bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predicting risk of hospitalisation: a retrospective population-based analysis in a paediatric population in Emilia-Romagna, Italy
Authors: Louis Daniel Z , Callahan Clara A , Robeson Mary , Liu Mengdan , McRae Jacquelyn , Gonnella Joseph S , Lombardi Marco , Maio Vittorio 
Published: May 2018

ObjectivesDevelop predictive models for a paediatric population that provide information for paediatricians and health authorities to identify children at risk of hospitalisation for conditions that may be impacted through improved patient care.DesignRetrospective healthcare utilisation analysis with multivariable logistic regression models.DataDemographic information linked with utilisation of health services in the years 2006–2014 was used to predict risk of hospitalisation or death in 2015 using a longitudinal administrative database of 527 458 children aged 1–13 years residing in the Regione Emilia-Romagna (RER), Italy, in 2014.Outcome measuresModels designed to predict risk of hospitalisation or death in 2015 for problems that are potentially avoidable were developed and evaluated using the C-statistic, for calibration to assess performance across levels of predicted risk, and in terms of their sensitivity, specificity and positive predictive value.ResultsOf the 527 458 children residing in RER in 2014, 6391 children (1.21%) were hospitalised for selected conditions or died in 2015. 49 486 children (9.4%) of the population were classified in the ‘At Higher Risk’ group using a threshold of predicted risk >2.5%. The observed risk of hospitalisation (5%) for the ‘At Higher Risk’ group was more than four times higher than the overall population. We observed a C-statistic of 0.78 indicating good model performance. The model was well calibrated across categories of predicted risk.ConclusionsIt is feasible to develop a population-based model using a longitudinal administrative database that identifies the risk of hospitalisation for a paediatric population. The results of this model, along with profiles of children identified as high risk, are being provided to the paediatricians and other healthcare professionals providing care to this population to aid in planning for care management and interventions that may reduce their patients’ likelihood of a preventable, high-cost hospitalisation.
Optimal Thromboprophylaxis in Elderly Chinese Patients with Atrial Fibrillation (ChiOTEAF) registry: protocol for a prospective, observational nationwide cohort study
Authors: Guo Yutao , Wang Yutang , Li Xiaoying , Shan Zaoliang , Shi Xiangmin , Xi Guorong , Lip Gregory Y H 
Published: May 2018

IntroductionAtrial fibrillation (AF) is a worldwide healthcare burden that is associated with the ageing population. Elderly patients with AF with multiple comorbidities usually present with a high risk of thromboembolism and bleeding. Limited prospective data are available from Asian cohorts on the epidemiology and complications of AF. The present prospective cohort study aims to explore contemporary antithrombotic strategies among the elderly Chinese population in the new era of non-vitamin K antagonist oral anticoagulants and to compare the clinical characteristics and outcomes between Chinese and European AF populations.Methods and analysisThe Optimal Thromboprophylaxis in Elderly Chinese Patients with Atrial Fibrillation (ChiOTEAF) registry will recruit 5000 patients with AF over 65 years of age in China. AF-related risks, including stroke/systemic thromboembolism and bleeding outcomes, will be assessed. Medical history, risk factors, demographic information and management will be collected at baseline, and clinical events during 1 year follow-up will be recorded. Follow-up will be conducted for at least 1 year and then annually thereafter. As our registry has a common protocol to the European Society of Cardiology EURObservational Research Programme AF general registry programme, preplanned analyses comparing the clinical profiles and outcomes will be performed. The ChiOTEAF registry offers an opportunity to provide a better understanding of the clinical profiles and adverse outcomes of patients with AF in China and allow for comparisons with a contemporary European population.Ethics and disseminationEthics approval was granted by the Central Medical Ethic Committee of Chinese PLA General Hospital (approval no S2014-065-01). The (inter)national research presentations, peer-reviewed publications and media coverage of the research will be sued for dissemination of the results.
Methods and quality of disease models incorporating more than two sexually transmitted infections: a protocol for a systematic review of the evidence
Authors: Sailer Fabian , Rait Greta , Howe Alice , Saunders John , Hunter Rachael 
Published: May 2018

IntroductionDisease models can be useful tools for policy makers to inform their decisions. They can help to estimate the costs and benefits of interventions without conducting clinical trials and help to extrapolate the findings of clinical trials to a population level.Sexually transmitted infections (STIs) do not operate in isolation. Risk-taking behaviours and biological interactions can increase the likelihood of an individual being coinfected with more than one STI.Currently, few STI models consider coinfection or the interaction between STIs. We aim to identify and summarise STI models for two or more STIs and describe their modelling approaches.Methods and analysisSix databases (Cochrane, Embase, PLOS, ProQuest, Medline and Web of Science) were searched on 27 November 2018 to identify studies that focus on the reporting of the methodology and quality of models for at least two different STIs. The quality of all eligible studies will be accessed using a percentage scale published by Kopecet al. We will summarise all used approaches to model two or more STIs in one model. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework will be used to report all outcomes.Ethics and disseminationEthical approval is not required for this systematic review. The results of this review will be published in a peer-reviewed journal and presented at a suitable conference. The findings from this review will be used to inform the development of a new multi-STI model.PROSPERO registration numberCRD42017076837.
Glycated haemoglobin A1c(HbA1c) for detection of diabetes mellitus and impaired fasting glucose in Malawi: a diagnostic accuracy study
Authors: Rathod Sujit D , Crampin Amelia C , Musicha Crispin , Kayuni Ndoliwe , Banda Louis , Saul Jacqueline , McLean Estelle , Branson Keith , Jaffar Shabbar , Nyirenda Moffat J 
Published: May 2018

ObjectivesTo examine the accuracy of glycated haemoglobin A1c(HbA1c) in detecting type 2 diabetes and impaired fasting glucose among adults living in Malawi.DesignA diagnostic validation study of HbA1c. Fasting plasma glucose (FPG) ≥7.0 mmol/L was the reference standard for type 2 diabetes, and FPG between 6.1 and 6.9 mmol/L as impaired fasting glucose.Participants3645 adults (of whom 63% were women) recruited from two demographic surveillance study sites in urban and rural Malawi. This analysis excluded those who had a previous diagnosis of diabetes or had history of taking diabetes medication.ResultsHbA1cdemonstrated excellent validity to detect FPG-defined diabetes, with an area under the receiver operating characteristic (AUROC) curve of 0.92 (95% CI 0.90 to 0.94). At HbA1c≥6.5% (140 mg/dL), sensitivity was 78.7% and specificity was 94.0%. Subgroup AUROCs ranged from 0.86 for participants with anaemia to 0.94 for participants in urban Malawi. There were clinical and metabolic differences between participants with true diabetes versus false positives when HbA1cwas ≥6.5% (140 mg/dL).ConclusionsThe findings from this study provide justification to use HbA1cto detect type 2 diabetes. As HbA1ctesting is substantially less burdensome to patients than either FPG testing or oral glucose tolerance testing, it represents a useful option for expanding access to diabetes care in sub-Saharan Africa.
Quantitative investigation of inappropriate regression model construction and the importance of medical statistics experts in observational medical research: a cross-sectional study
Authors: Nojima Masanori , Tokunaga Mutsumi , Nagamura Fumitaka 
Published: May 2018

ObjectiveTo investigate under what circumstances inappropriate use of ‘multivariate analysis’ is likely to occur and to identify the population that needs more support with medical statistics.Study design and settingsThe frequency of inappropriate regression model construction in multivariate analysis and related factors were investigated in observational medical research publications.ResultsThe inappropriate algorithm of using only variables that were significant in univariate analysis was estimated to occur at 6.4% (95% CI 4.8% to 8.5%). This was observed in 1.1% of the publications with a medical statistics expert (hereinafter ‘expert’) as the first author, 3.5% if an expert was included as coauthor and in 12.2% if experts were not involved. In the publications where the number of cases was 50 or less and the study did not include experts, inappropriate algorithm usage was observed with a high proportion of 20.2%. The OR of the involvement of experts for this outcome was 0.28 (95% CI 0.15 to 0.53). A further, nation-level, analysis showed that the involvement of experts and the implementation of unfavourable multivariate analysis are associated at the nation-level analysis (R=−0.652).ConclusionBased on the results of this study, the benefit of participation of medical statistics experts is obvious. Experts should be involved for proper confounding adjustment and interpretation of statistical models.
Delirium as a predictor of mortality in US Medicare beneficiaries discharged from the emergency department: a national claims-level analysis up to 12 months
Authors: Israni Juhi , Lesser Adriane , Kent Tyler , Ko Kelly 
Published: May 2018

BackgroundDelirium is common among seniors discharged from the emergency department (ED) and associated with increased risk of mortality. Prior research has addressed mortality associated with seniors discharged from the ED with delirium, however has generally relied on data from one or a small number of institutions and at single time points.ObjectivesAnalyse mortality rates among seniors discharged from the ED with delirium up to 12 months at the national level.DesignRetrospective cohort study.SettingAnalysed data from the Centers for Medicare & Medicaid Services limited data sets for 2012–2013.ParticipantsMedicare fee-for-service beneficiaries aged 65 years or older discharged from the ED. We focused on new incident cases of delirium, patients with any prior claims for delirium, hospice claims or end-stage renal disease were excluded. Sample size included 26 245 delirium claims, and a randomly selected sample of 262 450 controls.Outcome measuresMortality within 12 months after discharge from the ED, excluding patients transferred or admitted as inpatients.ResultsAmong all beneficiaries, 46 508 (16.1%) died within 12 months, of which 39 404 (15.0%) were in the non-delirium (ie, control group) and 7104 (27.1%) were in the delirium cohort, respectively. Mortality was strongest at 30 days with an adjusted HR of 4.82 (95% CI 4.60 to 5.04). Over time, delirium was consistently associated with increased mortality risk compared with controls up to 12 months (HR 2.07; 95% CI 2.01 to 2.13). Covariates that affected mortality included older age, comorbidity and presence of dementia.ConclusionsOur results demonstrate delirium is a significant marker of mortality among seniors in the ED, and mortality risk is most salient in the first 3 months following an ED visit. Given the significant clinical and financial implications, there is a need to increase delirium screening and management within the ED to help identify and treat this potentially fatal condition.
Reducing severe hypoglycaemia in hospitalised patients with diabetes: Early outcomes of standardised reporting and management
Authors: Araque Katherine A , Kadayakkara Deepak K , Gigauri Nino , Sheehan Diane , Majumdar Sachin , Buller Gregory , Flannery Clare A 
Published: May 2018

BackgroundSevere hypoglycaemic events (HGEs) in hospitalised patients are associated with poor outcomes and prolonged hospitalization. Systematic, coordinated care is required for acute management and prevention of HGEs; however, studies evaluating quality control efforts are scarce.ObjectiveTo investigate the effectiveness of system-based interventions to improve management response to HGEs.MethodsSystem-based interventions were designed and implemented following a root cause analysis of HGE in adult patients with diabetes from two general medical wards with the highest incidence of HGE. Interventions included electronic medical record programming for a standardised order set for basal-bolus insulin regimen and hypoglycemia protocol, automated dextrose order, automated MD notification, and recommendation for endocrine consultation after two critical HGEs. The Pyxis MedStation was programmed to alert nurses to recheck blood glucose 15 min after the treatment. A card with the HGE management protocol was attached to each provider’s ID badge and educational seminars were given to all providers.Main outcomes and measuresPrimary outcomes were to evaluate median time from HGE (glucose <50 mg/dL) to euglycemia (>100 mg/dL), and time from HGE to follow-up finger-stick (FS) testing preintervention and postintervention. Secondary outcomes were cumulative incidence of HGEs, recurrent hypoglycemia, rate of physician notification and use of standardised treatments among adults with diabetes on the two general medical wards.ResultsAmong hospitalised adults with diabetes and HGE, median time from HGE to euglycemia declined from 225±46 min preintervention to 87±26 min postintervention (p=0.03). Median time from HGE to next FS testing also declined (76±14 min to 28±10 min, p<0.001). Standardised treatment administration for HGE improved significantly from 34% (12/35) to 97% (36/37); physician notification rate improved significantly from 51% (18/35) to 78% (29/37).Among hospitalised adults with diabetes, incidence of HGE decreased from 12% (35/295) over 3 months (preintervention period) to 6% (37/610) over 6 months (postintervention period) (p<0.001), while recurrent HGE did not show significant differences (37% (13/35) to 24% (9/37) , p=0.09).ConclusionsSystem-based interventions had a clinically important impact on decreasing time from HGE to euglycemia and to next FS testing. This hypoglycemia bundle of care may be applied and tested in other community hospitals to improve patient safety.
Increased cardiovascular disease risk in international migrants is independent of residence duration or cultural orientation: the HELIUS study
Authors: Perini Wilco , Snijder Marieke B , Peters Ron J G , Stronks Karien , Kunst Anton E 
Published: May 2018

BackgroundInternational migrants differ from host populations in cardiovascular disease (CVD) risk. It has been postulated that these disparities narrow with longer residence duration. Our aim was to determine whether CVD risk still differs between migrants and host population after decades of residence and to determine whether this potential convergence of CVD risk would occur mainly among migrants with a strong cultural orientation towards the host culture.MethodsIn the Healthy Life in an Urban Setting study, we obtained data regarding residence duration, cultural orientation as estimated by the Psychological Acculturation Scale and CVD risk as estimated by SCORE among the Dutch host population and first generation migrants from South-Asian Surinamese, African Surinamese, Moroccan and Turkish ethnic background residing in Amsterdam. Estimated CVD risk was compared with the Dutch, separately for medium-term residence (15–30 years) or long-term residence (>30 years) migrants, and by strong/weak cultural orientation towards the Dutch culture, using age-adjusted regression analyses.ResultsAmong 8672 participants without prior CVD, estimated CVD risk was higher among migrant groups relative to the Dutch. CVD risk relative to the Dutch did not differ by residence duration (betas ranging from 0.1 to 3.4 for medium-term and from 0.6 to 3.3 for long-term residence, respectively). Furthermore, these patterns did not differ by cultural orientation towards the Dutch culture.ConclusionWe find no indication that CVD risk among South-Asian Surinamese, African Surinamese, Turkish or Moroccan migrants converges to that of the Dutch host population with increasing residence duration, not even among those with strong cultural orientation towards the host culture.
Molecular genetic classification in Prader-Willi syndrome: a multisite cohort study
Authors: Butler Merlin G , Hartin Samantha N , Hossain Waheeda A , Manzardo Ann M , Kimonis Virginia , Dykens Elisabeth , Gold June Anne , Kim Soo-Jeong , Weisensel Nicolette , Tamura Roy , Miller Jennifer L , Driscoll Daniel J 
Published: May 2018

BackgroundPrader-Willi syndrome (PWS) is due to errors in genomic imprinting. PWS is recognised as the most common known genetic cause of life-threatening obesity. This report summarises the frequency and further characterises the PWS molecular classes and maternal age effects.MethodsHigh-resolution microarrays, comprehensive chromosome 15 genotyping and methylation-specific multiplex ligation probe amplification were used to describe and further characterise molecular classes of maternal disomy 15 (UPD15) considering maternal age.ResultsWe summarised genetic data from 510 individuals with PWS and 303 (60%) had the 15q11-q13 deletion; 185 (36%) with UPD15 and 22 (4%) with imprinting defects. We further characterised UPD15 findings into subclasses based on the presence (size, location) or absence of loss of heterozygosity (LOH). Additionally, significantly older mothers (mean age=32.5 years vs 27.7 years) were found in the UPD15 group (n=145) compared with the deletion subtype (n=200).ConclusionsWe report on molecular classes in PWS using advanced genomic technology in the largest cohort to date. LOH patterns in UPD15 may impact the risk of having a second genetic condition if the mother carries a recessive mutant allele in the isodisomic region on chromosome 15. The risk of UPD15 may also increase with maternal age.
Omega “Ω” Pulley Plasty for Surgical Management of DeQuervain’s Disease
Authors: Bakhach Joseph , Chaya Bachar , Papazian Nazareth 
Published: May 2018

Background: DeQuervain tenosynovitis, refractory to medical conservative treatment, has been traditionally treated by a simple division of the pulley, a procedure associated with several complications. Many authors attempted to prevent these complications by describing techniques of pulley reconstruction after its release necessitating suturing the different flaps and subsequently promoting extensor tendons adhesions. The authors present an alternative procedure for the first extensor compartment pulley decompression: “Omegaplasty”.Methods: 25 Patients with 29 DeQuervain tenosynovitis cases were enrolled in a prospective, nonrandomized clinical trial from 2012 to 2016. At enrollment they were offered the option of Omegaplasty as a surgical treatment modality for their cases. The procedure is based on liberating the anterior attachment of the pulley from the anterior lip of the styloïd process while respecting its continuity with the periosteal flap as well as promoting expansion of the tunnel volume. All operated patients were evaluated using the “Opposition Kapandji Score”.Results: The authors present the results of 29 different “Omegaplasty” procedures. Based on the Kapandji opposition score, twenty cases scored 10/10 while the remaining nine cases yielded an 8/10 score each.Conclusions: The described technique is simple, reliable and respects the extensor tendons gliding physiology and biodynamics. By preserving the anatomical continuity of the first extensor compartment pulley at the wrist, the risk of adhesion formation is reduced. The preliminary results are encouraging and provide the “Ω” plasty the potential to be considered as a surgical option for treatment of De Quervain Tenosynovitis.
Three Year Review of Dorsal Plating for Complex Intra-Articular Fractures of the Distal Radius
Authors: Spiteri Michelle , Ng Wayne , Matthews Jamie , Power Dominic , Brewster Mark 
Published: May 2018

Background: The volar approach is commonly used for plating intra-articular fractures of the distal radius. Despite this, certain fracture configurations are more suitable for dorsal plate fixation. This technique has not gained favour due to the reported high incidence of extensor tendon irritation and attrition ruptures. With the advent of lower profile plates this risk has decreased.Methods: We report on forty-six cases performed in a tertiary hand centre between January 2011 and May 2014. Patients were identified from a database of distal radius fractures treated with open reduction and internal fixation. Pre-operative radiographs and computed tomogram (CT) scans were reviewed to classify fractures and evaluate fracture configurations. Dorsal displacement of fracture fragments was present in all cases. Records and imaging were reviewed to assess bony union and complications including tendon irritation, rupture and need for further surgery.Results: Plate placement was dependent on the degree of comminution in each fracture component. The combination of a dorsal and radial styloid plate was used in 52% of cases. There were no cases of tendon rupture and one case of post-operative loss of reduction. Removal of metal was performed in ten patients, mainly to improve motion and for tendon irritation (four cases each).Conclusions: Even though technically challenging, dorsal plating is useful in cases of dorsal fragment displacement and comminution, as well as complex AO-23C3 fractures with involvement of the lunate fossa. It allows stable reduction of the dorso-ulnar fragment which is important to restore DRUJ anatomy. The rate of tendon irritation and rupture is lower when compared to earlier plate designs, and removal of metal is only necessary in a few cases.
The Scottish oil-shale industry from the viewpoint of the modern-day shale-gas industry
Authors: Dean Graham 
Published: May 2018

Abstract
Oil production in West Lothian in Scotland started in 1851. It was not the first place to produce oil from shale but it was the largest and most successful. This oil production led to major developments in oil refining and, as a result, a large demand for oil products was created. This new demand for oil products stimulated the search for oil around the world and resulted in the first modern-day oil well being drilled in Titusville Pennsylvania in 1859.
Over the next 100 years, an estimated 75 MMbbl (million barrels) of oil and 500 Bcf (billion cubic ft) of gas were produced from the shales of West Lothian. Initially, the oil was produced from a thin layer of shale at Torbanehill near Bathgate. Later, the much thicker deposits in the Dinantian West Lothian Oil-shale Formation (WLO) were used to produce the oil, although there was also oil produced from other shales mostly in the Lower Coal Measures and Limestone Coal Formation.
This paper looks at the Scottish oil-shale industry from the viewpoint of the modern-day shale-gas industry and highlights the contribution the industry made as the forerunner of the oil industry. The paper attempts to explain why the Scottish oil-shale industry was so successful and influential. Reasons why the oil-shale industry did not develop into modern oil-well production are also put forward.
The Scottish shale-oil industry was successful not only thanks to James Young and his colleagues but also because of the geology of the Central Belt of Scotland and, in particular, the geochemical properties of the WLO.
The shale-oil industry, natural oil seepage, free oil encountered during mining and the historical exploration drilling demonstrate a rich functioning source rock suggesting significant prospectivity for future exploration for both oil fields and shale gas.