bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of document consolidation on healthcare providers’ perceived workload and information reconciliation tasks: a mixed methods study
Authors: Hosseini Masoud , Faiola Anthony , Jones Josette , Vreeman Daniel J , Wu Huanmei , Dixon Brian E 
Published: November 2018

Abstract

Background
Information reconciliation is a common yet complex and often time-consuming task performed by healthcare providers. While electronic health record systems can receive “outside information” about a patient in electronic documents, rarely does the computer automate reconciling information about a patient across all documents.

Materials and Methods
Using a mixed methods design, we evaluated an information system designed to reconcile information across multiple electronic documents containing health records for a patient received from a health information exchange (HIE) network. Nine healthcare providers participated in scenario-based sessions in which they manually consolidated information across multiple documents. Accuracy of consolidation was measured along with the time spent completing 3 different reconciliation scenarios with and without support from the information system. Participants also attended an interview about their experience. Perceived workload was evaluated quantitatively using the NASA-TLX tool. Qualitative analysis focused on providers’ impression of the system and the challenges faced when reconciling information in practice.

Results
While 5 providers made mistakes when trying to manually reconcile information across multiple documents, no participants made a mistake when the system supported their work. Overall perceived workload decreased significantly for scenarios supported by the system (37.2% in referrals, 18.4% in medications, and 31.5% in problems scenarios, P &lt; 0.001). Information reconciliation time was reduced significantly when the system supported provider tasks (58.8% in referrals, 38.1% in medications, and 65.1% in problem scenarios).

Conclusion
Automating retrieval and reconciliation of information across multiple electronic documents shows promise for reducing healthcare providers’ task complexity and workload.
Making the world from topological order
Authors: Ball Philip 
Published: November 2018

Abstract
Topology used to be a term confined to a branch of pure mathematics, where it referred to an invariant property of shape. The classic example was the way objects containing a single hole, like a torus and a coffee cup with handle, can be smoothly moulded into one another without tearing. But topological considerations have long played a role in the physics of matter, where for example they might dictate particular arrangements of component parts that can’t be erased from the system. The classic example here is the fact that a ‘hairy ball’ can’t be combed flat without having at least two pointy tufts. Such ‘defects’ in organization can be considered ‘topologically protected’, since they are robust against any recombing of the hair. They are universal features that don’t depend on the material specifics of the system: topological defects in liquid crystals are analogous to defects in spacetime called cosmic strings.
In the past several decades in particular, properties of matter arising from topological considerations have become a major theme, reflected for example in the award of the 1985 and 1998 Nobel Prizes in Physics for discoveries involving the quantum Hall effect. Here the ‘Hall conductance’, quantifying the passage of electrical current in a 2D conductor in the presence of a transverse magnetic field, takes precise integral or fractional multiples of a particular quantized value related to the electron charge. This behaviour persists regardless of how we modify the material, for example by adding impurities. Topological phases and transitions were also a feature of the work that won the 2016 Nobel Prize.
It has become recognized that the topological properties of the quantum-mechanical electronic structures of certain materials can give them unusual and perhaps useful properties. Some researchers think, for example, that ‘topological matter’ might supply quantum bits for quantum computation that resist the randomizing effects of noise.
Xiao-Gang Wen of the Massachusetts Institute of Technology has been developing ideas about ‘topological order’ in fundamental physics for several decades. His notions of how topology in the underlying structure of spacetime might give rise to fundamental particles and forces make a connection to the topological phases recognized in condensed matter, revealing a new unifying principle in physics. National Science Review spoke to him about his work.
Querying About the Use of Specific E-Cigarette Devices May Enhance Accurate Measurement of E-Cigarette Prevalence Rates Among High School Students
Authors: Morean Meghan E , Camenga Deepa R , Bold Krysten W , Kong Grace , Jackson Asti , Simon Patricia , Cavallo Dana A , Krishnan-Sarin Suchitra 
Published: November 2018

Abstract

Introduction
Prevalence estimates of electronic cigarette (e-cigarette) use may underestimate actual use in youth. Confusion resulting from the fact that a multitude of devices (eg, vape pens, JUULs) fall under the umbrella term “e-cigarettes,” the use of different names to refer to e-cigarettes (eg, vapes, electronic vaping devices), and the use of different terminology to refer to e-cigarette use (eg, “vaping,” “JUULing”), may lead some young e-cigarette users to incorrectly indicate nonuse. Therefore, we compared rates of endorsing lifetime e-cigarette use when adolescents were asked about lifetime e-cigarette use in two different ways.

Methods
In May to June 2018, a total of 1960 students from two high schools in Connecticut completed a computerized, school-based survey. Participants first reported on lifetime “e-cigarette” use and, subsequently, on lifetime use of five different e-cigarette devices: disposables, cig-a-likes, or E-hookahs; vape pens or Egos; JUULs; pod systems other than JUULs such as PHIX or Suorin; and advanced personal vaporizers or mods.

Results
In total, 35.8% of students endorsed lifetime “e-cigarette” use, whereas 51.3% endorsed lifetime use of at least one e-cigarette device. The kappa statistic indicated only 66.6% agreement between the methods of assessing e-cigarette use. Overall, 31.5% of adolescents who endorsed lifetime device use did not endorse lifetime “e-cigarette” use, although rates of discordant responding varied across subgroups of interest (eg, sex, race).

Conclusions
Assessing adolescents’ use of specific e-cigarette devices likely yields more accurate results than assessing the use of “e-cigarettes.” If these findings are replicated in a nationally representative sample, regulatory efforts requiring all e-cigarette devices to be clearly labeled as “e-cigarettes” may help to reduce confusion.

Implications
Different prevalence estimates of lifetime e-cigarette use were obtained depending on the way that prevalence was assessed. Specifically, fewer adolescents (35.8%) endorsed lifetime e-cigarette use when they were asked “Have you ever tried an e-cigarette, even one or two puffs?” than when they were queried about lifetime use of five different e-cigarette devices (51.3%). Among those who endorsed lifetime use of at least one specific e-cigarette device, 31.5% did not endorse lifetime “e-cigarette” use. These findings suggest that when assessing adolescents’ lifetime e-cigarette use, using of terms referring to specific devices likely produces more accurate prevalence estimates than using the term “e-cigarettes.”
Emotion regulation therapy for cancer caregivers—an open trial of a mechanism-targeted approach to addressing caregiver distress
Authors: Applebaum Allison J , Panjwani Aliza A , Buda Kara , O’Toole Mia S , Hoyt Michael A , Garcia Adam , Fresco David M , Mennin Douglas S 
Published: November 2018

Abstract
Informal caregivers (ICs) are integral to care provided to patients facing life-threatening or incurable illnesses. This responsibility causes considerable burden, as approximately one half of ICs report clinically significant symptoms of depression and/or anxiety that persist when left untreated. Psychosocial interventions containing efficacious treatment principles (e.g., cognitive behavior therapy [CBT]) show disappointing results in reducing anxiety and depression in ICs. This may reflect failure of these interventions to specifically target crucial mechanisms underlying the central feature of distress caused by the patient’s illness—notably, perseverative negative thinking (PNT). Emotion Regulation Therapy (ERT) is an efficacious CBT developed to explicitly target mechanisms underlying PNT and the emotional concomitants that arise in response to stressful situations. This open trial was conducted to evaluate the acceptability and initial efficacy of ERT adapted to the experience of cancer ICs (ERT-C). Thirty-one ICs provided informed consent and completed eight weekly individual sessions of ERT-C. Participants completed self-report measures of depression and anxiety symptoms, PNT, emotion regulation deficits, and caregiver burden before and after treatment. ERT-C was well tolerated as indicated by 22 treatment completers and feedback provided in exit interviews. ICs demonstrated reduced depression and anxiety symptoms, PNT, and emotion regulation deficits with moderate to large effect sizes (Hedge’s g range: 0.36–0.92). Notably, caregiver burden was not reduced but ICs expressed more ability to confront caregiving-related challenges. Findings offer promising but preliminary support for ERT-C as a conceptual model and treatment modality for distressed cancer ICs.
Biomarkers of Systemic Inflammation and Risk of Incident Hearing Loss
Authors: Gupta Shruti , Curhan Sharon G. , Curhan Gary C. 
Published: November 2018

Background:
Chronic inflammation may lead to cochlear damage, and the only longitudinal study that examined biomarkers of systemic inflammation and risk of hearing loss found an association with a single biomarker in individuals <60 years of age. The purpose of our study was to determine whether plasma inflammatory markers are associated with incident hearing loss in two large prospective cohorts, Nurses’ Health Studies (NHS) I and II.

Methods:
We examined the independent associations between plasma levels of markers of systemic inflammation (C-reactive protein [CRP], interleukin-6 [IL-6], and soluble tumor necrosis factor receptor 2 [TNFR-2]) and self-reported hearing loss. The participants in NHS I (n = 6194 women) were 42 to 69 years of age at the start of the analysis in 1990, while the participants in NHS II (n = 2885 women) were 32 to 53 years in 1995. After excluding women with self-reported hearing loss before the time of blood-draw, incident cases of hearing loss were defined as those women who reported hearing loss on questionnaires administered in 2012 in NHS I and 2009 or 2013 in NHS II. The primary outcome was hearing loss that was reported as moderate or worse in severity, pooled across the NHS I and NHS II cohorts. We also examined the pooled multivariable-adjusted hazard ratios for mild or worse hearing loss. Cox proportional hazards regression was used to adjust for potential confounders.

Results:
At baseline, women ranged from 42 to 69 years of age in NHS I and 32 to 53 years of age in NHS II. Among the NHS I and II women with measured plasma CRP, there were 628 incident cases of moderate or worse hearing loss during 100,277 person-years of follow-up. There was no significant association between the plasma levels of any of the three inflammatory markers and incident moderate or worse hearing loss (multivariable-adjusted pooled p trend for CRP = 0.33; p trend IL-6 = 0.54; p trend TNFR-2 = 0.70). There was also no significant relation between inflammatory marker levels and mild or worse hearing loss. While there was no significant effect modification by age for CRP or IL-6 in NHS I, there was a statistically significant higher risk of moderate or worse hearing loss (p interaction = 0.02) as well as mild or worse hearing loss (p interaction = 0.004) in women ≥60 years of age who had higher plasma TNFR-2 levels.

Conclusions:
Overall, there was no significant association between plasma markers of inflammation and risk of hearing loss.
Resveratrol Mitigates High-Fat Diet–Induced Vascular Dysfunction by Activating the Akt/eNOS/NO and Sirt1/ER Pathway
Authors: Huang Jiung-Pang , Hsu Sheng-Chieh , Li Dai-Er , Chen Kuan-Hsing , Kuo Chao-Yu , Hung Li-Man 
Published: November 2018

Abstract:
We investigated whether resveratrol (RSV) can attenuate obesity and diabetes progression and improve diabetes-induced vascular dysfunction, and we attempted to delineate its underlying mechanisms. Male C57Bl/6 mice were administered a high-fat diet (HFD) for 17 weeks. Mice developed type 2 diabetes with increased body weight, hyperglycemia, hyperinsulinemia, and hyperlipidemia. Oral gavage with RSV significantly reversed the symptoms induced by the HFD. Insulin sensitivity likewise improved after the RSV intervention in these mice. Phenylephrine-induced cremaster arteriolar constriction was impaired, whereas RSV treatment significantly mitigated the vessel responsiveness to phenylephrine. The obese diabetic mice exhibited increased leukocyte rolling, adhesion, and transmigration in the postcapillary venules of the cremaster muscle. By contrast, RSV treatment significantly attenuated HFD-induced extravasation. RSV significantly recovered phosphorylated Akt and eNOS expression in the thoracic aorta. In addition, activated adenosine monophosphate-activated protein kinase in the thoracic aorta was involved in the improvement of epithelial function after RSV intervention. RSV considerably upregulated the plasma NO level in HFD mice. Moreover, RSV-enhanced human umbilical vein endothelial cells healing through Sirt1/ER pathway may be involved in the prevention of leukocyte extravasation. Collectively, RSV attenuates diabetes-induced vascular dysfunction by activating Akt/eNOS/NO and Sirt1/ER pathway. Our mechanistic study provides a potential RSV-based therapeutic strategy against cardiovascular disease.
Understanding Quality of Care and Satisfaction With Sexual and Reproductive Healthcare Among Young Men
Authors: Pilgrim Nanlesta A. , Jennings Jacky M. , Sanders Renata , Page Kathleen R. , Loosier Penny S. , Dittus Patricia J. , Marcell Arik V. 
Published: November 2018

ABSTRACT

Introduction:
Sexual and reproductive healthcare (SRHC) guidelines recommend the delivery of quality preventive SRHC to males beginning in adolescence. A quality of care (QOC) framework was used to examine factors associated with young male's perceptions of QOC and satisfaction with care, which can influence their use of SRHC.

Methods:
Cross-sectional surveys were conducted from August 2014 to September 2016 with 385 male patients aged 15–24 years, recruited from primary care and sexually transmitted disease (STD) clinics. Surveys measured QOC received, satisfaction with care, and domains of a QOC framework. Poisson regression analyses examined associations between the framework domains and perceived QOC as well as satisfaction with care.

Results:
Over half of males reported QOC as excellent (59%) and were very satisfied with services (56.7%). Excellent QOC and high satisfaction with services were associated with timely care, higher Clinician-Client Centeredness, and being a bisexual male. Excellent QOC was also associated with greater comfort in the clinic, being tested for human immunodeficiency virus/STDs, attending primary care settings, and receipt of higher number of SRHC services.

Conclusions:
Using a QOC framework as part of providing SRHC to young males is important to improving their perceptions of QOC and satisfaction with services.
Short article: Association between liver fibrosis and hepatitis E seroprevalence among HIV-positive individuals in Nepal
Authors: Shah Shemal M. , Baniya Jagat B. , Gupta Birendra Prasad , Shrestha Ananta , Rodin Holly , Boonstra Andre , Debes Jose D. 
Published: November 2018

ObjectiveHepatitis E virus (HEV) seropositivity may confer an increased risk of liver fibrosis in immunosuppressed individuals. We studied this effect in HIV-infected individuals in Nepal, a country hyperendemic for HEV.Participants and methodsWe prospectively evaluated 200 HIV-positive individuals. Serum samples were tested for components of fibrosis scores and cytokeratin-18.ResultsOf 200 patients, 43% were HEV-immunoglobulin G+. The mean fibrosis-4 score was 8.02 in the HEV-positive and 1.17 in the HEV-negative group (P<0.001). The mean nonalcoholic fatty liver disease score was 2.12 in the HEV-positive and −2.53 in the HEV-negative group (P=0.02). The mean aminotransferase-platelet ratio index score was 0.37 in the HEV-positive and 0.38 in the HEV-negative group (P=0.9). The mean cytokeratin-18 levels were 119.9 in the HEV-positive group and 158.6 in the HEV-negative group (P=0.08).ConclusionWe found higher fibrosis-4 and nonalcoholic fatty liver disease scores in HEV-HIV-positive individuals, suggesting an increased liver fibrosis profile in this group. Further studies using liver stiffness measurements should be carried out.
Optimum Chest Compression Point for Cardiopulmonary Resuscitation in Children Revisited Using a 3D Coordinate System Imposed on CT: A Retrospective, Cross-Sectional Study
Authors: Park Myoungjae , Oh Won Sup , Chon Sung-Bin , Cho Sunho 
Published: November 2018

Objectives:
The optimum chest compression site (P_optimum) in children is debated: European Resuscitation Council recommends one finger breadth above the xiphisternal joint, whereas American Heart Association proposes the lower sternal half. Using a coordinate system imposed on CT, we aimed to determine the pediatric P_optimum to maximize stroke volume, the key point for successful cardiopulmonary resuscitation, while minimizing hepatic injury.

Design:
Retrospective, cross-sectional study.

Setting:
University hospital.

Patients:
Children 1–15 years old who underwent chest CT.

Interventions:
None.

Measurements and Main Results:
We defined zero point (0, 0) as the center of the xiphisternal joint designating leftward and upward directions of the patients as positive on each axis. P_optimum (x_max. left ventricle, y_max. left ventricle) was defined as the center of the maximum diameter of the left ventricle, whereas P_aorta (x_aorta, y_aorta) as that of the aortic annulus. To compress the left ventricle exclusively, y_max. left ventricle should range above the y coordinate of hepatic dome (y_liver_dome) and below y_aorta. Data were presented as median (interquartile range) and compared among age groups 1.0–5.0, 5.1–10.0, and 10.1–15.0 years using Kruskal-Wallis test. For universal application regardless of age, y coordinates were converted into relative ones with unit of sternal top: 1 unit of sternal top was the y coordinate of the sternal top. A total of 163 patients were enrolled, median age 8.8 year (4.2–14.3 yr). Among age groups, no significant difference was observed in y_max. left ventricle, relative y_max. left ventricle, y_aorta, and y_liver_dome: 1.0 cm (0.1–1.9 cm), 0.10 unit of sternal top (0.01–0.18 unit of sternal top), 0.39 unit of sternal top (0.30–0.47 unit of sternal top), and –0.14 unit of sternal top (–0.25 to –0.03 unit of sternal top), respectively. The probability to compress the left ventricle exclusively was greater than or equal to 96% when placing hand at 0.05–0.20 unit of sternal top. Subgroup analysis demonstrated the following regression equation: x_max. left ventricle (mm) = 0.173 × (height in cm) + 13 (n = 106; p < 0.001; R
2 = 0.278).

Conclusions:
Theoretically, pediatric P_optimum is located 1 cm (or 0.1 unit of sternal top) above the xiphisternal joint.
Monocyte-to-Lymphocyte Ratio Is Associated With Tuberculosis Disease and Declines With Anti-TB Treatment in HIV-Infected Children
Authors: Choudhary Rewa K , Wall Kristin M. , Njuguna Irene , Pavlinac Patricia B. , LaCourse Sylvia M. , Otieno Vincent , Gatimu John , Stern Joshua , Maleche-Obimbo Elizabeth , Wamalwa Dalton , John-Stewart Grace , Cranmer Lisa M. 
Published: November 2018

Background:
The blood monocyte-to-lymphocyte ratio (MLR) is associated with active tuberculosis (TB) in adults but has not been evaluated as a TB diagnostic biomarker in HIV-infected children in whom respiratory sampling is difficult.

Setting:
In a cohort of HIV-infected hospitalized Kenyan children initiating antiretroviral therapy, absolute monocyte and lymphocyte counts were determined at enrollment and 4, 12, and 24 weeks thereafter.

Methods:
Children were classified as confirmed, unconfirmed, or unlikely pulmonary TB. Receiver operating characteristic curves of MLR cutoff values were generated to distinguish children with confirmed TB from those with unconfirmed and unlikely TB. General estimating equations were used to estimate change in the MLR over time by TB status.

Results:
Of 160 children with median age 23 months, 13 (8.1%) had confirmed TB and 67 (41.9%) had unconfirmed TB. The median MLR among children with confirmed TB {0.407 [interquartile range (IQR) 0.378–0.675]} was higher than the MLR in children with unconfirmed [0.207 (IQR 0.148–0.348), P < 0.01] or unlikely [0.212 (IQR 0.138–0.391), P = 0.01] TB. The MLR above 0.378 identified children with confirmed TB with 77% sensitivity, 78% specificity, 24% positive predictive value, and 97% negative predictive value. After TB treatment, the median MLR declined in children with confirmed TB and levels were similar to children with unlikely TB after 12 weeks.

Conclusions:
The blood MLR distinguished HIV-infected children with confirmed TB from those with unlikely TB and declined with TB treatment. The MLR may be a useful diagnostic tool for TB in settings where respiratory-based microbiologic confirmation is inaccessible.
HIV-Related Stigma Affects Cognition in Older Men Living With HIV
Authors: Lam Austin , Mayo Nancy E. , Scott Susan , Brouillette Marie-Josée , Fellows Lesley K. 
Published: November 2018

Background:
Stigma remains a reality for many people living with HIV. Stigma bears on mental health, but we hypothesized that it might also affect cognition, in turn affecting function.

Methods:
We estimated the impact of HIV-related stigma on brain health and everyday functioning among 512 older white men living with HIV in Canada, using the International Classification of Functioning, Disability and Health as a comprehensive framework to integrate biopsychosocial perspectives. Experience of HIV-related stigma, as indicated by a single self-report item, was related to cognitive test performance, cognitive symptoms, and mood. Structural equation modeling was used to estimate the relationships between these variables.

Findings:
A comprehensive structural equation model was built including personal, environmental, and biological factors, measures of mental and cognitive health, activity limitations, and participation restrictions. HIV-related stigma contributed to lower cognitive test performance and worse mental health. These in turn affected real-world function. The paths from stigma to cognition and mood had distinct downstream effects on physical, cognitive, and meaningful activities.

Interpretation:
This provides evidence that HIV-related stigma is a threat to cognitive as well as mental health, with a negative impact on everyday function in men aging with HIV. This argues for direct links between the psychosocial and biological impacts of HIV at the level of the brain. Stigma reduction may be a novel route to addressing cognitive impairment in this population.

Funding:
Operating support was provided by the Canadian Institutes of Health Research (TCO-125272) and by the CIHR HIV Clinical Trials Network (CTN-273).