bluuebunny/crossref_metadata_2025_split huggingface dataset:
Accuracy of lung cancer ICD-9-CM codes in Umbria, Napoli 3 Sud and Friuli Venezia Giulia administrative healthcare databases: a diagnostic accuracy study
Authors: Montedori Alessandro , Bidoli Ettore , Serraino Diego , Fusco Mario , Giovannini Gianni , Casucci Paola , Franchini David , Granata Annalisa , Ciullo Valerio , Vitale Maria Francesca , Gobbato Michele , Chiari Rita , Cozzolino Francesco , Orso Massimiliano , Orlandi Walter , Abraha Iosief 
Published: May 2018

ObjectivesTo assess the accuracy of International Classification of Diseases 9th Revision–Clinical Modification (ICD-9-CM) codes in identifying subjects with lung cancer.DesignA cross-sectional diagnostic accuracy study comparing ICD-9-CM 162.x code (index test) in primary position with medical chart (reference standard). Case ascertainment was based on the presence of a primary nodular lesion in the lung and cytological or histological documentation of cancer from a primary or metastatic site.SettingThree operative units: administrative databases from Umbria Region (890 000 residents), ASL Napoli 3 Sud (NA) (1 170 000 residents) and Friuli Venezia Giulia (FVG) Region (1 227 000 residents).ParticipantsIncident subjects with lung cancer (n=386) diagnosed in primary position between 2012 and 2014 and a population of non-cases (n=280).Outcome measuresSensitivity, specificity and positive predictive value (PPV) for 162.x code.Results130 cases and 94 non-cases were randomly selected from each database and the corresponding medical charts were reviewed. Most of the diagnoses for lung cancer were performed in medical departments.True positive rates were high for all the three units. Sensitivity was 99% (95% CI 95% to 100%) for Umbria, 97% (95% CI 91% to 100%) for NA, and 99% (95% CI 95% to 100%) for FVG. The false positive rates were 24%, 37% and 23% for Umbria, NA and FVG, respectively. PPVs were 79% (73% to 83%)%) for Umbria, 58% (53% to 63%)%) for NA and 79% (73% to 84%)%) for FVG.ConclusionsCase ascertainment for lung cancer based on imaging or endoscopy associated with histological examination yielded an excellent sensitivity in all the three administrative databases. PPV was moderate for Umbria and FVG but lower for NA.
Exploring variation in human papillomavirus vaccination uptake in Switzerland: a multilevel spatial analysis of a national vaccination coverage survey
Authors: Riesen Maurane , Konstantinoudis Garyfallos , Lang Phung , Low Nicola , Hatz Christoph , Maeusezahl Mirjam , Spaar Anne , Bühlmann Marc , Spycher Ben D , Althaus Christian L 
Published: May 2018

ObjectiveUnderstanding the factors that influence human papillomavirus (HPV) vaccination uptake is critically important to the design of effective vaccination programmes. In Switzerland, HPV vaccination uptake (≥1 dose) by age 16 years among women ranges from 31% to 80% across 26 cantons (states). Our objective was to identify factors that are associated with the spatial variation in HPV vaccination uptake.MethodsWe used cross-sectional data from the Swiss National Vaccination Coverage Survey 2009–2016 on HPV vaccination status (≥1 dose) of 14–17-year-old girls, their municipality of residence and their nationality for 21 of 26 cantons (n=8965). We examined covariates at municipality level: language, degree of urbanisation, socioeconomic position, religious denomination, results of a vote about vaccination laws as a proxy for vaccine scepticism and, at cantonal level, availability of school-based vaccination and survey period. We used a series of conditional autoregressive models to assess the effects of covariates while accounting for variability between cantons and municipal-level spatial autocorrelation.ResultsIn the best-fit model, living in cantons that have school-based vaccination (adjusted OR 2.51; 95% credible interval 1.77 to 3.56) was associated with increased uptake, while living in municipalities with lower acceptance of vaccination laws was associated with lower HPV vaccination uptake (OR 0.61; 95% credible interval 0.50 to 0.73). Overall, the covariates explained 88% of the municipal-level variation in uptake.ConclusionsIn Switzerland, both cantons and community opinion about vaccination play a prominent role in the variation in HPV vaccination uptake. To increase uptake, efforts should be made to mitigate vaccination scepticism and to encourage school-based vaccination.
Investigating admitted patients’ satisfaction with nursing care at Debre Berhan Referral Hospital in Ethiopia: a cross-sectional study
Authors: Sharew Nigussie Tadesse , Bizuneh Hailegiorgis Teklegiorgis , Assefa Hilina Ketema , Habtewold Tesfa Dejenie 
Published: May 2018

ObjectivesThe aims of the study were (1) to assess the level of patient satisfaction with nursing care and (2) to identify factors influencing patient satisfaction.DesignA hospital-based, cross-sectional study was conducted with 252 admitted patients in the medical, surgical and paediatric wards.SettingDebre Berhan Referral Hospital, Debre Berhan, Ethiopia, with a catchment population of 2.8 million.ParticipantsAll patients admitted at least for 2 days and capable of independent communication were included. However, patients were excluded on any one of the following conditions: admitted for less than 2 days, cannot understand Amharic language, with critical illness or cognitive impairment that affects judgement, or inability to provide written informed consent. The mean age of the patients was 37.9 (SD=12.9) years, and half (50.4%) of them were male.Primary outcome measurePatient satisfaction with nursing care, measured by the Newcastle Satisfaction with Nursing Scale, was the outcome variable. Using a mean split approach, patient satisfaction scores were dichotomised into ‘satisfied’ and ‘unsatisfied’.Results49.2% of patients were satisfied with nursing care. Educational status and history of admission were significant factors influencing patient satisfaction with nursing care. Patients who had high educational status were 80% less satisfied compared with those who had no formal education (p=0.01, OR=0.2, 95% CI 0.1 to 0.7). Patients who had a history of admission were 2.2 times more satisfied compared with those who had no history of admission (p=0.02, OR=2.2, 95% CI 1.2 to 4.2).ConclusionsAbout half the admitted patients were satisfied with the nursing care. Satisfaction differed significantly by patients’ educational attainment and history of admission. This study provided evidence on patient satisfaction with nursing care in Ethiopia. This information may be useful in comparative studies of patient satisfaction and in identifying characteristics that may explain or predict patient satisfaction.
Thrombectomy 6-24 hours after stroke in trial ineligible patients
Authors: Desai Shashvat M , Rocha Marcelo , Molyneaux Bradley J , Starr Matthew , Kenmuir Cynthia L , Gross Bradley A , Jankowitz Brian Thomas , Jovin Tudor G , Jadhav Ashutosh P 
Published: May 2018

Background and purposeThe DAWN and DEFUSE-3 trials demonstrated the benefit of endovascular thrombectomy (ET) in late-presenting acute ischemic strokes due to anterior circulation large vessel occlusion (ACLVO). Strict criteria were employed for patient selection. We sought to evaluate the characteristics and outcomes of patients treated outside these trials.MethodsA retrospective review of acute ischemic stroke admissions to a single comprehensive stroke center was performed during the DAWN trial enrollment period (November 2014 to February 2017) to identify all patients presenting in the 6–24 hour time window. These patients were further investigated for trial eligibility, baseline characteristics, treatment, and outcomes.ResultsApproximately 70% (n=142) of the 204 patients presenting 6–24 hours after last known well with NIH Stroke Scale score ≥6 and harboring an ACLVO are DAWN and/or DEFUSE-3 ineligible, most commonly due to large infarct burden (38%). 26% (n=37) of trial ineligible patients with large vessel occlusion strokes received off-label ET and 30% of them achieved functional independence (modified Rankin Scale 0–2) at 90 days. Rates of symptomatic intracranial hemorrhage and mortality were 8% and 24%, respectivelyConclusionTrial ineligible patients with large vessel occlusion strokes receiving off-label ET achieved outcomes comparable to DAWN and DEFUSE-3 eligible patients. Patients aged <80 years are most likely to benefit from ET in this subgroup. These data indicate a larger population of patients who can potentially benefit from ET in the expanded time window if more permissive criteria are applied.
Factors associated with condom use and HIV testing among young men who have sex with men: a cross-sectional survey in a random online sample in Sweden
Authors: Johansson Klara , Persson Kristina Ingemarsdotter , Deogan Charlotte , El-Khatib Ziad 
Published: May 2018

ObjectivesThe objectives are to analyse social determinants of sexual health behaviour (condom use and HIV testing) among young, internet-active, cis men who have sex with men (MSM) in a high-income country. The aspects of sexual health behaviour analysed here are condomless anal intercourse with one or more new or casual partner(s), condomless anal intercourse during the most recent sex with a man and HIV testing.MethodsA randomised sample of men active on Sweden’s main online community for Lesbian, Gay, Bisexual and Trans people responded to an online survey (response rate 19%). A subsample of young people, aged 15–29, was analysed (effective sample 597–669) using multivariable logistic regression with respect to factors associated with condomless anal intercourse with one or more new or casual partner(s), condomless anal intercourse at most recent sex and not having had a test for HIV.ResultsLow education, being single and living in a metropolitan area were found to be independently associated with condomless anal intercourse with new or casual partner(s). Sex with a steady partner was associated with condomless anal intercourse during the most recent sex. Knowledge of where to get tested, high education, being born outside Sweden and condomless anal intercourse with new or casual sex partner(s) were independently associated with having been tested for HIV.ConclusionsThe factors associated with sexual health behaviour among young MSM are complex, and preventive messages need to be tailored accordingly.
Assessing the performance response of laying hens to intake levels of digestible balanced protein from 27 to 66 wk of age
Authors: Kumar D. , Raginski C. , Schwean-Lardner K. , Classen H.L. 
Published: May 2018

Laying hens continue to improve in egg production (EP) and feed efficiency (FE), and therefore, it is relevant to re-examine their digestible balanced protein (BP) requirements. From 27 to 66 wk of age, hens (Lohmann-LSL Lite) were fed diets designed to provide 550, 625, 700, 775, or 850 mg hen−1 d−1 of amino acid balanced digestible lysine (Dlys). Response criteria included EP, egg weight (EW), feed intake (FI), mortality, egg mass (EM), egg size classifications, FE (kg feed kg−1 EM), and lysine efficiency (LE; mg Dlys g−1 EM). The experiment was a completely randomized design, and data were analyzed using regression analysis. Differences were considered significant if P ≤ 0.05. Hen-day (HD) EP, EW, EM, FI, and LE increased and FE and mortality decreased in a quadratic fashion with increasing Dlys intake, while the proportion of cracked eggs increased linearly. Egg size classifications increased linearly (jumbo, extra-large) and quadratically (large) or decreased in a quadratic manner (medium, small) with increasing Dlys intake. Maximum HDEP, EW, and EM, and minimum FE were achieved at 769, 903, 836, and 839 mg hen−1 d−1 intake of Dlys, respectively. In conclusion, the digestible BP requirement of laying hens varies with response criteria.
Comparative effects of grain source on digestion characteristics of finishing diets for feedlot cattle: steam-flaked corn, barley, wheat, and oats
Authors: Plascencia Alejandro , González-Vizcarra Víctor M. , Zinn Richard A. 
Published: May 2018

Twelve Holstein steers (454 ± 32 kg) with cannulas in rumen and proximal duodenum were used in a generalized randomized block design to compare steam-flaked corn (SFC), barley (SFB), wheat (SFW), and oats (SFO) as grain sources (74% of diet dry matter, flake density = 0.31 kg L−1) on characteristics of digestion. Ruminal organic matter (OM) digestion was similar for SFC-, SFB-, and SFW-based diets, but lower for SFO. Ruminal microbial efficiency was greater for SFW and SFO. Given that the undegradable intake protein (UIP) value of SFC is 57%, the comparative UIP values for SFB, SFW, and SFO were 39.8%, 36.1%, and 47.3%, respectively. Ruminal starch digestion was lower for SFC than the other flaked grains. Total-tract OM digestion and digestible energy were greatest for SFC, intermediate for SFB and SFW, and lowest for SFO. Given the net energy maintenance (NEm) value of SFC is 2.40 Mcal kg−1, the comparative NEm value for SFB, SFW, and SFO were 2.25, 2.36, and 2.17 Mcal kg−1, respectively. Steam flaking results in important modifications of small grains that appreciably affect their comparative feeding value. Current standards underestimates the NE value of SFB, SFW, and SFO, and overestimates the UIP values for SFB and SFO.
The photovoltaic performance of Ag2S quantum dots-sensitized solar cells using plasmonic Au nanoparticles/TiO2 working electrodes
Authors: Badawi Ali , Mostafa Nasser Y. , Al-Hosiny Najm M. , Merazga Amar , Albaradi Ateyyah M. , Abdel-Wahab F. , Atta A. A. 
Published: May 2018

The photovoltaic performance of silver sulfide (Ag2S) quantum dots-sensitized solar cells (QDSSCs) using different concentrations (0, 0.05, 0.1, 0.3 and 0.5 wt.%) of plasmonic Au nanoparticles (NPs)/titania (TiO2) electrodes has been investigated. Ag2S quantum dots (QDs) were adsorbed onto the Au NPs/titania electrodes using the successive ionic layer adsorption and reaction (SILAR) deposition technique. The morphological properties of the Au NPs and the prepared titania electrodes were characterized using transmission electron microscope (TEM) and scanning electron microscope (SEM), respectively. The energy-dispersive X-ray (EDX) spectra of the bare titania and Ag2S QDs-sensitized titania electrodes were recorded. The optical properties of the prepared Ag2S QDs-sensitized titania electrodes were measured using a UV–visible spectrophotometer. The estimated energy band gap of Ag2S QDs-sensitized titania electrodes is 1.96 eV. The photovoltaic performance of the assembled Ag2S QDSSCs was measured under 100 mW/cm2 solar illumination. The optimal photovoltaic parameters were obtained as follows: open circuit voltage [Formula: see text] = 0.50 V, current density [Formula: see text] = 3.18 mA/cm2, fill factor (FF) = 0.35 and energy conversion efficiency [Formula: see text] = 0.55% for 0.3 wt.% of Au NPs/titania electrode. These results are attributed to the enhancement in the absorption and decrease in the electron–hole pairs recombination rate. The open circuit voltage decay (OCVD) measurements of the assembled Ag2S QDSSCs were measured. The calculated electron lifetime [Formula: see text] in Ag2S QDSSCs with Au NPs/titania electrodes is at least one order of magnitude more than that with bare titania electrode. The cut-on–cut-off cycles of the solar illumination measurements show the rapid sensitivity and good reproducibility of the assembled Ag2S QDSSCs.
STK11/LKB1 Mutations and PD-1 Inhibitor Resistance in KRAS-Mutant Lung Adenocarcinoma
Authors: Skoulidis Ferdinandos , Goldberg Michael E. , Greenawalt Danielle M. , Hellmann Matthew D. , Awad Mark M. , Gainor Justin F. , Schrock Alexa B. , Hartmaier Ryan J. , Trabucco Sally E. , Gay Laurie , Ali Siraj M. , Elvin Julia A. , Singal Gaurav , Ross Jeffrey S. , Fabrizio David , Szabo Peter M. , Chang Han , Sasson Ariella , Srinivasan Sujaya , Kirov Stefan , Szustakowski Joseph , Vitazka Patrik , Edwards Robin , Bufill Jose A. , Sharma Neelesh , Ou Sai-Hong I. , Peled Nir , Spigel David R. , Rizvi Hira , Aguilar Elizabeth Jimenez , Carter Brett W. , Erasmus Jeremy , Halpenny Darragh F. , Plodkowski Andrew J. , Long Niamh M. , Nishino Mizuki , Denning Warren L. , Galan-Cobo Ana , Hamdi Haifa , Hirz Taghreed , Tong Pan , Wang Jing , Rodriguez-Canales Jaime , Villalobos Pamela A. , Parra Edwin R. , Kalhor Neda , Sholl Lynette M. , Sauter Jennifer L. , Jungbluth Achim A. , Mino-Kenudson Mari , Azimi Roxana , Elamin Yasir Y. , Zhang Jianjun , Leonardi Giulia C. , Jiang Fei , Wong Kwok-Kin , Lee J. Jack , Papadimitrakopoulou Vassiliki A. , Wistuba Ignacio I. , Miller Vincent A. , Frampton Garrett M. , Wolchok Jedd D. , Shaw Alice T. , Jänne Pasi A. , Stephens Philip J. , Rudin Charles M. , Geese William J. , Albacker Lee A. , Heymach John V. 
Published: May 2018

Abstract
KRAS is the most common oncogenic driver in lung adenocarcinoma (LUAC). We previously reported that STK11/LKB1 (KL) or TP53 (KP) comutations define distinct subgroups of KRAS-mutant LUAC. Here, we examine the efficacy of PD-1 inhibitors in these subgroups. Objective response rates to PD-1 blockade differed significantly among KL (7.4%), KP (35.7%), and K-only (28.6%) subgroups (P &lt; 0.001) in the Stand Up To Cancer (SU2C) cohort (174 patients) with KRAS-mutant LUAC and in patients treated with nivolumab in the CheckMate-057 phase III trial (0% vs. 57.1% vs. 18.2%; P = 0.047). In the SU2C cohort, KL LUAC exhibited shorter progression-free (P &lt; 0.001) and overall (P = 0.0015) survival compared with KRASMUT;STK11/LKB1WT LUAC. Among 924 LUACs, STK11/LKB1 alterations were the only marker significantly associated with PD-L1 negativity in TMBIntermediate/High LUAC. The impact of STK11/LKB1 alterations on clinical outcomes with PD-1/PD-L1 inhibitors extended to PD-L1–positive non–small cell lung cancer. In Kras-mutant murine LUAC models, Stk11/Lkb1 loss promoted PD-1/PD-L1 inhibitor resistance, suggesting a causal role. Our results identify STK11/LKB1 alterations as a major driver of primary resistance to PD-1 blockade in KRAS-mutant LUAC.
Significance: This work identifies STK11/LKB1 alterations as the most prevalent genomic driver of primary resistance to PD-1 axis inhibitors in KRAS-mutant lung adenocarcinoma. Genomic profiling may enhance the predictive utility of PD-L1 expression and tumor mutation burden and facilitate establishment of personalized combination immunotherapy approaches for genomically defined LUAC subsets. Cancer Discov; 8(7); 822–35. ©2018 AACR.
See related commentary by Etxeberria et al., p. 794.
This article is highlighted in the In This Issue feature, p. 781
Wake-Up Stroke versus Stroke with Known Onset Time: Clinical and Multimodality CT Imaging Characteristics
Authors: Dankbaar Jan W. , Bienfait Henri P. , van den Berg Coen , Bennink Edwin , Horsch Alexander D. , van Seeters Tom , van der Schaaf Irene C. , Kappelle L. Jaap , Velthuis Birgitta K. ,   on behalf of the DUST investigators
Published: May 2018

<b><i>Background:</i></b> Current guidelines for the treatment of acute ischemic stroke are mainly based on the time between symptom onset and initiation of treatment. This time is unknown in patients with wake-up stroke (WUS). We investigated clinical and multimodality CT imaging characteristics on admission in patients with WUS and in patients with a stroke with a known onset time. <b><i>Methods:</i></b> All patients were selected from a large prospective cohort study (Dutch acute stroke study). WUS patients last seen well &#x3e; 4.5 and ≤4.5 h were separately compared to patients with a known onset time ≤4.5 h. In addition, WUS patients with a proximal occlusion of the anterior circulation last seen well &#x3e; 6 and ≤6 h were separately compared to patients with a known onset time ≤6 h and a proximal occlusion. National Institute of Health Stroke Score, age, gender, history of atrial fibrillation, non-contrast CT (NCCT) Alberta Stroke Program Early CT Score (ASPECTS), CT-perfusion abnormalities, proximal occlusions, and collateral filling on CT angiography were compared between groups using the Mann-Whitney U test and Fisher’s exact test. <b><i>Results:</i></b><i></i> WUS occurred in 149/1,393 (10.7%) patients. Admission clinical and imaging characteristics of WUS patients last seen well &#x3e; 4.5 h (<i>n</i> = 81) were not different from WUS patients last seen well ≤4.5 h (<i>n</i> = 68). Although WUS patients last seen well &#x3e; 4.5 h had a significantly lower NCCT ASPECTS than patients with a known time of stroke symptom onset of ≤4.5 h (<i>n</i> = 1,026), 85.2% had an NCCT ASPECTS &#x3e; 7 and 75% had a combination of favorable ASPECTS &#x3e; 7 and good collateral filling. There were no statistically significant differences between the admission clinical and imaging characteristics of WUS patients with proximal occlusions last seen well &#x3e; 6 h (<i>n</i> = 23), last seen well ≤6 h (<i>n</i> = 40), and patients with a known time to stroke symptom onset ≤6 h (<i>n</i> = 399). Of all WUS patients with proximal occlusions last seen well &#x3e; 6 h, only 4.3% had severe ischemia (ASPECTS &#x3c; 5), 13 (56.5%) had ASPECTS &#x3e; 7 and good collateral filling. <b><i>Conclusions:</i></b><i></i> There are only minor differences between clinical and imaging characteristics of WUS patients and patients who arrive in the hospital within the time criteria for intravenous or endovascular treatment. Therefore, CT imaging may help to identify WUS patients who would benefit from treatment and rule out those patients with severe ischemia and poor collaterals.
Relationship Between Glycated Hemoglobin and Stroke Risk: A Systematic Review and Meta‐Analysis
Authors: Mitsios John Peter , Ekinci Elif Ilhan , Mitsios Gregory Peter , Churilov Leonid , Thijs Vincent 
Published: May 2018

Background

Diabetes mellitus is a major risk factor for ischemic stroke. Rising hemoglobin A
1c
(HbA
1c
) levels are associated with microvascular diabetes mellitus complication development; however, this relationship has not been established for stroke risk, a macrovascular complication.

Methods and Results

We conducted a systematic review and meta‐analysis of observational cohort and nested case‐control cohort studies assessing the association between rising HbA
1c
levels and stroke risk in adults (≥18 years old) with and without type 1 or type 2 diabetes mellitus. Random‐effects model meta‐analyses were used to calculate pooled adjusted hazard ratios (HRs) and their precision. The systematic review yielded 36 articles, of which 29 articles (comprising n=532 779 participants) were included in our meta‐analysis. Compared to non–diabetes mellitus range HbA
1c
(<5.7%), diabetes mellitus range HbA
1c
(≥6.5%) was associated with an increased risk of first‐ever stroke with average HR (95% confidence interval) of 2.15 (1.76, 2.63), whereas pre–diabetes mellitus range HbA
1c
(5.7–6.5%) was not (average HR [95% confidence interval], 1.19 [0.87, 1.62]). For every 1% HbA
1c
increment (or equivalent), the average HR (95% confidence interval) for first‐ever stroke was 1.12 (0.91, 1.39) in non–diabetes mellitus cohorts and 1.17 (1.09, 1.25) in diabetes mellitus cohorts. For every 1% HbA
1c
increment, both non–diabetes mellitus and diabetes mellitus cohorts had a higher associated risk of first‐ever ischemic stroke with average HR (95% confidence interval) of 1.49 (1.32, 1.69) and 1.24 (1.11, 1.39), respectively.

Conclusions

A rising HbA
1c
level is associated with increased first‐ever stroke risk in cohorts with a diabetes mellitus diagnosis and increased risk of first‐ever ischemic stroke in non–diabetes mellitus cohorts. These findings suggest that more intensive HbA
1c
glycemic control targets may be required for optimal ischemic stroke prevention.