bluuebunny/crossref_metadata_2025_split huggingface dataset:
Drug utilisation among Dutch adolescents: a pharmacy prescription records study
Authors: Kosse Richelle C , Koster Ellen S , de Vries Tjalling W , Bouvy Marcel L 
Published: June 2018

BackgroundStudies on adolescent drug use are scarce as most studies do not distinguish between children and adolescents. Therefore, we assessed overall drug use in adolescents.MethodsA retrospective cohort study was conducted using pharmacy dispensing records from 62 community pharmacies in the Netherlands. Dispensing records of the previous 5 years were extracted for adolescents (12–18 years).ResultsThe study population consisted of 47 421 adolescents who collected at least one medication prescription during adolescence (mean age 15.5±1.8 years; 48.9% males). Half of them collected dermatologicals (46.2% males; 52.3% females), followed by drugs for the respiratory system (43.4% males; 40.3% females) and anti-infectives for systemic use (31.3% males; 39.1% females). The percentage of males using dermatologicals slightly increased, while the percentage of female users decreased with age. The most prescribed active ingredient was methylphenidate.ConclusionsThese insights into adolescent drug use help us to better understand adolescent healthcare use.Trial registration numberDutch trial register NTR5061.
Evaluation of keratoconus progression
Authors: Shajari Mehdi , Steinwender Gernot , Herrmann Kim , Kubiak Kate Barbara , Pavlovic Ivana , Plawetzki Elena , Schmack Ingo , Kohnen Thomas 
Published: June 2018

AimTo define variables for the evaluation of keratoconus progression and to determine cut-off values.MethodsIn this retrospective cohort study (2010–2016), 265 eyes of 165 patients diagnosed with keratoconus underwent two Scheimpflug measurements (Pentacam) that took place 1 year apart ±3 months. Variables used for keratoconus detection were evaluated for progression and a correlation analysis was performed. By logistic regression analysis, a keratoconus progression index (KPI) was defined. Receiver-operating characteristic curve (ROC) analysis was performed and Youden Index calculated to determine cut-off values.ResultsVariables used for keratoconus detection showed a weak correlation with each other (eg, correlation r=0.245 between RPImin and Kmax, p<0.001). Therefore, we used parameters that took several variables into consideration (eg, D-index, index of surface variance, index for height asymmetry, KPI). KPI was defined by logistic regression and consisted of a Pachymin coefficient of −0.78 (p=0.001), a maximum elevation of back surface coefficient of 0.27 and coefficient of corneal curvature at the zone 3 mm away from the thinnest point on the posterior corneal surface of −12.44 (both p<0.001). The two variables with the highest Youden Index in the ROC analysis were D-index and KPI: D-index had a cut-off of 0.4175 (70.6% sensitivity) and Youden Index of 0.606. Cut-off for KPI was −0.78196 (84.7% sensitivity) and a Youden Index of 0.747; both 90% specificity.ConclusionsKeratoconus progression should be defined by evaluating parameters that consider several corneal changes; we suggest D-index and KPI to detect progression.
Self-rated walking pace and all-cause, cardiovascular disease and cancer mortality: individual participant pooled analysis of 50 225 walkers from 11 population British cohorts
Authors: Stamatakis Emmanuel , Kelly Paul , Strain Tessa , Murtagh Elaine M , Ding Ding , Murphy Marie H 
Published: June 2018

Background/objectivesWalking pace is associated with risk of premature mortality. However, whether this relationship is independent of total volume of physical activity and highest physical activity intensity remains unclear. We examined the associations between walking pace and cause-specific mortality, investigating the potential modifying effect of factors such as total physical activity volume, highest physical activity intensity, age, sex and body mass index (BMI).MethodsProspective pooled analysis of 11 population-based baseline surveys in England and Scotland between 1994 and2008 that were linked with mortality records. Multivariate-adjusted Cox proportional hazards models examined associations between walking pace (slow, average, brisk/fast) and all-cause, cancer and cardiovascular disease (CVD) mortality.Results50 225 walkers were entered in the core analyses. Among participants who did not experience an event in the first 2 years of follow-up (n=49 731), walking at an average or brisk/fast pace was associated with a reduced risk of all-cause (20% (95% CI 12% to 28%) and 24% (95% CI 13% to 33%), respectively) and CVD mortality (24% (95% CI 9% to 36%) and 21% (95% CI 1% to 38%), respectively), compared with reporting walking at a slow pace. In stratified analyses, such associations were evident among those over 50 years, those not meeting the physical activity recommendations and those who did not undertake vigorous-intensity activity. There were no interactions by sex or BMI. No associations were seen between pace and cancer mortality.ConclusionWalking benefits health. Assuming causality, these analyses suggest that increasing walking pace could reduce risk for all-cause and CVD mortality. Walking pace could be emphasised in public health messages, especially in situations when increase in walking volume or frequency is less feasible.
Walking on sunshine: scoping review of the evidence for walking and mental health
Authors: Kelly Paul , Williamson Chloë , Niven Ailsa G , Hunter Ruth , Mutrie Nanette , Richards Justin 
Published: June 2018

Background/objectivesWalking has well-established positive relationships with, and effects on, physical health. In contrast, while poor mental health contributes substantially to global health burden, an overview of the benefits from walking has not previously been published. We aimed to scope the literature and present what is known, and highlight what is not known, about walking and mental health.MethodsDesign: Scoping review.Data sources: Ovid (Medline), ProQuest, Web of Science.Screening and reporting: 13 014 records were identified and screened by a team of researchers. Included full texts were analysed and reported according to mental health outcome.ResultsFor the 8 mental health outcomes (identified a priori), there were a total of 5 systematic reviews and 50 individual papers included. Depression had the most evidence and existing systematic reviews were reported. Evidence for anxiety, psychological stress, psychological well-being, subjective well-being and social isolation and loneliness varied in volume and effectiveness, but no harmful effects were identified. There were no studies for walking and resilience. The setting and context of walking seems to be important variables.ConclusionThe evidence base that suggests walking benefits mental health is growing, but remains fragmented and incomplete for some important outcomes. Policy and national guidelines should promote the known mental health benefits of increased walking and future research should directly address the gaps we have identified.
Quantifying patient preferences for symptomatic breast clinic referral: a decision analysis study
Authors: Quinlan Aisling , O’Brien Kirsty K , Galvin Rose , Hardy Colin , McDonnell Ronan , Joyce Doireann , McDowell Ronald D , Aherne Emma , Keogh Claire , O’Sullivan Katriona , Fahey Tom 
Published: June 2018

ObjectivesDecision analysis study that incorporates patient preferences and probability estimates to investigate the impact of women’s preferences for referral or an alternative strategy of watchful waiting if faced with symptoms that could be due to breast cancer.SettingCommunity-based study.ParticipantsAsymptomatic women aged 30–60 years.InterventionsParticipants were presented with 11 health scenarios that represent the possible consequences of symptomatic breast problems. Participants were asked the risk of death that they were willing to take in order to avoid the health scenario using the standard gamble utility method. This process was repeated for all 11 health scenarios. Formal decision analysis for the preferred individual decision was then estimated for each participant.Primary outcome measureThe preferred diagnostic strategy was either watchful waiting or referral to a breast clinic. Sensitivity analysis was used to examine how each varied according to changes in the probabilities of the health scenarios.ResultsA total of 35 participants completed the interviews, with a median age 41 years (IQR 35–47 years). The majority of the study sample was employed (n=32, 91.4%), with a third-level (university) education (n=32, 91.4%) and with knowledge of someone with breast cancer (n=30, 85.7%). When individual preferences were accounted for, 25 (71.4%) patients preferred watchful waiting to referral for triple assessment as their preferred initial diagnostic strategy. Sensitivity analysis shows that referral for triple assessment becomes the dominant strategy at the upper probability estimate (18%) of breast cancer in the community.ConclusionsWatchful waiting is an acceptable strategy for most women who present to their general practitioner (GP) with breast symptoms. These findings suggest that current referral guidelines should take more explicit account of women’s preferences in relation to their GPs initial management strategy.
Patterns of smoking initiation during adolescence and young adulthood in South-West China: findings of the National Nutrition and Health Survey (2010–2012)
Authors: Zhang Qiang , Yu Bin , Chen Xinguang , Varma Deepthi S , Li Juanjuan , Zhao Jiang , Ruan Yuan , Han Xingmeng , Min Xiangdong , Liu Zhitao 
Published: June 2018

ObjectiveThis study aims to understand the age patterns of smoking initiation during adolescence and young adulthood in South-West China, where the prevalence of tobacco use is reported as the highest in the country.DesignA cross-sectional study.SettingThe data were derived from the China National Nutrition and Health Survey in Yunnan Province, South-West China (2010–2012).ParticipantsA total of 4801 participants aged 15–65 years were included.Primary outcome measuresA survival model was used to estimate the hazard of smoking initiation by age and log-rank test was used to compare the hazard curves across subgroups (men/women, urban/rural, Han Chinese/ethnic minority).ResultsThe prevalence of current smoking among men and women were 60.4% (95% CI 58.2% to 62.6%) and 5.1% (95% CI 4.3% to 5.9%), respectively. Smoking was more prevalent among men and women of lower education and less income, as well as rural and ethnic minority women. Among the current smokers, cigarette (80.7%) was the most commonly used tobacco product, followed by waterpipe (10.8%) and pipe tobacco (8.5%). The hazards of smoking initiation were low for both men and women before the age of 15 years (1% for men and 0.05% for women); and the hazards increased quickly from age 15 years and peaked at 19years (21.5% for men and 1.0% for women). Rural and ethnic minority women were at higher risk of smoking initiation than their counterparts between 15 years and 19 years of age (χ2=44.8, p<0.01; χ2=165.2, p<0.01) and no such difference was found in men.ConclusionsFindings of this study underscore the importance to implement tobacco prevention interventions among older teens and young adults in South-West China, especially for rural and ethnic minority women.
Interventional study to improve diabetic guidelines adherence using mobile health (m-Health) technology in Lahore, Pakistan
Authors: Hashmi Noreen Rahat , Khan Shazad Ali 
Published: June 2018

ObjectiveTo check if mobile health (m-Health) short message service (SMS) can improve the knowledge and practice of the American Diabetic Association preventive care guidelines (ADA guidelines) recommendations among physicians.MethodologyQuasi-experimental pre–post study design with a control group.ParticipantsThe participants of the study were 62 medical officers/medical postgraduate trainees from two hospitals in Lahore, Pakistan. Pretested questionnaire was used to collect baseline information about physicians’ knowledge and adherence according to the ADA guidelines. All the respondents attended 1-day workshop about the guidelines. The intervention group received regular reminders by SMS about the ADA guidelines for the next 5 months. Postintervention knowledge and practice scores of 13 variables were checked again using the same questionnaire. Statistical analysis included χ2and McNemar’s tests for categorical variables and t-test for continuous variables. Pearson’s correlation analysis was done to check correlation between knowledge and practice scores in the intervention group. P values of <0.05 were considered statistically significant.ResultsThe total number of participating physicians was 62. Fifty-three (85.5%) respondents completed the study. Composite scores within the intervention group showed statistically significant improvement in knowledge (p<0.001) and practice (p<0.001) postintervention. The overall composite scores preintervention and postintervention also showed statistically significant difference of improvement in knowledge (p=0.002) and practice (p=0.001) between non-intervention and intervention groups. Adherence to individual 13 ADA preventive care guidelines level was noted to be suboptimal at baseline. Statistically significant improvement in the intervention group was seen in the following individual variables: review of symptoms of hypoglycaemia and hyperglycaemia, eye examination, neurological examination, lipid examination, referral to ophthalmologist, and counselling about non-smoking.Conclusionm-Health technology can be a useful educational tool to help with improving knowledge and practice of diabetic guidelines. Future multicentre trials will help to scale this intervention for wider use in resource-limited countries.
A survey across four European countries to determine rheumatology health professionals’ awareness of physical activity measures in people with inflammatory joint diseases
Authors: Kennedy Norelee M , McKenna Sean G , O’Neill Aoife , Appel Esbensen Bente , Swinnen Thijs Willem , Nordgren Birgitta , Willemijns Sara , Hammer Nanna Maria , Brodin Nina 
Published: June 2018

ObjectivesThe objectives of this study were to determine rheumatology health professionals' (HPs)' awareness of and confidence in using physical activity (PA) measures in people with inflammatory joint diseases (IJDs), their own self-reported PA levels and to identify HP-related educational needs.MethodsRheumatology HPs in Denmark, Sweden, Ireland and Belgium participated in an on-line survey. Descriptive statistics and latent class analysis (LCA) were undertaken SPSS (v21and SASv9.4) to describe data aggregates and range and to identify subclasses of groups with respect to use of PA measures.Results322 (n=322, 75.5% women) HPs responded from Denmark (n=50, 15.5%), Sweden (n=66, 20.5%), Ireland (n=28, 8.7%) and Belgium (n=178, 55.3%) and the majority of respondents (n=286, 91.7%) reported it was important to measure PA in people with IJDs. Only 28.2% of HPs used simple body worn sensors to measure PA levels in their patients. The majority were interested in on-line education on measuring PA (82.9%). LCA, used to generate classes of PA measures employed by HPs, revealed three distinct classes reflecting differences in self-reported PA levels, awareness of PA measures, further education requirements and professional background.ConclusionsThe majority of respondents reported that they considered measuring PA as important in people with IJDs; however, the majority lacked confidence in how to measure it. There was strong interest in further education around measuring PA. Three distinct respondent classes were identified to inform targeted education on how to measure PA.
Quantifying the incidence and burden of herpes zoster in New Zealand general practice: a retrospective cohort study using a natural language processing software inference algorithm
Authors: Turner Nikki M , MacRae Jayden , Nowlan Mary L , McBain Lynn , Stubbe Maria H , Dowell Anthony 
Published: June 2018

ObjectiveTo investigate the incidence of primary care presentations for herpes zoster (zoster) in a representative New Zealand population and to evaluate the utilisation of primary healthcare services following zoster diagnosis.DesignA cross-sectional retrospective cohort study used a natural language processing software inference algorithm to identify general practice consultations for zoster by interrogating 22 million electronic medical record (EMR) transactions routinely recorded from January 2005 to December 2015. Data linking enabled analysis of the demographics of each case. The frequency of doctor visits was assessed prior to and after the first consultation diagnosing zoster to determine health service utilisation.SettingGeneral practice, using EMRs from two primary health organisations located in the lower North Island, New Zealand.ParticipantsThirty-nine general practices consented interrogation of their EMRs to access deidentified records for all enrolled patients. Out-of-hours and practice nurse consultations were excluded.Main outcome measuresThe incidence of first and repeated zoster-related visits to the doctor across all age groups and associated patient demographics. To determine whether zoster affects workload in general practice.ResultsOverall, for 6 189 019 doctor consultations, the incidence of zoster was 48.6 per 10 000 patient-years (95% CI 47.6 to 49.6). Incidence increased from the age of 50 years to a peak rate of 128 per 10 000 in the age group of 80–90 years and was significantly higher in females than males (p<0.001). Over this 11-year period, incidence increased gradually, notably in those aged 80–85 years. Only 19% of patients had one or more follow-up zoster consultations within 12 months of a zoster index consultation. The frequency of consultations, for any reason, did not change between periods before and after the diagnosis.ConclusionsZoster consultations in general practice are rare, and the burden of these cases on overall general practice caseload is low.
Automated enumeration of lymphoid and plasma cells in bone marrow to establish normal reference ranges
Authors: Liang James , Malherbe Jacques A J , Fuller Kathryn A , Mirzai Bob , George Carly , Carter Tina L , Cole Catherine H , Guo Belinda B , Meehan Katie , Erber Wendy N 
Published: June 2018

AimsThe number of precursor and mature lymphoid cells and plasma cells in normal bone marrow trephine (BMT) biopsies throughout the human lifespan is unknown. Reference ranges have been established from aspirated marrow, but due to haemodilution errors, these do not accurately reflect the native marrow milieu. We aimed to define age-specific, normal reference ranges for lymphoid and plasma cells in BMT biopsy specimens using a combined immunophenotyping and digital enumeration approach.MethodsMorphologically normal BMT biopsy specimens (n=483) were obtained from patients aged 1 month to 90 years of age. Immunohistochemistry was performed to identify lymphoid progenitors , T-lymphocytes (CD3), B-lymphocytes (CD20) and plasma cells (CD138 and MUM1). Positive cells were counted using digital enumeration software, and the percent positivity for each antigen was determined per case. Mean values were generated for specific age groups, and age-defined reference ranges were determined for each antigen using normalised data.ResultsA mean of 16 609 cells (range: 7210–34 097) were counted per biopsy. Infant marrows showed a predominance of immature lymphoid progenitors and B cells. With increasing age, an increase in mean T cell and plasma cell numbers were observed. The results showed the same trends to flow cytometry references for aspirate material although the absolute values differed.ConclusionsCombined immunohistochemistry and automated enumeration gives an accurate, reproducible number of antigen-positive cells and has generated normal reference ranges for these cell types in BMT biopsies. The method and ranges we have established have the potential to be applied in routine clinical practice.
PON1gene polymorphisms in patients with chronic obstructive pulmonary disease
Authors: Grdić Rajković Marija , Popović-Grle Sanja , Vukić Dugac Andrea , Rogić Dunja , Rako Ivana , Radić Antolić Margareta , Beriša Mirela , Rumora Lada 
Published: June 2018

AimsChronic obstructive pulmonary disease (COPD) is characterised with oxidative stress. Paraoxonase 1 (PON1) is an enzyme, coded byPON1gene, with distinctive antiatherogenic and antioxidative roles. We aimed to investigate the frequencies of Q192R, L55M and −108C>T polymorphisms and association of those polymorphisms with paraoxonase and arylesterase activities in patients with COPD.MethodsPON1genotype was determined by PCR–restriction fragment length polymorphism method. PON1 activity was measured by paraoxon and phenylacetate.ResultsOnly −108C>T polymorphism resulted in significantly different distribution of genotypes and alleles, with higher frequency of TT genotype and T allele in patients compared with control subjects. Moreover, T allele (OR 2.29 (95% CI 1.54 to 3.41); p<0.001) as well as TT genotype (OR 5.00 (95% CI 2.19 to 11.43); p<0.001) showed an association with the disease. −108C>T polymorphism was suggested as a significant diagnostic predictor for the disease (OR (95% CI) 2.65 (1.53 to 4.59), p=0.001), with an area under the receiver operating characteristic curve of 0.90 (95% CI 0.84 to 0.93) and with 83.90% of correctly classified cases.ConclusionsHigher frequency of TT genotype and T allele could contribute to the observed reduction of PON1 activity in patients with COPD. T allele and TT genotype are associated with COPD, and thePON1−108C>T polymorphism could be a potential predictor of the disease.
Association between age and outcomes following thrombectomy for anterior circulation emergent large vessel occlusion is determined by degree of recanalisation
Authors: Jayaraman Mahesh V , Kishkovich Thomas , Baird Grayson L , Hemendinger Morgan L , Tung Eric L , Yaghi Shadi , Cutting Shawna , Saad Ali , Burton Tina M , Mac Grory Brian , Haas Richard A , Furie Karen L , McTaggart Ryan A 
Published: June 2018

BackgroundOlder patients undergoing thrombectomy for emergent large vessel occlusion have worse outcomes. However, complete or near-complete reperfusion (modified Thrombolysis in Cerebral Ischemia (mTICI) score of 2 c/3) is associated with improved outcomes compared with partial recanalisation (mTICI 2b).ObjectiveTo examine the relationship between outcomes and age separately for the mTICI 2c/3, 2b and 0-2a groups in patients undergoing thrombectomy for anterior circulation emergent large vessel occlusion.MethodsRetrospective review of 157 consecutive patients undergoing thrombectomy at a single centre with an occlusion of the internal carotid artery (ICA), M1 or proximal M2 segments of the middle cerebral artery (MCA). Angiograms were graded in a blinded fashion. Patients were divided into three groups: mTICI 0-2a, mTICI 2b, and mTICI 2c/3. Demographics and workflow parameters were compared. Outcomes at 90 days were compared as a function of age, using both the conventional modified Rankin scale (mRs) and utility weighted mRs (UWmRs).ResultsThere were 72, 61 and 24 patients in the mTICI 2c/3, 2b and 0-2a groups, respectively. Outcomes were significantly worse with increasing age for the mTICI 2b group, but not for the mTICI 0-2a and 2c/3 groups (P=0.0002). With increasing age, outcomes of the mTICI 2b group approached those of the mTICI 0-2a group. However, outcomes of the mTICI 2c/3 groups were similar for all ages. This association was present for both the original mRs and UWmRs.ConclusionIncreasing age was associated with worse outcomes for those with partial (mTICI 2b) recanalisation, not in patients with complete (mTICI 2c/3) recanalisation.