bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of electronic medical data: Identifying diabetes prevalence in general practice
Authors: Henderson Joan , Barnett Stephen , Ghosh Abhijeet , Pollack Allan J , Hodgkins Adam , Win Khin Than , Miller Graeme C , Bonney Andrew 
Published: October 2018

Background: Electronic medical records are increasingly used for research with limited external validation of their data. Objective: This study investigates the validity of electronic medical data (EMD) for estimating diabetes prevalence in general practitioner (GP) patients by comparing EMD with national Bettering the Evaluation and Care of Health (BEACH) data. Method: A “decision tree” was created using inclusion/exclusion of pre-agreed variables to determine the probability of diabetes in absence of diagnostic label, including diagnoses (coded/free-text diabetes, polycystic ovarian syndrome, impaired glucose tolerance, impaired fasting glucose), diabetic annual cycle of care (DACC), glycated haemoglobin (HbA1c) > 6.5%, and prescription (metformin, other diabetes medications). Via SQL query, cases were identified in EMD of five Illawarra and Southern Practice Network practices (30,007 active patients; from 2 years to January 2015). Patient-based Supplementary Analysis of Nominated Data (SAND) sub-studies from BEACH investigating diabetes prevalence (1172 GPs; 35,162 patients; November 2012 to February 2015) were comparison data. SAND results were adjusted for number of GP encounters per year, per patient, and then age–sex standardised to match age–sex distribution of EMD patients. Cluster-adjusted 95% confidence intervals (CIs) were calculated for both datasets. Results: EMD diabetes prevalence (T1 and/or T2) was 6.5% (95% CI: 4.1–8.9). Following age–sex standardisation, SAND prevalence, not significantly different, was 6.7% (95% CI: 6.3–7.1). Extracting only coded diagnosis missed 13.0% of probable cases, subsequently identified through the presence of metformin/other diabetes medications (*without other indicator variables) (6.1%), free-text diabetes label (3.8%), HbA1c result* (1.6%), DACC* (1.3%), and diabetes medications* (0.2%). Discussion: While complex, proxy variables can improve usefulness of EMD for research. Without their consideration, EMD results should be interpreted with caution. Conclusion: Enforceable, transparent data linkages in EMRs would resolve many problems with identification of diagnoses. Ongoing data quality improvement remains essential.
Assessing the Feasibility of Measuring Variation in Facility Design Among American Childbirth Facilities
Authors: Plough Avery , Polzin-Rosenberg Deb , Galvin Grace , Shao Amie , Sullivan Brendan , Henrich Natalie , Shah Neel T. 
Published: October 2018

Objective: To assess the feasibility of quantifying variation in childbirth facility design and explore the implications for childbirth service delivery across the United States. Background: Design has been shown to impact quality of care in childbirth. However, most prior studies use qualitative data to examine associations between the design of patient rooms and patient experience. There has been limited exploration of measures of unit design and its impact on care provision. Method: We recruited 12 childbirth facilities that were diverse with regard to facility type, location, delivery volume, cesarean delivery rate, and practice model. Each facility provided annotated floor plans and participated in a site visit or telephone interview to provide information on their design and clinical practices. These data were analyzed with self-reported primary cesarean delivery rates to assess associations between design and care delivery. Results: We observed wide variation in childbirth unit design. Deliveries per labor room per year ranged from 75 to 479. The ratio of operating rooms to labor rooms ranged from 1:1 to 1:9. The average distance between labor rooms and workstations ranged from 23 to 114 ft, and the maximum distance between labor rooms ranged from 9 to 242 ft. More deliveries per room, fewer labor rooms per operating room, and longer distances between spaces were all associated with higher primary cesarean delivery rates. Conclusions: Clinically relevant differences in design can be feasibly measured across diverse childbirth facilities. The design of these facilities may not be optimally matched to service delivery needs.
Assessing the feasibility of parent participation in a commercial weight loss program to improve child body mass index and weight-related health behaviors
Authors: Song MinKyoung , Lee Christopher S , Lyons Karen S , Stoyles Sydnee , Winters-Stone Kerri M 
Published: October 2018

Objectives: Little is known about how children’s health might be affected by parents’ participation in commercial weight loss programs. Given that more than 3.2 million people subscribe to just one commercial weight loss program, Weight Watchers, any secondary effects on children’s weight-related health behaviors (e.g. dietary behaviors, physical activity, and sedentary time) and body mass index from parent participation in commercial weight loss programs may have significant public health implications. This study examined the feasibility of conducting a study to assess such effects. Methods for recruitment and retention, and perceived acceptability and satisfaction among participants in small-scale preliminary study, were evaluated. Changes in body mass index and health behaviors among the parent–child dyads were also measured to test whether a larger-scale study would be warranted. Methods: This was an 8-week, pre–post observational feasibility study involving 20 parent–child dyads where both members had overweight or obesity. Physical and behavioral data were collected at baseline and 8 weeks from both members of the dyads. Parenting data were collected at the same time periods through parents’ self-report. Bivariate correlation was used to quantify the associations in changes for dyad members. Results: Feasibility goals for retention and perceived acceptability/satisfaction among participants were met. We reached approximately 80% of our enrollment goal. Parents showed a significant decrease in body mass index of 0.53 points (p < 0.05), while children showed a significant increase in raw body mass index (0.42, p < 0.05) and body mass index percentile (0.59, p < 0.05). However, correlation between changes in parent body mass index and changes in children body mass index percentile was positively correlated (r = 0.24, p = 0.31). A decrease in parent intake of total fat was associated with a decrease in the intake of fat in their children (r = 0.47, p < 0.05). Conclusion: Our findings support the viability of a larger-scale follow-up to assess the potential of using parent-only commercial weight loss program as a mechanism for improving health behaviors and body mass index in children with overweight or obesity.
Unilateral Coronal Craniosynostosis in an Apert-Like Patient
Authors: Pourtaheri Navid , Wang Derek Z. , Lesko Robert P. , Bonfield Christopher M. , Taub Peter , Kumar Anand R. 
Published: October 2018

Background and Significance: Apert syndrome is a congenital disorder of patients who typically present with bilateral coronal craniosynostosis and varying degrees of complex syndactyly of the hands and feet, among other features. We describe a unique presentation of a rare Apert-like patient with unilateral coronal craniosynostosis and complex syndactyly of the hands and feet. Case Report: A 2-year-old male patient presented to the craniofacial clinic with his mother due to a concerning head shape. The patient also had bilateral syndactyly of the hands and feet and underwent prior surgical release of the third web space. Computerized tomography of the head illustrated a small open anterior fontanelle, a left harlequin orbit, complete left coronal craniosynostosis, and a patent right coronal suture. The patient subsequently underwent fronto-orbital advancement for expansion of the cranial vault and correction of the asymmetric forehead and orbit. The procedure resulted in improvement of his deformity. Conclusion: This case illustrates a unique presentation of an acrocephalosyndactyly (ACS) syndrome with asymmetric, unilateral coronal craniosynostosis and complete complex syndactyly of the hands and feet that is most consistent with Apert syndrome. Although the majority of patients with ACS can be categorized into known syndromes, other more unusual presentations must still be considered. Such unique cases are exceedingly rare and only through additional reporting and review of unique phenotypes can new subtypes of common ACS syndromes be classified.
The Utility and Efficiency of a Resident Hand Clinic for the Management of Acute Hand Trauma at the University of Alberta
Authors: Robertson Emilie M. , Budden Curtis R. , Ball Brandon J. , Ladak Adil 
Published: October 2018

Background: The University of Alberta established a resident-run hand clinic in 2005 to expeditiously manage the growing numbers of patients with traumatic hand injuries. The purpose of this study was to examine the clinical volume and types of cases assessed and treated in the clinic, as well as gauge patient satisfaction with care received. Methods: A retrospective chart review and patient satisfaction questionnaire were conducted for patients assessed in the hand clinic in 2015. Demographic data, referral data, and treatment required were recorded. Patients were asked to complete a survey on their experience at the end of their visit. Results: A total of 1022 charts were reviewed. The most common reason for referral was a fracture or dislocation (57%), followed by tendon injury (18%). The average wait time to be seen in clinic was 2.97 ± 2.13 days in the winter and 4.12 ± 2.14 days in the summer. Forty-seven percent of patients required splinting, 17% required a procedure, and 21% of patients were referred for surgery. Patient satisfaction on average was 9.29 ± 0.87 on a satisfaction scale of 10. Conclusion: In a 6-month period, residents attending hand clinic assessed and treated 1022 patients, providing timely management of acute injuries. A resident-run hand clinic is an effective model to decrease wait times for patients, to decrease time spent assessing nonemergent injuries in the emergency department, and to concentrate hand trauma in a setting conducive to resident training, while still maintaining high patient satisfaction.
A three-dimensional virtual morphometry study of the sigmoid notch of the distal radius
Authors: Shivdas Sachin , Hashim MS , Ahmad T Sara 
Published: October 2018

Purpose: Our primary objectives were to create a reliable, noninvasive method for three-dimensional morphometry of deep bony parameters within the sigmoid notch of the distal radius, to identify its morphological patterns, and to identify any significant variation between the left and the right wrists. Our secondary objectives were to obtain morphometric values that could represent our population and to identify any possible ethnic variations. Methods: Computed tomography scans of 102 wrists from 51 healthy individuals were analyzed using a virtualization software. Four anatomical parameters at the distal radius sigmoid notch, namely, the radius of curvature, depth, version angle, and sagittal slope were measured. Morphological patterns of the sigmoid notch surface were identified. The results were statistically analyzed to assess the reliability of the technique and were compared with previously published literature. Results: Comparing our findings with previously published values, our study revealed a slightly larger radius of curvature and sagittal slope, while revealing a smaller depth and version. We identified the S-type, C-type, and ski-slope morphological variants. The flat-face morphological variant, however, was not identified. The sigmoid notch at the left and right wrists were similar, except for the radius of curvature. Conclusion: This study demonstrates a noninvasive, fast, reliable, and reproducible technique for analyzing the sigmoid notch of the distal radius. In wrist injuries with intact distal radius sigmoid notch but involving comminuted fractures of the ulnar head, ulnar head replacement may be indicated. In such cases, analysis of the ipsilateral intact sigmoid notch would allow us to prepare an ulnar head prosthesis of appropriate size.
Anterior humeral approach with nerve stimulator
Authors: Gulcek Murat , Gamli Mehmet 
Published: October 2018

Introduction: The prevalence of radial nerve injury during surgery is as high as the prevalence of radial nerve injury due to trauma. The aim of this study is to minimize the risk of iatrogenic injury of radial nerve. Materials and Methods: Fifty patients with middle or distal diaphysis fractures of humerus and 18 patients with pseudoarthrosis at the same localizations were treated with surgery. Plate-screw fixation was performed with anterior approach in 43 patients. Eleven patients had minimally invasive plate osteosynthesis, and 14 patients had intramedullary nailing. The localization of the radial nerve was determined with nerve stimulator at the area of dissection. Results: Iatrogenic radial nerve injury did not occur in patients treated with open reduction or minimally invasive approach. Discussion: Nerve stimulator may be a method that decreases radial nerve injury, an iatrogenic complication. This method may be used in anterior approach and minimally invasive procedures.
Mitrofanovite, Pt3Te4, a new mineral from the East Chuarvy deposit, Fedorovo–Pana intrusion, Kola Peninsula, Russia
Authors: Subbotin Victor V. , Vymazalová Anna , Laufek František , Savchenko Yevgeny E. , Stanley Chris J. , Gabov Dmitry A. , Plášil Jakub 
Published: October 2018

AbstractMitrofanovite, Pt3Te4, is a new telluride discovered in low-sulfide disseminated ore in the East Chuarvy deposit, Fedorovo–Pana intrusion, Kola Peninsula, Russia. It forms anhedral grains (up to ~20 μm × 50 μm) commonly in intergrowths with moncheite in aggregates with lukkulaisvaaraite, kotulskite, vysotskite, braggite, keithconnite, rustenburgite and Pt–Fe alloys hosted by a chalcopyrite–pentlandite–pyrrhotite matrix. Associated silicates are: orthopyroxene, augite, olivine, amphiboles and plagioclase. Mitrofanovite is brittle; it has a metallic lustre and a grey streak. Mitrofanovite has a good cleavage, along {001}. In plane-polarised light, mitrofanovite is bright white with medium to strong bireflectance, slight pleochroism, and strong anisotropy on non-basal sections with greyish brown rotation tints; it exhibits no internal reflections. Reflectance values for the synthetic analogue of mitrofanovite in air (Ro,Re’in %) are: 58.4, 54.6 at 470 nm; 62.7, 58.0 at 546 nm; 63.4, 59.1 at 589 nm; and 63.6, 59.5 at 650 nm. Fifteen electron-microprobe analyses of mitrofanovite gave an average composition: Pt 52.08, Pd 0.19, Te 47.08 and Bi 0.91, total 100.27 wt.%, corresponding to the formula (Pt2.91Pd0.02)Σ2.93(Te4.02Bi0.05)Σ4.07based on 7 atoms; the average of eleven analyses on synthetic analogue is: Pt 52.57 and Te 47.45, total 100.02 wt.%, corresponding to Pt2.94Te4.06. The density, calculated on the basis of the formula, is 11.18 g/cm3. The mineral is trigonal, space groupR$\overline 3 $m, witha= 3.9874(1),c= 35.361(1) Å,V= 486.91(2) Å3andZ= 3. The crystal structure was solved and refined from the powder X-ray-diffraction data of synthetic Pt3Te4. Mitrofanovite is structurally and chemically related to moncheite (PtTe2). The strongest lines in the powder X-ray diffraction pattern of synthetic mitrofanovite [din Å (I) (hkl)] are: 11.790(23)(003), 5.891(100)(006), 2.851(26)(107), 2.137(16)(1013), 2.039(18)(0114), 1.574(24)(0120), 1.3098(21)(0027). The structural identity of natural mitrofanovite with synthetic Pt3Te4was confirmed by electron backscatter diffraction measurements on the natural sample. The mineral name is chosen to honour Felix P. Mitrofanov, a Russian geologist who was among the first to discover platinum-group element mineralisation in the Fedorova–Pana complex.
Micro-structural phenomena in agate/chalcedony: spiral growth
Authors: Götze Jens , Berek Harry , Schäfer Klaus 
Published: October 2018

AbstractAgates with spectacular micro-structural features were found in volcanic rocks at several occurrences in the Saar-Nahe region (Germany). These agates include spirals of several tens up to several hundreds of μm in size within zones lacking the characteristic structural agate banding. A combined mineralogical study by polarising microscopy, scanning electron microscopy, cathodoluminescence microscopy and spectroscopy, and electron backscatter diffraction provided evidence that the spirals consist of well-ordered trigonal α-quartz, whereas the surrounding matrix is composed of strongly disordered or amorphous SiO2phases. The quartz micro-crystals show a systematic rotation of the crystal orientation perpendicular to the direction of the spiral loops indicating helical growth.It is assumed that the spiral growth is initiated by dislocations with a screw component. The lacking symmetry of the strongly disordered or amorphous matrix initiated a curved development by a screw dislocation in a system far from equilibrium. The atoms/molecules are packed into spiral layers, which is energetically favoured in comparison with the incorporation into plane crystal faces. Such self-organisation growth and polymerisation initiated by a screw dislocation can produce variable spiral morphologies sometimes resembling living forms.
Cell-lineage level–targeted sequencing to identify acute myeloid leukemia with myelodysplasia-related changes
Authors: Yokoyama Kazuaki , Shimizu Eigo , Yokoyama Nozomi , Nakamura Sousuke , Kasajima Rika , Ogawa Miho , Takei Tomomi , Ito Mika , Kobayashi Asako , Yamaguchi Rui , Imoto Seiya , Miyano Satoru , Tojo Arinobu 
Published: October 2018

Abstract
Acute myeloid leukemia (AML) is a clonal myeloid neoplasm that typically arises de novo; however, some cases evolve from a preleukemic state, such as myelodysplastic syndrome (MDS). Such secondary AMLs and those with typical MDS-related clinical features are known as AMLs with myelodysplasia-related changes (AML-MRC). Because patients with AML-MRC have poor prognosis, more accurate diagnostic approaches are required. In this study, we performed targeted sequencing of 54 genes in 3 cell populations (granulocyte, blast, and T-cell fractions) using samples from 13 patients with MDS, 16 patients with clinically diagnosed AML-MRC, 4 patients with suspected AML-MRC but clinically diagnosed as AML not otherwise specified (AML-NOS), and 11 patients with de novo AML. We found that overlapping mutations, defined as those shared at least by the blast and granulocyte fractions, were significantly enriched in patients with MDS and AML-MRC, including those with suspected AML-MRC, indicating a substantial history of clonal hematopoiesis. In contrast, blast-specific nonoverlapping mutations were significantly enriched in patients with de novo AML. Furthermore, the presence of overlapping mutations, excluding DNMT3A, TET2, and ASXL1, effectively segregated patients with MDS and AML-MRC or suspected AML-MRC from patients with de novo AML. Additionally, the presence of ≥3 mutations in the blast fraction was useful for distinguishing patients with AML-MRC from those with MDS. In conclusion, our approach is useful for classifying clinically diagnosable AML-MRC and identifying clinically diagnosed AML-NOS as latent AML-MRC. Additional prospective studies are needed to confirm the utility of this approach.
FeNO-based asthma management results in faster improvement of airway hyperresponsiveness
Authors: Bernholm Katrine Feldballe , Homøe Anne-Sophie , Meteran Howraman , Jensen Camilla Bjørn , Porsbjerg Celeste , Backer Vibeke 
Published: October 2018

Asthma is characterised by inflammation and respiratory symptoms. Current asthma treatment is based on severity of asthma symptoms only. Exhaled nitric oxide fraction (FeNO) is not recommended by the Global Initiative for Asthma guidelines. The aim was to compare the usefulness of aFeNOguidedversussymptom-based treatment in achieving improved asthma control assessed by airway hyperresponsiveness (AHR).80 asthmatic patients were included in a double-blinded, parallel, randomised controlled trial with follow-up visits after 8, 24 and 36 weeks. Treatment was tailored using either aFeNOor Asthma Control Questionnaire (ACQ) based algorithm. Inclusion criteria were asthma symptoms and a provocative dose causing a 15% fall in forced expiratory volume in 1 s <635 mg mannitol. At each visit AHR,FeNO, ACQ and blood tests were performed.No differences between the two groups were found at inclusion. AHR from 8 to 24 weeks was improved in theFeNOgroup compared to the ACQ group (response dose ratio (RDR) geometric mean (95% CI): 0.02 (0.01–0.04)versus0.05 (0.03–0.07), respectively, p=0.015). AHR to mannitol at 36 weeks showed no differences between the two groups (mean difference RDR (95% CI): −0.02 (−0.05–0.02), p=0.3). Total doses of inhaled steroid and number of exacerbations were similar (p>0.05).When usingFeNOas a treatment management tool, lowering of airway responsiveness occurred earlier than using ACQ. However, airway responsiveness and asthma control after 9 months were similar.
Axillary Lymph Node Dissection for Breast Cancer: Efficacy and Complication in Developing Countries
Authors: Abass Mohaned O. , Gismalla Mohamed D.A. , Alsheikh Ahmed A. , Elhassan Moawia M.A. 
Published: October 2018

Purpose Axillary lymph node dissection (ALND) frequently is performed as part of the surgical management of breast cancer as a therapeutic and prognostic index, but increasingly has been perceived as associated with significant complications. Data on efficacy and complications of ALND in Sudan are lacking. The aim of this study was to assess the efficacy and complications of ALND in patients with breast cancer treated with mastectomy and breast-conserving surgery. Methods We performed a prospective, hospital-based study in women with invasive breast cancer who underwent modified radical mastectomy or breast-conserving surgery with ALND between September 2014 and August 2015. The efficacy of ALND was defined as retrieval of ≥ 10 lymph nodes. Complications of ALND were assessed objectively and subjectively and defined as either present or absent. Results Of 96 patients with breast cancer included in the study, 40 (42%) developed postaxillary clearance complications. The median follow-up time was 18 months (range, 12 to 24 months). Numbness was reported by 21.9% of patients. Seroma was noted in 15.6% and lymphedema in 9.4%. Approximately 9% reported episodes of infection or inflammation at the surgical site. None of the studied factors were found to affect the incidence of complications significantly. Ten or more lymph nodes were retrieved in 81.3% of patients, and nodal metastasis was found in 62.5%. Conclusion This study shows that the prevalence of undesirable adverse effects after ALND is 42%, with paresthesia and seroma being the most prevalent. The lymphedema prevalence was low in relation to other evaluated symptoms.