bluuebunny/crossref_metadata_2025_split huggingface dataset:
Complex care for kids Ontario: protocol for a mixed-methods randomised controlled trial of a population-level care coordination initiative for children with medical complexity
Authors: Orkin Julia , Chan Carol Y , Fayed Nora , Lin Jia Lu Lilian , Major Nathalie , Lim Audrey , Peebles Erin R , Moretti Myla E , Soscia Joanna , Sultan Roxana , Willan Andrew R , Offringa Martin , Guttmann Astrid , Bartlett Leah , Kanani Ronik , Culbert Erin , Hardy-Brown Karolyn , Gordon Michelle , Perlmutar Marty , Cohen Eyal 
Published: August 2019

IntroductionTechnological and medical advances have led to a growing population of children with medical complexity (CMC) defined by substantial medical needs, healthcare utilisation and morbidity. These children are at a high risk of missed, fragmented and/or inappropriate care, and families bear extraordinary financial burden and stress. While small in number (<1% of children), this group uses ~1/3 of all child healthcare resources, and need coordinated care to optimise their health. Complex care for kids Ontario (CCKO) brings researchers, families and healthcare providers together to develop, implement and evaluate a population-level roll-out of care for CMC in Ontario, Canada through a randomised controlled trial (RCT) design. The intervention includes dedicated key workers and the utilisation of coordinated shared care plans.Methods and analysisOur primary objective is to evaluate the CCKO intervention using a randomised waitlist control design. The waitlist approach involves rolling out an intervention over time, whereby all participants are randomised into two groups (A and B) to receive the intervention at different time points determined at random. Baseline measurements are collected at month 0, and groups A and B are compared at months 6 and 12. The primary outcome is the family-prioritized Family Experiences with Coordination of Care (FECC) survey at 12 months. The FECC will be compared between groups using an analysis of covariance with the corresponding baseline score as the covariate. Secondary outcomes include reports of child and parent health outcomes, health system utilisation and process outcomes.Ethics and disseminationResearch ethics approval has been obtained for this multicentre RCT. This trial will assess the effect of a large population-level complex care intervention to determine whether dedicated key workers and coordinated care plans have an impact on improving service delivery and quality of life for CMC and their families.Trial registration numberNCT02928757.
Lumbar spine surgery across 15 years: trends, complications and reoperations in a longitudinal observational study from Norway
Authors: Grotle Margreth , Småstuen Milada Cvancarova , Fjeld Olaf , Grøvle Lars , Helgeland Jon , Storheim Kjersti , Solberg Tore K , Zwart John-Anker 
Published: August 2019

BackgroundStudies from different Western countries have reported a rapid increase in spinal surgery rates, an increase that exceeds by far the growing incidence rates of spinal disorders in the general population. There are few studies covering all lumbar spine surgery and no previous studies from Norway.ObjectivesThe purpose of this study was to investigate trends in all lumbar spine surgery in Norway over 15 years, including length of hospital stay, and rates of complications and reoperations.DesignA longitudinal observational study over 15 years using hospital patient administrative data and sociodemographic data from the National Registry in Norway.Setting and participantsPatients aged ≥18 years discharged from Norwegian public hospitals between 1999 and 2013.Outcome measuresAnnual rates of simple (microsurgical discectomy, decompression) and complex surgical procedures (fusion, disc prosthesis) in the lumbar spine.ResultsThe rate of lumbar spine surgery increased by 54%, from 78 (95% CI (75 to 80)) to 120 (107 to 113) per 100 000, from 1999 to 2013. More men had simple surgery whereas more women had complex surgery. Among elderly people over 75 years, lumbar surgery increased by a factor of five during the 15-year period. The rates of complications were low, but increased from 0.7% in 1999 to 2.4% in 2013.ConclusionsThere was a substantial increase in lumbar spine surgery in Norway from 1999 to 2013, similar to trends in other Western world countries. The rise in lumbar surgery among elderly people represents a significant workload and challenge for health services, given our aging population.
Usability of existing alcohol survey data in South Africa: a qualitative analysis
Authors: Fontes Marx Mayara , London Leslie , Harker Burnhams Nadine , Ataguba John 
Published: August 2019

ObjectiveThis paper assesses the usability of existing alcohol survey data in South Africa (SA) by documenting the type of data available, identifying what possible analyses could be done using these existing datasets in SA and exploring limitations of the datasets.SettingsA desktop review and in-depth semistructured interviews were used to identify existing alcohol surveys in SA and assess their usability.ParticipantsWe interviewed 10 key researchers in alcohol policies and health economics in SA (four women and six men). It consisted of academic/researchers (n=6), government officials (n=3) and the alcohol industry (n=1).Primary and secondary outcome measuresThe desktop review examined datasets for the level of the data, geographical coverage, the population surveyed, year of data collection, available covariables, analyses possible and limitations of the data. The 10 in-depth interviews with key researchers explored informant’s perspective on the usability of existing alcohol datasets in SA.ResultsIn SA, alcohol data constraints are mainly attributed to accessibility restrictions on survey data, limited geographical coverage, lack of systematic and standardised measurement of alcohol, infrequency of surveys and the lack of transparency and public availability of industry data on production, distribution and consumption.ConclusionThe International Alcohol Control survey or a similar framework survey focusing on substance abuse should be considered for implementation at the national level. Also, alcohol research data funded by the taxpayers’ money and alcohol industry data should be made publicly available.
Do β-adrenoreceptor blocking drugs associate with reduced risk of symptomatic osteoarthritis and total joint replacement in the general population? A primary care-based, prospective cohort study using the Clinical Practice Research Datalink
Authors: Nakafero Georgina , Grainge Matthew , Valdes Ana , Townsend Nick , Mallen Christian , Zhang Weiya , Doherty Michael , Mamas Mamas A , Abhishek Abhishek 
Published: August 2019

IntroductionTo investigate if β-adrenoreceptor blocking drug (β-blocker) prescription reduces the risk of knee or hip osteoarthritis, total joint replacement and analgesic prescription.SettingPrimary care.Methods and analysisThis is a cohort study using data from the Clinical Practice Research Datalink. Two separate analyses will be performed. Study 1 will be on the association between β-blocker prescription and incident knee/hip osteoarthritis. Inclusion criteria will be age ≥40 years. Exposed participants will be those with ≥2 continuous β-blocker prescriptions, and the index date will be the date of the first prescription of β-blocker. Unexposed participants will include up to four controls matched for age, sex, general practice surgery and propensity score for β-blocker prescription. Exclusion criteria will include contraindications to β-blockers, consultations for osteoarthritis or potent analgesic prescription before the index date. Outcomes will be knee osteoarthritis (primary outcome), hip osteoarthritis, knee pain and hip pain. Study 2 will be on the association between β-blocker prescription and total joint replacement and analgesic prescription in people with osteoarthritis. Inclusion criteria will be age ≥40 years, knee or hip osteoarthritis, and index date will be as in study 1. Unexposed participants will be as in study 1, additionally matched for consultation for knee or hip osteoarthritis prior to the index date. Exclusion criteria will include contraindications to β-blockers and osteoarthritis in other joints prior to the index date. Outcomes will be total knee replacement (primary outcome), total hip replacement and new analgesic prescription.Statistical analysisKaplan-Meier curves will be plotted, and Cox proportional HRs and 95% CIs will be calculated. Stratified analysis will be performed by class of β-blocker, intrinsic sympathomimetic effect and indication(s) for prescription.Ethics and disseminationThis study was ethically approved by the Independent Scientific Advisory Committee of the Medicines and Healthcare Authority (Ref 18_227R). The results of this study will be published in peer-reviewed journals and presented at conferences.SummaryThis prospective cohort study will evaluate the analgesic potential of commonly used drugs for osteoarthritis pain.
Adeno-associated virus in the liver: natural history and consequences in tumour development
Authors: La Bella Tiziana , Imbeaud Sandrine , Peneau Camille , Mami Iadh , Datta Shalini , Bayard Quentin , Caruso Stefano , Hirsch Theo Z , Calderaro Julien , Morcrette Guillaume , Guettier Catherine , Paradis Valerie , Amaddeo Giuliana , Laurent Alexis , Possenti Laurent , Chiche Laurence , Bioulac-Sage Paulette , Blanc Jean-Frederic , Letouze Eric , Nault Jean-Charles , Zucman-Rossi Jessica 
Published: August 2019

ObjectiveAdeno-associated virus (AAV) is a defective mono-stranded DNA virus, endemic in human population (35%–80%). Recurrent clonal AAV2 insertions are associated with the pathogenesis of rare human hepatocellular carcinoma (HCC) developed on normal liver. This study aimed to characterise the natural history of AAV infection in the liver and its consequence in tumour development.DesignViral DNA was quantified in tumour and non-tumour liver tissues of 1461 patients. Presence of episomal form and viral mRNA expression were analysed using a DNAse/TaqMan-based assay and quantitative RT-PCR. In silico analyses using viral capture data explored viral variants and new clonal insertions.ResultsAAV DNA was detected in 21% of the patients, including 8% of the tumour tissues, equally distributed in two major viral subtypes: one similar to AAV2, the other hybrid between AAV2 and AAV13 sequences. Episomal viral forms were found in 4% of the non-tumour tissues, frequently associated with viral RNA expression and human herpesvirus type 6, the candidate natural AAV helper virus. In 30 HCC, clonal AAV insertions were recurrently identified inCCNA2,CCNE1,TERT,TNFSF10,KMT2BandGLI1/INHBE. AAV insertion triggered oncogenic overexpression through multiple mechanisms that differ according to the localisation of the integration site.ConclusionWe provided an integrated analysis of the wild-type AAV infection in the liver with the identification of viral genotypes, molecular forms, helper virus relationship and viral integrations. Clonal AAV insertions were positive selected during HCC development on non-cirrhotic liver challenging the notion of AAV as a non-pathogenic virus.
Subcategorisation of AUS/FLUS thyroid lesions as per the 2017 Bethesda System for Reporting Thyroid Cytopathology: a retrospective study from a tertiary care centre analysing risk of malignancy (ROM) of the different subcategories
Authors: Guleria Prerna , Agarwal Shipra , Iyer Venkateswaran K , Jain Deepali , Mathur Sandeep R , Yadav Diksha 
Published: August 2019

AimsThe 2017 Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) recommends subclassification of atypia of undetermined significance (AUS)/follicular lesion of undetermined significance (FLUS) into six subcategories. The present study evaluates the risk of malignancy (ROM) and risk of neoplasm (RON) among these.MethodsAll thyroid aspirates reported as AUS/FLUS over a 4.5-year period, with available histology, were reviewed and subclassified as per TBSRTC. ROM and RON were calculated and compared.ResultsOf 2554 thyroid aspirates, 281 (11.0%) were AUS/FLUS. Eighty-one with available histology were evaluated. ROM was 51.8%. Cytologic and architectural atypia (AUS-C&A) was the most prevalent (62.9%), followed by Hürthle cell type (19.6%), AUS-A (11.1%), AUS-not otherwise specified (NOS) (7.4%), cytologic atypia (AUS-C) (4.9%) and atypical lymphoid cells (1.2%). Papillary thyroid carcinoma (PTC) and adenomatous goitre (AG) were the most common histological diagnoses (27% each). On histology, AUS-C had 2/4 PTC and 2/4 AG on histology. AUS-A had 4/9 follicular neoplasm (FN) and 2/9 non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) while AUS C&A had 18/51 PTC, 13/51 AG, 11/51 NIFTP and 5/51 FN. ROM and RON were similar across subcategories, ROM was the highest for AUS-C&A (58.8%), AUS-C (50%) and AUS-NOS (50%). NIFTP reclassification as non-malignant reduced ROM to 35.8% (absolute reduction of 16% and a relative decrease of 31%) with the greatest relative decrease seen in AUS-A (50%), followed by AUS-C&A (37%), and none in others.ConclusionsAUS/FLUS subcategorisation helped to indicate risk for the more likely neoplasm, whether PTC or FN. ROM was the highest for cases with cytological atypia but did not differ significantly across different subcategories. NIFTP changed the ROM of AUS-A and AUS-C&A, since both NIFTP and FN have microfollicles.
Perioperative duloxetine for acute postoperative analgesia: a meta-analysis of randomized trials
Authors: Zorrilla-Vaca Andrés , Stone Alexander , Caballero-Lozada Andres Fabricio , Paredes Stephania , Grant Michael Conrad 
Published: August 2019

BackgroundMultimodal analgesia is a fundamental part of modern surgery and enhanced recovery pathways. Duloxetine, a serotonin and norepinephrine reuptake inhibitor, has been validated for the treatment of chronic neuropathic pain. The evidence for duloxetine as an adjunct for the treatment of acute postoperative pain remains controversial. We conducted a meta-analysis to determine the efficacy of duloxetine in the acute perioperative setting.MethodsA literature search was conducted in the major databases (PubMed, EMBASE and Google Scholar) for randomized controlled trials (RCTs) evaluating duloxetine compared with placebo control for acute postoperative pain. The primary outcome was postoperative pain assessed at 2, 4, 6, 24 and 48 hours time frames. Secondary outcomes included postoperative opioid administration, as well as side effects, such as postoperative nausea/vomiting (PONV), pruritus, dizziness and headache.Results574 patients (n=9 RCTs) were included in the analysis, divided between duloxetine (n=285 patients) and placebo (n=289 patients). Duloxetine use was associated with a significant reduction in pain scores as early as 4 (mean difference (MD) −0.9, 95% CI −1.33 to −0.47) and as late as 48 (MD −0.94, 95% CI −1.56 to −0.33) hours postoperatively compared with placebo. In addition, duloxetine was associated with a significant reduction in opioid administration at 24 (standardized MD (SMD) −2.24, 95% CI −4.28 to −0.19) and 48 (SMD −2.21, 95% CI −4.13 to −0.28) hours as well as a significant reduction in PONV (risk ratio 0.69, 95% CI 0.49 to 0.95, p=0.03) compared with placebo. There was no difference between groups in other side effects.ConclusionDuloxetine, a non-opioid neuromodulator, may provide efficacy for the treatment of acute perioperative pain. Additional prospective studies are required to establish optimal perioperative dosing regimens, role in the setting of a comprehensive multimodal analgesic plan and impact on chronic postsurgical pain.PROSPERO registration numberCRD42019121416
Concentration of fibrin monomer in pregnancy and during the postpartum period
Authors: Kristoffersen Ann Helen , Petersen Per Hyltoft , Bjørge Line , Røraas Thomas , Sandberg Sverre 
Published: August 2019

Background D-dimer increases during pregnancy and is problematic to use in the diagnosis of venous thromboembolism. Fibrin monomer represents an alternative biomarker for venous thromboembolism. However, to be useful in pregnancy, the fibrin monomer concentration should be stable throughout pregnancy and during postpartum. Methods To describe the course of fibrin monomer concentration during pregnancy and the postpartum period in healthy pregnant women and to compare their within-subject biological variation (CVI) with non-pregnant women. Blood samples were obtained every fourth week during pregnancy and three samples after delivery in 20 healthy women and every fourth week during a 40-week period in 19 healthy non-pregnant women. Fibrin monomer (STA Liatest FM, Stago) was analysed in duplicates for all samples. Concentrations of fibrin monomer in pregnant and non-pregnant women were compared and the CVI for fibrin monomer was calculated. Results The median fibrin monomer concentration in pregnant women was 6.2 mg/L (2.5 and 97.5 percentiles 3.7–10.8 mg/L) and in non-pregnant women 4.8 mg/L (3.6–8.2) ( P < 0.01). The fibrin monomer concentration was relatively stable during pregnancy, although a few unexplained high fibrin monomer concentrations were found during pregnancy/postpartum. Fibrin monomer CVI in pregnancy and postpartum was 20.6% (95% CI 18.3, 23.5) and in non-pregnant 16.1% (13.7, 18.9). Conclusions For clinical purposes, fibrin monomer concentration can be considered stable during pregnancy, although it is slightly higher than in non-pregnant women. Pregnant and non-pregnant women have the same CVI. The suitability of fibrin monomer in venous thromboembolism diagnosis in pregnant women should be validated in further studies.
The impact of self-stigma on self-esteem among persons with different mental disorders
Authors: Park Keunwoo , MinHwa Lee , Seo Mikyung 
Published: August 2019

Background: This study assumes that just as public stigma differs depending on types of mental disorder, so too does self-stigma. Aims: This study aims to compare self-stigma among persons with schizophrenia, alcohol use disorder and gambling disorder, and thereby analyze the effects of self-stigma on their self-esteem. Methods: A total of 321 Korean adults involved in community mental services for schizophrenia ( N = 116), alcohol use disorder ( N = 102) and gambling disorder ( N = 103) were surveyed ( Mage = 40.74, standard deviation ( SD) = 10.10, 83.8% male, 16.2% female). Participants were questioned on self-stigma and self-esteem. One-way analysis of variance (ANOVA) was used to compare the self-stigma by mental disorder type. Furthermore, in order to analyze the effects of self-stigma on self-esteem with subjects’ age and educational background controlled, hierarchical regression analysis was used. Results: The self-stigma of gambling disorder group was highest not only in overall self-stigma but also some of its subscales – alienation, stereotype endorsement and stigma resistance – followed by alcohol use disorder group and schizophrenia group. In all three groups, self-stigma had a negative effect on self-esteem, while stigma resistance of subscales was the most important predictor. In addition to stigma resistance, alienation was a predictor in the schizophrenia group, alienation and social withdrawal in the alcohol use disorder group and social withdrawal was a significant predictor in the gambling disorder group. Therefore, the predictors of self-esteem differed depending on the type of mental disorder. Conclusion: Based on these results, we suggest cognitive-behavioral intervention to raise subject awareness of the unjust social stigma and boost self-advocacy to resist the stigma.
Black Out-group Marriages and Hate Crime Rates: A Cross-sectional Analysis of U.S. Metropolitan Areas
Authors: Piatkowska Sylwia J. , Messner Steven F. , Hövermann Andreas 
Published: August 2019

Objectives: This study introduces an indicator of racial out-group marriage to the research on hate crime. Drawing upon a variant of group threat theory, we hypothesize that Black out-group marriage with Whites will be positively related to anti-Black hate crime rates insofar as such marriages are perceived as transgressions of cultural boundaries. Informed by Allport’s contact theory, we hypothesize that Black out-group marriage with Whites will be negatively related to anti-Black hate crime rates insofar as such marriages indicate intercultural accommodation. Methods: Using data for a sample of U.S. Metropolitan Statistical Areas circa 2010, we assess our hypotheses with two operationalizations of levels of hate crime—incidence rates and victimization rates. Results: Our results reveal that levels of Black out-group marriages with Whites are positively related to the Black hate crime victimization rate but not related to the incidence rate. Conclusions: Our analyses suggest that any salutary effect of intercultural accommodation associated with interracial marriage is overwhelmed by the influence of the perceived cultural threat and intensification of animus for the “at-risk” population for perpetrating anti-Black hate crimes.
Anatomical analysis of periapical bone of maxillary posterior teeth: a cone beam computed tomography study
Authors: Hu Xiaoli , Lei Lizhen , Cui Minyi , Huang Zhuwei , Zhang Xiaolei 
Published: August 2019

Objectives To investigate the periapical bone thicknesses of maxillary posterior teeth at the preferred level for root resection (3 mm apical to the root end) and to determine vertical distances from apex to maxillary sinus floor (MSF) using cone beam computed tomography (CBCT) scans. Methods CBCT scans were collected from 341 subjects (2389 teeth). Associations of bone thicknesses and vertical distances with age and sex were determined by one-way analysis of variance. Results At the level of root-end resection, buccal bone was the thickest over the mesiobuccal roots of second molars (mean, 2.99 mm) and thinnest over the double-root first premolars (mean, 0.29 mm). In maxillary posterior teeth, thicker buccal bone was found in men than in women. The mesiobuccal roots of second molars were nearest to the MSF (mean, 1.33 mm), and were also most frequently extended into the sinus cavity (15.81%). Subjects more than 40 years of age had larger vertical distances from root apices to MSF in the molar region, compared with younger subjects. Conclusions Generally, periapical bone was thicker in men, and root apices were located nearer to the MSF in younger subjects. Age and sex should be considered before endodontic microsurgery.