bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Validation Study of the Chinese Version of the Mini-Addenbrooke’s Cognitive Examination for Screening Mild Cognitive Impairment and Mild Dementia
Authors: Yang Lili , Li Xiaojia , Yin Jia , Yu Nengwei , Liu Jie , Ye Fang 
Published: April 2019

Background/Aims: There are limited cognitive screening tests for the Chinese-speaking population. This study aimed to validate the Chinese version of the Mini-Addenbrooke’s Cognitive Examination (M-ACE) for detecting mild cognitive impairment (MCI) and mild dementia. Its diagnostic accuracy was compared with that of Mini-Mental State Examination (MMSE). The study also evaluated the influential factors of M-ACE scores and its convergent validity against Clinical Dementia Rating Scale (CDR) and MMSE. Method: One hundred sixty-nine participants were classified into 3 groups: mild dementia, MCI, and healthy control. Mini-Mental State Examination and M-ACE were administered by researchers who were blinded to the clinical grouping. Receiver operating characteristic curves were graphed to test the diagnostic accuracy. Results: Mini-Addenbrooke’s Cognitive Examination scores had good convergent validity against CDR and MMSE. Years of education ( r = 0.4, P < .001) yielded significant impacts on M-ACE scores. The optimal cutoff score of M-ACE to detect MCI was 25/26 (sensitivity = 0.88; specificity = 0.72) with an area under curve (AUC) significantly higher than MMSE (0.86 vs 0.72). The optimal cutoff score of M-ACE to screen mild dementia (21/22) yielded satisfactory sensitivity (0.96) and specificity (0.87) with a comparable AUC to MMSE (0.96 vs 0.94). Conclusions: Mini-Addenbrooke’s Cognitive Examination was a brief and reliable tool to detect MCI and mild dementia in the Chinese-speaking population significantly superior to MMSE when detecting MCI.
Diffuse Alveolar Hemorrhage Following Pirfenidone Initiation
Authors: Dull Stacey K. , Jagan Nikhil , Moore Douglas R. , DePew Zachary S. , Morrow Lee E. , Malesker Mark A. 
Published: April 2019

Introduction Diffuse alveolar hemorrhage (DAH) is bleeding into the alveolar space of the lungs. Pirfenidone is an antifibrotic agent that is approved for the treatment of idiopathic pulmonary fibrosis (IPF). The most commonly reported side effects include gastrointestinal and skin-related events. We present 3 cases of hemoptysis and DAH among patients on pirfenidone therapy for IPF. Case Summaries An 88-year-old female, a 75-year-old male, and a 73-year-old male all with IPF on pirfenidone presented with hemoptysis and chest computed tomography (CT) findings of usual interstitial pneumonia (UIP) with superimposed opacities. In 2 patients, DAH was confirmed with bronchoscopy. Corticosteroids were initiated and pirfenidone discontinued in all patients, and 2 patients improved while the third continued to deteriorate. Nintedanib was initiated in the remaining 2 patients at follow-up visit with no further issues. Discussion IPF is a chronic, progressive, fibrotic interstitial lung disease (ILD) which appears to be increasing in the United States and has a relatively short survival. Nintedanib and pirfenidone were the first Food and Drug Administration (FDA)-approved agents for the treatment of IPF in October 2014. We present 3 cases of DAH in patients with IPF receiving pirfenidone. Symptoms occurred within 2 months of pirfenidone initiation and resolved with discontinuation of pirfenidone and initiation of systemic corticosteroids in 2 patients; however, one case was complicated by concomitant discontinuation of aspirin. The mechanism by which DAH occurred in our patients remains unclear. Conclusion We report the first cases of possible pirfenidone-induced DAH. Further studies are warranted to explore this reaction, but prescribers should be cognizant of this potential issue when choosing to prescribe pirfenidone.
Investigations on the tooth root bending strength and the fatigue fracture characteristics of case-carburized and shot-peened gears of different sizes
Authors: Winkler KJ , Schurer S , Tobie T , Stahl K 
Published: April 2019

This paper contains data of the research project FVA 293 III by Schurer et al. and investigates the tooth root bending strength and the fatigue fracture characteristics of case-carburized and shot-peened gears of different sizes. The investigated carburized and shot-peened gears are made out of high-purity steel batches of the materials 20MnCr5 and 18CrNiMo7-6. Three different gear sizes with the normal modules mn = 1.5, 5, and 10 mm are examined in pulsator test rigs. Additionally, gear running tests in the FZG back-to-back gear test rigs for the gear size mn = 1.5 are performed.
Relative Performance Versus Market Share Delegation in a Vertically Related Market
Authors: Wang Leonard F. S. 
Published: April 2019

This article, considering relative performance vs. market share delegation in a vertically related market, shows how the order of firms’ move and the type of delegation contract would affect the input-pricing decision of the upstream monopolist and examines which delegation contract is a dominant strategy for downstream firms. The major finding is that having considered input-price commitment and delegation decision together, input price–delegation–quantity competition order coupled with relative performance delegation is the dominant strategy for downstream rivals in a vertically related market.JEL: D21, D43, L13, L21
Triage accuracy of online symptom checkers for Accident and Emergency Department patients
Authors: Yu Stephanie Wing Yin , Ma Andre , Tsang Vivian Hiu Man , Chung Lulu Suet Wing , Leung Siu-Chung , Leung Ling-Pong 
Published: April 2019

Background: Overutilisation of the Accident and Emergency Department is an increasingly serious healthcare challenge. Online symptom checkers could help alleviate this challenge by allowing patients to self-triage before visiting the Accident and Emergency Department. Objectives: This study aimed to assess the triage accuracy of online symptom checkers, which would help determine the potential roles of symptom checkers in an Accident and Emergency Department setting. Methods: A total of 100 random Accident and Emergency Department records were sampled from the Queen Mary Hospital in Hong Kong. The inclusion criteria were patients over the age of 18 attending the Queen Mary Hospital Accident and Emergency Department in 2016. Symptom checkers by Drugs.com and FamilyDoctor were selected as representative tools. One triage recommendation was generated by each symptom checker for each case record. Each symptom checker’s triage accuracy was then evaluated using a few outcome measures: overall sensitivity, sensitivity for emergency cases and specificity for non-emergency cases, when compared with the triage categories assigned by the triage nurses. Results: The results showed that Drugs.com had a higher overall triage accuracy than FamilyDoctor (74% and 50%, respectively), but both checkers are inadequately sensitive to emergency cases (70% and 45%, respectively) with low negative predictive values (43% and 24%, respectively). Conclusion: In their current states, symptom checkers are not yet suitable as alternatives to Accident and Emergency Department triage protocols due to their low overall sensitivities and negative predictive values. However, symptom checkers might serve as useful Accident and Emergency Department adjuncts in other ways, such as to provide more information prior to a patient’s arrival to streamline the triage and preparation process at the Accident and Emergency Department.
The Birth Prevalence of Cleft Lip and/or Cleft Palate After the 2011 Tōhoku Earthquake and Tsunami
Authors: Imai Yoshimichi , Sanada Takehiko , Tachi Masahiro 
Published: April 2019

Objective: This study examined whether the 2011 Tōhoku earthquake and tsunami affected the birth prevalence of cleft lip and/or cleft palate (CL/P) in Miyagi Prefecture, where the earthquake and tsunami caused severe damage. Design: This was a retrospective cohort study. Setting: The study was conducted at university and children’s hospitals in Miyagi Prefecture. Participants: The annual and monthly numbers of infants born with CL/P were obtained from medical records. The affected period of birth was defined as 1 year from December 1, 2011, to November 30, 2012. The control period was 5 years from January 1, 2006, to December 31, 2010. The annual and monthly numbers of births in Miyagi Prefecture were obtained using e-Stat, which is a portal for Japanese government statistics. Main Outcome Measures: Main outcome measures were birth prevalence of CL/P during the control and affected periods. Results: There were no significant differences between the control and affected periods in the prevalence (per 10 000 live births) of cleft lip with or without palate (13.8 vs 16.7; P = .342), isolated cleft palate (5.2 vs 3.2; P = .267), or overall CL/P (19.0 vs 19.9; P = .799). Conclusions: We did not observe that the 2011 Tōhoku earthquake and tsunami affected the birth prevalence of CL/P in Miyagi Prefecture, even though it severely impacted human health in the area.
Venous thromboprophylaxis after total hip arthroplasty: aspirin, warfarin, enoxaparin, or factor Xa inhibitors?
Authors: Bala Abiram , Murasko Marlon J , Burk David R , Huddleston James I , Goodman Stuart B , Maloney William J , Amanatullah Derek F 
Published: April 2019

Introduction: Debate over the ideal agent for venous thromboembolism (VTE) prophylaxis after total hip arthroplasty (THA) has led to changes in prescribing trends of commonly used agents. We investigate variation in utilisation and the differences in VTE incidence and bleeding risk in primary THA after administration of aspirin, warfarin, enoxaparin, or factor Xa inhibitors. Methods: 8829 patients were age/sex matched from a large database of primary THAs performed between 2007 and 2016. Utilisation was calculated using compound annual growth rate. Incidence of postoperative deep venous thrombosis (DVT), pulmonary embolism (PE), bleeding-related complications, postoperative anaemia, and transfusion were identified at 2 weeks, 30 days, 6 weeks, and 90 days. Results: Aspirin use increased by 33%, enoxaparin by 7%, and factor Xa inhibitors by 31%. Warfarin use decreased by 1%. Factor Xa inhibitors (1.7%) and aspirin (1.7%) had the lowest incidence of DVT followed by enoxaparin (2.6%), and warfarin (3.7%) at 90 days. Factor Xa inhibitors (12%) and aspirin (12%) had the lowest incidence of blood transfusion followed by warfarin (15%) and enoxaparin (17%) at 90 days. There was no difference in incidence of blood transfusion or bleeding-related complications nor any detectable difference in symptomatic PE incidence. Conclusions: The utilisation of aspirin and factor Xa inhibitors increased over time. Aspirin and factor Xa inhibitors provided improved DVT prophylaxis with lower rates of postoperative anaemia compared to enoxaparin and warfarin.
Is prophylaxis for heterotopic ossification with radiation therapy after THR associated with early loosening or carcinogenesis?
Authors: Pakos Emilios E , Papadopoulos Dimitrios V , Gelalis Ioannis D , Tsantes Andreas G , Gkiatas Ioannis , Kosmas Dimitrios , Tsekeris Pericles G , Xenakis Theodoros A 
Published: April 2019

Introduction: Heterotopic ossification may develop after major hip surgeries, thus preventive strategies including radiation therapy and non steroid anti-inflammatory drugs are commonly employed. There are certain concerns regarding the effects of radiation therapy on implant loosening and carcinogenesis. Our study aims to evaluate whether radiation therapy results in implant loosening or radiation-induced tumours in the long term. Patients and methods: This was a prospective study including 97 high-risk patients for heterotopic ossification who underwent total hip arthroplasty. Patients were divided into 2 groups and received either a combination of radiation therapy and indomethacin (Group A), or indomethacin alone (Group B). Evaluated outcomes included implant loosening or development of radiation-induced tumours during the follow-up period. Results: The follow-up period of the study was 10 years. Group A consisted of 50 patients, while Group B consisted of 47 patients. 3 patients died during the follow-up. There were 2 cases of implant loosening, 1 from each of the 2 groups at 9 and 10 years after surgery respectively; thus, no statistically significant difference regarding implant loosening was found ( p < 0.05). During the follow-up period no cases of radiation-induced tumours were identified. Conclusion: Our results are consistent with those of other studies supporting the safety of radiation therapy as a preventive strategy for heterotopic ossification following major surgeries in high risk patients. Further studies with even longer follow-up may be required to definitely exclude the possibility of adverse outcomes linked with radiation therapy.
Intravenous Immunoglobulin for Patients With Alzheimer’s Disease: A Systematic Review and Meta-Analysis
Authors: Manolopoulos Apostolos , Andreadis Panagiotis , Malandris Konstantinos , Avgerinos Ioannis , Karagiannis Thomas , Kapogiannis Dimitrios , Tsolaki Magda , Tsapas Apostolos , Bekiari Eleni 
Published: April 2019

Aim:To assess the efficacy and safety of intravenous immunoglobulin (IVIg) for patients with Alzheimer’s disease (AD).Materials and Methods:We searched electronic databases and other sources for randomized controlled trials comparing IVIg with placebo or other treatment for adults with AD. Primary outcome was change from baseline in Alzheimer’s Disease Assessment Scale–Cognitive subscale (ADAS-Cog).Results:Five placebo-controlled trials were included in the meta-analysis. Compared to placebo, IVIg 0.2 and 0.4 g/kg once every two weeks did not change ADAS-Cog score (weighted mean difference: 0.37, 95% confidence interval: −1.46 to 2.20 and 0.77, −1.34 to 2.88, respectively). Furthermore, except for an increase in the incidence of rash, IVIg did not affect the incidence of other adverse events.Conclusion:IVIg, albeit safe, is inefficacious for treatment of patients with AD. Future trials targeting earlier stages of disease or applying different dosing regimens may be warranted to clarify its therapeutic potential.
Assessing nurses’ informatics competency and identifying its related factors
Authors: Khezri Hero , Abdekhoda Mohammadhiwa 
Published: April 2019

Background Due to the increasing use of informatics as an infrastructure in developing the quality of care and patient safety, informatics competency has become a crucial requirement for nurses. Aim This study was conducted to assess nursing informatics competency, and identify related factors in registered nurses. Method This research is an analytical descriptive study in which the research community included 205 nurses working at Tabriz University of Medical Sciences’ hospitals. The researcher-made questionnaire was developed as a data collection tool (α = 98%). The data was entered into SPSS16 software and correlation analysis and regression were carried out. Results The mean score percentage of total nursing informatics competency was 59.92%. The highest mean score was related to informatics skills (62.98), followed by the informatics knowledge subscale (59%). In addition, informatics competency was positively correlated with self-efficacy ( r = 0.27, p = 0.001), evidence-based practice ( r = 0.55, p = 0.001) and time spent on hospital information systems ( r = 0.16, p = 0.01). Conclusion Computer skills, self-efficacy, evidence-based practice and time spent on hospital information systems are determinant factors of nurses’ informatics competency. Developing nurses’ basic computer skills and incorporating informatics education programmes into the curriculum can enhance nurses’ informatics competency.
Wrist arthroscopy for the treatment of scaphoid delayed or nonunions and judging the need for bone grafting
Authors: Liu Bo , Wu Feiran , Ng Chye Yew 
Published: April 2019

This study reports outcomes of arthroscopy in the treatment of delayed or nonunions of 25 scaphoids (25 patients). The surgery was performed between 8 and 43 weeks after injury. Intraoperatively, 11 fractures were deemed stable to probing and underwent percutaneous screw fixation only; 14 were unstable and received arthroscopic bone grafting with percutaneous screw fixation. All fractures united. At a mean follow-up of 21 months (range 12–48), the mean Mayo wrist score was 96, and patient-rated wrist evaluation was 4, and the flexion–extension arc was 90% of the contralateral wrist. We conclude that arthroscopy is valuable in the treatment of scaphoid delayed or nonunions and in judging the need for bone grafting. Our data indicate that regardless of cystic formation in the scaphoid, bone grafting is not always necessary. Percutaneous fixation alone is sufficient when scaphoid delayed or nonunions are between 8 weeks and 1 year following injury, without scaphoid nonunion advanced collapse or dorsal intercalated segment instability, and when forceful probing confirms stability of the scaphoid arthroscopically. Level of evidence: IV
A health utility assessment of trapeziectomy with ligament reconstruction and tendon interposition for thumb trapeziometacarpal osteoarthritis
Authors: Efanov Johnny Ionut , Nguyen David-Dan , Izadpanah Ali , Danino Michel Alain , Harris Patrick 
Published: April 2019

Trapeziectomy with ligament reconstruction and tendon interposition (LRTI) for trapeziometacarpal joint osteoarthritis may have both postoperative benefits and complications. This study sought to determine the health state utility outcome measures of trapeziectomy with LRTI. Patients who underwent trapeziectomy with LRTI were invited to complete the brief Michigan Hand Questionnaire and utility questionnaires outcomes using a visual analogue scale , time trade-off and standard gamble. Quality-adjusted life years (QALYs) were derived from these utility measures. For this study 32 patients were recruited, with a mean age of 61. Most patients (27/32) perceived the procedure as successful. Utility measures and QALYs serve the purpose of comparing different surgical procedures in terms of their impact on the quality of life of patients as a function of the benefits and complications of each procedure. In this study, the utility of trapeziectomy with LRTI was less than has been described for open palmar fasciectomy but more than for total wrist arthrodesis. Level of evidence: IV
Proposal for a standardized discharge letter after hospital stay for acute myocardial infarction
Authors: Schiele Francois , Lemesle Gilles , Angoulvant Denis , Krempf Michel , Kownator Serge , Cheggour Saida , Belle Loic , Ferrières Jean , Bauters Christophe , Bergerot Cyrille , Beygui Farzin , Boccara Franck , Bonnefoy Eric , Bruckert Eric , Cayla Guillaume , Collet Jean-Philippe , Coste Pierre , Descotes-Genon Vincent , Ducrocq Gregory , Elbaz Meyer , Farnier Michel , Ferrari Emile , Guedj Dominique , Levai Laszlo , Mansourati Jacques , Mansencal Nicolas , Meneveau Nicolas , Meune Christophe , Morel Olivier , Ohlmann Patrick , Paillard Francois , Piot Christophe , Puymirat Etienne , Rioufol Gilles , Roubille François , Sabouret Pierre , Teiger Emmanuel 
Published: April 2019

Abstract
In patients admitted for acute myocardial infarction, the communication and transition from specialists to primary care physicians is often delayed, and the information imparted to subsequent healthcare providers (HCPs) may be sub-optimal. A French group of cardiologists, lipidologists and diabetologists decided to establish a consensus to optimize the discharge letter after hospitalization for acute myocardial infarction. The aim is to improve both the timeframe and the quality of the content transmitted to subsequent HCPs, including information regarding baseline assessment, procedures during hospitalization, residual risk, discharge treatments, therapeutic targets and follow-up recommendations in compliance with European Society of Cardiology guidelines. A consensus was obtained regarding a template discharge letter, to be released within two days after patient’s discharge, and containing the description of the patient’s history, risk factors, acute management, risk assessment, discharge treatments and follow-up pathway. Specifically for post acute MI patients, tailored details are necessary regarding the antithrombotic regimen, lipid-lowering and anti-diabetic treatments, including therapeutic targets. Lastly, the follow-up pathway needs to be precisely mentioned in the discharge letter. Additional information such as technical descriptions, imaging, and quality indicators may be provided separately. A template for a standardized discharge letter based on 8 major headings could be useful for implementation in routine practice and help to improve the quality and timing of information transmission between HCPs after acute MI.
Prevalence of human T-lymphotropic virus 1/2 in Nigeria’s capital territory and meta-analysis of Nigerian studies
Authors: Anyanwu Nneoma Confidence JeanStephanie , Ella Elijah Ekah , Aminu Maryam , Azam Maleeha , Ajmal Muhammad , Kazeem Haruna Makonjuola 
Published: April 2019

Objectives: This study was aimed at determining human T-lymphotropic virus 1/2 prevalence among apparently healthy, immunocompromised and haematologic malignant individuals in Nigeria’s capital, as well as meta-analysis of all Nigerian studies until date. Methods: A total of 200 participants were recruited into a cross-sectional study. In total, 1 mL each of sera and plasma were obtained from 5 mL blood of each participant and analysed for antibodies to human T-lymphotropic virus 1/2 using enzyme-linked immunosorbent assay; positive samples confirmed with qualitative real-time polymerase chain reaction, followed by statistical and meta-analysis. Sociodemographic characteristics and possible risk factors were assessed via questionnaires. Results: Enzyme-linked immunosorbent assay yielded 1% prevalence which was confirmed to be zero via polymerase chain reaction. A total of 119 (59.5%) of the participants were male, while the mean age was 35.28 ± 13.61 years. Apart from sex and blood reception/donation, there was generally a low rate of exposure to human T-lymphotropic virus–associated risk factors. Meta-analysis revealed pooled prevalence of human T-lymphotropic virus 1 and 2 to be 3% and 0%, respectively, from Nigerian studies. Conclusion: This study discovered zero prevalence of human T-lymphotropic virus 1/2 from five major hospitals in Nigeria’s capital, exposing the importance of confirmatory assays after positive antibody detection assay results. Meta-analysis highlighted the existence of very few reliable Nigerian studies compared to the demography of the nation. Large-scale epidemiological studies and routine screening of risk populations are therefore needed since Nigeria lies in the region of endemicity.