bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of the point of care Afinion AS100 analyser in a community setting
Authors: Jain Anjly , Rao Nandini , Sharifi Mahtab , Bhatt Nirav , Patel Payal , Nirmal Divyabala , Persaud Jham Want , Nair Devaki R 
Published: July 2016

Background A ‘one stop shop’ model for multifactorial risk factor management in a culturally sensitive environment may improve cardiovascular disease and diabetes prevention. A full biochemical profile for cardiovascular disease risk assessment includes a lipid profile, glucose, glycated haemoglobin and urine albumin creatinine ratio measurements. This may require the use of more than one point of care testing instrument. Methods Individuals who attended a community cardiovascular disease risk screening or an audit programme of the diabetic care pathway in the community were sampled. Bland–Altman and Deming regression plots were used to assess agreement between methods for total cholesterol, high-density lipoprotein cholesterol, triglycerides, glycated haemoglobin and urine albumin creatinine ratio. Results There was good agreement between the Afinion AS100 analyser, Cholestech LDX and the laboratory methods for total cholesterol, high-density lipoprotein cholesterol and triglycerides ( n = 232). The Afinion AS100 agreed well with the laboratory method for glycated haemoglobin ( n = 255) and urine albumin creatinine ratio ( n = 176). There was statistically significant bias ( p = 0.03 to <0.0001) for several measurements. However, these were judged not to be clinically relevant. Specifically for the total cholesterol and high-density lipoprotein cholesterol values, we obtained good agreement (weighted kappa: 0.91 and 0.94 for the Afinion AS100 vs. Cholestech LDX and Afinion AS100 vs. laboratory method, respectively) for cardiovascular disease risk calculation using QRISK2. Conclusions Point of care testing can support a ‘one stop shop’ approach by providing rapid, reliable results. The Afinion AS100 analyser provides a multi-analyte platform and compares well with laboratory-based methods and another well-established point of care testing analyser.
Self-administration of vitamin D supplements in the general public may be associated with high 25-hydroxyvitamin D concentrations
Authors: Shea Robyn L , Berg Jonathan D 
Published: July 2016

Introduction Our dried blood spot vitamin D testing service enables members of the public to assess their vitamin D status. Vitamin D has become popular with the media and the general public. We noticed that our direct access service had a higher rate of high to toxic 25-hydroxyvitamin D levels compared with our GP population and we wanted to know why. Methods Between January 2013 and September 2015 we contacted all direct access users who had 25-hydroxyvitamin D >220 nmol/L measured using LC/MS/MS. We investigated the amount, type and length of supplementation used and whether or not users were medically supervised. Results A total of 372 service users had 25-hydroxyvitamin D concentrations >220 nmol/L. Of 14,806 direct access samples received, 372 (2.5%) were from users with 25-hydroxyvitamin D concentrations ranging from 221 to 1235 nmol/L. Only 0.06% of GP patients had results >220 nmol/L over the same time frame. There were 361 direct access users regularly supplementing, taking between 1000 to 120,000 IU/day. Two users took bolus doses of 300,000 and 900,000 IU. Only 23 users taking supplements (6.4%) were under medical supervision. There were 28 users with levels >500 nmol/L, but only one was under medical supervision. The internet was the main source of supplements (74%). Conclusions The proportion of high to toxic concentrations of vitamin D was higher in direct access users than in the GP population. Many people were taking more than the Institute of Medicine's recommendation of 10,000 IU/day, yet only a few were being medically supervised. Clinicians should be aware that patients may be self-administering very high concentrations of vitamin D, especially when investigating unexplained hypercalcaemia.
Benefits of Imperfect Conflict Resolution Advisory Aids for Future Air Traffic Control
Authors: Trapsilawati Fitri , Wickens Christopher D. , Qu Xingda , Chen Chun-Hsien 
Published: July 2016

Objective: The aim of this study was to examine the human–automation interaction issues and the interacting factors in the context of conflict detection and resolution advisory (CRA) systems. Background: The issues of imperfect automation in air traffic control (ATC) have been well documented in previous studies, particularly in conflict-alerting systems. The extent to which the prior findings can be applied to an integrated conflict detection and resolution system in future ATC remains unknown. Method: Twenty-four participants were evenly divided into two groups corresponding to a medium– and a high–traffic density condition, respectively. In each traffic density condition, participants were instructed to perform simulated ATC tasks under four automation conditions, including reliable, unreliable with short time allowance to secondary conflict (TAS), unreliable with long TAS, and manual conditions. Dependent variables accounted for conflict resolution performance, workload, situation awareness, and trust in and dependence on the CRA aid, respectively. Results: Imposing the CRA automation did increase performance and reduce workload as compared with manual performance. The CRA aid did not decrease situation awareness. The benefits of the CRA aid were manifest even when it was imperfectly reliable and were apparent across traffic loads. In the unreliable blocks, trust in the CRA aid was degraded but dependence was not influenced, yet the performance was not adversely affected. Conclusion: The use of CRA aid would benefit ATC operations across traffic densities. Application: CRA aid offers benefits across traffic densities, regardless of its imperfection, as long as its reliability level is set above the threshold of assistance, suggesting its application for future ATC.
A randomized prospective long-term (>1 year) clinical trial comparing the efficacy and safety of radiofrequency ablation to 980 nm laser ablation of the great saphenous vein
Authors: Sydnor Malcolm , Mavropoulos John , Slobodnik Natalia , Wolfe Luke , Strife Brian , Komorowski Daniel 
Published: July 2016

Purpose To compare the short- and long-term (>1 year) efficacy and safety of radiofrequency ablation (ClosureFAST™) versus endovenous laser ablation (980 nm diode laser) for the treatment of superficial venous insufficiency of the great saphenous vein. Materials and methods Two hundred patients with superficial venous insufficiency of the great saphenous vein were randomized to receive either radiofrequency ablation or endovenous laser ablation (and simultaneous adjunctive therapies for surface varicosities when appropriate). Post-treatment sonographic and clinical assessment was conducted at one week, six weeks, and six months for closure, complications, and patient satisfaction. Clinical assessment of each patient was conducted at one year and then at yearly intervals for patient satisfaction. Results Post-procedure pain ( p < 0.0001) and objective post-procedure bruising ( p = 0.0114) were significantly lower in the radiofrequency ablation group. Improvements in venous clinical severity score were noted through six months in both groups (endovenous laser ablation 6.6 to 1; radiofrequency ablation 6.2 to 1) with no significant difference in venous clinical severity score ( p = 0.4066) or measured adverse effects; 89 endovenous laser ablation and 87 radiofrequency patients were interviewed at least 12 months out with a mean long-term follow-up of 44 and 42 months ( p = 0.1096), respectively. There were four treatment failures in each group, and every case was correctable with further treatment. Overall, there were no significant differences with regard to patient satisfaction between radiofrequency ablation and endovenous laser ablation ( p = 0.3009). There were no cases of deep venous thrombosis in either group at any time during this study. Conclusions Radiofrequency ablation and endovenous laser ablation are highly effective and safe from both anatomic and clinical standpoints over a multi-year period and neither modality achieved superiority over the other.
Which Are the Most Reliable Methods of Predicting the Meniscal Size for Transplantation?
Authors: Kaleka Camila Cohen , Netto Alfredo Santos , Silva Júlio César Almeida e , Toma Mariana Key , de Paula Leite Cury Ricardo , Severino Nilson Roberto , Santili Claudio 
Published: July 2016

Background: Although the size of the meniscal allograft is crucial during meniscal transplantation, the accuracy of meniscal measurement methods is still under debate. A number of methods based on radiographic and magnetic resonance imaging (MRI) data as well as on anthropometric data have been proposed, but their reproducibility and reliability are still unclear. Purpose: To compare meniscal length and width as measured by different techniques (anthropometric and plain radiographic) to establish which of these 2 methods is more reliable and cost-effective for determining the meniscal size in comparison to MRI. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: The MRI scans and plain radiographic films of 22 patients (44 knees) from a single institution were studied. The width and length of the medial and lateral menisci were measured using specific techniques. Data on sex, age, body weight, and height were used to develop a regression formula for meniscal measurements (comparing both imaging methods) to establish meniscal dimensions. Data validation was achieved using the Pearson correlation, the intraclass correlation coefficient, and the Wilcoxon nonparametric test for all variables, with a significance level established at 95%. Accuracy was established as a 10% measure discrepancy from the gold standard (MRI) and was considered an average between the right and left knees. Results: No statistically significant difference was observed between the right and left knees on radiographic and MRI measurements. The Pollard technique of radiographic measurement overestimated the width of the lateral meniscus when compared with anthropometric measurements ( P < .001), considering MRI as the gold standard. The same was observed for MRI measurements of the length of the lateral meniscus in which not only anthropometric but also plain radiographic measurements using the Yoon technique were significantly smaller than those values found with the Pollard technique ( P < .001). The anthropometric method underestimated the width and length of the medial meniscus with an accuracy of 68.2% and 63.6%, respectively. The radiographic method was comparable with MRI in establishing all medial meniscal measurements with an accuracy of 93.2% for length and 77.3% for width. Conclusion: Some viable alternatives to MRI have been suggested. For the lateral meniscus, anthropometric data are an alternative for width, and the Yoon method can be used to assess length. For the medial meniscus, the Pollard method is considered a satisfactory alternative. This study emphasized the importance of measuring the width and length of the meniscus independently during preoperative sizing for a meniscal allograft transplantation procedure. Using MRI as a gold standard, the study also proposed other less costly and satisfactory methods of obtaining such measurements.
A Randomized Trial of Social Comparison Feedback and Financial Incentives to Increase Physical Activity
Authors: Patel Mitesh S. , Volpp Kevin G. , Rosin Roy , Bellamy Scarlett L. , Small Dylan S. , Fletcher Michele A. , Osman-Koss Rosemary , Brady Jennifer L. , Haff Nancy , Lee Samantha M. , Wesby Lisa , Hoffer Karen , Shuttleworth David , Taylor Devon H. , Hilbert Victoria , Zhu Jingsan , Yang Lin , Wang Xingmei , Asch David A. 
Published: July 2016

Purpose: To compare the effectiveness of different combinations of social comparison feedback and financial incentives to increase physical activity. Design: Randomized trial ( Clinicaltrials.gov number, NCT02030080). Setting: Philadelphia, Pennsylvania. Participants: Two hundred eighty-six adults. Interventions: Twenty-six weeks of weekly feedback on team performance compared to the 50th percentile (n = 100) or the 75th percentile (n = 64) and 13 weeks of weekly lottery-based financial incentive plus feedback on team performance compared to the 50th percentile (n = 80) or the 75th percentile (n = 44) followed by 13 weeks of only performance feedback. Measures: Mean proportion of participant-days achieving the 7000-step goal during the 13-week intervention. Analysis: Generalized linear mixed models adjusting for repeated measures and clustering by team. Results: Compared to the 75th percentile without incentives during the intervention period, the mean proportion achieving the 7000-step goal was significantly greater for the 50th percentile with incentives group (0.45 vs 0.27, difference: 0.18, 95% confidence interval [CI]: 0.04 to 0.32; P = .012) but not for the 75th percentile with incentives group (0.38 vs 0.27, difference: 0.11, 95% CI: −0.05 to 0.27; P = .19) or the 50th percentile without incentives group (0.30 vs 0.27, difference: 0.03, 95% CI: −0.10 to 0.16; P = .67). Conclusion: Social comparison to the 50th percentile with financial incentives was most effective for increasing physical activity.
Diagnosing melancholic depression: some personal observations
Authors: Parker Gordon 
Published: July 2016

Objectives: The objective of this study was to offer some personal observations as to how melancholia can be diagnosed and differentiated from the non-melancholic depressive conditions. Methods: Personal clinical and research-based observations are presented following a critique of common current strategies. Results: The paper offers views on the most differentiating clinical features, argues for adding illness course variables to symptoms and provides details of the Sydney Melancholic Prototypic Index, a measure with a high overall classification rate in differentiating melancholic and non-melancholic depression. Conclusions: Greater precision in differentiating melancholic from non-melancholic depression is advanced by weighting signs and symptoms of psychomotor disturbance, as well as including illness correlates and family history in the diagnostic process.
Attitudes toward utility, effects and side effects of treatment for anxiety and depression
Authors: Lim Leslie , Goh Justine , Chan Yiong-Huak , Poon Shi-Hui 
Published: July 2016

Objectives: Negative perceptions about psychiatric treatment are likely to affect treatment adherence. We compared attitudes of patients with psychiatric illness and those of medical patients towards psychiatric treatment. Methods: Both patients with psychiatric illness and medical patients (controls) were shown a printed copy of two vignettes depicting major depression and generalized anxiety disorder. They were asked for their perceptions on the utility, effects and possible side effects of psychiatric medications, as well as the utility of psychotherapy in treating major depression and generalized anxiety disorder. Responses between psychiatric patients and medical patients were compared using appropriate statistical tests, including logistic regression. Results: Patients with psychiatric illness were more likely than medical patients to endorse the utility of medications in treating major depression and generalized anxiety disorder ( p<0.001). Those with psychiatric illness were more likely to endorse the utility of psychotherapy in treating major depression ( p=0.004). Both groups of patients were of the view that psychotherapy would benefit generalized anxiety disorder. Older and lesser educated patients held negative beliefs about medications. Conclusions: While patients with psychiatric illnesses endorsed favourable attitudes toward medications ( p<0.001), the older and lesser educated were more likely to hold negative views ( p<0.05). Psychoeducation should be tailored to the needs of older and lesser educated patients.
Implementation and Evaluation of the Skills Training in Affective and Interpersonal Regulation (STAIR) in a Community Setting in the Context of Childhood Sexual Abuse
Authors: MacIntosh Heather B. , Cloitre Marylene , Kortis Kerrie , Peck Alison , Weiss Brandon J. 
Published: July 2016

Purpose: The objective of this article is to describe the implementation of the Skills Training in Affective and Interpersonal Regulation (STAIR), a manualized, evidence-based cognitive behavioral group treatment for childhood trauma at Cedar Centre, a community-based trauma treatment center, and describe the preliminary evaluation of the effectiveness of the treatment. Method: Pre- and postmeasurements of emotion regulation, interpersonal problems, and traumatic stress symptoms using psychometrically validated instruments were collected. Outcomes were assessed for 85 individuals who experienced childhood sexual abuse and participated in the first cycles of intervention at the center. Results: Results indicated significant reductions in difficulties in emotion regulation, interpersonal problems, and trauma symptoms among participants from pretreatment to posttreatment. Discussion: Overall, there was a positive response to the adoption and integration of the STAIR intervention into the program. Qualitative assessment identified the benefits perceived by both facilitators and group participants.
Asymmetry of the Receding Hairline in Men With Early Androgenetic Alopecia
Authors: Azar Reza Pashmineh , Thomas Alexander Horst , Maurer Marcus , Lindner Gerd 
Published: July 2016

Background: The Norwood classification system is commonly used to ascertain the progress of androgenetic alopecia (AGA) with a robust and quick assessment, but it lacks precision in the frontal region, notably during the onset of male pattern hair loss. Objective: Due to the ongoing technical improvement in restorative hair transplantation practices, we aim to develop simple quantitative methods for measuring the progression of AGA. Methods: Here, we used a quantitative system to evaluate the progress of AGA of the frontal receding hairline in a case study with 41 patients. Results: We found subtle differences in the extent of frontotemporal regressions that were not captured by the Norwood classification system. The majority of patients exhibited significantly larger right-sided frontotemporal regressions. Conclusion: These results indicate that the quantification system used is a valuable tool in complementing the Norwood classification system to more precisely determine the recessing hairline characteristics in early stages of hair loss. Our findings also suggest that hairline regression in AGA-affected patients is asymmetrical, a hitherto unnoticed disorder-associated phenomenon with unknown biological causality.
A multivariate single-index model for longitudinal data
Authors: Wu Jingwei , Tu Wanzhu 
Published: July 2016

Abstract: Index measures are commonly used in medical research and clinical practice, primarily for quantification of health risks in individual subjects or patients. The utility of an index measure is ultimately contingent on its ability to predict health outcomes. Construction of medical indices has largely been based on heuristic arguments, although the acceptance of a new index typically requires objective validation, preferably with multiple outcomes. In this article, we propose an analytical tool for index development and validation. We use a multivariate single-index model to ascertain the best functional form for risk index construction. Methodologically, the proposed model represents a multivariate extension of the traditional single-index models. Such an extension is important because it assures that the resultant index simultaneously works for multiple outcomes. The model is developed in the general framework of longitudinal data analysis. We use penalized cubic splines to characterize the index components while leaving the other subject characteristics as additive components. The splines are estimated directly by penalizing nonlinear least squares, and we show that the model can be implemented using existing software. To illustrate, we examine the formation of an adiposity index for prediction of systolic and diastolic blood pressure in children. We assess the performance of the method through a simulation study.
Empirical and philosophical analysis of physicians’ judgments of medical indications
Authors: Björk Joar , Lynöe Niels , Juth Niklas 
Published: July 2016

Background The aim of this study was to investigate whether physicians who felt strongly for or against a treatment, in this case a moderately life prolonging non-curative cancer treatment, differed in their estimation of medical indication for this treatment as compared to physicians who had no such sentiment. A further aim was to investigate how the notion of medical indication was conceptualised. Methods A random sample of GPs, oncologists and pulmonologists (n = 646) comprised the study group. Respondents were randomised to receive either version of a case presentation; in one version, the patient had smoked and in the other version she had never smoked. The physicians were labelled value-neutral (65%) and value-influenced (35%) on the basis of their attitude towards the treatment. Results In the ‘value-influenced’ group, there was a significant difference in the estimation of medical indication for treatment depending upon whether the patient had smoked (50% (95% CI: 41–59) or never smoked (67% (95% CI: 58–76) (Chi-2 = 5.8, df = 1; p = 0.016)). There was no such difference in the ‘value-neutral’ group. Conclusion This study shows that compared to value-neutral physicians, value-influenced physicians are more likely to base decisions of medical indication on medically irrelevant factors (in this case: the patient’s smoking status). Moreover, medical indication is used in an ambiguous manner. Hence, we recommend that the usage of ‘medical indication’ be disciplined.
Optimization of Single Voxel MR Spectroscopy Sequence Parameters and Data Analysis Methods for Thermometry in Deep Hyperthermia Treatments
Authors: Hartmann J. , Gellermann J. , Brandt T. , Schmidt M. , Pyatykh S. , Hesser J. , Ott O. , Fietkau R. , Bert C. 
Published: July 2016

Objective: The difference in the resonance frequency of water and methylene moieties of lipids quantifies in magnetic resonance spectroscopy the absolute temperature using a predefined calibration curve. The purpose of this study was the investigation of peak evaluation methods and the magnetic resonance spectroscopy sequence (point-resolved spectroscopy) parameter optimization that enables thermometry during deep hyperthermia treatments. Materials and Methods: Different Lorentz peak-fitting methods and a peak finding method using singular value decomposition of a Hankel matrix were compared. Phantom measurements on organic substances (mayonnaise and pork) were performed inside the hyperthermia 1.5-T magnetic resonance imaging system for the parameter optimization study. Parameter settings such as voxel size, echo time, and flip angle were varied and investigated. Results: Usually all peak analyzing methods were applicable. Lorentz peak-fitting method in MATLAB proved to be the most stable regardless of the number of fitted peaks, yet the slowest method. The examinations yielded an optimal parameter combination of 8 cm3 voxel volume, 55 millisecond echo time, and a 90° excitation pulse flip angle. Conclusion: The Lorentz peak-fitting method in MATLAB was the most reliable peak analyzing method. Measurements in homogeneous and heterogeneous phantoms resulted in optimized parameters for the magnetic resonance spectroscopy sequence for thermometry.