bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pattern and spectrum of tornado injury and its geographical information system distribution in Yancheng, China: a cross-sectional study
Authors: Deng Qiangyu , Lv Yipeng , Xue Chen , Kang Peng , Dong Junqiang , Zhang Lulu 
Published: June 2018

ObjectivesFew studies of tornado injuries have considered differences related to damage levels and Enhanced-Fujita (EF) scale ratings. This study aimed to evaluate the pattern, spectrum and geographical distribution of injuries related to the Yancheng tornado and provide guidelines for effective emergency medical strategies.SettingThe study was conducted at three hospitals which treated patients with injuries related to the tornado in Yancheng, China.ParticipantsWe obtained the records of 451 patients with tornado-related injuries. Of these, 401 valid trauma medical records were included; 50 other records were excluded for insufficient information. Informed consent was obtained from all patients by telephone.Main outcome measuresWe analysed patients’ injury sites and types and used the abbreviated injury scale (AIS) to standardise injury severity. Geographical information system and non-parametric tests were used to analyse the effects of geographical factors on casualties.ResultsWomen, middle-aged/elderly individuals (age>45 years) and children/adolescents (<18 years) accounted for 51.62%, 77.30% and 12.47% of injured patients, respectively. This caused a dumbbell-shaped age distribution. Head (46.63%), body surface (39.90%) and lower-limb (29.43%) injuries were common, as were soft-tissue injuries (90.77%), fractures (38.90%) and organ damage (19.70%). Minor injuries (AIS=1) were common (60.85%), whereas critical/fatal injuries (AIS≥5) were very rare (2.50%). Although the densities of injury varied among damage levels and EF ratings for different areas, area-wise differences in injury severity (AIS scores) were not significant (p>0.05).ConclusionWe recommend the use of helmets to prevent head injuries caused by tornadoes and suggest prioritising the treatment of high-risk head and multiple-organ injuries. Additionally, medical rescuers should follow the ‘same quality and different quantity’ principle: the injured in all affected areas should receive equal attention, but numbers of medical personnel should be allocated based on the level of effects from the tornado.
Full-text publication rate of abstracts presented at the Japan Primary Care Association Annual Meetings (2010–2012): a retrospective observational study
Authors: Komagamine Junpei , Yabuki Taku 
Published: June 2018

ObjectiveTo determine the publication rate of abstracts presented at the Japan Primary Care Association Annual Meetings and the factors associated with publication.DesignA retrospective observational study.ParticipantsAll abstracts presented at the Japan Primary Care Association Annual Meetings (2010–2012).Main outcome measuresPublication rates were determined by searching the MEDLINE database for full-text articles published by September 2017. Data on presentation format (oral vs poster), affiliation of the first author, number of authors, number of involved institutions, journal of publication and publication date were abstracted.ResultsOf the 1003 abstracts evaluated, 38 (3.8%, 95% CI 2.6% to 5.0%) were subsequently published in peer-reviewed journals indexed in the MEDLINE database. The median time to publication was 15.5 months (IQR, 9.3–29.3 months). More than 95% of published abstracts were published within 4 years. The publications appeared in 23 different journals (21 English-language journals and two Japanese-language journals). Based on univariate analysis using binary logistic regression, publication was more frequent for oral presentations (7.3%vs2.0% for poster presentations; OR 3.91,95% CI 1.98 to 7.75), and for first authors affiliated with university-associated institutions (6.4%vs2.4% for first authors affiliated with non-university-associated institutions; OR 2.75,95% CI 1.42 to 5.30). Based on multivariate analysis, oral presentation and first author affiliation with a university-associated institution were still the only independent predictive factors for publication (adjusted OR 3.50(95% CI 1.72 to 7.12) and adjusted OR 2.35(95% CI 1.19 to 4.63), respectively). Even among 151 abstracts presented orally by first authors affiliated with a university-associated institution, only 18 abstracts (11.9%) were subsequently published in peer-reviewed journals.ConclusionsThe publication rate of abstracts presented at the Japan Primary Care Association Annual Meetings was extremely low. Further studies are warranted to investigate the barriers to publication among investigators who participate in conferences where the publication rate is extremely low.
Cardiovascular disease risk marker responses to breaking up prolonged sedentary time in individuals with paraplegia: the Spinal Cord Injury Move More (SCIMM) randomised crossover laboratory trial protocol
Authors: Withers Thomas M , Croft Louise , Goosey-Tolfrey Victoria L , Dunstan David W , Leicht Christof A , Bailey Daniel P 
Published: June 2018

IntroductionSedentary behaviour is a distinct risk factor for cardiovascular disease (CVD) and could partly explain the increased prevalence of CVD in people with spinal cord injury (SCI). Interrupting prolonged sitting periods with regular short bouts of walking acutely suppresses postprandial glucose and lipids in able-bodied individuals. However, the acute CVD risk marker response to breaking up prolonged sedentary time in people with SCI has not been investigated.Methods and analysisA randomised two-condition laboratory crossover trial will compare: (1) breaking up prolonged sedentary time with 2 min moderate-intensity arm-crank activity every 20 min, with (2) uninterrupted prolonged sedentary time (control) in people with SCI. Outcomes will include acute effects on postprandial glucose, insulin, lipids and blood pressure. Blood samples will be collected and blood pressure measured at regular intervals during each 5½-hour condition.Ethics and disseminationThis study was approved by the Cambridge South National Health Service Research Ethics Committee. This research will help determine if breaking up prolonged sedentary time could be effective in lowering CVD risk in people with SCI. The findings of the research will be published in a peer-reviewed journal and disseminated to relevant user groups.Trial registration numberISRCTN51868437; Pre-results.
Satisfactory Analgesia with Minimal Emesis in Day Surgeries (SAME DayS): a protocol for a randomised controlled trial of morphine versus hydromorphone
Authors: Shanthanna Harsha , Paul James , Lovrics Peter , Devereaux P J , Bhandari Mohit , Thabane Lehana 
Published: June 2018

IntroductionThere has been an exponential increase in the number of ambulatory surgeries (AS). Pain and postoperative nausea vomiting (PONV) affects the recovery, discharge and overall satisfaction of patients having AS. Opioids remain the primary modality for moderate to severe pain. Since there is no perfect opioid, physicians should ideally use the opioid that optimally balances benefits and risks. Present decisions on the choice between morphine (M) and hydromorphone (HM) are based on individual experience and observation. Our primary objective is to compare the proportion of patients having AS achieving satisfactory analgesia without significant PONV when using M compared with HM. Secondarily we will compare the proportion of patients with adverse events, analgesic used, patient satisfaction, time to discharge and postdischarge symptoms.Methods and analysisThis is a two-arm, multicentre, parallel group, randomised controlled trial of 400 patients having AS. Eligible patients undergoing AS of the abdominal and pelvic regions with a potential to cause moderate to severe pain will be recruited in the preoperative clinic. Using a computer-generated randomization, with a 1:1 allocation ratio, patients will be randomised to M or HM. Patients, healthcare providers and research personnel will be blinded. Study interventions will be administered in the recovery using equianalgesic doses of M or HM in concealed syringes. Patients will be followed in hospital and up to 3 months. Intention-to-treat approach will be used for analysis.Ethics and disseminationThis study has been approved by the Hamilton integrated research ethics board. We plan to publish our trial findings and present our findings at scientific meetings.Trail registration numberNCT02223377; Pre-results.
Medical expenditure clustering and determinants of the annual medical expenditures of residents: a population-based retrospective study from rural China
Authors: Zhang Yan , Lu Shan , Niu Yadong , Zhang Liang 
Published: June 2018

ObjectiveTo identify the characteristics of high-cost (HC) patients and the determinants of the annual medical expenditures of Chinese rural residents.MethodsMedical expenditure clustering was performed by Lorentz curve and Gini index. T and X2tests were performed to identify the characteristics of the respondents, and a multilevel regression model examined the determinants of their annual medical expenditures.DesignA cluster sampling study was performed to identify those residents who availed healthcare services and to assign them to HC (top 5%), moderate-cost (top 30%) and low-cost (others) groups based on their annual medical expenditures.SettingThe annual healthcare utilisation was calculated by using data from the population-based database of the 2014 New Rural Cooperative Medical System.ParticipantsA total of 478 051 residents who availed healthcare services were recruited for the retrospective study in 2014. The annual medical expenditures of these residents were used as the research object.ResultsThe total medical expenditures of Macheng city residents for the year 2014 have a Gini index of 0.81 and around 68.01% of these expenditures can be attributed to HC patients. Female residents (51.5%) and persons aged over 60 years (34.48%) who are suffering from diseases that are difficult to diagnose have a high tendency to accumulate high medical costs. The annual medical expenditures of people living in the same village or town tend to be approximated. Age, disease category, inpatient status, healthcare utilisation and utilisation level are identified as the determinants of annual medical expenditures.ConclusionsThe medical expenditures of rural residents are clustered at a remarkably high level, and HC patients are suffering from high economic burden. Therefore, policy-makers must guide these patients in seeking appropriate healthcare services and improve their management of healthcare quality to reduce the unnecessary healthcare utilisation of these patients.Trial registration numberChiCTR-OOR-14005563.
The first 6 months: developing a user-informed anticipatory counselling video about the levonorgestrel intrauterine system
Authors: Gilmore Kelly , Ojanen-Goldsmith Alison , Callegari Lisa S , Godfrey Emily M 
Published: June 2018

BackgroundThe levonorgestrel intrauterine system (LNG-IUS) is a contraceptive method that can cause irregular bleeding and cramping during the first 6 months of use. Expected side effects are common reasons given for LNG-IUS device discontinuation within 12 months of use. Anticipatory counselling regarding expected LNG-IUS side effects may reduce method discontinuation and improve patient satisfaction. Educational videos could improve anticipatory counselling for LNG-IUS users; however, none have been developed. This article describes the process of developing an anticipatory counselling video with input from women in the first 6 months of LNG-IUS use and from family planning (FP) experts.MethodsWe used a participatory, iterative process to develop an anticipatory counselling video about the first 6 months of LNG-IUS use. We developed a preliminary draft using evidence from the published literature. We sought feedback from 11 FP experts and 49 LNG-IUS users to revise the script before creating the final video.ResultsFP experts suggested balancing negative with positive information and using colloquial language. LNG-IUS users requested more detailed information on the LNG-IUS mechanism of action and expected side effects in the form of statistics, infographic animations, testimonials from LNG-IUS users, and technical as opposed to colloquial language. The final video is 6 min in length and features seven LNG-IUS users, three physicians, and infographic animations.ConclusionIncluding input from FP experts and LNG-IUS users in the development process resulted in a 6-min anticipatory counselling video that will be piloted among patients on the day of their LNG-IUS insertion.
Effective resource management using machine learning in medicine: an applied example
Authors: Williams Alan , Mekhail Ann-Marie , Williams James , McCord Johanna , Buchan Vanessa 
Published: June 2018

BackgroundThe field of medicine is rapidly becoming digitised, and in the process passively amassing large volumes of healthcare data. Machine learning and data analytics are advancing rapidly, but these have been slow to be taken up in the day-to-day delivery of healthcare. We present an application of machine learning to optimise a laboratory testing programme as an example of benefiting from these tools.MethodsCanterbury District Health Board has recently implemented a system for urgent lab sample processing in the community, reducing unnecessary emergency presentations to hospital. Samples are transported from primary care facilities to a central laboratory. To improve the efficiency of this service, our team built a prototype transport scheduling platform using machine learning techniques and simulated the efficiency and cost impact of the platform using historical data.ResultsOur simulation demonstrated procedural efficiency and potential for annual savings between 5% and 14% from implementing a real-time lab sample transport scheduling platform. Advantages included providing a forward job list to the laboratory, an expected time to result and a streamlined transport request process.ConclusionThere are a range of opportunities in healthcare to use large datasets for improved delivery of care. We have described an applied example of using machine learning techniques to improve the efficiency of community patient lab sample processing at scale. This is with a view to demonstrating practical avenues for collaboration between clinicians and machine learning engineers.
Facility-level association of preoperative stress testing and postoperative adverse cardiac events
Authors: Valle Javier A , Graham Laura , Thiruvoipati Thejasvi , Grunwald Gary , Armstrong Ehrin J , Maddox Thomas M , Hawn Mary T , Bradley Steven M 
Published: June 2018

BackgroundDespite limited indications, preoperative stress testing is often used prior to non-cardiac surgery. Patient-level analyses of stress testing and outcomes are limited by case mix and selection bias. Therefore, we sought to describe facility-level rates of preoperative stress testing for non-cardiac surgery, and to determine the association between facility-level preoperative stress testing and postoperative major adverse cardiac events (MACE).MethodsWe identified patients undergoing non-cardiac surgery within 2 years of percutaneous coronary intervention in the Veterans Affairs (VA) Health Care System, from 2004 to 2011, facility-level rates of preoperative stress testing and postoperative MACE (death, myocardial infarction (MI) or revascularisation within 30 days). We determined risk-standardised facility-level rates of stress testing and postoperative MACE, and the relationship between facility-level preoperative stress testing and postoperative MACE.ResultsAmong 29 937 patients undergoing non-cardiac surgery at 131 VA facilities, the median facility rate of preoperative stress testing was 13.2% (IQR 9.7%–15.9%; range 6.0%–21.5%), and 30-day postoperative MACE was 4.0% (IQR 2.4%–5.4%). After risk standardisation, the median facility-level rate of stress testing was 12.7% (IQR 8.4%–17.4%) and postoperative MACE was 3.8% (IQR 2.3%–5.6%). There was no correlation between risk-standardised stress testing and composite MACE at the facility level (r=0.022, p=0.81), or with individual outcomes of death, MI or revascularisation.ConclusionsIn a national cohort of veterans undergoing non-cardiac surgery, we observed substantial variation in facility-level rates of preoperative stress testing. Facilities with higher rates of preoperative stress testing were not associated with better postoperative outcomes. These findings suggest an opportunity to reduce variation in preoperative stress testing without sacrificing patient outcomes
Severity of obstructive sleep apnea (OSA) in 382 Han and Uyghur patients with sleep disorders
Authors: Gul Aman , Memtily Nassirhadjy , Aihemaiti Aikeranmu , Abdukadir Amir , Wushuer Palidan 
Published: June 2018

Objective: Race and ethnicity may impact the prevalence and severity of Obstructive Sleep Apnea (OSA) in adults and children. In this study, we aim to investigate the ethnologic influence on OSA severity between Han and Uyghur OSA patients in Xinjiang, China.Methods: We enrolled total of 382 (205 Han and 177 Uyghur) patients diagnosed with OSA with apnea/hypopnea index (AHI) or respiratory disturbance index (RDI) [Formula: see text] 5. During admission, the severity of OSA was evaluated by polysomnography (PSG).Results: From demographic characteristics of enrolled patients, we found that there was no significant difference in sex, age, BMI, and neck circumference between two study populations. Uyghur OSA patients had longer sleep latency, longer REM sleep and N3 stage, but shorter N1 phase than Han OSA patients. AHI and apnea RDI level, but not hypopnea RDI, were evidently higher in Han patients compared with Uyghur patients. There was no distinctive difference between two ethnic populations in average and minimum peripheral capillary oxygen saturation (SaO2) level.Conclusion: Better understanding of impact factors encompassing ethnicity may help improve OSA diagnosis accuracy, management and treatment for patients in Xinjiang.
Combination Forecasting Reversion Strategy for Online Portfolio Selection
Authors: Huang Dingjiang , Yu Shunchang , Li Bin , Hoi Steven C. H. , Zhou Shuigeng 
Published: June 2018

Machine learning and artificial intelligence techniques have been applied to construct online portfolio selection strategies recently. A popular and state-of-the-art family of strategies is to explore the reversion phenomenon through online learning algorithms and statistical prediction models. Despite gaining promising results on some benchmark datasets, these strategies often adopt a single model based on a selection criterion (e.g., breakdown point) for predicting future price. However, such model selection is often unstable and may cause unnecessarily high variability in the final estimation, leading to poor prediction performance in real datasets and thus non-optimal portfolios. To overcome the drawbacks, in this article, we propose to exploit the reversion phenomenon by using combination forecasting estimators and design a novel online portfolio selection strategy, named
Combination Forecasting Reversion
(CFR), which outputs optimal portfolios based on the improved reversion estimator. We further present two efficient CFR implementations based on online Newton step (ONS) and online gradient descent (OGD) algorithms, respectively, and theoretically analyze their regret bounds, which guarantee that the online CFR model performs as well as the best CFR model in hindsight. We evaluate the proposed algorithms on various real markets with extensive experiments. Empirical results show that CFR can effectively overcome the drawbacks of existing reversion strategies and achieve the state-of-the-art performance.
Sleep Apnea, the Risk of Developing Heart Failure, and Potential Benefits of Continuous Positive Airway Pressure (CPAP) Therapy
Authors: Holt Anders , Bjerre Jenny , Zareini Bochra , Koch Henning , Tønnesen Philip , Gislason Gunnar H. , Nielsen Olav W. , Schou Morten , Lamberts Morten 
Published: June 2018

Background

Whether there is an association between sleep apnea (
SA
) and the risk of developing heart failure (
HF
) is unclear. Furthermore, it has never been established whether continuous positive airway pressure (
CPAP
) therapy can prevent development of
HF
. We aimed to investigate
SA
patients’ risk of developing
HF
and the association of
CPAP
therapy.

Methods and Results

Using nationwide databases, the entire Danish population was followed from 2000 until 2012. patients with
SA
receiving and not receiving
CPAP
therapy were identified and compared with the background population. The primary end point was first‐time hospital contact for
HF
and adjusted incidence rate ratios of
HF
were calculated using Poisson regression models. Among 4.9 million individuals included, 40 485 developed
SA
during the study period (median age: 53.4 years, 78.5% men) of whom 45.2% received
CPAP
therapy. Crude rates of
HF
were increased in all patients with
SA
relative to the background population. In the adjusted model, the incidence rate ratios of
HF
were increased in the untreated
SA
patients of all ages, compared with the background population. Comparing the
CPAP
‐treated patients with
SA
with the untreated patients with
SA
showed significantly lower incidence rate ratios of
HF
among older patients.

Conclusions

In this nationwide cohort study,
SA
not treated with
CPAP
was associated with an increased risk of
HF
in patients of all ages. Use of
CPAP
therapy was associated with a lower risk of incident
HF
in patients >60 years of age, suggesting a protective effect of
CPAP
therapy in the elderly.
Making genealogical language classifications available for phylogenetic analysis
Authors: Dediu Dan 
Published: June 2018

AbstractOne of the best-known types of non-independence between languages is caused by genealogical relationships due to descent from a common ancestor. These can be represented by (more or less resolved and controversial) language family trees. In theory, one can argue that language families should be built through the strict application of the comparative method of historical linguistics, but in practice this is not always the case, and there are several proposed classifications of languages into language families, each with its own advantages and disadvantages. A major stumbling block shared by most of them is that they are relatively difficult to use with computational methods, and in particular with phylogenetics. This is due to their lack of standardization, coupled with the general non-availability of branch length information, which encapsulates the amount of evolution taking place on the family tree. In this paper I introduce a method (and its implementation in R) that converts the language classifications provided by four widely-used databases (Ethnologue, WALS, AUTOTYP and Glottolog) into the de facto Newick standard generally used in phylogenetics, aligns the four most used conventions for unique identifiers of linguistic entities (ISO 639-3, WALS, AUTOTYP and Glottocode), and adds branch length information from a variety of sources (the tree’s own topology, an externally given numeric constant, or a distance matrix). The R scripts, input data and resulting Newick trees are available under liberal open-source licenses in a GitHub repository (https://github.com/ddediu/lgfam-newick), to encourage and promote the use of phylogenetic methods to investigate linguistic diversity and its temporal dynamics.