bluuebunny/crossref_metadata_2025_split huggingface dataset:
Midterm result of custom-made iliac branch device for common iliac aneurysm with and without abdominal aortic aneurysm
Authors: Huang Chun-Yang , Chen Po-Lin , Lu Hsin-Ying , Hsu Hung-Lung , Kuo Tzu-Ting , Chen I.-Ming , Hsu Chiao-Po , Shih Chun-Che 
Published: September 2020

Abstract

OBJECTIVES
Although commercial iliac branch devices offer a new and valid endovascular approach to treating iliac aneurysm and effectively preserve antegrade flow of the internal iliac artery, their use may not be suited for all types of challenging anatomy, especially isolated common iliac artery aneurysm. Our custom-made iliac bifurcation device has a unique design and excludes both combined and isolated iliac branch aneurysm. This study validated the efficacy and safety of the custom device by comparing clinical outcomes between groups receiving commercial and custom devices.

METHODS
Data of consecutive patients receiving iliac bifurcation device implantation for iliac aneurysm with or without concomitant endovascular repair for abdominal aortic aneurysm from January 2010 to May 2019 were reviewed.

RESULTS
Iliac bifurcation device implantation with or without concomitant abdominal aortic aneurysm stent grafting was completed in 46 patients (commercial, n = 35; custom, n = 11). No significant differences were observed regarding postoperative complications, occlusion or endoleak. Comparisons of primary (80.8% vs 85.7%, P = 0.88) and secondary (86.5% vs 85.7%, P = 0.85) patency and freedom from reintervention (88.2% vs 100%, P = 0.33), all-cause mortality (78.6% vs 100%, P = 0.25) and aneurysm-related mortality (100% vs 100%, P = 1.00) also indicated no differences at a 5-year surveillance point. Furthermore, the iliac aneurysms of the groups displayed similar shrinkage 1 year after procedures.

CONCLUSIONS
For iliac aneurysm, the novel custom-made iliac bifurcation device is an adaptable design not inferior to commercial devices with regard to postoperative complications, bridge occlusion, endoleak and short-term aneurysm remodelling. It provides an alternative for treatment, particularly when certain anatomic challenges are present.

Clinical trial registration
2018-07-050BC, 2017-01-023ACF.
Average Bound Toward the Generalized Ramanujan Conjecture and Its Applications on Sato–Tate Laws for GL(n)
Authors: Lau Yuk-Kam , Ho Ng Ming , Wang Yingnan 
Published: September 2020

Abstract
We give the 1st non-trivial estimate for the number of $GL(n)$ ($n\ge 3$) Hecke–Maass forms whose Satake parameters at any given prime $p$ fail the Generalized Ramanujan Conjecture and study some applications on the (vertical) Sato–Tate laws.
Building the evidence-base to reduce electronic health record–related clinician burden
Authors: Dymek Christine , Kim Bryan , Melton Genevieve B , Payne Thomas H , Singh Hardeep , Hsiao Chun-Ju 
Published: September 2020

Abstract
Clinicians face competing pressures of being clinically productive while using imperfect electronic health record (EHR) systems and maximizing face-to-face time with patients. EHR use is increasingly associated with clinician burnout and underscores the need for interventions to improve clinicians’ experiences. With an aim of addressing this need, we share evidence-based informatics approaches, pragmatic next steps, and future research directions to improve 3 of the highest contributors to EHR burden: (1) documentation, (2) chart review, and (3) inbox tasks. These approaches leverage speech recognition technologies, natural language processing, artificial intelligence, and redesign of EHR workflow and user interfaces. We also offer a perspective on how EHR vendors, healthcare system leaders, and policymakers all play an integral role while sharing responsibility in helping make evidence-based sociotechnical solutions available and easy to use.
Burn Injuries in Hospitalized Australian Children—An Epidemiological Profile
Authors: Ryder Courtney , Mackean Tamara , Hunter Kate , Rogers Kris , Holland Andrew J A , Ivers Rebecca 
Published: September 2020

Abstract
Globally, First Nations children sustain burns at a higher rate than other children. Little is understood about how health inequities contribute, especially from an Indigenous viewpoint. We analyzed data from the Burns Registry of Australian and New Zealand (BRANZ) for acute burns in children (&lt;16 years) admitted to hospital between October 2009 and July 2018. Descriptive statistics examined equity variables in patient and injury characteristics. Poisson regression was used to describe factors associated with bacterial infection. Indigenous research methods were used throughout. Aboriginal and Torres Strait Islander children represented 10.4% of the study population. Health inequities were present for Aboriginal and Torres Strait Islander children with longer hospital length of stay (9.5 vs 4.6 days), rural residency (61.3% vs 13.9%), lower socioeconomic status (72.2% vs 34.9%), and more flame burns (19.5% vs 10.6%) compared to other Australian children. Streptococcus sp. infection risk was four times greater in Aboriginal and Torres Strait Islander children compared to other Australian children. Flame burns and high percentage total body surface area burns were a risk for Staphylococcus sp. and Streptococcus sp. infection in all children. The epidemiological profile for burn injuries managed in Australian burns centers differs between Aboriginal and Torres Strait Islander children and other children, indicating persistent health inequities. These differences should be considered in the development of injury prevention strategies and the clinical management of burn injuries for Aboriginal and Torres Strait Islander children and their families.
Scalp mass: an atypical presentation of multiple myeloma
Authors: Tift Benjamin D , Prickett Joshua T , Sampson Lorenzo K 
Published: September 2020

Abstract
A 64-year-old male with no history of trauma presented to the general surgery clinic with a 6-month history of an asymptomatic left parietal scalp mass. The differential included benign etiologies such as lipoma or sebaceous cyst. At surgery, a hemorrhagic soft tissue mass with underlying defect in the parietal calvarium was noted. The initial attempt at resection was abandoned and neurosurgical consultation was requested. Magnetic resonance imaging demonstrated an enhancing scalp mass with a lytic lesion of the parietal calvarium with no intradural extension. Craniectomy with mass resection and mesh cranioplasty were performed. Pathology confirmed plasma cell neoplasm; serum protein electrophoresis and lytic skull lesions confirmed multiple myeloma. This rare presentation of multiple myeloma serves as a call for providers to maintain a broad differential when evaluating a seemingly benign mass, consider rare etiologies when appropriate and maintain vigilance for abnormal findings during any procedure.
Associations Among Behavioral Risk, Sociodemographic Identifiers, and Sexually Transmitted Infections in Male and Female Army Enlisted Personnel
Authors: Hood Kristina B , Pollack Lance M , Jackson Dawnyéa D , Boyer Cherrie B 
Published: September 2020

ABSTRACT

Introduction
Rates of sexually transmitted infections (STIs) are higher among U.S. military personnel than their civilian counterparts. Yet there is a paucity of military-specific research that has utilized theoretical frameworks to describe the relative influence of the multiple and interrelated risk factors associated with STIs in this population of young, healthy men and women. The aim of this study was to examine the relative influence of Information, Motivation, and Behavioral Skills Model (IMB) factors known to be associated with condom use and STI diagnosis, as well as examine gender differences among a cohort of young, active duty enlistees who are in the very early stages of their military careers.

Materials and Methods
Data were collected in 2011 to 2013 through self-administered questionnaires and laboratory-confirmed tests of STIs. Logistic regression analyses were used to assess IMB constructs, behavioral risk variables, and sociodemographic factors associated with STI diagnosis and condom use separately among female and male military personnel.

Results
STIs among males were significantly associated with nonwhite race, lower STI behavioral intentions and STI behavioral skills, and engaging in sex after drinking alcohol. Further, males who reported more positive attitudes toward using condoms, higher confidence in preventing drinking, higher alcohol prevention norms among peers, a lower frequency of drinking alcohol before engaging in sexual intercourse, more sexual partners, and higher STI behavioral intentions were significantly more likely to report using condoms consistently during sexual encounters. Among female participants, a history of STIs was significantly associated with higher numbers of reported sexual partners and greater alcohol prevention efficacy while lifetime consistent condom use was significantly associated only with stronger intentions to avoid behaviors that might result in STI acquisition.

Conclusion
Our findings support the need for development of STI prevention strategies that include education and skills-building approaches to reduce alcohol misuse among enlisted military personnel, and especially male personnel. Such programs should include factors that uniquely influence the experiences of males and females in the military context.
Features of tumor texture influence surgery and outcome in intracranial meningioma
Authors: Sauvigny Thomas , Ricklefs Franz L , Hoffmann Lena , Schwarz Raphael , Westphal Manfred , Schmidt Nils Ole 
Published: September 2020

Abstract

Background
Texture-related factors such as consistency, vascularity, and adherence vary considerably in meningioma and are thought to be linked with surgical resectability and morbidity. However, data analyzing the true impact of meningioma texture on the surgical management is sparse.

Methods
Patients with intracranial meningioma treated between 08/2014 and 04/2018 at our institution were prospectively collected for demographics, clinical presentation, histology, and surgical treatment with related morbidity and extend of resection. Tumor characteristics were reported by the surgeon using a standardized questionnaire including items such as tumor consistency, homogeneity, vascularization, and adherence to surrounding neurovascular structure and analyzed for their impact surgical outcome parameters using univariate and logistic regression analyses.

Results
Tumor texture-related parameters of 300 patients (72.3% female) with meningioma were analyzed. Meningioma localizations were grouped into 3 different cohorts namely convexity, skull base, and posterior. Postoperative occurrence of a neurological deficit (transient 23.0%; permanent 6.1%) was associated with the duration of surgery (P = .001), size of tumor (P = .046), tumor vascularization (P = .015), and adherence to neurovascular structures (P = .002). Coherently, the duration of surgery (mean 230.99 ± 101.33 min) was associated with size of tumor (P &lt; .0001), vascularization (P &lt; .0001), and adherence (P &lt; .0001). Similar associations were recapitulated in subgroup analyses of different tumor localizations. Noteworthy, tumor rigidity had no significant impact on time of surgery and neurological outcome.

Conclusions
Our analysis demonstrates that tumor texture has an impact on the surgical management of meningioma and provides data that tumor vascularization and adherence are significant factors influencing surgical outcome whereas the influence of tumor consistency has less impact than previously thought.
Asymmetric incentives and the new politics of monetary policy
Authors: Park Gene , Cheung Gabrielle , Katada Saori N 
Published: September 2020

AbstractThis article develops and tests a theory of asymmetric incentives to explain why politicians might be less motivated to confront deflation than inflation. Leveraging Japan as a least-likely crucial case, we analyze the conditions that lead legislators to take advantage of their power to summon central bankers for questioning. We find that even moderate inflation makes it more likely that legislators will summon central bankers compared to periods when the inflation rate is near zero. By contrast, deflation has either no effect or reduces the likelihood of summonses. We also find some evidence that unconventional monetary policies to combat deflation, specifically quantitative easing, are likely to invite greater legislative scrutiny. These findings have important policy implications. While deflation is widely viewed as pernicious and more difficult to exit than inflation, there are weaker incentives for politicians to address it.
New 2013 incidence peak in childhood narcolepsy: more than vaccination?
Authors: Zhang Zhongxing , Gool Jari K , Fronczek Rolf , Dauvilliers Yves , Bassetti Claudio L A , Mayer Geert , Plazzi Giuseppe , Pizza Fabio , Santamaria Joan , Partinen Markku , Overeem Sebastiaan , Peraita-Adrados Rosa , da Silva Antonio Martins , Sonka Karel , del Rio-Villegas Rafael , Heinzer Raphael , Wierzbicka Aleksandra , Young Peter , Högl Birgit , Manconi Mauro , Feketeova Eva , Mathis Johannes , Paiva Teresa , Canellas Francesca , Lecendreux Michel , Baumann Christian R , Lammers Gert Jan , Khatami Ramin 
Published: September 2020

Abstract
Increased incidence rates of narcolepsy type-1 (NT1) have been reported worldwide after the 2009–2010 H1N1 influenza pandemic (pH1N1). While some European countries found an association between the NT1 incidence increase and the H1N1 vaccination Pandemrix, reports from Asian countries suggested the H1N1 virus itself to be linked to the increased NT1 incidence. Using robust data-driven modeling approaches, that is, locally estimated scatterplot smoothing methods, we analyzed the number of de novo NT1 cases (n = 508) in the last two decades using the European Narcolepsy Network database. We confirmed the peak of NT1 incidence in 2010, that is, 2.54-fold (95% confidence interval [CI]: [2.11, 3.19]) increase in NT1 onset following 2009–2010 pH1N1. This peak in 2010 was found in both childhood NT1 (2.75-fold increase, 95% CI: [1.95, 4.69]) and adulthood NT1 (2.43-fold increase, 95% CI: [2.05, 2.97]). In addition, we identified a new peak in 2013 that is age-specific for children/adolescents (i.e. 2.09-fold increase, 95% CI: [1.52, 3.32]). Most of these children/adolescents were HLA DQB1*06:02 positive and showed a subacute disease onset consistent with an immune-mediated type of narcolepsy. The new 2013 incidence peak is likely not related to Pandemrix as it was not used after 2010. Our results suggest that the increased NT1 incidence after 2009–2010 pH1N1 is not unique and our study provides an opportunity to develop new hypotheses, for example, considering other (influenza) viruses or epidemiological events to further investigate the pathophysiology of immune-mediated narcolepsy.
COVID-19 conspiracy beliefs, health behaviors, and policy support
Authors: Earnshaw Valerie A , Eaton Lisa A , Kalichman Seth C , Brousseau Natalie M , Hill E Carly , Fox Annie B 
Published: September 2020

Abstract
Conspiracy theories have been proliferating during the COVID-19 pandemic. Evidence suggests that belief in conspiracy theories undermines engagement in pro-health behaviors and support for public health policies. Moreover, previous work suggests that inoculating messages from opinion leaders that expose conspiracy theories as false before people are exposed to them can help to prevent belief in new conspiracies. Goals of this study were to: (a) explore associations between COVID-19 conspiracy beliefs with SARS-CoV-2 vaccine intentions, cooperation with public health recommendations, and support for public health policies among U.S. adults and (b) investigate trusted sources of COVID-19 information to inform strategies to address conspiracy beliefs. A cross-sectional, online survey was conducted with 845 U.S. adults in April 2020. Data were analyzed using analyses of variance and multivariable regressions. One-third (33%) of participants believed one or more conspiracies about COVID-19. Participants who believed conspiracies reported that their intentions to vaccinate were 3.9 times lower and indicated less support for COVID-19 public health policies than participants who disbelieved conspiracies. There were no differences in cooperation with public health recommendations by conspiracy belief endorsement in the multivariable regression analysis. Although there were some key differences in trusted sources of COVID-19 information, doctor(s) were the most trusted source of information about COVID-19 overall with 90% of participants trusting doctor(s). Doctor(s) may play a role in addressing COVID-19 conspiracy theories before people are exposed to them to promote COVID-19 prevention efforts.
Outcomes of Severe Seronegative Hepatitis‐associated Aplastic Anemia
Authors: Kemme Sarah , Stahl Marisa , Brigham Dania , Lovell Mark A. , Nakano Taizo , Feldman Amy G. , Mack Cara 
Published: September 2020

ABSTRACTObjectives:Hepatitis‐associated aplastic anemia (HAAA) is a potentially life‐threatening diagnosis without clear treatment guidelines. The goal of the study was to characterize the presentation, evaluation, histopathology, and outcomes of therapy in children with HAAA to guide future research and to develop standardized care guidelines for this rare disease.Methods:Retrospective chart review of 4 patients with HAAA who presented to Children's Hospital Colorado between 2016 and 2019 was conducted. Patient presentation, evaluation, bone marrow and liver pathology, interventions, and clinical course were collected. Immunohistochemistry of liver biopsies was performed.Results:We treated 4 patients with HAAA without liver failure. All had evidence of systemic hyperinflammation and CD8+ T cell predominant liver tissue infiltration. One had a genetic mutation predisposing him to immune‐mediated disease, but all other genetic testing was negative. In 3 of the 4 patients, hepatitis was poorly responsive to standard therapy with steroids, azathioprine, or tacrolimus; however, sustained biochemical remission of hepatitis was induced after more aggressive immunosuppressive therapies including Anti‐Thymocyte Globulin (ATG) at standard immunosuppressive therapy (IST) dosing for severe Aplastic Anemia (sAA). Two patients underwent hematopoietic stem cell transplant (HSCT); 1 as first line therapy and 1 for refractory sAA.Conclusions:We found that ATG‐based IST induced remission of hepatitis in patients with steroid‐refractory HAAA. This is also an appropriate initial treatment for severe Aplastic Anemia, though may not prevent the need for HSCT. We propose that equine ATG based IST at standard dosing regimen for sAA is a therapy that in select cases can be considered early on in the treatment course and could lead to a sustained remission of both hepatitis and sAA. This should be considered in collaboration with a pediatric hematologist.
Two‐step Testing for Clostridioides Difficile is Inadequate in Differentiating Infection From Colonization in Children
Authors: Parnell Jacob M. , Fazili Irtiqa , Bloch Sarah C. , Lacy D. Borden , Garcia‐Lopez Valeria A. , Bernard Rachel , Skaar Eric P. , Edwards Kathryn M. , Nicholson Maribeth R. 
Published: September 2020

ABSTRACTObjectives:Recent Infectious Disease Society of America guidelines recommend multistep testing algorithms to diagnose Clostridioides difficile infection (CDI), including a combination of nucleic acid amplification‐based testing (NAAT) and toxin enzyme immunoassay (EIA). The use of these algorithms in children, including the ability to differentiate between C. difficile colonization and CDI, however, has not been evaluated.Methods:We prospectively enrolled asymptomatic pediatric patients with cancer, cystic fibrosis (CF), or inflammatory bowel disease (IBD) and obtained a stool sample for NAAT testing. If positive by NAAT (colonized), EIA was performed. In addition, children with symptomatic CDI who tested positive by NAAT via the clinical laboratory were enrolled, and EIA was performed on residual stool. A functional cell cytotoxicity neutralization assay (CCNA) was also applied to stool samples from both the colonized and symptomatic cohorts.Results:Of the 225 asymptomatic children enrolled in the study, 47 (21%) were colonized with C. difficile including 9/59 (15.5%) with cancer, 30/92 (32.6%) with CF, and 8/74 (10.8%) with IBD. An additional 41 children with symptomatic CDI were enrolled. When symptomatic and colonized children were compared, neither EIA positivity (44% vs 26%, P = 0.07) nor CCNA positivity (49% vs 45%, P = 0.70) differed significantly or were able to predict disease severity in the symptomatic cohort.Conclusions:Use of a multistep testing algorithm with NAAT followed by EIA failed to differentiate symptomatic CDI from asymptomatic colonization in our pediatric cohort. As multistep algorithms are moved into clinical care, the pediatric provider will need to be aware of their limitations.
A Novel Interdisciplinary Iterative Approach for Optimizing the Electronic Health Record to Improve Perioperative Efficiency
Authors: Franceschi Dido , Suarez Maritza M. , Ruiz Jose W. , Seo David , Merchant Nipun B. 
Published: September 2020

Objective:
We present a holistic perioperative optimization approach led by a CI team with the goal to optimize the workflow within our EHR, improve operative room metrics and user satisfaction.

Summary of Background Data:
The EHR has become integral to perioperative care. Many approaches are utilized to improve performance including systems-based approaches, process redesign, lean methodology, checklists, root cause analysis, and parallel processing. Although most reports describe strategies improving day or surgery productivity, few include perioperative interventions to improve efficiencies.

Methods:
An interdisciplinary CI team consisting of clinicians, informatics specialists, and analysts spent 6 weeks assessing users and optimizing all perioperative areas (scheduling, day of surgery, postop discharge/admission). Elbow-to-elbow retraining and simultaneous content development was performed utilizing an Agile workflow process optimization with the Scrum framework. This iterative approach averaged 1 week from build to change implementation. Pre/post optimization surveys were sent.

Results:
Two hundred forty-two perioperative enhancements were completed. While most impacted documentation, all areas were enhanced including billing, reporting, registration, device integration, scheduling, central supply, and so on. FCOTS improved from <70% to >85% and total delay was halved. These parameters were consistently sustained for over 1 year after the 6-week optimization. While only 5% of pre-optimization users agreed to proficiency in the EHR system, this improved to 70% post-optimization. Furthermore, EHR confidence and acceptance improved from 40% to 90%.

Conclusions:
To improve workflow efficiency, all who contribute to the perioperative process must be assessed. This IT driven initiative resulted in improved FCOTS, perioperative workflows, and user satisfaction.