bluuebunny/crossref_metadata_2025_split huggingface dataset:
Individual and Regional‐level Factors Contributing to Variation in Length of Stay After Cerebral Infarction in Six European Countries
Authors: Peltola Mikko , Seppälä Timo T. , Malmivaara Antti , Belicza Éva , Numerato Dino , Goude Fanny , Fletcher Eilidh , Heijink Richard ,   on behalf of the EuroHOPE study group
Published: December 2015

AbstractUsing patient‐level data for cerebral infarction cases in 2007, gathered from Finland, Hungary, Italy, the Netherlands, Scotland and Sweden, we studied the variation in risk‐adjusted length of stay (LoS) of acute hospital care and 1‐year mortality, both within and between countries. In addition, we analysed the variance of LoS and associations of selected regional‐level factors with LoS and 1‐year mortality after cerebral infarction. The data show that LoS distributions are surprisingly different across countries and that there is significant deviation in the risk‐adjusted regional‐level LoS in all of the countries studied. We used negative binomial regression to model the individual‐level LoS, and random intercept models and ordinary least squares regression for the regional‐level analysis of risk‐adjusted LoS, variance of LoS, 1‐year risk‐adjusted mortality and crude mortality for a period of 31–365 days. The observed variations between regions and countries in both LoS and mortality were not fully explained by either patient‐level or regional‐level factors. The results indicate that there may exist potential for efficiency gains in acute hospital care of cerebral infarction and that healthcare managers could learn from best practices. Copyright © 2015 John Wiley & Sons, Ltd.
Parameter Heterogeneity In Breast Cancer Cost Regressions – Evidence From Five European Countries
Authors: Smith Joel , Banks Helen , Campbell Harry , Douglas Anne , Fletcher Eilidh , McCallum Alison , Moger Tron Anders , Peltola Mikko , Sveréus Sofia , Wild Sarah , Williams Linda J. , Forbes John ,   on behalf of the EuroHOPE study group
Published: December 2015

AbstractWe investigate parameter heterogeneity in breast cancer 1‐year cumulative hospital costs across five European countries as part of the EuroHOPE project. The paper aims to explore whether conditional mean effects provide a suitable representation of the national variation in hospital costs. A cohort of patients with a primary diagnosis of invasive breast cancer (ICD‐9 codes 174 and ICD‐10 C50 codes) is derived using routinely collected individual breast cancer data from Finland, the metropolitan area of Turin (Italy), Norway, Scotland and Sweden. Conditional mean effects are estimated by ordinary least squares for each country, and quantile regressions are used to explore heterogeneity across the conditional quantile distribution. Point estimates based on conditional mean effects provide a good approximation of treatment response for some key demographic and diagnostic specific variables (e.g. age and ICD‐10 diagnosis) across the conditional quantile distribution. For many policy variables of interest, however, there is considerable evidence of parameter heterogeneity that is concealed if decisions are based solely on conditional mean results. The use of quantile regression methods reinforce the need to consider beyond an average effect given the greater recognition that breast cancer is a complex disease reflecting patient heterogeneity. © 2015 The Authors. Health Economics Published by John Wiley & Sons Ltd.
European Regional Differences in All‐Cause Mortality and Length of Stay for Patients with Hip Fracture
Authors: Medin Emma , Goude Fanny , Melberg Hans Olav , Tediosi Fabrizio , Belicza Eva , Peltola Mikko ,   on behalf of the EuroHOPE study group
Published: December 2015

SummaryThe objective of this study was to compare healthcare performance for the surgical treatment of hip fractures across and within Finland, Hungary, Italy, the Netherlands, Norway, Scotland, and Sweden. Differences in age‐adjusted and sex‐adjusted 30‐day and one‐year all‐cause mortality rates following hip fracture, as well as the length of stay of the first hospital episode in acute care and during a follow up of 365 days, were investigated, and associations between selected country‐level and regional‐level factors with mortality and length of stay were assessed.Hungary showed the highest one‐year mortality rate (mean 39.7%) and the lowest length of stay in one year (12.7 days), whereas Italy had the lowest one‐year mortality rate (mean 19.1 %) and the highest length of stay (23.3 days). The observed variations were largely explained by country‐specific effects rather than by regional‐level factors. The results show that there should still be room for efficiency gains in the acute treatment of hip fracture, and clinicians, healthcare managers, and politicians should learn from best practices. This study demonstrates that an international comparison of acute hospital care is possible using pooled individual‐level administrative data. Copyright © 2015 John Wiley & Sons, Ltd.
A Window on Geographic Variation in Health Care: Insights from EuroHOPE
Authors: Heijink Richard , Engelfriet Peter , Rehnberg Clas , Kittelsen Sverre A. C. , Häkkinen Unto ,   on behalf of the EuroHOPE study group
Published: December 2015

AbstractThe aim of EuroHOPE was to provide new evidence on the performance of healthcare systems, using a disease‐based approach, linkable patient‐level data and internationally standardized methods. This paper summarizes its main results. In the seven EuroHOPE countries, the Acute Myocardial Infarction (AMI), stroke and hip fracture patient populations were similar with regard to age, sex and comorbidity. However, non‐negligible geographic variation in mortality and resource use was found to exist. Survival rates varied to similar extents between countries and regions for AMI, stroke, hip fracture and very low birth weight. Geographic variation in length of stay differed according to type of disease. Regression analyses showed that only a small part of geographic variation could be explained by demand and supply side factors. Furthermore, the impact of these factors varied between countries. The findings show that there is room for improvement in performance at all levels of analysis and call for more in‐depth disease‐based research. In using international patient‐level data and a standardized methodology, the EuroHOPE approach provides a promising stepping‐stone for future investigations in this field. Still, more detailed patient and provider information, including outside of hospital care, and better data sharing arrangements are needed to reach a more comprehensive understanding of geographic variations in health care. Copyright © 2015 John Wiley & Sons, Ltd.
A novel approach for estimating karst groundwater recharge in mountainous regions and its application in Switzerland
Authors: Malard Arnauld , Sinreich Michael , Jeannin Pierre‐Yves 
Published: December 2015

AbstractA pragmatic and simple approach for estimating the groundwater recharge of karst aquifers in mountainous regions by extrapolation of the hydrological regimes of gauged and well‐documented systems is presented. Specific discharge rates are derived using annual precipitation and spring measurements by taking into account catchment size and elevation, which are assumed to be the dominant factors. Reference sites with high data reliability are used for calibration and regional extrapolation. This is performed with normalized values employing spatial precipitation deviations and correlation with the elevation of the catchment areas. A tiered step procedure provides minimum and maximum normalized gradients for the relationship between recharge quantity and elevation for karst regions. The normalized recharge can therefore be obtained and extrapolated for any location using the spatial precipitation variability to provide an estimate of annual groundwater recharge.The approach was applied to Switzerland (approximately 7500 km2 of karst terrain situated between 200 and over 4000 m a.s.l.) using annual precipitation data from meteorological stations for the years 2000 to 2011. Results show that the average recharge rates of different Swiss karst domains range from 20 to 46 L/km2s, which corresponds to an infiltration ratio between 0.6 and 0.9 of total precipitation. Despite uncertainties inherent in the approach, these results provide a benchmark for renewable karst groundwater resources in Switzerland of about 8.4 km3/year. The approach can be applied to any other mountainous karst region, that is, where a clear relationship between elevation, precipitation and recharge can be assumed. Copyright © 2015 John Wiley & Sons, Ltd.
Population Pharmacokinetics and Exposure‐Response of a Fixed‐Dose Combination of Azilsartan Medoxomil and Chlorthalidone in Patients With Stage 2 Hypertension
Authors: Tsai Max C. , Wu Jingtao , Kupfer Stuart , Vakilynejad Majid 
Published: December 2015

AbstractPopulation pharmacokinetic and exposure‐response models for azilsartan medoxomil (AZL‐M) and chlorthalidone (CLD) were developed using data from an 8‐week placebo‐controlled phase 3, factorial study of 20, 40, and 80 mg AZL‐M every day (QD) and 12.5 and 25 mg CLD QD in fixed‐dose combination (FDC) in subjects with moderate to severe essential hypertension. A 2‐compartment model with first‐order absorption and elimination was developed to describe pharmacokinetics. An Emax model for exposure‐response analysis evaluated AZL‐M/CLD effects on ambulatory systolic blood pressure (SBP). Estimated oral clearance and apparent volume of distribution (central compartment) were 1.47 L/h and 3.98 L for AZL, and 4.13 L/h and 62.1 L for CLD. Age as a covariate had the largest effect on AZL and CLD exposure (±20% change). Predicted maximal SBP responses (Emax) were –15.6 and –23.9 mm Hg for AZL and CLD. Subgroup analysis identified statistically significant Emax differences for black vs nonblack subjects, whereby the reduced AZL response in black subjects was offset by greater response to CLD. The estimated Emax for AZL and CLD was generally greater in subjects with higher baseline BP. In conclusion, no dose adjustments to AZL‐M or CLD are warranted based on identified covariates, and antihypertensive efficacy of AZL‐M/CLD combination therapy is comparable in black and nonblack subjects.
Gait alterations can reduce the risk of edge loading
Authors: Wesseling Mariska , Meyer Christophe , De Groote Friedl , Corten Kristoff , Simon Jean‐Pierre , Desloovere Kaat , Jonkers Ilse 
Published: December 2015

ABSTRACTFollowing metal‐on‐metal hip arthroplasty, edge loading (i.e., loading near the edge of a prosthesis cup) can increase wear and lead to early revision. The position and coverage angle of the prosthesis cup influence the risk of edge loading. This study investigates the effect of altered gait patterns, more specific hip, and pelvis kinematics, on the orientation of hip contact force and the consequent risk of antero‐superior edge loading using muscle driven simulations of gait. With a cup orientation of 25° anteversion and 50° inclination and a coverage angle of 168°, many gait patterns presented risk of edge loading. Specifically at terminal double support, 189 out of 405 gait patterns indicated a risk of edge loading. At this time instant, the high hip contact forces and the proximity of the hip contact force to the edge of the cup indicated the likelihood of the occurrence of edge loading. Although the cup position contributed most to edge loading, altering kinematics considerably influenced the risk of edge loading. Increased hip abduction, resulting in decreasing hip contact force magnitude, and decreased hip extension, resulting in decreased risk on edge loading, are gait strategies that could prevent edge loading. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1069–1076, 2016.
Investigations in Fundamental and Applied Polymer Mechanochemistry
Authors: Larsen Michael B. , Boydston Andrew J. 
Published: December 2015

The field of polymer mechanochemistry has experienced rapid growth over the past decade, propelled largely by the development of force‐activated functional groups (mechanophores) and polymer structure‐reactivity principles for mechanochemical transduction. In addition to fundamental guidelines for converting mechanical input into chemical output, there has also been increasing focus toward the application of polymer mechanochemistry for specific functions, materials, and devices. These endeavors are made possible by multidisciplinary approaches involving designer polymer synthesis, computational modeling and design, and different fields of engineering. Described herein are contributions from our group on the development of flex activated mechanophores for small molecule release and star polymer mechanochemistry, as well as collaborative efforts toward mechanochemically triggered depolymerizations and 3D printed mechanochromic materials.
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An Exploratory Study of the Experience of Ageing with Ankylosing Spondylitis: ‘Same Backdrop but a Changing Scene’
Authors: Martindale J. , Kashefi Elham , Goodacre L. 
Published: December 2015

AbstractObjectivesPeople are living longer with a long‐term health condition. Our aim was to develop a greater understanding of the experience and needs of people as they age with ankylosing spondylitis (AS).MethodsEthical approval was obtained for six focus groups, with participants over 60 years of age, to explore experiences through peer group discussion. The groups were recorded and transcribed. Transcripts were coded and a thematic analysis was conducted using NVIVO 10.ResultsFour women and 28 men, with an average age of 68 (range 60–83) years, consented to participate. Analysis identified a central organizing concept, ‘same backdrop but a changing scene’, which conceptualizes the continued impact of AS set against a backdrop of people transitioning into a new phase of their lives and facing differing challenges. Five themes underpin this concept: ‘it doesn't go away’ (AS remains active with continuing functional and symptomatic challenges); ‘wheels fall off after 60’ (perceptions of disease progression within the context of ‘normal ageing’); ‘keep on pushing, keep on doing’ (challenges of remaining active and motivated); ‘living a fulfilling life’ (actively engaging with life) and a ‘price to pay’ (significant psychological, physical and financial consequences on participants and their families).ConclusionsAs people living with AS make the transition into retirement, many aspire to live active lives while facing new challenges in relation to their lifestyles and priorities. There is a need to offer tailored interventions to enable older people to remain active and continue to lead the lives they choose within the context of an active and often debilitating condition. Copyright © 2015 John Wiley & Sons, Ltd.
Effect of continuous positive airway pressure on nocturnal urine production in patients with obstructive sleep apnea syndrome
Authors: Miyazato Minoru , Tohyama Kazuyo , Touyama Masato , Nakamura Hiroshi , Oshiro Takuma , Ueda Shinichiro , Saito Seiichi 
Published: December 2015

AimThe aim of this study was to identify the clinical features of patients with obstructive sleep apnea syndrome (OSAS) and investigate the impact of continuous positive airway pressure (CPAP) treatment on nocturnal urine volume.Materials and MethodsThis study enrolled 53 patients with moderate‐to‐severe OSAS and an apnea‐hypoxia index of >20/hr. Data were collected on serum brain natriuretic peptide (BNP) level, International Prostate Symptom Score‐Quality of Life (IPSS‐QOL) score, Overactive Bladder Symptom Score (OABSS), International Consultation on Incontinence Modular Questionnaire‐Nocturia QOL (ICIQ‐NQOL) score, Epworth Sleepiness Scale (ESS) score, and the frequency volume chart. Only patients who continued CPAP treatment for 3 months were included in the analysis.ResultsIn total, 40 patients (33 men and 7 women) completed the study (75.5%). The mean age was 56.9 years. The night‐time frequency to void was significantly decreased from 2.1 to 1.2 after CPAP treatment (P < 0.01). The mean scores as assessed by ESS, IPSS‐QOL, OABSS, and ICIQ‐NQOL significantly improved after CPAP (P < 0.01). The mean diastolic blood pressure significantly decreased after CPAP treatment. However, there was no significant change in the BNP level before and after CPAP treatment. In the frequency volume chart, hours of undisturbed sleep, total nocturnal voided volume, and nocturnal polyuria index significantly improved after CPAP treatment (P < 0.05). However, 24‐hr voided volume and mean voided volume during night‐time did not change after CPAP treatment.ConclusionCPAP treatment decreases night‐time urinary frequency by reducing nocturnal urine production and improves QOL in patients with OSAS. Neurourol. Urodynam. 36:376–379, 2017. © 2015 Wiley Periodicals, Inc.
Pelvic floor muscle functions are improved after successful transobturator vaginal mesh procedures
Authors: Huang Wen‐Chen , Yang Shwu‐Huey , Yang Jenn‐Ming 
Published: December 2015

AimsTo explore functional changes of pelvic floor muscle (PFM) after successful Perigee procedures.MethodsWe retrospectively analyzed information from 145 women having achieved anatomic success, defined as <stage II cystocele according to the pelvic organ prolapse quantification (POP‐Q) system. The investigated data included results from the POP‐Q system and four‐dimensional ultrasound at the preoperative and 12‐month postoperative evaluations. The involuntary and voluntary PFM functions were, respectively, investigated during coughing and squeezing using the ultrasound parameters of the bladder neck distance (BND), bladder neck angle (BNA), genitohiatal distance (GHD), and genitohiatal angle.ResultsPostoperatively more women displayed normal involuntary PFM function in maintaining a stable bladder neck (preoperative vs. postoperative: 4.8% vs. 22.8%, P < 0.001) and genitohiatal (preoperative vs. postoperative: 16.6% vs. 30.3%, P = 0.008) locations upon coughing and could perform voluntary PFM contractions (preoperative vs. postoperative: 49.7% vs. 64.1%, P = 0.018). Compared with preoperative manifestations, less caudal displacement of the bladder neck indicated by smaller ranges of dynamic changes in BNA following coughing (preoperative vs. postoperative: 28° vs. 12°, P < 0.001), more cranial movement of the bladder neck indicated by larger values of changes in BND following squeezing (−0.26 vs. 0.06 cm, P < 0.001), and less reduction of genitohiatal size indicated by larger values of changes in GHD following squeezing (preoperative vs. postoperative: −0.95 vs. −0.63 cm, P = 0.027) were demonstrated postoperatively.ConclusionsInvoluntary and voluntary PFM functions are improved after successful Perigee procedures. Neurourol. Urodynam. 36:380–384, 2017. © 2015 Wiley Periodicals, Inc.
Slow‐release nanopolymeric biodegradable composites holding doxorubicin and evaluation its antiproliferative potency on cancer
Authors: Helaly Fahima M. , El Nashar Doaa E. , Khalaf Aman I. , Abdelhamid Hala F. , Wietrzyk Joanna , Psurski Mateusz , Soliman Abdelmohsen 
Published: December 2015

This work represents the functionalization of nanoscale biodegradable polymer and controls its sustained release rate for long time period. The polymer was synthesized by free radical polymerization reaction. Starch cellulose acetate co‐acrylate (SCAA) polymer was prepared and loaded with doxorubicin drug. The polymer before and after loading was characterized by Fourier‐transform infrared spectroscopy, gel permeation chromatography, and high‐resolution transmission electron microscopy. The release‐rate study illustrated good property through sustained release and extended to ∼65 days. The antiproliferative effect of doxorubicin slowly released from the prepared nanobiodegradable polymer illustrated growth inhibition potency toward human colon and liver cancer cell lines LoVo and HEPG2. POLYM. COMPOS., 38:E34–E41, 2017. © 2015 Society of Plastics Engineers
Predicted Anisotropic Thermal Conductivity for Crystalline 1,3,5‐Triamino‐2,4,6‐trinitobenzene (TATB): Temperature and Pressure Dependence and Sensitivity to Intramolecular Force Field Terms
Authors: Kroonblawd Matthew P. , Sewell Thomas D. 
Published: December 2015

AbstractThe anisotropic thermal conductivity of the layered molecular crystal 1,3,5‐triamino‐2,4,6‐trinitrobenzene (TATB), an insensitive secondary high explosive, is determined using classical molecular dynamics on the P=0.0 GPa isobar for temperatures 200 K≤T≤700 K and on the T=300 K isotherm for pressures 0.0 GPa≤P≤2.5 GPa. Sensitivity of the predicted (300 K, 0.0 GPa) conductivity to intramolecular terms in the force field is investigated. Two conduction directions are considered, one nominally within and the other exactly perpendicular to the stacked planar single‐molecule‐thick layers comprising the TATB crystal. The thermal conductivity λ(T,P) along both directions is found to decrease approximately as λ∝1/T with increasing temperature and increase approximately linearly λ ∝ T with increasing pressure. The temperature dependence is found to be highly anisotropic with nearly twice as large a reduction in absolute conductivity within the molecular layers (Δλ=−0.67 W m−1 K−1) compared to between them (Δλ=−0.35 W m−1 K−1). Anisotropy in the conductivity is predicted to decrease with increasing temperature; the P=0.0 GPa conductivity is 68 % greater within the layers than between them at 200 K, but only 49 % greater at 700 K. The pressure dependence is also anisotropic, with a 51 % and 76 % increase in conductivity within and between the layers, respectively. Predicted values for the conductivity are found to differ by less than 12 % for several instructive modifications to the intramolecular force field. Completely eliminating high‐frequency NH bond vibrations using the SHAKE algorithm leads to an isotropic reduction in the conductivity that scales as the corresponding reduction in the classical heat capacity, indicating that optical phonons are likely significant contributors to the total conductivity. Replacing harmonic bond potential energy functions with anharmonic Morse functions results in an isotropic ≈6 % reduction that is likely due to stronger phonon‐phonon coupling and corresponding reduction in the phonon mean free path.
New York State Public Health System Response to Hurricane Sandy: An Analysis of Emergency Reports
Authors: Shipp Hilts Asante , Mack Stephanie , Eidson Millicent , Nguyen Trang , Birkhead Guthrie S. 
Published: December 2015

AbstractObjectiveAnalyzing Hurricane Sandy emergency reports to assess the New York State (NYS) public health system response will help inform and improve future disaster preparedness and response.MethodsQualitative analysis of NYS Department of Health (NYSDOH) and Nassau and Suffolk County local health department (LHD) emergency reports was conducted. Three after-action reports and 48 situation reports were reviewed, grouped by key words and sorted into 16 Public Health Preparedness Capabilities. Within each capability, key words were labeled as strengths, challenges, or recommendations.ResultsThe NYSDOH capability most cited as a strength was successful emergency operations coordination, eg, interagency conference calls (27.4% of 1681 strengths). The most cited challenge was environmental health protection, eg, mold and oil spills (28% of 706 challenges). The LHD capability most cited both as a strength (46.7% of 30 strengths) and as a challenge (32.5% of 123 challenges) was emergency operations coordination. Strengths were exemplified by sharing local resources and challenges by insufficient memorandums of understanding for coordination.ConclusionsPost-disaster emergency reports should be systematically reviewed to highlight both successes and areas for improvement. Future studies should prioritize collecting feedback from a wider spectrum of public health and service provider staff for planning of preparedness and response activities. (Disaster Med Public Health Preparedness. 2015;10:308–313)