bluuebunny/crossref_metadata_2025_split huggingface dataset:
Linking Big Data and Prediction Strategies: Tools, Pitfalls, and Lessons Learned
Authors: Yang Shiming , Stansbury Lynn G. , Rock Peter , Scalea Thomas , Hu Peter F. 
Published: March 2019

Objectives:
Modern critical care amasses unprecedented amounts of clinical data—so called “big data”—on a minute-by-minute basis. Innovative processing of these data has the potential to revolutionize clinical prognostics and decision support in the care of the critically ill but also forces clinicians to depend on new and complex tools of which they may have limited understanding and over which they have little control. This concise review aims to provide bedside clinicians with ways to think about common methods being used to extract information from clinical big datasets and to judge the quality and utility of that information.

Data Sources:
We searched the free-access search engines PubMed and Google Scholar using the MeSH terms “big data”, “prediction”, and “intensive care” with iterations of a range of additional potentially associated factors, along with published bibliographies, to find papers suggesting illustration of key points in the structuring and analysis of clinical “big data,” with special focus on outcomes prediction and major clinical concerns in critical care.

Study Selection:
Three reviewers independently screened preliminary citation lists.

Data Extraction:
Summary data were tabulated for review.

Data Synthesis:
To date, most relevant big data research has focused on development of and attempts to validate patient outcome scoring systems and has yet to fully make use of the potential for automation and novel uses of continuous data streams such as those available from clinical care monitoring devices.

Conclusions:
Realizing the potential for big data to improve critical care patient outcomes will require unprecedented team building across disparate competencies. It will also require clinicians to develop statistical awareness and thinking as yet another critical judgment skill they bring to their patients’ bedsides and to the array of evidence presented to them about their patients over the course of care.
Morphine Dose Optimization in Critically Ill Pediatric Patients With Acute Respiratory Failure: A Population Pharmacokinetic-Pharmacogenomic Study
Authors: Zuppa Athena F. , Benitez Giselle R. , Zane Nicole R. , Curley Martha A. Q. , Bradfield Jonathan , Hakonarson Hakon , Gastonguay Madeleine S. , Moorthy Ganesh , Prodell Janice , Gastonguay Marc R. 
Published: March 2019

Objective:To develop a pharmacokinetic-pharmacogenomic population model of morphine in critically ill children with acute respiratory failure.Design:Prospective pharmacokinetic-pharmacogenomic observational study.Setting:Thirteen PICUs across the United States.Patients:Pediatric subjects (n= 66) mechanically ventilated for acute respiratory failure, weight greater than or equal to 7 kg, receiving morphine and/or midazolam continuous infusions.Interventions:Serial blood sampling for drug quantification and a single blood collection for genomic evaluation.Measurements and Main Results:Concentrations of morphine, the two main metabolites, morphine-3-glucuronide and morphine-6-glucuronide, were quantified by high-performance liquid chromatography tandem mass spectrometry/mass spectroscopy. Subjects were genotyped using the Illumina HumanOmniExpress genome-wide single nucleotide polymorphism chip. Nonlinear mixed-effects modeling was performed to develop the pharmacokinetic-pharmacogenomic model. A two-compartment model with linear elimination and two individual compartments for metabolites best describe morphine disposition in this population. Our analysis demonstrates that body weight and postmenstrual age are relevant predictors of pharmacokinetic parameters of morphine and its metabolites. Furthermore, our research shows that a duration of mechanical ventilation greater than or equal to 10 days reduces metabolite formation and elimination upwards of 30%. However, due to the small sample size and relative heterogeneity of the population, no heritable factors associated with uridine diphosphate glucuronyl transferase 2B7 metabolism of morphine were identified.Conclusions:The results provide a better understanding of the disposition of morphine and its metabolites in critically ill children with acute respiratory failure requiring mechanical ventilation due to nonheritable factors. It also provides the groundwork for developing additional studies to investigate the role of heritable factors.
Characterizing Early State Regulation in Preterm Infants
Authors: Litt Jonathan S. , Ho Timmy , Obregon Evelyn , Patel Palak , Ziyeh Tiglath , McCormick Marie C. 
Published: March 2019

ABSTRACT:

Objectives:
To characterize state regulation and behavior of preterm infants after discharge from the neonatal intensive care unit (NICU).

Methods:
We recruited singleton infants born at ≤35 weeks of gestational age (GA) before NICU discharge. Parents completed surveys at discharge and 1, 3, and 6 months after discharge. Infant medical history was gleaned from the medical record. Surveys captured sociodemographic information and measures of infant state regulation (Baby Pediatric Symptom Checklist [BPSC]) and feeding behaviors. We calculated the median BPSC subscale scores at each time point and the proportion of infants with scores in the problem range (≥3/5). We explored longitudinal and cross-sectional correlates of BPSC scores.

Results:
Fifty families completed the discharge questionnaire, and 42 (84%) completed the 6-month questionnaire. The median GA at birth was 34 weeks (IQR 30.1, 34.4 weeks); the median birth weight was 1930 g (IQR 1460, 2255 g). The median scores were above population norms for irritability and difficulty with routines. Twenty-one infants (40%) had irritability subscale scores in the problem range at 1 month, and 20 (38%) had problem scores on difficulties with routines. Only 9 infants (17%) had problem scores on the inflexibility subscale. Scores in all 3 domains showed different patterns from population norms from 1 to 6 months. BPSC scores were correlated with infant feeding behaviors at 1, 3, and 6 months.

Conclusion:
Scores for irritability and difficulty with routines among preterm infants were high compared with population norms and differed from normative values through 6 months after discharge. Preterm infants demonstrate problems with state regulation after NICU discharge that may require directed intervention.
Children's Inattention and Hyperactivity, Mother's Parenting, and Risk Behaviors in Adolescence: A 10-Year Longitudinal Study of Chilean Children
Authors: Nelson Theodora , East Patricia , Delva Jorge , Lozoff Betsy , Gahagan Sheila 
Published: March 2019

ABSTRACT:

Objective:
To examine how mothers' nurturant and, separately, hostile parenting mediate the effects of young children's inattentiveness and hyperactivity on risk behaviors in adolescence.

Method:
Data were analyzed from 920 healthy Chilean children, studied at 5.5, 10 years, and adolescence. Children's hyperactivity and inattentiveness at 5.5 years were assessed by mother ratings on the Children's Adaptive Behavior Inventory. Mothers' nurturance and hostility toward the child at 10 years were assessed by maternal interview on the Home Observation for Measurement of the Environment. Youth's delinquent and aggressive behaviors in adolescence were compiled from the Youth Self-Report questionnaire, and youth's substance use in adolescence was assessed by an extensive self-report substance use inventory. Structural equation modeling was used to identify direct and indirect effects.

Results:
Findings supported a mediating effect, with more severe child hyperactivity at 5.5 years leading to mothers' greater hostility toward her child at age 10, which, in turn, led to greater delinquency and aggression in adolescence. Marginal mediating effects were also found from child hyperactivity and inattention at 5.5 years to mothers' lower nurturance at 10 years to youth substance use in adolescence.

Conclusion:
Mothers' hostile treatment of children with hyperactive or inattentive behaviors contributed to adolescent risk behaviors and is an area of intervention.
Radiation Monitoring of an Isolation Room for 131I Therapy After the Patients Were Released
Authors: Karo Choeung , Ideguchi Reiko , Nishi Kodai , Fukuda Naoko , Miura Miwa , Matuda Naoki , Kudo Takashi 
Published: March 2019

Abstract

Purpose: This study was performed to obtain a better understanding of the radiation environment in an 131I isolation room after the release of patients with metastasis from thyroid cancer that were treated with 131I doses ranging from 3.7 GBq (100 mCi) to 5.5 GBq (150 mCi) because there have not been any previous studies regarding the ambient radiation levels encountered in 131I isolation rooms after patients are released. Methods: Ambient radiation levels and total and removable surface contamination levels were monitored for 3 weeks after each patient’s release (and before the entry of the next patient). An area located 0.75 m along the corridor outside the room, the door, window, bedside, and the wall of the shower room were monitored with a Nal scintillation survey meter, which was used to obtain readings of the ambient radiation level in six directions, and the mean value for each area was recorded. In addition, areas that were suspected to be highly contaminated, including the toilet bowl, toilet sink, bed head, back of the bed, sink, trash box, and the patient’s pillow, were monitored for total surface contamination with a GM survey meter. Furthermore, the toilet’s U-bend, toilet sink, bed guard, table, shielding, sink plug, and door knob were swabbed for monitoring removable surface contamination, which was measured using a well counter. Conclusion: Ambient radiation monitoring in an 131I isolation room showed that there was negligible risk of harm in terms of the occupational radiation dose level after patients were released. The ambient radiation dose rate was higher near the door because the sink and trash box were located nearby. The toilet bowl, the toilet’s U-bend, and the area around the sink exhibited heavy surface contamination, so these areas require cautious hygiene management.
Hyaluronic Acid Gel Biodegradation After Intrapalpebral and Intraorbital Injection in Experimental Study
Authors: Sheptulin Vladimir , Fedorov Anatoly , Prause Jan , Fay Aaron , Grusha Yaroslav 
Published: March 2019

Purpose:
Amid the increasing clinical application of hyaluronic acid (HA) fillers in the ocular adnexa is a paucity of histological data concerning the fate of the injected material. The current study documents the in vivo biodegradation of HA deposited in the eyelid and orbit.

Methods:
The study included 22 chinchilla rabbits. The right upper eyelid of 12 rabbits received a single 0.2 ml Restylane (Galderma, Uppsala, Sweden) subcutaneous injection. In 10 different rabbits, the right orbit was injected with 1.0 ml Restylane SubQ (Galderma, Uppsala, Sweden) in the extraconal space. The rabbits in the eyelid group were euthanized at 2 weeks, 1 month, 2, 4, 6, and 9 months, while the rabbits in the orbit group were euthanized at 1 month, 3, 6, 12, and 18 months. Histological analysis was performed on the harvested samples.

Results:
In the eyelid, the HA assumed a sponge-like structure that diminished gradually over time. At 9 months, the injected HA partially persisted, mainly in the peripheral areas of injection. A similar histologic pattern was observed in the injected orbits, with slow changes persisting at the eighteenth month. In both cohorts, clear signs of collagen deposition and pseudocapsule formation were observed around HA droplets, with no signs inflammation.

Conclusions:
HA injected subcutaneously into the eyelid and orbit of rabbits undergoes slow and gradual biodegradation, with HA persisting to no less than 9 months in the eyelid and 18 months in orbit. Neocollagen synthesis and lack of hyaluronidase activity could explain the unexpectedly prolonged HA persistence.
Risk factors for hospital-acquired non–catheter-associated urinary tract infection
Authors: Aloush Sami M. , Al Qadire Mohammad , Assmairan Kholoud , Al sheikh Hind , Mosbah Adel , Hussien Hamzah , Al bzoor Baha'a 
Published: March 2019

ABSTRACT

Background and purpose:
Nosocomial urinary tract infection in patients with no Foley catheter [non–catheter-associated urinary tract infection (non-CAUTI)] has been a serious health issue that is associated with an increase in the cost of care, morbidity, and mortality. Identifying the risk factors of non-CAUTI would help determine patients at high risk and prevent complications. This study aims to identify the risk factors of non-CAUTI.

Method:
This study was conducted in four hospitals in three Middle Eastern countries: Jordan, Qatar, and Saudi Arabia. A convenience sample of 189 participants was recruited, of which 83 had non-CAUTI. Case–control design was used. Patients who had non-CAUTI while hospitalized were compared with others who did not. A questionnaire was developed based on the non-CAUTI diagnostic criteria from the Centers for Disease Control and Prevention. The questionnaire contained two parts: part one included participants’ characteristics and part two assessed the symptoms of non-CAUTI.

Conclusion:
Comorbidity is associated with a higher risk of having nosocomial non-CAUTI among hospitalized patients. This study showed that the diagnosis and management of comorbidity is important in lowering the risk of non-CAUTI in hospitalized patients. Age and antibiotic administration were statistically significant; however, their effects were small and were unlikely to have any clinical significance.

Implication for practice:
Identifying patients at high risk is imperative to prevent the development of non-CAUTI. Nurse practitioners may implement an early intervention for patients with comorbidity to counteract its effect on patients' health.
Advancing the practice of nursing through specialty fellowship development for pediatric nurse practitioners
Authors: Keefe Marcoux Kelly , Dickson Shayleigh , Clarkson Kristin 
Published: March 2019

ABSTRACT
Fellowship training for physicians has historically been a training model for physicians to specialize their practice and develop research skills following medical school and residency. Advanced practice registered nurses, specifically nurse practitioners (NPs) practice in primary care, acute care, and specialty settings across the lifespan. Fellowship programs have emerged as a way for NPs to specialize their practice and meet the needs of an expanding health care system. This article describes the design, implementation, and outcomes of two similar yet distinct specialty NP fellowship programs: one in Developmental–Behavioral Pediatrics and one in Pediatric Physical Medicine and Rehabilitation.
Enteral versus oral feeding in advanced dementia
Authors: Vellani Shirin 
Published: March 2019

ABSTRACT
The global population is aging, and with this demographic shift, the incidence and prevalence of dementia are expected to increase. According to the World Health Organization, an estimated 50 million people are living with dementia worldwide, and this number is expected to triple to 150 million by 2050. Dementia initially affects the brain, eventually affecting the entire body culminating in death, commonly from the complications and comorbidities. People with dementia often experience eating difficulties in addition to a severe decline in cognitive, verbal, and functional abilities secondary to gradual neurodegenerative process, leading to weight loss, malnutrition, and dehydration. When eating difficulties and weight loss occur, health care providers and families often feel obligated to decide to either continue the oral feeding or opt for feeding tube placement. Primary care clinicians, both nurse practitioners and physicians, are presented with challenges when facilitating the decision regarding the feeding options in patients with advanced dementia. This narrative review aims at evaluating the impact of enteral nutrition versus oral feeding by comparing the rates of survival and adverse events in older adults with advanced dementia. It also highlights the best approaches to optimizing nutrition for this frail population.
Posterior occipital intramuscular hemangioma mimicking arteriovenous malformation
Authors: Chen Hao , Xu Baofeng , Wang Guangming , Guo Yunbao , Hou Kun , Yu Jinlu 
Published: March 2019

Abstract

Rationale:
Intermuscular hemangioma (IH) usually occurs in the muscles of the limbs and trunk, but can rarely occur in the occipital region. IH in the occipital region is easily misdiagnosed as arteriovenous malformation (AVM).

Patient concerns:
A 31-year-old woman had a right occipital mass for 5 months without pulsation.

Diagnosis:
Head computered tomography angiography (CTA) and digital substraction angiography (DSA) examinations showed that the lesion was mainly vascular, approximately 3 × 5 cm in size, and supplied by occipital arteries and the muscular branches of vertebral arteries. The venous drainage of the lesions communicated with the suboccipital vein plexus and the paravertebral vein in the venous phase, indicating AVM. Postoperative histological investigation showed the lesion was a hemangioma.

Interventions:
It was recommended for surgical removal. The surgery was carried out under general anesthesia. The lesion showed a clear boundary. The occipital artery touched the anterior margin of the lesion, was exposed and ligated, and was removed around the lesion. The lesion consisted of massive blood vessels, and the surrounding muscles were swollen, indicating IH.
After the lesion was removed, the normal muscle tissue around the lesion was also removed.

Outcomes:
The patient achieved a good recovery after surgery, and pathology confirmed IH. A postoperative 1-year CTA review was performed and showed partial residual, then the radiotherapy was recommended. She refused further radiotherapy, follow-up 2 years later showed no enlargement of the lesion.

Lessons:
Although IH rarely occurs in the occipital region, this can occur. Due to the complexity of the drainage veins in the occipital region, these IH are prone to misdiagnosis as AVM.
Effect of ALDH2 polymorphism on cancer risk in Asians
Authors: Zuo Wei , Zhan Zhenyu , Ma Lin , Bai Wei , Zeng Shanggan 
Published: March 2019

Abstract
Numerous studies have investigated the association between ALDH2 gene rs671G>A polymorphism and various cancer type in Asians. However, the results remain inconclusive.
We conducted a comprehensive meta-analysis including 63 articles with 66 studies containing 25,682 cases and 47,455 controls retrieved by searching PubMed and Embase electronic databases up to March 5, 2018.
Pooled results indicated that ALDH2 gene rs671 polymorphism was significantly associated with the overall cancer risk in Asians (homozygous model: odds ratio [OR] = 0.85, 95% confidence interval [CI] = 0.72–0.99, P = .042; heterozygous model: OR = 1.32, 95% CI = 1.14–1.52, P  < .001; recessive model: OR = 0.73, 95% CI = 0.60–0.88, P = .001; dominant model: OR = 1.32, 95% CI = 1.16–1.51, P < .001; and allele comparison model: OR = 1.11, 95% CI = 1.03–1.19, P = .004), especially in esophageal cancer and among the Chinese and the Japanese.
Our results suggest that ALDH2 rs671 polymorphism is associated with the overall cancer risk in Asians. Well-designed prospective studies with more information about gene–environment interaction, such as drinking, should be conducted to validate our findings.
Scalp acupuncture treatment for children's autism spectrum disorders
Authors: Liu Chang , Li Ting , Wang Zhijie , Zhou Rui , Zhuang Lixing 
Published: March 2019

Abstract

Background:
Autism spectrum disorder (ASD) is a neurodevelopment disorder without definitive cure. Previous studies have provided evidences for efficacy and safety of scalp acupuncture in children with ASD. However, the efficacy of scalp acupuncture treatment (SAT) in children with ASD has not been evaluated systematically. The objective of this study is to evaluate the efficacy of SAT in children with ASD.

Methods:
Information from 6 databases, including MEDLINE, EMBASE, Cochrane database, AMED, China National Knowledge Infrastructure, and Wanfang Data, were retrieved from the inception of each database from 1980 through September 2018. Randomized controlled trials evaluating the efficacy of SAT for patients with ASD were included. The primary outcome measures were the Childhood Autism Rating Scale (CARS) and Autism Behavior Checklist (ABC). The secondary outcome measures were Psychoeducational Profile (Third Edition) (PEP-3) scores. Risk of bias assessment and data synthesis were conducted with Review Manager 5.3 software. Methodological quality was assessed with the Cochrane risk of bias tool.

Results:
Fourteen trials with 968 participants were conducted and 11 of the trials were suitable for meta-analysis. Compared with behavioral and educational interventions, SAT significantly decreased the overall CARS scores for children under 3 years old (mean difference (MD) = 3.08, 95% confidence interval (CI) [−3.96, −2.19], P < .001) and above 3 years old (MD = 5.29, 95% CI [−8.53, −2.06], P < .001), ABC scores (MD = 4.70, 95% CI [−6.94, −2.79], P < .001). Furthermore, SAT significantly improved PEP-3 scores in communication (MD = 3.61, 95% CI [2.85, 4.37], P < .001), physical ability (MD = 2.00, 95% CI [1.16, 2.84], P < .001), and behavior (MD = 2.76, 95% CI [1.80, 2.71], P < .001).

Conclusion:
SAT may be an effective treatment for children with ASD. Given the heterogeneity and number of participants, randomized controlled trials of high quality and design are required before widespread application of this therapy.
Effects of receptor activator nuclear factor κB gene polymorphisms on the susceptibility to knee osteoarthritis
Authors: Wang Changcheng , Luo Li , Tian Fengde , An Ning , Zhang Yao , Hao Ruihu , Li Dongyi , Zhou Zihao , Xiao Peng , Guo Lin 
Published: March 2019

Abstract
The present study aimed to explore genetic association of receptor activator nuclear factor κB (RANK) polymorphisms with individual susceptibility to knee osteoarthritis (OA) in different Kellgren–Lawrence (KL) grades.
This case–control study included 138 knee OA patients and 145 healthy individuals. RANK rs1805034 and rs8086340 polymorphisms were genotyped through polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The effects of RANK polymorphisms on knee OA risk were analyzed via χ2 test or Fisher exact test, and the results were expressed using odds ratios (ORs) with corresponding 95% confidence intervals (CIs).
The C allele of rs1805034 polymorphism had significantly higher frequency in knee OA patients than in controls (P = .044), indicating that this allele could increase the risk of knee OA (OR = 1.424, 95% CI = 1.010–2.008). Besides, the CC genotype and C allele of the rs1805034 polymorphism were significantly associated with elevated risk of knee OA in moderate grade (CC vs TT: P = .018, OR = 3.071, 95% CI = 1.187–7.941; C vs T: P = .012, OR = 1.787, 95% CI = 1.131–2.823). However, rs8086340 polymorphism had no significant association with knee OA risk
The C allele of RANK rs1805034 polymorphism is closely correlated with increased risk of knee OA, especially for moderate grade.