bluuebunny/crossref_metadata_2025_split huggingface dataset:
Computer-assisted clinical coding: A narrative review of the literature on its benefits, limitations, implementation and impact on clinical coding professionals
Authors: Campbell Sharon , Giadresco Katrina 
Published: June 2019

Background: Information technology has the potential to streamline processes in healthcare for improved efficiency, quality and safety, while reducing costs. Computer-assisted clinical coding (CAC) has made it possible to automate the clinical coding process by assigning diagnoses and procedures from electronic sources of clinical documentation. Implementation of CAC requires both investigation of the clinical coding workflow and exploration of how the clinical coding professional’s role might change and evolve as a result of this technology. Objective: To examine the benefits and limitations of CAC technology; best practices for CAC adoption; the impact of CAC on traditional coding practices and roles in the inpatient setting. Method: This narrative review explores the current literature available on CAC. Literature indexed in ProQuest, Medline and other relevant sources between January 2006 and June 2017 was considered. Results: A total of 38 journal articles, published dissertations and case studies revealed that CAC has demonstrated value in improving clinical coding accuracy and quality, which can be missed during the manual clinical coding process. Conclusion: Clinical coding professionals should view CAC as an opportunity not a threat. CAC will allow clinical coding professionals to further develop their clinical coding skills and knowledge for future career progression into new roles such as clinical coding editors and clinical coding analysts. Sound change management strategies are essential for successful restructuring of the clinical coding workflows during the implementation of CAC.
Pulmonary type-2 innate lymphoid cells in paediatric severe asthma: phenotype and response to steroids
Authors: Nagakumar Prasad , Puttur Franz , Gregory Lisa G. , Denney Laura , Fleming Louise , Bush Andrew , Lloyd Clare M. , Saglani Sejal 
Published: June 2019

Children with severe therapy-resistant asthma (STRA) have poor control despite maximal treatment, while those with difficult asthma (DA) have poor control from failure to implement basic management, including adherence to therapy. Although recognised as clinically distinct, the airway molecular phenotype, including the role of innate lymphoid cells (ILCs) and their response to steroids in DA and STRA is unknown.Immunophenotyping of sputum and blood ILCs and T-cells from STRA, DA and non-asthmatic controls was undertaken. Leukocytes were analysed longitudinally pre- and post-intramuscular triamcinolone in children with STRA. Cultured ILCs were evaluated to assess steroid responsivenessin vitro.Airway eosinophils, type 2 T-helper (Th2) cells and ILC2s were significantly higher in STRA patients compared to DA and disease controls, while IL-17+lymphoid cells were similar. ILC2s and Th2 cells were significantly reducedin vivofollowing intramuscular triamcinolone andin vitrowith steroids. Furthermore, asthma attacks and symptoms reduced after systemic steroids despite persistence of steroid-resistant IL-17+cells and eosinophils.Paediatric STRA and DA have distinct airway molecular phenotypes with STRA characterised by elevated type-2 cells. Systemic corticosteroids, but not maintenance inhaled steroids resulted in improved symptom control and exacerbations concomitant with a reduction in functional ILC2s despite persistently elevated IL-17+lymphoid cells.
Enabling multi-hop remote method invocation in device-to-device networks
Authors: Le Minh , Clyde Stephen , Kwon Young-Woo 
Published: June 2019

Abstract
To avoid shrinking down the performance and preserve energy, low-end mobile devices can collaborate with the nearby ones by offloading computation intensive code. However, despite the long research history, code offloading is dilatory and unfit for applications that require rapidly consecutive requests per short period. Even though Remote Procedure Call (RPC) is apparently one possible approach that can address this problem, the RPC-based or message queue-based techniques are obsolete or unwieldy for mobile platforms. Moreover, the need of accessibility beyond the limit reach of the device-to-device (D2D) networks originates another problem. This article introduces a new software framework to overcome these shortcomings by enabling routing RPC architecture on multiple group device-to-device networks. Our framework provides annotations for declaring distribution decision and out-of-box components that enable peer-to-peer offloading, even when a client app and the service provider do not have a direct network link or Internet connectivity. This article also discusses the two typical mobile applications that built on top of the framework for chatting and remote browsing services, as well as the empirical experiments with actual test-bed devices to unveil the low overhead conduct and similar performance as RPC in reality.
The use of leukocytes’ secretome to individually target biological therapy in autoimmune arthritis: a case report
Authors: Poubelle Patrice E. , Pagé Nathalie , Longchamps Marie‐Pier , Sampaio Moura Natalia , Beck David B. , Aksentijevich Ivona , Tessier Philippe A. , Pelletier Martin 
Published: June 2019

AbstractBackgroundBiological agents have allowed remarkable improvement in controlling autoimmune arthropathies, although none of the numerous biologics readily available represent a universal treatment standard. Moreover, classical and genetic predictors are currently unsatisfactory to predict individual response to a biologic, and the best treatment selection is still based on a trial‐and‐error approach. Here, we report a clinical case demonstrating the usefulness of examining the leukocytes’ secretome of patients. We set up and standardized a protocol that examines a patient's immune responses to establish the secretome of the blood mononuclear leukocytes and personalize the biotherapy.Case presentationA 24‐year‐old woman was diagnosed with active early rheumatoid arthritis. The initial treatment regimen (prednisone, methotrexate, hydroxychloroquine, naproxen) was inefficient, as well as the anti‐TNF adalimumab. The diagnosis was revised as possible rheumatoid arthritis‐like psoriatic arthritis and adalimumab was replaced by abatacept (IgG1 Fc‐CTLA‐4) to no avail. Five years later, abatacept was replaced by the anti‐IL‐12/IL‐23 ustekinumab with no objective control over the symptoms. The patient was thus enrolled in a prospective study based on the quantification of cytokines secreted by peripheral blood leukocytes stimulated with well‐known immune activators of pattern recognition receptors and cytokine signalling. The results of this study revealed that plasma concentrations of cytokines were similar between the patient and healthy donors. In comparison to leukocytes from healthy donors, the patient's secretome showed a unique overproduction of IL‐6. The anti‐IL‐6 receptor tocilizumab was, therefore, administered with a rapid improvement of her active psoriatic arthritis that remained dependent on low prednisone dosage. Clinical parameters progressively returned to normal levels and her quality of life was greatly improved, despite the major delay to begin the present personalized treatment.ConclusionsAn efficient way to effectively treat patients with complex autoimmune arthropathies, and avoid irreversible disability, is to know their leukocytes’ secretome to identify abnormally secreted cytokines and personalize their biotherapy, as exemplified by this case report.
Tobacco smoking and schizophrenia: re-examining the evidence
Authors: Isuru Amila , Rajasuriya Mahesh 
Published: June 2019

SUMMARYTobacco smoking among people with mental illnesses can be explained by biological, psychological and social factors. The prevalence of smoking in people diagnosed with schizophrenia is higher than in people with other mental disorders and in the general population. This article explores three current hypotheses that explain this higher prevalence of smoking in schizophrenia. The first, the self-medication hypothesis, is increasingly countered by a growing body of evidence indicating that smokers experience more severe symptoms of schizophrenia. Numerous researchers have already identified smoking as a possible risk factor for the development of schizophrenia, which is the second hypothesis. The third hypothesis (shared genetic vulnerability) identifies certain genes that confer vulnerability for both schizophrenia and nicotine dependence. Understanding the reasons behind the higher prevalence of smoking among people with schizophrenia is vital in planning effective primary, secondary and tertiary smoking prevention for these individuals.LEARNING OBJECTIVESAt the end of this article, readers will be able to:
•understand the self-medication hypothesis in relation to tobacco smoking by people with schizophrenia•understand the role of tobacco smoking as a possible risk factor for causation of schizophrenia•understand the role of shared genetic vulnerability in the causation of both schizophrenia and nicotine dependence.
Resumption of Immune Checkpoint Inhibitor Therapy After Immune-Mediated Colitis
Authors: Abu-Sbeih Hamzah , Ali Faisal S. , Naqash Abdul Rafeh , Owen Dwight H. , Patel Sandipkumar , Otterson Gregory A. , Kendra Kari , Ricciuti Biagio , Chiari Rita , De Giglio Andrea , Sleiman Joseph , Funchain Pauline , Wills Beatriz , Zhang Jiajia , Naidoo Jarushka , Philpott Jessica , Gao Jianjun , Subudhi Sumit K. , Wang Yinghong 
Published: June 2019

PURPOSE Immune checkpoint inhibitor (ICI) therapy often is suspended because of immune-mediated diarrhea and colitis (IMDC). We examined the rate of and risk factors for IMDC recurrence after ICI resumption. METHODS This retrospective multicenter study examined patients who resumed ICI therapy after improvement of IMDC between January 2010 and November 2018. Univariable and multivariable logistic regression analyses assessed the association of clinical covariates and IMDC recurrence. RESULTS Of the 167 patients in our analysis, 32 resumed an anti–cytotoxic T-cell lymphocyte-4 (CTLA-4) agent, and 135 an anti–programmed cell death 1 or ligand 1 (PD-1/L1) agent. The median age was 60 years (interquartile range [IQR], 50-69 years). The median duration from IMDC to restart of ICI treatment was 49 days (IQR, 23-136 days). IMDC recurred in 57 patients (34%) overall (44% of those receiving an anti–CTLA-4 and 32% of those receiving an anti–PD-1/L1); 47 of these patients (82%) required immunosuppressive therapy for recurrent IMDC, and all required permanent discontinuation of ICI therapy. The median duration from ICI resumption to IMDC recurrence was 53 days (IQR, 22-138 days). On multivariable logistic regression, patients who received anti–PD-1/L1 therapy at initial IMDC had a higher risk of IMDC recurrence (odds ratio [OR], 3.45; 95% CI, 1.59 to 7.69; P = .002). Risk of IMDC recurrence was higher for patients who required immunosuppression for initial IMDC (OR, 3.22; 95% CI, 1.08 to 9.62; P = .019) or had a longer duration of IMDC symptoms in the initial episode (OR, 1.01; 95% CI, 1.00 to 1.03; P = .031). Risk of IMDC recurrence was lower after resumption of anti–PD-1/L1 therapy than after resumption of anti–CTLA-4 therapy (OR, 0.30; 95% CI, 0.11 to 0.81; P = .019). CONCLUSION One third of patients who resumed ICI treatment after IMDC experienced recurrent IMDC. Recurrence of IMDC was less frequent after resumption of anti–PD-1/L1 than after resumption of anti–CTLA-4.
The Effects of Dapagliflozin on Systemic and Renal Vascular Function Display an Epigenetic Signature
Authors: Solini Anna , Seghieri Marta , Giannini Livia , Biancalana Edoardo , Parolini Federico , Rossi Chiara , Dardano Angela , Taddei Stefano , Ghiadoni Lorenzo , Bruno Rosa Maria 
Published: June 2019

AbstractContextMechanisms mediating the cardiovascular and renal protection exerted by SGLT2 inhibitors are still partially unknown. We investigated whether dapagliflozin modulates systemic and renal vascular function and structure, and induces epigenetic modifications.Subjects and MethodsForty hypertensive patients with type 2 diabetes were randomly assigned to 4-week treatment with dapagliflozin 10 mg or hydrochlorothiazide (HCT) 12.5 mg. Routine analyses; plasma renin activity; aldosterone, catecholamine, and 24-hour urinary electrolyte levels; flow-mediated dilation (FMD) of the brachial artery; carotid-femoral pulse-wave velocity (PWV); augmentation index; and resistive index and dynamic renal resistive index (DRIN) were measured at baseline and after treatment. Circulating miRNAs (miRs) related to heart failure (miR30e-5p, miR199a-3p), endothelial dysfunction (miR27b and miR200b), and renal function (miR130b-3p, miR21-5p) were assessed and related to the effects of treatments.ResultsDapagliflozin and HCT marginally lowered blood pressure. Fasting glucose was lowered, whereas 24-hour diuresis, glycosuria, and osmolar clearance were increased by dapagliflozin (P < 0.001 for all), without affecting sodium excretion and glomerular filtration rate. Magnesium levels significantly increased after dapagliflozin treatment (P = 0.02). Neither dapagliflozin nor HCT modified FMD or PWV. DRIN did not vary in the dapagliflozin group, whereas it increased in the HCT group (P = 0.047 for time by treatment interaction). Both treatments induced variations in the expression of some miRs; dapagliflozin, but not HCT, significantly up-regulated miR30e-5p and downregulated miR199a-3p.ConclusionA putative epigenetic regulation of the protecting cardiovascular effect exerted by SGLT2 inhibitors was found. Dapagliflozin might exert nephroprotection by preserving renal vasodilating capacity.
Case Report: Pigmented paravenous retinochoroidal atrophy: a case report
Authors: Zarei Mohammad , Mahmoudzadeh Raziyeh , Riazi-Esfahani Hamid 
Published: June 2019

This article, to the best of our knowledge, reports the youngest typical case of pigmented paravenous retinochoroidal atrophy (PPRCA) reported to date. A 27-month-old girl presented with exodeviation in her right eye. She had normal birth and development with unremarkable family history. There were no inflammatory signs. In funduscopy, typical bilateral radial paravenous pigmentary changes and retinochoroidal atrophy were noticed in both eyes. The pigmentations consisted of coarse black pigmentations and fine subretinal yellowish round flecks. They arborized into the peripheral retina along the veins. Unaffected areas between the lesions seemed to be normal. Electroretinogram (ERG) responses showed mild to moderate reductions in both scotopic and photopic tests. Based on retinal examination and ERG findings PPRCA was diagnosed. On 16-month follow up, clinical and ERG findings were the same as the initial presentation. This case showed no progression during 16 months of follow up, which may indicate that primary congenital PPRCA with no inflammatory association may be a non-progressive disease.
Evidence for the Feedback Role of Performance Measurement Systems
Authors: Anderson Shannon W. , Kimball Amanda 
Published: June 2019

Performance measurement systems (PMSs) are used to diagnose and remediate problems, termed the “decision-facilitating” or feedback role of management control. We examine whether use of PMSs by individual decision makers is associated with better performance. Experimental studies have isolated individual-level effects of feedback on decision quality; however, it is difficult to extend these findings to natural settings. Archival and survey studies offer evidence on the association between the presence of PMSs and performance but have had limited success in measuring decision makers’ actual use of PMSs and addressing endogeneity of the decision to use PMSs. We use unobtrusively collected data on actual PMS use in 30 K–12 charter schools over three years to test whether teachers who make greater use of two PMSs are associated with greater growth in student learning. We find that teachers’ use of PMSs is associated with increased student learning, consistent with the premise that PMSs facilitate teacher interventions and improve student outcomes. The results are both statistically and materially significant, and they are better explained by PMS use than by selection effects of better teachers using PMSs. Consistent with the organization’s focus on “at-risk” students, the strongest effects of teachers’ use of one PMS are concentrated among the lowest-performing students. In sum, we find broad support for the thesis that the feedback role of PMSs is associated with meaningful performance improvement. This paper was accepted by Suraj Srinivasan, accounting.
Sustainable, Hydraulic-Lime-Limestone Binders for Construction
Authors: Pavía S. , Aly M. 
Published: June 2019

Abstract
This work intends to reduce the carbon footprint and increase the sustainability of hydraulic lime (HL) mortars and concretes, a growing market in both new building and refurbishment, by partially replacing HL with limestone. Limestone cements are widely used in the world. Portland cement (PC) is partially replaced with limestone to reduce the large carbon print of cement and improve sustainability. The effect of limestone in PC has been widely investigated; however, the effect of limestone in HL has not yet been investigated. HLs contain clinkers identical to those in PC; therefore, this article first reviews the effect of limestone in PC and then experimentally investigates its impact in HL. The results showed that limestone is active in HL. The limestone changed the microstructure of the HL paste and the nature of the phases formed upon hydration, with calcium carbosilicate hydrates (resulting from dicalcium silicate and calcium carbonate [C2S-CaCO3] reaction) and carboaluminate hydrates (resulting from tricalcium aluminate and calcium carbonate [C3A-CaCO3] reaction) growing on interfaces and in the matrix. Limestone replacement enhanced the performance of the HL by improving strength: a 10 % replacement increased HL strength (compressive by 36 % and flexural by 56 %). A 20 % replacement enhanced strength up to 125 and 40 days (compressive and flexural, respectively); therefore, the limestone replacement threshold is higher in HL than in PC. The rise in strength does not affect moisture and vapor permeability, and the composites remain ‘breathable.’ Contrary to PC, limestone reduces the water demand of HL mortars. The superior strength of the limestone-filled HL mortars is attributed to their lower water demand, an increase of early hydrates, and their placement—strengthening transition zones and interparticle links.
Factors Associated With Management of Pediatric Ovarian Neoplasms
Authors: Lawrence Amy E. , Gonzalez Dani O. , Fallat Mary E. , Aldrink Jennifer H. , Hewitt Geri D. , Hertweck S. Paige , Onwuka Amanda , Bence Christina , Burns Robert C. , Dillon Patrick A. , Ehrlich Peter F. , Fraser Jason D. , Grabowski Julia E. , Hirschl Ronald B. , Kabre Rashmi , Kohler Jonathan E. , Lal Dave R. , Landman Matthew P. , Leys Charles M. , Mak Grace Z. , Sato Thomas T. , Scannell Madeline , Sujka Joseph A. , Minneci Peter C. , Deans Katherine J. 
Published: June 2019

BACKGROUND:
Available evidence supports ovary-sparing surgery for benign ovarian neoplasms; however, preoperative risk stratification of pediatric ovarian masses can be difficult. Our objective of this study was to characterize the surgical management of pediatric ovarian neoplasms across 10 children’s hospitals and to identify factors that could potentially aid in the preoperative risk stratification of these lesions.

METHODS:
A retrospective review of girls and women aged 2 to 21 years who underwent surgery for an ovarian neoplasm between 2010 and 2016 at 10 children’s hospitals was performed. Multivariable logistic regression was used to examine the relationships between the preoperative cohort characteristics, procedure performed, and risk of malignancy.

RESULTS:
Among 819 girls and women undergoing surgery for an ovarian neoplasm, malignant lesions were identified in 11%. The overall oophorectomy rate for benign disease was 33% (range: 15%–49%) across institutions. Oophorectomy for benign lesions was independently associated with provider specialty (P = .002: adult gynecologist, 45%; pediatric surgeon, 32%; pediatric gynecologist, 18%), premenarchal status (P = .02), preoperative suspicion for malignancy (P &lt; .0001), larger lesion size (P &lt; .0001), and presence of solid components (P &lt; .0001). Preoperative findings independently associated with malignancy included increasing size (P &lt; .0001), solid components (P = .003), and age (P &lt; .0001).

CONCLUSIONS:
The rate of oophorectomy for benign ovarian disease remains high within the pediatric population. Identification of factors associated with the choice of procedure and the risk of malignancy may allow for improved preoperative risk stratification and fewer unnecessary oophorectomies. These results have been used to develop and validate a multidisciplinary preoperative risk stratification algorithm that is currently being studied prospectively across 10 institutions.
ДОСЛІДЖЕННЯ ТРУБНИХ СТАЛЕЙ ОХОЛОДЖУЮЧИХ СИСТЕМ ТРИВАЛОЇ ЕКСПЛУАТАЦІΪ В УМОВАХ ПРОМИСЛОВИХ ВИРОБ-НИЦТВ
Authors: Бойко Андрій Васильович , Кулик Василь Петрович , Макаренко Валерій Дмитрович , Сизоненко Анатолій Вадимович 
Published: June 2019

В роботі наведені результати експериментальних і теоретичних досліджень, які дозволили пояснити механізми знеміцнення трубних сталей охолоджуючих систем тривалої експлуатації в умовах бродильного виробництва. Зокрема встановлено, що з ростом терміну експлуатації і зниженням мінусових температур охолоджуючої суміші різко збільшуються значення напружень викривлень кристалічних граток α-матриці. Показано, що з пониженням температури від -10 до -50ºС зменшуються параметри кристалічної гратки. З використанням математичного апарату дислокаційної теорії міцності розрахована енергія, величина якої достaтня для зародження мікротріщини в присутності каталізатора – водню. Встановлено, що з ростом терміну експлуатації масова частка цементиту трубних сталей різко зменшується, що свідчить про знеміцнення і погіршення властивостей матеріалу. Доказано, що близько 35-30% атомів вуглецю цементиту переходить при його розчині в α-твердий розчин в процесі тривалої експлуатації труб теплообмінників охолоджуючих систем, що приводить до зниження міцнісних характеристик сталі.
ДОСЛІДЖЕННЯ ЛОКАЛІЗАЦІЇ І ІНТЕНСИВНОСТІ КАВІТАЦІЙНОЇ ЕРОЗІЇ ПРИ ВИСОКОНАПІРНОМУ ДРОСЕЛЮВАННІ РІДИНИ В ГІДРАВЛІЧНИХ ПРИСТРОЯХ
Authors: Тарасенко Тарас Валерійович , Бадах Валерій Миколайович 
Published: June 2019

Дослідження проводилися з метою підвищення ресурсу елементів апаратури авіаційних гідросистем на основі обґрунтування заходів щодо зниження їх кавітаційної ерозії. Надзвичайно важливим і недостатньо вивченим фактором є вплив на кавітаційну ерозію умов дроселювання потоків в гідроагрегатах і пристроях, виникнення механізму кавітаційної ерозії. Представлено результати дослідження кавітаційної ерозії різних металів, які широко застосовуються у авіаційному гідроприводі. Приведено методику визначення стійкості металів авіаційного гідроприводу до кавітаційної ерозії. Визначено сплави, які мають підвищену стійкість до кавітаційної ерозії. Визначено механізм руйнування поверхні конструкційного матеріалу кавітаційними кавернами. Досліджено фактори які впливають на інтенсивність кавітаційної ерозії: умови дроселювання робочої рідини, розташування дослідних зразків відносно сопла. Запропоновано заходи зі зменшення впливу кавітаційної ерозії на конструкційні елементи гідравлічних агрегатів при їх роботі. Визначено раціональні геометричні характеристики генераторів гідродинамічної кавітації, які використовуються для дослідження кавітаційної ерозії конструкційних матеріалів: кут розкриття дифузору, довжини дифузорної частитни.