bluuebunny/crossref_metadata_2025_split huggingface dataset:
Web services for data warehouses: OMOP and PCORnet on i2b2
Authors: Klann Jeffrey G , Phillips Lori C , Herrick Christopher , Joss Matthew A H , Wagholikar Kavishwar B , Murphy Shawn N 
Published: June 2018

AbstractObjectiveHealthcare organizations use research data models supported by projects and tools that interest them, which often means organizations must support the same data in multiple models. The healthcare research ecosystem would benefit if tools and projects could be adopted independently from the underlying data model. Here, we introduce the concept of a reusable application programming interface (API) for healthcare and show that the i2b2 API can be adapted to support diverse patient-centric data models.Materials and MethodsWe develop methodology for extending i2b2’s pre-existing API to query additional data models, using i2b2’s recent “multi-fact-table querying” feature. Our method involves developing data-model-specific i2b2 ontologies and mapping these to query non-standard table structure.ResultsWe implement this methodology to query OMOP and PCORnet models, which we validate with the i2b2 query tool. We implement the entire PCORnet data model and a five-domain subset of the OMOP model. We also demonstrate that additional, ancillary data model columns can be modeled and queried as i2b2 “modifiers.”Discussioni2b2’s REST API can be used to query multiple healthcare data models, enabling shared tooling to have a choice of backend data stores. This enables separation between data model and software tooling for some of the more popular open analytic data models in healthcare.ConclusionThis methodology immediately allows querying OMOP and PCORnet using the i2b2 API. It is released as an open-source set of Docker images, and also on the i2b2 community wiki.
Back pain, mental health and substance use are associated in adolescents
Authors: Kamper S J , Michaleff Z A , Campbell P , Dunn K M , Yamato T P , Hodder R K , Wiggers J , Williams C M 
Published: June 2018

Abstract

Background
During adolescence, prevalence of pain and health risk factors such as smoking, alcohol use and poor mental health all rise sharply. The aim of this study was to describe the relationship between back pain and health risk factors in adolescents.

Methods
Cross-sectional data from the Healthy Schools Healthy Futures study, and the Australian Child Wellbeing Project was used, mean age: 14–15 years. Children were stratified according to back pain frequency. Within each strata, the proportion of children that reported drinking alcohol or smoking or that experienced feelings of anxiety or depression was reported. Test-for-trend analyses assessed whether increasing frequency of pain was associated with health risk factors.

Results
Data was collected from ~2500 and 3900 children. Larger proportions of children smoked or drank alcohol within each strata of increasing pain frequency. The trend with anxiety and depression was less clear, although there was a marked difference between the children that reported no pain, and pain more frequently.

Conclusion
Two large, independent samples show adolescents that experience back pain more frequently are also more likely to smoke, drink alcohol and report feelings of anxiety and depression. Pain appears to be part of the picture of general health risk in adolescents.
Cerebral Concussion Primes the Lungs for Subsequent Neutrophil-Mediated Injury
Authors: Humphries Duncan C. , O’Neill Stephen , Scholefield Emma , Dorward David A. , Mackinnon Alison C. , Rossi Adriano G. , Haslett Christopher , Andrews Peter J. D. , Rhodes Jonathan , Dhaliwal Kevin 
Published: June 2018

Objectives:
Mild traumatic brain injury in the form of concussion is extremely common, and the potential effects on pulmonary priming have been underestimated. The aim of this study was to characterize the pulmonary response following mild traumatic brain injury and assess the pulmonary susceptibility to lung injury after a subsequent innocuous pulmonary insult.

Design:
Experimental in vivo study.

Setting:
University research laboratory.

Subjects:
Male CD1 mice.

Interventions:
We developed a model of concussive traumatic brain injury in mice followed by pulmonary acid microaspiration. To assess the dependent role of neutrophils in mediating pulmonary injury, we specifically depleted neutrophils.

Measurements and Main Results:
Lateral fluid percussion to the brain resulted in neuronal damage and neutrophil infiltration as well as extensive pulmonary interstitial neutrophil accumulation but no alveolar injury. Following subsequent innocuous acid microaspiration, augmented alveolar neutrophil influx led to the development of pulmonary hemorrhage that was reduced following neutrophil depletion.

Conclusions:
This model shows for the first time that innocuous acid microaspiration is sufficient to induce neutrophil-mediated lung injury following mild concussion and that the extracranial effects of mild traumatic brain injury have been underestimated.
Transitional Dynamics of Household Food Insecurity Impact Children's Developmental Outcomes
Authors: Grineski Sara E. , Morales Danielle X. , Collins Timothy W. , Rubio Ricardo 
Published: June 2018

ABSTRACT:

Objective:
To determine how transitions into and out of varying degrees of food insecurity impact children's academic competencies, executive functioning, and social skills (i.e., self-control, interpersonal skills, externalizing behaviors, and internalizing behaviors).

Method:
Data come from the nationally representative kindergarten and first-grade waves of the Early Childhood Longitudinal Study (2010–2011); 11,958 children attending 1289 schools are included. Statistical analyses involve using a novel framework for measuring the transitional dynamics and depth of food insecurity to predict children's developmental outcomes using hierarchal linear models, which adjust for child- and school-level confounders.

Results:
Deepening food insecurity (DeepenFIS) was detrimental to children's self-control (−0.208, p < 0.01), math (−0.153, p < 0.01), and working memory (−5.202, p < 0.05) scores. Remitting marginal food insecurity was associated with negative effects on children's self-control (−0.082, p < 0.05) and interpersonal skills (−0.098, p < 0.01) but not on math or working memory. Persisting marginal food insecurity (PersistMFIS) negatively impacted children's self-control (−0.106, p < 0.05) and interpersonal skills (−0.115, p < 0.05). Emerging food insecurity (0.146, p < 0.01) and persisting food insecurity (0.071, p < 0.05) had detrimental effects on children's externalizing behaviors.

Conclusion:
Based on a novel food insecurity transitions framework and examination of multiple developmental outcomes, this study highlights the importance of examining both depth and transitional dynamics of food insecurity. Findings indicate that DeepenFIS and PersistMFIS may have potentially the most harmful effects on children's developmental outcomes. Clinically, findings support the need for addressing food insecurity in early childhood, even if the food insecurity challenges are marginal and just emerging.
Innovation contest: Effect of perceived support for learning on participation
Authors: Jung Olivia S. , Blasco Andrea , Lakhani Karim R. 
Published: June 2018

Background:
Frontline staff are well positioned to conceive improvement opportunities based on first-hand knowledge of what works and does not work. The innovation contest may be a relevant and useful vehicle to elicit staff ideas. However, the success of the contest likely depends on perceived organizational support for learning; when staff believe that support for learning-oriented culture, practices, and leadership is low, they may be less willing or able to share ideas.

Purpose:
We examined how staff perception of organizational support for learning affected contest participation, which comprised ideation and evaluation of submitted ideas.

Methodology/Approach:
The contest held in a hospital cardiac center invited all clinicians and support staff (n ≈ 1,400) to participate. We used the 27-item Learning Organization Survey to measure staff perception of learning-oriented environment, practices and processes, and leadership.

Results:
Seventy-two frontline staff submitted 138 ideas addressing wide-ranging issues including patient experience, cost of care, workflow, utilization, and access. Two hundred forty-five participated in evaluation. Supportive learning environment predicted participation in ideation and idea evaluation. Perceptions of insufficient experimentation with new ways of working also predicted participation.

Conclusion:
The contest enabled frontline staff to share input and assess input shared by other staff. Our findings indicate that the contest may serve as a fruitful outlet through which frontline staff can share and learn new ideas, especially for those who feel safe to speak up and believe that new ideas are not tested frequently enough.

Practice Implications:
The contest’s potential to decentralize innovation may be greater under stronger learning orientation. A highly visible intervention, like the innovation contest, has both benefits and risks. Our findings suggest benefits such as increased engagement with work and community as well as risks such as discontent that could arise if staff suggestions are not acted upon or if there is no desired change after the contest.
Gamma and Beta Absorbed Dose Conversion Coefficients in the Range from 10 keV to 10 MeV for Accidental Exposures From Point Sources Placed in Clothing in Proximity to the Body
Authors: Owens A. , Bertelli L. , Brandl A. 
Published: June 2018

Abstract
Retrospective dose assessment following acute radiation exposures during radiological incidents can be difficult and inaccurate due to the large uncertainties associated with dose estimation. However, rapid and accurate dose assessment is critical following an incident so that appropriate treatment can be provided to the patient as early as possible. Incident dose assessment relies heavily on biological dosimetry with corresponding large uncertainties for inhomogeneous exposures, resulting from the estimates of whole-body doses, while the assessment of absorbed doses to individual tissues might actually be more appropriate for acute radiation exposures. Incident exposure scenarios for orphan sources placed in a breast or back pants pocket were modeled using the International Commission on Radiological Protection computational reference male and female and the Monte Carlo N-particle code MCNP6 to compute absorbed dose conversion coefficients for organs of interest for monoenergetic photon and beta sources. The absorbed dose conversion coefficients are intended for use in conjunction with source information to rapidly estimate absorbed doses to organs of interest from radiological sources in one of the two pocket geometries. Absorbed dose conversion coefficients also have been calculated specifically for 60Co, 137Cs, and 192Ir. Those absorbed dose conversion coefficients were applied to data from a radiological incident in Yanango, Peru, for comparison with published dose assessments; the results agree within 20%. The conversion coefficients are expected to provide an accurate tool for assessing doses for the modeled geometries, provided uncertainties due to the exact source-body geometry and exposure time are considered.
Coverage of Haemophilus influenzae Type b Conjugate Vaccine for Children in Mainland China
Authors: Yang Ya , Yang Yu , Scherpbier Robert W. , Zhu Xu , Chen Yue , Zhou Yibiao , Jiang Qingwu 
Published: June 2018

Background:
Use of Haemophilus influenzae type b conjugate vaccine is effective in reducing the disease burden, but its coverage in China is unclear. The aim of this meta-analysis is to assess the coverage of Hib conjugate vaccines in children in Mainland China.

Methods:
We systematically searched Pubmed, Web of Science, Medline, CNKI and Wanfang to identify studies assessing the coverage of Hib vaccine in Chinese children. Random-effects models were used to obtain pooled estimates for Hib vaccine coverage and analyzed heterogeneity with meta-regression and subgroup analyses.

Results:
Thirty-three studies that included 7,227,480 subjects in 12 provinces met our inclusion criteria. The pooled overall coverage of Hib conjugate vaccine was 54.9% [95% confidence interval (CI): 52.9–57.0]. The pooled coverage for the nonlocal population (54.3%; 95% CI: 52.4–56.3) was lower than that for the local residents (62.0%; 95% CI: 58.4–65.6). The region-pooled coverage was higher in the east of China (59.7%; 95% CI: 57.3–62.1) than in the central and west parts of the country (48.5%; 95% CI: 40.6–56.4). Overall, 26.7% (95% CI: 20.1–33.2) had 1 dose only, 14.8% (95% CI: 10.0–19.6%) had 2 doses, 13.5% (95% CI: 9.1–17.8) had 3 doses and 14.3% (95% CI: 9.7–18.9) had 4 doses.

Conclusions:
We found a low coverage of Hib conjugate vaccine, particularly for the nonlocal children and those living in the central and west parts of China. Including Hib vaccine into the national immunization program is recommended to reduce disparities in vaccination coverage.
Light Chain Amyloidosis Presenting as Bilateral External Auditory Canal Obstructing Masses
Authors: Sethi Shenon , Paner Agne , Okwuosa Tochukwu , Jandali Danny , Dua Sumeet , Wiet Richard M. , Ghai Ritu 
Published: June 2018

A morbidly-obese 57-year-old diabetic and hypertensive man with chronic kidney disease, diastolic heart failure, and bilateral hearing loss was found to have soft tissue masses/densities in the lateral aspect of both auditory canals on local examination and on imaging. He underwent biopsies of both ear canal masses and histologic examination revealed amyloid deposits in the dermis. These deposits were confirmed as AL (amyloid light chain) kappa-type amyloid by laser mass spectrometry. A systemic work-up showed plasma cell dyscrasia with 9% kappa light chain restricted plasma cells in the bone marrow as well as amyloid deposits on a kidney biopsy.
Involvement of the external auditory canals is a rare manifestation of systemic amyloidosis with only 13 cases reported so far, of which four cases had bilateral external auditory canal involvement, associated with multiple myeloma. Interpretation of small biopsies can be challenging especially with early, scant amyloid deposits, but a sufficient biopsy to type amyloid by immunohistochemistry or laser mass spectrometry is imperative for further management. Early diagnosis and treatment of systemic light chain amyloidosis translates to better patient outcomes, while delay in management could lead to dismal prognosis.
Sickle cell disease is associated with higher mortality among patients hospitalized with ischemic bowel disease
Authors: Akanbi Olalekan , Adejumo Adeyinka C. , Saleem Nasir , Francisque Frantz , Soliman Mohanad , Ogunbayo Gbolahan O. 
Published: June 2018

BackgroundSickle cell disease (SCD) is the most common inheritable hematologic disorder in the USA and is associated with ischemic organ diseases. SCD-associated ischemic bowel disease is increasing being recognized, and studies on the hospitalization outcomes of such patients are limited.ObjectiveThis study aimed to compare the inpatient outcomes of ischemic bowel disease among patients with SCD compared with patients without SCD.Materials and methodsThis is a case–control study using data from the National Inpatient Sample Database (2007–2014). We analyzed and compared outcomes between cases (ischemic bowel disease with SCD) and controls (ischemic bowel disease without SCD), matched in a 1 : 5 ratio. The primary outcome was in-hospital mortality, and the secondary outcomes were healthcare resource utilization including mechanical ventilation, hemodialysis, transfusion, length of stay, and hospital charges.ResultsOf the 194 262 patients admitted with ischemic bowel disease, 98 had a diagnosis of SCD and were matched successfully to the controls. In multivariate analysis, patients with SCD had twice the mortality odds of those without (adjusted odds ratio=2.06, 95% confidence intervals: 1.13–3.74). They were more likely to require mechanical ventilation and blood transfusion, and to be discharged to secondary health facilities [1.68 (1.02–2.76), 3.32 (2.15–5.12), and 1.84 (1.02–3.35)]. Patients with SCD also had a higher frequency of pneumonia, acute respiratory failure, and hemodialysis for acute renal failure. There was no significant difference in the length of stay or the total hospital charge between the two groups.ConclusionIn patients hospitalized with ischemic bowel disease, SCD is associated with significantly increased mortality and healthcare burden.
Corneal Biomechanics in Unilateral Keratoconus and Fellow Eyes with a Scheimpflug-based Tonometer
Authors: Catalán-López Sara , Cadarso-Suárez Luis , López-Ratón Mónica , Cadarso-Suárez Carmen 
Published: June 2018

SIGNIFICANCE
Before the appearance of evident keratoconus, corneal biomechanical changes may be detectable. Here, these properties are analyzed to detect any difference that could help in the early recognition of keratoconus to allow patients to benefit from early treatments and to avoid refractive procedures in these corneas.

PURPOSE
The purpose of this study was to compare corneal biomechanical characteristics as determined by Corvis Scheimpflug Technology tonometry between normal eyes and asymmetric keratoconic eyes.

METHODS
Retrospective data from normal eyes (n = 100), keratoconic eyes (n = 18), and their topographically normal fellow eyes (n = 18) were analyzed. Differences in the variables among the groups were determined. For the parameters that showed significant differences, the receiver operating characteristic curve and the area under the curve (AUC) were used to assess the diagnostic accuracy of each variable. The optimal cutoff points were determined when comparing normal and fellow eyes. Also, a new linear combination of variables was performed to obtain better discriminative values.

RESULTS
The following variables differed significantly between normal and fellow eyes: length of the flattened cornea in the second applanation, peak distance, curvature radius at highest concavity, and central corneal thickness. When each variable was independently considered, AUCs, sensitivity, and specificity were insufficiently high for good discrimination between the two groups. However, using a linear combination of variables, an optimal cutoff point (0.157) was obtained with an AUC of 0.78, sensitivity of 0.84, and specificity of 0.69.

CONCLUSIONS
A best predictive linear combination of corneal biomechanical variables was tested including diameter of the flattened cornea in the second applanation and central corneal thickness. This combination was considered as the best in terms of its prediction capacity, simplicity and clinical application. This formula may be useful in clinical practice to discriminate between normal eyes and incipient keratoconus.
To Admit or Not to Admit: That is the Cleft Lip Question. Confirming the Safety of Outpatient Cleft Lip Repair
Authors: Fahradyan Artur , Galdyn Izabela , Azadgoli Beina , Tsuha Michaela , Urata Mark M. , Francis Stacey H. 
Published: June 2018

Background:
There is no accepted protocol for inpatient versus ambulatory cleft lip surgery. The aim of this study was to review the safety of outpatient repair and develop guidelines.

Methods:
A retrospective review of patients younger than 2 years undergoing primary cleft lip repair from 2008 to 2015 at six centers was performed. Patients were divided into two groups: predominantly ambulatory (discharged or admitted for specific concerns) and inpatient (admitted due to surgeon’s preference). The impact of independent variables on admission, emergency department visits, and readmission within 1 month of discharge was analyzed.

Results:
Of 546 patients, 68.1 percent were boys, 4.4 percent had syndromes, and 23.6 percent had comorbidities. One hundred forty-two patients were admitted postoperatively. Forty-nine admissions were attributable to the surgeon’s preference. After excluding this subset, our ambulatory surgery rate was 81 percent. There was no difference in emergency department visits (3 percent versus 2.2 percent; p = 0.6) or readmissions (0 percent versus 1.45 percent; p = 0.5) between groups. None of the ambulatory surgery patients were readmitted within 36 hours, for a successful ambulatory surgery rate of 100 percent. Female sex; surgical time; prematurity and/or postconceptional age younger than 52 weeks; and cardiac, respiratory, central nervous system, gastrointestinal, genitourinary, and other congenital comorbidities had significant impact on admission rates in the predominantly ambulatory group (p < 0.05). Respiratory comorbidities and syndromes were risk factors for readmission if patients presented to the emergency department (p < 0.05).

Conclusions:
Ambulatory cleft lip repair can be performed safely in most patients with no difference in emergency department visits or readmission. Patients with comorbidities should be admitted for observation.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Evaluation of the In Vivo Kinetics and Biostimulatory Effects of Subcutaneously Injected Hyaluronic Acid Filler
Authors: Mochizuki Masato , Aoi Noriyuki , Gonda Koichi , Hirabayashi Shinichi , Komuro Yuzo 
Published: June 2018

Background:
Because subcutaneously injected hyaluronic acid filler is absorbed over 6 months to 1 year after the treatment of facial wrinkles, frequent retreatment may be required. However, persistent long-term effects are often clinically observed when hyaluronic acid filler is injected as a bolus for facial augmentation. Therefore, the authors investigated, over time, the changes in volume and histologic features of subcutaneous bolus injections of hyaluronic acid.

Methods:
Hyaluronic acid filler was subcutaneously injected as a bolus into the dorsum of 6-week-old rats. At several time points (immediately after injection and 4, 8, 16, 32, and 64 weeks thereafter), magnetic resonance imaging was introduced to observe morphologic changes and to measure volume. Histologic examination of sectioned tissues was also performed.

Results:
The average volume increased for up to 4 weeks after injection and then gradually decreased, with 74.8 percent of the injected volume remaining after 64 weeks, with no statistical difference compared to the initial volume. Histologic analysis revealed that lattice structures were created by fibroblasts and collagen fibers, and blood vessels and adipocytes were also generated in the filler.

Conclusions:
Although subcutaneous bolus injections of hyaluronic acid filler exhibited flattening, the total volume was maintained even after 64 weeks. Histologically, hyaluronic acid filler acted as a scaffold for autogenous tissue replacement by means of fibroblast migration and proliferation, collagen induction, and angiogenesis, followed by proliferation of adipocytes. This study demonstrates that the total volume is maintained long-term by replacing part of the injected hyaluronic acid filler with autologous tissues.