bluuebunny/crossref_metadata_2025_split huggingface dataset:
Are low levels of serum bicarbonate associated with risk of progressing to impaired fasting glucose/diabetes? A single-centre prospective cohort study in Beijing, China
Authors: Li Sen , Wang Ying-Ying , Cui Jing , Chen Dong-Ning , Li Yu , Xin Zhong , Xie Rong-Rong , Cao Xi , Lu Jing , Yang Fang-Yuan , Yang Jin-Kui 
Published: July 2018

AimsBicarbonate is involved in many human essential metabolic processes, but little is known about the association between serum bicarbonate and glucose metabolism. This study aims to investigate the association between serum bicarbonate and the risk of progressing to impaired fasting glucose (IFG)/diabetes mellitus (DM).SettingThe data were obtained from a large-scale prospective cohort study in a single health centre in Beijing.ParticipantsA total of 5318 participants aged 18–70 years who underwent health examinations annually with baseline fasting plasma glucose (FPG) ranging from 3.9 to 5.5 mmol/L, without a history of either diabetes or concomitant chronic diseases, were enrolled in this 6-year observational study.Primary outcome measuresA logistic regression analysis was used to calculate ORs for progressing to IFG/DM by the category of baseline serum bicarbonate. In addition, an analysis of the receiver operating characteristic (ROC) curve for predicting IFG was performed.ResultsOf the 5318 participants, 210 developed IFG after a median 2.2 years of follow-up. After adjusting for sex, age, FPG, body mass index, systolic blood pressure, serum creatinine, serum alanine aminotransferase and low-density lipoprotein cholesterol at baseline, the participants in the first (OR 4.18, 95% CI 2.42 to 7.21; p<0.001), second (OR 3.02, 95% CI 1.71 to 5.33; p<0.001) and third (OR 2.12, 95% CI 1.15 to 3.89; p=0.015) quartiles of serum bicarbonate had higher odds for progressing to IFG/DM compared with those in the highest quartile. The area under the ROC curve for predicting IFG/DM was 0.69 (95% CI 0.65 to 0.72; p<0.001).ConclusionsLower serum bicarbonate is associated with higher risk of the development of IFG/DM.
Accuracy of administrative databases in detecting primary breast cancer diagnoses: a systematic review
Authors: Abraha Iosief , Montedori Alessandro , Serraino Diego , Orso Massimiliano , Giovannini Gianni , Scotti Valeria , Granata Annalisa , Cozzolino Francesco , Fusco Mario , Bidoli Ettore 
Published: July 2018

ObjectiveTo define the accuracy of administrative datasets to identify primary diagnoses of breast cancer based on the International Classification of Diseases (ICD) 9th or 10th revision codes.DesignSystematic review.Data sources: MEDLINE, EMBASE, Web of Science and the Cochrane Library (April 2017).Eligibility criteriaThe inclusion criteria were: (a) the presence of a reference standard; (b) the presence of at least one accuracy test measure (eg, sensitivity) and (c) the use of an administrative database.Data extractionEligible studies were selected and data extracted independently by two reviewers; quality was assessed using the Standards for Reporting of Diagnostic accuracy criteria.Data analysisExtracted data were synthesised using a narrative approach.ResultsFrom 2929 records screened 21 studies were included (data collection period between 1977 and 2011). Eighteen studies evaluated ICD-9 codes (11 of which assessed both invasive breast cancer (code 174.x) and carcinoma in situ (ICD-9 233.0)); three studies evaluated invasive breast cancer-related ICD-10 codes. All studies except one considered incident cases.The initial algorithm results were: sensitivity ≥80% in 11 of 17 studies (range 57%–99%); positive predictive value was ≥83% in 14 of 19 studies (range 15%–98%) and specificity ≥98% in 8 studies. The combination of the breast cancer diagnosis with surgical procedures, chemoradiation or radiation therapy, outpatient data or physician claim may enhance the accuracy of the algorithms in some but not all circumstances. Accuracy for breast cancer based on outpatient or physician’s data only or breast cancer diagnosis in secondary position diagnosis resulted low.ConclusionBased on the retrieved evidence, administrative databases can be employed to identify primary breast cancer. The best algorithm suggested is ICD-9 or ICD-10 codes located in primary position.Trial registration numberCRD42015026881.
Protected adults’ voting rights: an interdisciplinary study of medical assessment and jurisprudence in France
Authors: Bosquet Antoine , Mahé Isabelle 
Published: July 2018

ObjectivesThe study’s objective was to describe the decision-making about voting rights of protected adults, which includes the medical assessment and the magistrate’s decision to maintain voting rights or not.DesignThis work explores using an interdisciplinary approach: first, magistrate’s decision-making with a systematic review of jurisprudence and second medical assessment with semistructured questionnaires sent to physicians assessing adults under guardianship.SettingFrance.ParticipantsFor jurisprudence’s analysis, all guardianship decisions found on the Legifrance.gouv.fr website and that specified the protected person’s voting rights were analysed. For the survey about medical civic assessment, an 18-item questionnaire was sent to all physicians drawing up medical certificates prior to placement under guardianship in one urban (Paris and the three surrounding departments) and one rural area of France (the 10 most rural French administrative departments).Main outcome measuresThe analysis of jurisprudence explores the situation concerning protected adults’ voting rights and the reasons for magistrates’ decision. The survey about medical civic assessment explores the means of medical assessment (persons consulted, information collected), the content of the medical certificate, the physicians’ opinions regarding their role.ResultsThe analysis of the jurisprudence demonstrates that 30% (51/171) of protected adults kept the right to vote. The survey shows that medical assessment varied according to the physician’s gender, specialty and geographical location. Voting capacity was the main criterion common to both physicians and magistrates in the decision whether to maintain voting rights. 27% (34/124) of physicians would like the official texts to be more precise, and one-third (41/133) wished to have tools to facilitate assessment of civic capacity.ConclusionsOfficial guides need to be drawn up to detail the criteria for and means of medical assessment of the civil capacity of protected adults, with a view to ensuring transparency and homogeneity in the exercise of justice.
Risk factors and complications of lower limb cellulitis in Africa: a systematic review
Authors: Tianyi Frank-Leonel , Mbanga Clarence Mvalo , Danwang Celestin , Agbor Valirie Ndip 
Published: July 2018

ObjectiveTo summarise available data on the risk factors, complications and the factors associated with complications of lower limb cellulitis in Africa.MethodsWe did electronic searches on PubMed, EMBASE, Scopus and African Journals Online from 1 January 1986 to 30 October 2017, extracted and summarised data on the risk factors, complications and the factors associated with the complications of lower limb cellulitis from eligible literature.ResultsA total of seven studies were retained for final review after the search and screening processes. Local risk factors of cellulitis reported were: disruption of the skin barrier, neglected wounds, toe-web intertrigo, leg ulcers, use of depigmentation drugs and leg oedema. Obesity was the only reported general risk factor of cellulitis. Five studies reported on the complications of cellulitis which included: abscess formation, necrotising fasciitis, bullae, haemorrhagic lesions, necrosis, phlebitis and amputations. Nicotine addiction, chronic use of non-steroidal anti-inflammatory drugs, delay in the initiation of antibiotic treatment and elevated erythrocyte sedimentation rate were risk factors of complications of lower limb cellulitis identified from three studies.ConclusionThis review highlights the important role of local risk factors in the pathogenesis of lower limb cellulitis in Africa. The association between voluntary skin depigmentation and lower limb cellulitis should alert public health authorities and the general population to the health risks associated with this practice. The identification and improved management of the risk factors of lower limb cellulitis and its complications could go a long way in decreasing the morbidity and health costs incurred by lower limb cellulitis in Africa.
Trends in the utilisation of emergency departments in California, 2005–2015: a retrospective analysis
Authors: Hsia Renee Y , Sabbagh Sarah H , Guo Joanna , Nuckton Thomas J , Niedzwiecki Matthew J 
Published: July 2018

ObjectiveTo examine current trends in the characteristics of patients visiting California emergency departments (EDs) in order to better direct the allocation of acute care resources.DesignA retrospective study.SettingWe analysed ED utilisation trends between 2005 and 2015 in California using non-public patient data from California’s Office of Statewide Health Planning and Development.ParticipantsWe included all ED visits in California from 2005 to 2015.Primary and secondary outcome measuresWe analysed ED visits and visit rates by age, sex, race/ethnicity, payer and urban/rural trends. We further examined age, sex, race/ethnicity and urban/rural trends within each payer group for a more granular picture of the patient population. Additionally, we looked at the proportion of patients admitted from the ED and distribution of diagnoses.ResultsBetween 2005 and 2015, the annual number of ED visits increased from 10.2 to 14.2 million in California. ED visit rates increased by 27.8% (p<0.001), with the greatest increases among patients aged 5–19 (37.4%, p<0.001) and 45–64 years (41.1%, p<0.001), non-Hispanic Black and Hispanic patients (56.8% and 48.8%, p<0.001), the uninsured and Medicaid-insured (36.1%, p=0.002; 28.6%, p<0.001) and urban residents (28.3%, p<0.001). The proportion of ED visits resulting in hospitalisation decreased by 18.3%, with decreases across all payer groups.ConclusionsOur findings reveal an increasing demand for emergency care and may reflect current limitations in accessing care in other parts of the healthcare system. Policymakers may need to recognise the increasingly vital role that EDs are playing in the provision of care and consider ways to incorporate this changing reality into the delivery of health services.
Accurate estimation of cardiovascular risk in a non-diabetic adult: detecting and correcting the error in the reported Framingham Risk Score for the Systolic Blood Pressure Intervention Trial population
Authors: Warner Frederick , Dhruva Sanket S , Ross Joseph S , Dey Pranammya , Murugiah Karthik , Krumholz Harlan M 
Published: July 2018

ObjectivesTo understand the discrepancy between the published 10-year cardiovascular risk and 10-year cardiovascular risk generated from raw data using the Framingham Risk Score for participants in the Systolic Blood Pressure Intervention Trial (SPRINT).DesignSecondary analysis of SPRINT data published inThe New England Journal of Medicine(NEJM) and made available to researchers in late 2016.SettingSPRINT clinical trial sites.ParticipantsStudy participants enrolled into SPRINT.ResultsThe number of SPRINT study participants identified as having ≥15% 10-year cardiovascular risk was not consistent with what was reported in the original publication. Using the data from the trial, the Framingham Risk Score indicated ≥15% 10-year cardiovascular risk for 7089 participants compared with 5737 reported in the paper, a change from 61% to 76% of the total study population.ConclusionsThe analysis of the clinical trial data by independent investigators identified an error in the reporting of the risk of the study population. The SPRINT trial enrolled a higher risk population than was reported in the initial publication, which was brought to light by data sharing.
How do Korean nursing students build knowledge? A constructivist grounded theory study
Authors: Lee Jung Jae , Clarke Charlotte L , Carson Maggie N , Yang Sook Ching 
Published: July 2018

IntroductionNursing is a knowledge-intensive profession. Therefore, to cope with the demands of the nursing role, nursing students need to become competent in managing information to build nursing knowledge. However, nursing students’ knowledge building process is poorly understood. This research aimed to explore (1) nursing students’ dynamics of how they process nursing information for knowledge building and (2) nursing students’ learning context in South Korea for their knowledge building.MethodsA constructivist grounded theory approach was used for this research. Data collection was achieved through four rounds of intensive individual and group interviews with 16 fourth year nursing students in South Korea. The collected data were coded by initial, focused and theoretical coding methods. Constant comparison analysis between data, codes, memos and categories was applied.ResultsThis research identified knowledge building dynamics consisting of three cognitive processes: connecting with information, deciding to accept information and building knowledge. Five motivational factors, including learners’ interest, necessity of information, volition to learn, utility of information and the frequency of information that influence the processes were discovered. Moreover, four knowledge stages of memorising, understanding, synthesising and applying and creating emerged.ConclusionsThis is the first empirical study on knowledge building dynamics in educational environments for healthcare professionals. The findings of this research provide nursing educators with a practical model that can be used to improve nursing curricula in facilitating students’ knowledge building processes. Moreover, a deeper understanding of sociocultural influences on nursing education can assist educators to adapt and generalise the findings to their pedagogical contexts, providing a culturally sensitive and relevant approach to nursing education.
A prospective, observational study investigating the use of carbon monoxide screening to identify maternal smoking in a large university hospital in Ireland
Authors: Reynolds Ciara Marie Edel , Egan Brendan , Kennedy Rachel AK , O’Malley Eimer G , Sheehan Sharon R , Turner Michael J 
Published: July 2018

ObjectivesThis study evaluated breath carbon monoxide (BCO) testing in identifying maternal smokers as well as the difference between disclosers and non-disclosers of smoking status. We also investigated if other extrinsic factors affected the women’s BCO levels in pregnancy.DesignA prospective observational study.SettingA university obstetric hospital in an urban setting in Ireland.ParticipantsWomen (n=250) and their partners (n=54) were recruited at their first antenatal visit. Women <18 years and those who did not understand English were excluded. A booking history, including recording of smoking status, was collected by midwives. Following this, women were recruited and completed a detailed research questionnaire on smoking and extrinsic/environmental BCO sources. A BCO test was performed on both the woman and her partner.Primary and secondary outcome measuresThe number of self-reported smokers and those that were positive on the BCO test. The characteristics of women who disclosed and did not disclose smoking status. The effect of extrinsic factors on the BCO test results.ResultsBased on the receiver-operating characteristic curve, a BCO cut-off point of ≥3 ppm was the optimal level to identify ongoing smoking. At booking history, 15% of women reported as current smokers. Based on BCO levels ≥3 ppm combined with self-reported smoking in the research questionnaire, the rate increased to 25%. Non-disclosers had similar characteristics to non-smokers. No extrinsic factors affected maternal BCO levels.ConclusionsBased on self-report and BCO levels, a quarter of women presenting for antenatal care continued to smoke, but only 60% reported their smoking to midwives. BCO measurement is an inexpensive, practical method of improving identification of maternal smoking, and it was not effected by extrinsic sources of BCO. Improved identification means more smokers can be supported to stop smoking in early pregnancy potentially improving the short-term and long-term health of both mother and child.
Mural destabilization after aneurysm treatment with a flow-diverting device: a report of two cases
Authors: Hampton Timothy , Walsh Donal , Tolias Christos , Fiorella David 
Published: July 2018

BackgroundFlow-diverting stents have demonstrated great promise for the treatment of cerebral aneurysms; however, clinical experience with the devices remains very preliminary. We present two cases of spontaneous delayed complications—one fatal aneurysm rupture and one symptomatic increase in aneurysm volume—following the treatment of intradural aneurysms with the Pipeline Embolization Device (PED).Presentation/interventionTwo patients with unruptured, intradural aneurysms of the carotid artery underwent uneventful treatment with the PED (eV3, Irvine, California, USA). One patient, with a giant aneurysm of the carotid terminus, experienced worsening headache 5 days after the procedure and ultimately collapsed and became unresponsive. CT of the head demonstrated acute subarachnoid and intraventricular hemorrhage. The patient died the following day. A second patient with a large left posterior communicating artery aneurysm presented with progressive memory loss 3 months after PED reconstruction of the carotid artery. Although serial CT angiograms showed progressive thrombosis of the aneurysm to near-complete occlusion, MR of the brain demonstrated marked interval growth of the collective aneurysm–intra-aneurysmal thrombus mass with extensive edema throughout the adjacent left temporal lobe.ConclusionsFlow-diverting devices have demonstrated tremendous promise for the treatment of complex, unruptured cerebral aneurysms. However, experience with this novel approach to aneurysm treatment is preliminary and the consequences of its application within the cerebrovasculature remain incompletely defined. Mural destabilization resulting in delayed, spontaneous, aneurysm growth and/or rupture may occur in the days to weeks following the application of flow-diverting devices to treat previously unruptured intracranial aneurysms. A better understanding of the incidence and etiology of these complications is essential for this technology to be optimally applied.
Initial clinical experience with the ADAPT technique: A direct aspiration first pass technique for stroke thrombectomy
Authors: Turk Aquilla S , Spiotta Alex , Frei Don , Mocco J , Baxter Blaise , Fiorella David , Siddiqui Adnan , Mokin Maxim , Dewan Michael , Woo Henry , Turner Raymond , Hawk Harris , Miranpuri Amrendra , Chaudry Imran 
Published: July 2018

BackgroundThe development of new revascularization devices has improved recanalization rates and time but not clinical outcomes. We report our initial results with a new technique utilizing a direct aspiration first pass technique with a large bore aspiration catheter as the primary method for vessel recanalization.MethodsA retrospective evaluation of a prospectively captured database of 37 patients at six institutions was performed on patients where the ADAPT technique was utilized. The data represent the initial experience with this technique.ResultsThe ADAPT technique alone was successful in 28 of 37 (75%) cases although six cases had large downstream emboli that required additional aspiration. Nine cases required the additional use of a stent retriever and one case required the addition of a Penumbra aspiration separator to achieve recanalization. The average time from groin puncture to at least Thrombolysis in Cerebral Ischemia (TICI) 2b recanalization was 28.1 min, and all cases were successfully revascularized. TICI 3 recanalization was achieved 65% of the time. On average, patients presented with an admitting National Institutes of Health Stroke Scale (NIHSS) score of 16.3 and improved to an NIHSS score of 4.2 by the time of hospital discharge. There was one procedural complication.DiscussionThis initial experience highlights the fact that the importance of the technique with which new stroke thrombectomy devices are used may be as crucial as the device itself. The ADAPT technique is a simple and effective approach to acute ischemic stroke thrombectomy. Utilizing the latest generation of large bore aspiration catheters in this fashion has allowed us to achieve excellent clinical and angiographic outcomes.
Effect of crop and residue type on nitrous oxide emissions from rotations in the semi-arid Canadian prairies
Authors: Lemke R.L. , Liu L. , Baron V.S. , Malhi S.S. , Farrell R.E. 
Published: July 2018

Crop rotations on the Canadian prairies commonly include sequences of pulses, oilseeds, and cereals; however, limited information is available regarding the influence that different crop types and sequences may have on direct nitrous oxide (N2O) emissions. A 3 yr field study was conducted on a site near Scott, SK, to compare N2O emissions from selected crop phases of rotations containing pea (Pisum sativum L.), wheat (Triticum aestivum L.), and canola (Brassica napus L.) and to examine the potential influence of these residues on N2O emissions during the subsequent crop phase. Nitrous oxide losses from N-fertilized canola or wheat crops were generally higher than losses from pea or the control treatments. Nitrous oxide losses from N-fertilized wheat or canola crops grown on pea residue were comparable or lower than losses from N-fertilized wheat or canola crops grown on wheat residues. Cumulative N2O loss over the 3 yr was significantly higher from N-fertilized wheat grown on canola compared with pea or wheat residues. Losses from wheat grown on canola residue were 67% and 56% higher than from wheat grown on pea or wheat residue, respectively. This indicates that the emission factors used to estimate direct N2O loss may need to be adjusted upwards for N-fertilized crops grown on canola compared with wheat or pea residues.
On-chip optical isolator based on unidirectional wavelength-mode conversion waveguide
Authors: Liu Wenlong , Liu Xuebin , Yan Qiangqiang , Qiang Simiao , Pi Haifeng , Hu Bingliang , Zhang Lingxuan 
Published: July 2018

Breaking Lorentz reciprocity is one necessary condition of optical isolator design. Unidirectional wavelength-mode conversion will be realized in a time-dependent system through a short operating range. Based on plasma dispersion effect, generate space-asymmetric periodical time-space modulation on silicon waveguide, and non-reciprocal propagation is realized in the waveguide. The designed unidirectional wavelength-mode conversion waveguide demonstrated that in the forward direction, input 1.55 [Formula: see text]m fundamental mode light signal and then output 1.5492 [Formula: see text]m is of 1st-order mode, while in the backward direction, input 1.5492 [Formula: see text]m is of 1st-order mode light signal and then output 1.5484 [Formula: see text]m is of fundamental mode. Based on this non-reciprocal structure, mode conversion waveguide and two-ring resonance filters were designed then, to accomplish on-chip optical isolation. The scale of the designed isolator is 160 [Formula: see text]m × 60 [Formula: see text]m, and the isolation is 21 dB, revealing perfect application potential.