2173.1) and in cases without DVT is (927.4±1064.6). Using wells score and D dimer together, sensitivity is 100%, Specificity is 94%. PPV is 90%, and NPV is 100% in predicting DVT. All cases with negative d dimer and low risk probability do not have DVT.Conclusions: Based on this result, using wells score and d dimer level in early work up of patients suspected to have DVT will decrease overusing and cost of venous duplex.
A clinical study for preoperative prediction of cyst-biliary communications in hepatic hydatid cyst disease
Authors: Sharma Dharmanjai K. , Khedar Mukesh , Sukhadia Mukta , Sethi Deepak 
Published: January 2020

Background: Cyst-biliary communication with hepatic hydatid cyst disease is responsible for postoperative bile leakage after surgical management. This study aims to detect various predictors of cyst-biliary communication and their predictive accuracy.Methods: This study was done in the patients of hydatid cysts who underwent surgical management for hydatid disease of the liver. Various factors were studied and their accuracy for preoperative prediction of cyst-biliary communication analyzed.Results: There were 38 (22 males, 16 females) patients with hepatic hydatid cysts with a mean age of 38.7±15.4 years. Cyst-biliary communications were detected in 12 patients (31.6%). Independent strong predictors were tenderness in right hypochondrium (p=0.035), total leucocyte count (TLC)>12,000/mm3 (p=0.0017), eosinophil count >5 × 108/l (p=0.0086), red blood cell distribution width (RDW) >15% (p=0.014), segment IV,V,VII involvement and cyst size >10 cms (p=0.01) on multivariate analysis.Conclusions: Cyst-biliary communication is more common in patients presenting with tenderness in right hypochondrium, large cyst size, location in the central segments of liver close to biliary confluence, and with high values of TLC, Eosinophil count and RDW. The predictors demonstrated in this study should allow the likelihood of cyst-biliary communication to be determined preoperatively and, thus, indicate the need for additional procedures during operations to prevent the complications of biliary leakage.
FACTORS INFLUENCING INCOME SMOOTHING PRACTICE IN THE OIL AND NATURAL GAS MINING COMPANIES DURING 2012-2016 PERIOD
Authors: Ernayani Rihfenti , Herianingrum Sri , Widiastuti Tika , Pudjut Harianto Rudy , Isradi Zainal Muhammad 
Published: January 2020

Purpose of the study: This study aims to determine factors that influence the practice of income smoothing in a company.
Methodology: Method of analysis applied logistic regression. This study employed a logistic regression analysis. The use of logistic regression is because the dependent variable is a dummy variable.
Main Findings: Results of the test results show that company size significantly influences the income smoothing practice; while for variables of financial leverage, profitability, and public ownership partially give no effect on the practice of income smoothing.
Applications of this study: Observations were done in oil and natural gas mining companies during 2012-2016.
Novelty/Originality of this study: The results of this study show that the size of the company affects the practice of income smoothing in the oil and natural gas mining companies listed in Indonesia Stock Exchange during the 2012-2016 period. Meanwhile, the financial leverage, profitability, and public ownership partially have an insignificant influence on the practice of income smoothing.
Vector analysis of Contoura Vision for the correction of myopia and myopic astigmatism
Authors: Author) Ying Lin(Former Corresponding , Huanjun Su , Jianbin Wu , Xia Zhang , Author) Yuan Muzhi(New Corresponding 
Published: January 2020

Abstract

Objective: To evaluate the visual outcomes of Contoura Vision with automatic eye tracking system in eyes with myopia and myopic astigmatism.
Methods: In this prospective study, 40 consecutive patients (80 eyes) with moderate myopia and irregular astigmatism were included from January to August 2018 at Liuzhou Worker’s Hospital. Subjects were randomly divided into an experimental group (40 eyes) that underwent Contoura Vision FS-LASIK and a control group (40 eyes) that underwent wavefront-optimized FS-LASIK. Target refractions of all subjects were plano. Visual outcomes and astigmatic vector analysis were evaluated and compared between preoperatively and 3 months post-operatively.
Results: The preoperative spherical and cylindrical refractive errors were similar in both groups (P>0.05). At 3 months postoperatively, cumulative uncorrected distance visual acuity (UDVA) was 20/16, 20/20, or 20/25 in 30 %, 95%, 100 % of patients in the experimental group, respectively. The experimental group was better than the control group in predictability of astigmatism correction at 3 months after operation. In the experimental group, 80% of eyes had deviation of astigmatic axis within 15° and 35% of eyes had deviation of astigmatic axis within 5°, both were better than those in the control group. The number of eyes with residual astigmatism within 0.5D were higher in the experimental group (60%, 24 eyes) than the control group (50%, 20 eyes). Compared with the preoperative, C7 significantly reduced to 0.056±0.030 in the experimental group at 3 months after the procedure (P<0.05), and were significantly lower than those in the control group (P<0.05).
Conclusion: Contoura Vision with automatic eye tracking system was safe and effective for the correction of myopia and myopic astigmatism.
Predicting the need for supportive services after discharged from hospital: a systematic review
Authors: Kobewka Daniel , Mulpuru Sunita , Chassé Michaël , Thavorn Kednapa , Lavallée Luke , English Shane , Neilipovitz Benjamin , Neilipovitz Jonathan , Forster Alan , McIsaac Daniel 
Published: January 2020

Abstract
Background
Some patients admitted to acute care hospital require supportive services after discharge. The objective of our review was to identify models and variables that predict the need for supportive services after discharge from acute care hospital.
Methods
We performed a systematic review searching the MEDLINE, CINAHL, EMBASE, and COCHRANE databases from inception to May 1st 2017.
We selected studies that derived and validated a prediction model for the need for supportive services after hospital discharge for patients admitted non-electively to a medical ward. We extracted cohort characteristics, model characteristics and variables screened and included in final predictive models. Risk of bias was assessed using the Quality in Prognostic Studies tool.
Results
Our search identified 3362 unique references. Full text review identified 6 models. Models had good discrimination in derivation (c-statistics >0.75) and validation (c-statistics >0.70) cohorts. There was high quality evidence that age, impaired physical function, disabilities in performing activities of daily living, absence of an informal care giver and frailty predict the need for supportive services after discharge. Stroke was the only unique diagnosis with at least moderate evidence of an independent effect on the outcome. No models were externally validated, and all were at moderate or higher risk of bias.
Conclusions
Deficits in physical function and activities of daily living, age, absence of an informal care giver and frailty have the strongest evidence as determinants of the need for support services after hospital discharge.
Trial Registration: This review was registered with PROSPERO #CRD42016037144
Challenges with Scale-up of GeneXpert MTB/RIF® inUganda: a Health Systems Perspective
Authors: Nalugwa Talemwa , Shete Priya B. , Nantale Mariam , Farr Katherine , Ojok Christopher , Ochom Emma , Mugabe Frank , Joloba Moses , Dowdy David W. , Moore David A.J. , Davis J. Lucian , Cattamanchi Adithya , Katamba Achilles 
Published: January 2020

Abstract
Background: Many high burden countries are scaling-up GeneXpertÒMTB/RIF (Xpert) testing for tuberculosis (TB) using a hub-and-spoke model. However, the effect of scale up on reducing TB has been limited. We sought to characterize variation in implementation of referral-based Xpert TB testing across Uganda, and to identify healthsystem factors that may enhance or prevent high-qualityimplementation of Xpert testing services. Methods: We conducted a cross-sectional study triangulatingquantitative and qualitative data sources at 23 community health centers linked to one of 15 Xpert testing sites between November 2016 and May 2017 to assess health systems infrastructure for hub-and-spoke Xpert testing. Data sources included a standardized site assessment survey, routine TB notification data, and field notes from site visits. Results: Challenges with Xpert implementation occurred at every step of the diagnostic evaluation process, leading to low overall uptake of testing. Of 2,192 patients eligible for TB testing, only 574 (26%) who initiated testing were referred for Xpert testing. Of those, 54 (9.4%)were Xpert confirmed positive just under half initiated treatment within 14 days (n=25, 46%). Gaps in required infrastructure at 23 community health centers to support the hub-and-spoke system included lack of refrigeration (n=14, 61%) for sputum testing and lack of telephone/mobile communication (n=21, 91%). Motorcycle riders responsible for transporting sputum to Xpert sites operated variable with trips once, twice, or three times a week at 10 (43%), nine (39%) and four (17%) health centers, respectively. Staff recorded Xpert results in the TB laboratory register at only one health center and called patients with positive results at only two health centers. Of the 15 Xpert testing sites, five (33%) had at least one non-functioning module. The median number of tests per day was 3.57 (IQR 2.06-4.54), and 10 (67%) sites had error/invalid rates >5%. Conclusions: Although Xpert devices are now widely distributed throughout Uganda, health system factors across the continuum from test referral to results reporting and treatment initiation preclude effective implementation of Xpert testing for patients presenting to peripheral health centers. Support for scale up of innovative technologies should include support for communication, coordination and health systems integration.
Establishing a Normative Database for Quantitative Pupillometry in the Pediatric Population
Authors: Shah Sanket S , Ranaivo Hantamalala Ralay , Mets-Halgrimson Rebecca B , Rychlik Karen , Kurup Sudhi P 
Published: January 2020

Abstract
Background Pupillary evaluation is a crucial element of physical exams. Noting size, reactivity, and consensual response is critical in assessing for optic nerve dysfunction. We aim to establish normative data for scotopic pupillary size and function in the pediatric population in a clinical setting. Methods Pupillometry was obtained prospectively for consecutive, normal patients <18 years old being evaluated by Lurie Children’s Ophthalmology. Quantitative data included maximum (MAX) and minimum (MIN) diameters, constriction percentage (CON), latency (LAT), average (ACV) and maximum (MCV) constriction velocities, average dilation velocity (ADV), and 75% recovery time (T75). Iris color was noted as light, intermediate, or dark. Results 196 eyes of 101 participants (42.6% male, ages 1–17 years, average age 10.3 years) were analyzed. Mean MAX was 6.6 mm (5.1–8.1 mm 95% CI); MIN was 4.7 mm (3.1–6.1 mm 95% CI); CON was 30% (17–42% 95% CI); LAT was 230 milliseconds (160–300 ms 95% CI); ACV was 3.70 mm/sec (2.21–5.18 mm/sec 95% CI); and ADV was 0.88 mm/sec (0.38–1.38 mm/sec 95% CI). Age had a positive correlation with MAX, MIN, and CON. 84.2% and 95.8% of participants showed resting pupil asymmetry of ≤0.5 mm and ≤1.0 mm, respectively. Conclusions Quantitative pupillometry can be a useful tool for screening pediatric patients. We sought to establish normative data in this group. We found males to have significantly greater MCV and CON than females (p < 0.05). Also, age had a positive correlation with MAX, MIN, and CON.
360-Degree Delphi: addressing sociotechnical challenges of healthcare IT
Authors: Waldmueller Heiko Dominik , Spreckelsen Cord , Rudat Hannah , Krumm Norbert , Rolke Roman , Jonas Stephan Michael 
Published: January 2020

Abstract
This approach uses the strong advantages a Delhi study has, identifies the disadvantages of traditional Delphi techniques and aims to introduce and evaluate a modified approach called 360-Degree Delphi. Key aspects of 360-Degree Delphi are tested by applying the approach to the needs and requirements analysis of a system for managing patients’ advance directives and living wills. 360-Degree Delphi, as a modified Delphi process, is specified as a structured workflow with the optional use of stakeholder groups. Consensus is created within individual stakeholder groups, but is also communicated between groups, while the iterative structure of the Delphi process remains unchanged. We hypothesize that (1) 360-Degree Delphi yields complementary statements from different stakeholders, which would be lost in classical Delphi; while (2) the variation of statements within individual stakeholder groups is lower than within the total collective. A user study is performed that addresses five stakeholder groups (patients, relatives, medical doctors, nurses and software developers) on the topic of living will communication in an emergency context. About 25% of the invited experts (stakeholders) agreed to take part in the Delphi round 0 (three patients, two relatives, three medical doctors, two qualified nurses and three developers), forming a structured panel of the five stakeholder groups. Two raters created a bottom-up coding, and 238 thematic codes were identified by the qualitative text analysis. Based on a consented coding list, a quantitative online-questionnaire was developed and send to different stakeholder groups. With respect to the hypotheses, Delphi round 0 had the following results: (1) doctors had a completely different focus from all the other stakeholder groups on possible channels of communications with the patient; (2) the dispersion of codes within individual stakeholder groups and within the total collective was approximately 28% higher in the total collective than in the sub-collectives, but without a marked effect size. With respect to the hypotheses, Delphi round 1 had the following results: different stakeholder groups had highly diverging opinions with respect to central questions on IT-development. In comparison, the total group would not be representative of either of these individual stakeholder needs (mean 4,344, stdev +/- 1,870)
The Roles of Lumbar load thresholds in lifetime cumulative lifting exposure to predict disk protrusion in an Asian Population
Authors: Hung Isabella Yu-Ju , Shih Tiffany Ting-Fang , Chen Bang-Bin , Ho Ing-Kang , Liou Saou-Hsing , Guo Yue Leon 
Published: January 2020

Abstract
Background: The purpose of this study was to determine whether a specific threshold per lifting movement, the accumulation above which best predicts lumbar disk protrusion, exists or the total lifting load should be considered. Methods: This was a retrospective study. Subjects with various lifting exposures were recruited. Disk protrusion was assessed by magnetic resonance imaging. The cumulative lifting load was defined as the sum of the time-weighed lumbar load for each job and was calculated using a biomechanical software system. The effectiveness of accumulation above different thresholds in predicting disk protrusion were compared using four statistical methods. Results: A total of 252 men and 301 women were included in the final analysis. For the men, 3000 Newtons for each lifting task was the optimal threshold for predicting L4-S1 disk protrusion, whereas for the women, 2800 Newtons was optimal. Conclusions Our findings suggested that for cumulative lifting exposure, including the total lifting load without defining a minimal exposure limit might not be the optimal method for predicting disk protrusion. The NIOSH 3400 Newton recommended limits do not appear to be the optimal thresholds for preventing disk protrusion. Different lifting thresholds might be needed for men and women in the workplace for their safety.
Retrospective analysis of cases of intraoperative awareness in a large multi-hospital health system reported in the early postoperative period
Authors: Deis Amanda S. , Schnetz Michael P. , Ibinson James W. , Vogt Keith M 
Published: January 2020

Abstract
Background : Awareness with recall under general anesthesia remains a rare but important issue that warrants further study. Methods : We present a series of seven cases of awareness that were identified from provider-reported adverse event data from the electronic anesthesia records of 647,000 general anesthetics. Results : The low number of identified cases suggests an under-reporting bias. Themes that emerge from this small series can serve as important reminders to anesthesia providers to ensure delivery of an adequate anesthetic for each patient. Commonalities between a majority of our identified anesthetic awareness cases include: obesity, use of total intravenous anesthesia, use of neuromuscular blockade, and either a lack of processed electroencephalogram (EEG) monitoring or documented high depth of consciousness index values. An interesting phenomenon was observed in one case, where adequately-dosed anesthesia was delivered without technical issue, processed EEG monitoring was employed, and the index value suggested an adequate depth of consciousness throughout the case. Conclusions : Provider-reported adverse event data in the immediate post-operative period are likely insensitive for detecting cases of intraoperative awareness. Though causation cannot firmly be established from our data, themes identified in this series of cases of awareness with recall under general anesthesia provide important reminders for anesthesia providers to maintain vigilance in monitoring depth and dose of anesthesia, particularly with total intravenous anesthesia.
Prevalence and factors associated with intestinal parasitic infections among food handlers working at higher public University student’s cafeterias and public food establishments in Ethiopia: a systematic review and meta-analysis
Authors: Alemnew Birhan , Gedefaw Getnet , Diress Gedefaw , Bizuneh Asmamaw Demis 
Published: January 2020

Abstract
Background: Intestinal infection is still an important public health problem in low-income countries. Food handlers may be infected by a wide range of enteropathogens and have been implicated in the transmission of many infections to the public. Therefore, the aim of this review was to produce the pooled prevalence and factors associated with intestinal parasitic infections among food handlers working at higher public University student’s cafeterias and public food establishments in Ethiopia.

Methods: Articles published in PubMed/Medline, Hinari, Web of Science, Science Direct, and Google Scholar were used using a search strategy. Observational studies (cross-sectional) revealing the prevalence and factors associated with intestinal parasitic infections at higher public University student’s cafeterias and public food establishments were incorporated. Meta-analysis was computed using STATA version 14 statistical software. Heterogeneity of the study was assessed using Cochrane Q test statistics and I2 test. The pooled prevalence of the intestinal parasitic infection and associated factors among food handlers was calculated by the random-effect model.

Results: Out of 138 reviewed studies, 18 studies were included to estimate the pooled prevalence of intestinal parasitic infections among food handlers in Ethiopia. All the eighteen articles were included in the analysis. This study revealed that the pooled prevalence of intestinal parasitic infections was 28.5% (95%CI: 27.4, 29.7). E. hystolitica /E. dispar complex 6.38 (95%Cl: 5.73, 7.04), A.lumbricodes 4.12 (95%Cl: 3.56, 4.67), and G. lamblia 3.12(95%Cl: 2.65, 3.60) were the most common intestinal parasitic infections in this study. Untrimmed fingernail 3.04 (95% CI: 2.19, 4.22), do not washing hands after defecation 2.71 (95%CI: 1.93, 3.82), do not washing hands after touching any body parts 2.41 (95%CI: 1.64, 3.56), do not made medical checkup 2.26 (95%CI: 1.57, 3.25), and do not receive food safety training 1.79 (95%CI: 1.30, 2.45) were factors significantly and positively associated with intestinal parasitic infections.

Conclusion: Parasitic infections among food handlers were significantly high. Untrimmed fingernail, do not washing hands after defecation, do not washing hands after touching any body parts, do not made regular medical checkup and do not receive food safety training were factors that increase the prevalence of intestinal parasitic infections.
Simplified Molecular Classification of Lung Adenocarcinomas Based on EGFR, KRAS, and TP53 Mutations
Authors: Ruiz-Cordero Roberto , Ma Junsheng , Khanna Abha , Lyons Genevieve Ray , Rinsurongkawong Waree , Bassett Roland , Guo Ming , Routbort Mark J , Zhang Jianjun , Skoulidis Ferdinandos , Heymach John Victor , Roarty Emily B , Tang Zhenya , Medeiros L. Jeffrey , Patel Keyur P , Luthra Rajyalakshmi , Roy-Chowdhuri Sinchita 
Published: January 2020

Abstract
Background: Gene expression profiling has consistently identified three molecular subtypes of lung adenocarcinoma that have prognostic implications. To facilitate stratification of patients with this disease into similar molecular subtypes, we developed and validated a simple, mutually exclusive classification. Methods: Mutational status of EGFR , KRAS , and TP53 was used to define seven mutually exclusive molecular subtypes. A development cohort of 283 cytology specimens of lung adenocarcinoma was used to evaluate the associations between the proposed classification and clinicopathologic variables including demographic characteristics, smoking history, fluorescence in situ hybridization and molecular results. For validation and prognostic assessment, 63 of the 283 cytology specimens with available survival data were combined with a separate cohort of 428 surgical pathology specimens of lung adenocarcinoma. Results: The proposed classification yielded significant associations between these molecular subtypes and clinical and prognostic features. We found better overall survival in patients who underwent surgery and had tumors enriched for EGFR mutations. Worse overall survival was associated with older age, stage IV disease, and tumors with co-mutations in KRAS and TP53 . Interestingly, neither chemotherapy nor radiation therapy showed benefit to overall survival. Conclusions: The mutational status of EGFR , KRAS , and TP53 can be used to easily classify lung adenocarcinoma patients into seven subtypes that show a relationship with prognosis, especially in patients who underwent surgery, and these subtypes are similar to classifications based on more complex genomic methods reported previously.