bluuebunny/crossref_metadata_2025_split huggingface dataset:
Benefit-risk of Patients' Online Access to their Medical Records: Consensus Exercise of an International Expert Group
Authors: Liyanage Harshana , Liaw Siaw-Teng , Konstantara Emmanouela , Mold Freda , Schreiber Richard , Kuziemsky Craig , Terry Amanda , de Lusignan Simon 
Published: April 2018

Background: Patients' access to their computerised medical records (CMRs) is a legal right in many countries. However, little is reported about the benefit-risk associated with patients' online access to their CMRs.
Objective: To conduct a consensus exercise to assess the impact of patients' online access to their CMRs on the quality of care as defined in six domains by the Institute of Medicine (IoM), now the National Academy of Medicine (NAM).
Method: A five-round Delphi study was conducted. Round One explored experts' (n = 37) viewpoints on providing patients with access to their CMRs. Round Two rated the appropriateness of statements arising from Round One (n = 16). The third round was an online panel discussion of findings (n = 13) with the members of both the International Medical Informatics Association and the European Federation of Medical Informatics Primary Health Care Informatics Working Groups. Two additional rounds, a survey of the revised consensus statements and an online workshop, were carried out to further refine consensus statements.
Results: Thirty-seven responses from Round One were used as a basis to initially develop 15 statements which were categorised using IoM's domains of care quality. The experts agreed that providing patients online access to their CMRs for bookings, results, and prescriptions increased efficiency and improved the quality of medical records. Experts also anticipated that patients would proactively use their online access to share data with different health care providers, including emergencies. However, experts differed on whether access to limited or summary data was more useful to patients than accessing their complete records. They thought online access would change recording practice, but they were unclear about the benefit-risk of high and onerous levels of security. The 5-round process, finally, produced 16 consensus statements.
Conclusion: Patients' online access to their CMRs should be part of all CMR systems. It improves the process of health care, but further evidence is required about outcomes. Online access improves efficiency of bookings and other services. However, there is scope to improve many of the processes of care it purports to support, particularly the provision of a more effective interface and the protection of the vulnerable.
History of Romanian Medical Informatics: Learning from the Past to Reshape the Future
Authors: Mihalas George , Stoicu-Tivadar Lacramioara 
Published: April 2018

Objectives: The paper presents a review of the history of medical informatics in Romania, starting from the pioneering works, relating the present, and foreseeing the future.
Methods: Major milestones of the development of this field have not been simply enumerated, but described within the specific socio-political frame, grasping the entire context over the last four decades in Romania. Two main perspectives have been traced: education and training in medical informatics and implementations in healthcare.
Results: Four distinctive historical periods are identified and the major events of each period are described in a critical manner. The history of the Romanian Society of Medical Informatics is presented in a separate chapter. The last section is dedicated to the present state of the field in Romania.
Conclusion: The history of Romanian Medical Informatics spans many years and is rich in content. The Romanian Society of Medical Informatics is mainly the result of the efforts undertaken by an enthusiastic and sound professional community, trying to continue the tradition, to achieve new goals, and to work as an active member of the international biomedical/health informatics community.
Middle East and North African Health Informatics Association (MENAHIA): Building Sustainable Collaboration
Authors: Al-Shorbaji Najeeb , Househ Mowafa , Taweel Adel , Alanizi Abdullah , Mohammed Bennani , Abaza Haitham , Bawadi Hala , Rasuly Hamayon , Alyafei Khalid , Fernandez-Luque Luis , Shouman Mohamed , El-Hassan Osama , Hussein Rada , Alshammari Riyad , Mandil Salah , Shouman Sarah , Taheri Shahrad , Emara Tamer , Dalhem Wasmiya , Al-Hamdan Zaid , Serhier Zineb 
Published: April 2018

SummaryThere has been a growing interest in Health Informatics applications, research, and education within the Middle East and North African Region over the past twenty years. People of this region share similar cultural and religious values, primarily speak the Arabic language, and have similar health care related issues, which are in dire need of being addressed. Health Informatics efforts, organizations, and initiatives within the region have been largely under-represented within, but not ignored by, the International Medical Informatics Association (IMIA). Attempts to create bonds and collaboration between the different organizations of the region have remained scattered, and often, resulted in failure despite the fact that the need for a united health informatics collaborative within the region has never been more crucial than today. During the 2017 MEDINFO, held in Hangzhou, China, a new organization, the Middle East and North African Health Informatics Association (MENAHIA) was conceived as a regional non-governmental organization to promote and facilitate health informatics uptake within the region endorsing health informatics research and educational initiatives of the 22 countries represented within the region. This paper provides an overview of the collaboration and efforts to date in forming MENAHIA and displays the variety of initiatives that are already occurring within the MENAHIA region, which MENAHIA will help, endorse, support, share, and improve within the international forum of health informatics.
Significant Hypo-Responsiveness to GPVI and CLEC-2 Agonists in Pre-Term and Full-Term Neonatal Platelets and following Immune Thrombocytopenia
Authors: Hardy Alexander , Palma-Barqueros Verónica , Watson Stephanie , Malcor Jean-Daniel , Eble Johannes , Gardiner Elizabeth , Blanco José , Guijarro-Campillo Rafael , Delgado Juan , Lozano María , Teruel-Montoya Raúl , Vicente Vicente , Watson Steve , Rivera José , Ferrer-Marín Francisca 
Published: April 2018

AbstractNeonatal platelets are hypo-reactive to the tyrosine kinase-linked receptor agonist collagen. Here, we have investigated whether the hypo-responsiveness is related to altered levels of glycoprotein VI (GPVI) and integrin α2β1, or to defects in downstream signalling events by comparison to platelet activation by C-type lectin-like receptor 2 (CLEC-2). GPVI and CLEC-2 activate a Src- and Syk-dependent signalling pathway upstream of phospholipase C (PLC) γ2. Phosphorylation of a conserved YxxL sequence known as a (hemi) immunotyrosine-based-activation-motif (ITAM) in both receptors is critical for Syk activation. Platelets from human pre-term and full-term neonates display mildly reduced expression of GPVI and CLEC-2, as well as integrin αIIbβ3, accounted for at the transcriptional level. They are also hypo-responsive to the two ITAM receptors, as shown by measurement of integrin αIIbβ3 activation, P-selectin expression and Syk and PLCγ2 phosphorylation. Mouse platelets are also hypo-responsive to GPVI and CLEC-2 from late gestation to 2 weeks of age, as determined by measurement of integrin αIIbβ3 activation. In contrast, the response to G protein-coupled receptor agonists was only mildly reduced and in some cases not altered in neonatal platelets of both species. A reduction in response to GPVI and CLEC-2, but not protease-activated receptor 4 (PAR-4) peptide, was also observed in adult mouse platelets following immune thrombocytopenia, whereas receptor expression was not impaired. Our results demonstrate developmental differences in platelet responsiveness to GPVI and CLEC-2, and also following immune platelet depletion leading to reduced Syk activation. The rapid generation of platelets during development or following platelet depletion is achieved at the expense of signalling by ITAM-coupled receptors.
Remediation in Practicing Physicians: Current and Alternative Conceptualizations
Authors: Bourgeois-Law Gisèle , Teunissen Pim W. , Regehr Glenn 
Published: April 2018

Suboptimal performance in practicing physicians is a decades-old problem. The lack of a universally accepted definition of remediation, the paucity of research on best remediation practices, and the ongoing controversy regarding the institutional responsibility for enacting and overseeing the remediation of physicians suggest that it is not merely a difficult problem to solve but a problem that the community does not grapple with meaningfully. Undoubtedly, logistical and political considerations contribute to this state of affairs; however, other underlying conceptual issues may also play a role in the medical profession’s difficulties in engaging with the challenges around remediation.
Through a review of the medical education and other literatures, the authors examined current conceptualizations of both reme-diation itself and the individual being remediated, as well as how the culture of medicine influences these conceptions. The authors explored how conceptualizations of remediation and the surrounding culture might affect not only the medical community’s ability to support but also its willingness to engage with physicians in need of remediation.
Viewing remediation as a means of supporting practice change—rather than as a means of redressing gaps in knowledge and skill—might be a useful alternative conceptualization, providing a good place to start exploring new avenues of research. However, moving forward will require more than simply a reconceptualization of remediation; it will also necessitate a change in how the community views its struggling members and a change in the medical culture that currently positions professional autonomy as the foundational premise for individual practice improvement.
Temporal Sensitivity Measured Shortly After Cochlear Implantation Predicts 6-Month Speech Recognition Outcome
Authors: Erb Julia , Ludwig Alexandra Annemarie , Kunke Dunja , Fuchs Michael , Obleser Jonas 
Published: April 2018

Objectives:
Psychoacoustic tests assessed shortly after cochlear implantation are useful predictors of the rehabilitative speech outcome. While largely independent, both spectral and temporal resolution tests are important to provide an accurate prediction of speech recognition. However, rapid tests of temporal sensitivity are currently lacking. Here, we propose a simple amplitude modulation rate discrimination (AMRD) paradigm that is validated by predicting future speech recognition in adult cochlear implant (CI) patients.

Design:
In 34 newly implanted patients, we used an adaptive AMRD paradigm, where broadband noise was modulated at the speech-relevant rate of ~4 Hz. In a longitudinal study, speech recognition in quiet was assessed using the closed-set Freiburger number test shortly after cochlear implantation (t

0
) as well as the open-set Freiburger monosyllabic word test 6 months later (t

6
).

Results:
Both AMRD thresholds at t

0
(r = –0.51) and speech recognition scores at t

0
(r = 0.56) predicted speech recognition scores at t

6
. However, AMRD and speech recognition at t

0
were uncorrelated, suggesting that those measures capture partially distinct perceptual abilities. A multiple regression model predicting 6-month speech recognition outcome with deafness duration and speech recognition at t

0
improved from adjusted R2
= 0.30 to adjusted R2
= 0.44 when AMRD threshold was added as a predictor.

Conclusions:
These findings identify AMRD thresholds as a reliable, nonredundant predictor above and beyond established speech tests for CI outcome. This AMRD test could potentially be developed into a rapid clinical temporal-resolution test to be integrated into the postoperative test battery to improve the reliability of speech outcome prognosis.
Factors Associated With Gaps in Medicaid Enrollment Among People With HIV and the Effect of Gaps on Viral Suppression
Authors: Monroe Anne K. , Myint Leslie , M. Rutstein Richard , Aberg Judith , L. Boswell Stephen , L. Agwu Allison , A.Gebo Kelly , D. Moore Richard ,   for the HIV Research Network
Published: April 2018

Introduction:
Gaps in Medicaid enrollment may affect HIV outcomes. We evaluated factors associated with Medicaid enrollment gaps and their effect on viral suppression (VS) within the HIV Research Network.

Methods:
We used a combined data set with Medicaid enrollment files from 2006 to 2010 and HIV Research Network demographic and clinical data. A gap was defined as ≥1 month without Medicaid and gap length was determined. We used multivariable logistic regression to determine factors associated with a gap and multivariable logistic regression with generalized estimated equations to evaluate factors associated with VS after gap.

Results:
Of 5836 participants, the majority were male, of black race, and aged 25–50 years. More than half had a gap in Medicaid. Factors associated with a gap included male sex [adjusted odds ratio (aOR) 1.79, (1.53, 2.08)] and younger age (aORs ranging from 1.50 to 4.13 comparing younger age groups to age >50, P < 0.05 for all). About a quarter of gaps had VS information before and after gap. Of those, 53.7% had VS both before and after gap and 25.8% were unsuppressed both before and after gap. The strongest association with VS after gap was VS before gap [aOR 15.76 (10.48, 23.69)]. Transition into Ryan White HIV/AIDS Program coverage during Medicaid gaps was common (28% of all transitions).

Conclusions:
Gaps in Medicaid enrollment were common and many individuals with pre-gap VS maintained VS after gap, possibly due to accessing other sources of antiretroviral therapy coverage. Implementing initiatives to maintain Medicaid enrollment and to expedite Medicaid reenrollment and having alternate resources available in gaps are important to ensure continuous antiretroviral therapy to optimize HIV outcomes.
High cholesterol diet modulates macrophage polarization and liver inflammation during early hepatocellular carcinoma progression in zebrafish
Authors: de Oliveira Sofia , Houseright Ruth A. , Graves Alyssa L. , Golenberg Netta , Korte Benjamin G. , Miskolci Veronika , Huttenlocher Anna 
Published: April 2018

AbstractDiabetes and obesity have been associated with nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH) and increased incidence of hepatocellular carcinoma (HCC). Here we use optically transparent zebrafish to visualize liver inflammation and disease progression in a NAFLD/NASH-HCC model. We combined a high-cholesterol diet (HCD) with a transgenic zebrafish HCC model induced by hepatocyte-specific activated β-catenin and found that diet induced an increase in liver size and enhanced angiogenesis and neutrophil infiltration in the liver. Although macrophage number was not affected by diet, HCD induced changes in macrophage morphology and polarization with an increase in liver associated TNFα-positive macrophages. Treatment with metformin altered macrophage polarization and reduced liver size in NAFLD/NASH-associated HCC larvae. Moreover, ablation of macrophages limited progression in NAFLD/NASH-associated HCC larvae but not in HCC alone. These findings suggest that HCD alters macrophage polarization and exacerbates the liver inflammatory microenvironment and cancer progression in a zebrafish model of NAFLD/NASH-associated HCC.
Pattern of severe injuries in Spanish children: boys and falls are alarmingly overrepresented
Authors: Benito Sergio , López-Parellada Rosa , Esteban Elisabeth , Hemández-Platero Lluïsa , Prat Salvi , Esparza Mireia , José Cambra Francisco , Esther Esteban Maria 
Published: April 2018

ABSTRACTBackground: Taking into account that injury is one of the main causes of child fatalities in developed countries, and that boys are more likely to suffer it than girls, we have explored a database of pediatric patients with severe injuries to determine whether sex and age influence the pattern of these fatalities, and the magnitude of this.Method: Observational study of the demographic and clinical characteristics of 227 patients from a Spanish pediatric reference hospital, all of them admitted with a diagnosis of trauma.Result: Falls are the most frequent type of trauma (60.7%), followed by pedestrian traffic collisions (15%). Boys are over-represented in falls (72% vs 28% in girls) and pedestrian traffic injuries (61% vs 39 %). In boys, falls are mainly observed in public roads and during leisure activities (53.8%) whereas in girls at home (55.2%). In a logistic regression, sex and age are statistically significant predictors of severe trauma, boys (OR = 1.59) and the adolescent age group (OR = 3.7) showed the highest odds.Conclusion: We have observed a clear gender-biased pattern of injury-related events: falls are the leading cause of injuries, with 2.5 boys for every girl. Falls mostly happened during outdoor leisure activities in boys and at home in girls. Pedestrian traffic injuries also show significant differences between sexes, emphasizing the role of cognitive and cultural factors in children’s behavior.
Aligning Needs: Integrating Citizen Science Efforts into Schools Through Service Requirements
Authors: Tsueng Ginger , Kumar Arun , Nanis Steven M. , Su Andrew I 
Published: April 2018

AbstractCitizen science is the participation in scientific research by members of the public, and it is an increasingly valuable tool for both scientists and educators. For researchers, citizen science is a means of more quickly investigating questions which would otherwise be time-consuming and costly to study. For educators, citizen science offers a means to engage students in actual research and improve learning outcomes. Since most citizen science projects are usually designed with research goals in mind, many lack the necessary educator materials for successful integration in a formal science education (FSE) setting. In an ideal world, researchers and educators would build the necessary materials together; however, many researchers lack the time, resources, and networks to create these materials early on in the life of a citizen science project. For resource-poor projects, we propose an intermediate entry point for recruiting from the educational setting: community service or service learning requirements (CSSLRs). Many schools require students to participate in community service or service learning activities in order to graduate. When implemented well, CSSLRs provide students with growth and development opportunities outside the classroom while contributing to the community and other worthwhile causes. However, CSSLRs take time, resources, and effort to implement well. Just as citizen science projects need to establish relationships to transition well into formal science education, schools need to cultivate relationships with community service organizations. Students and educators at schools with CSSLRs where implementation is still a work in progress may be left with a burdensome requirement and inadequate support. With the help of a volunteer fulfilling a CSSLR, we investigated the number of students impacted by CSSLRs set at different levels of government and explored the qualifications needed for citizen science projects to fulfill CSSLRs by examining the explicitly-stated justifications for having CSSLRs, surveying how CSSLRs are verified, and using these qualifications to demonstrate how an online citizen science project, Mark2Cure, could use this information to meet the needs of students fulfilling CSSLRs.
Automated delineation of non-small cell lung cancer
Authors: Saad Maliazurina 
Published: April 2018

AbstractPurposeThe tendencies of non-small cell lung cancers (NSCLC) to be large-sized, irregularly shaped, and to grow against the surrounding structures can cause even expert clinicians to experience difficulty with accurate segmentation.MethodsAn automated delineation tool based on spatial analysis was developed and studied on 25 sets of CT scans of primary NSCLCs with diverse radiological characteristics (sizes, shapes, contouring, localization, and microenvironment). Manual and automated gross delineations of the gross tumor were compared using a specific metric built based on spatially overlapping pixels.ResultsThe proposed algorithm exhibited robustness in terms of the tumor size (5.32–18.24 mm), shape (spherical or non-spherical), contouring (lobulated, spiculated, or cavitated), localization (solitary, pleural, mediastinal, endobronchial, or tagging), and microenvironment (left or right lobe), with sensitivity, specificity, and accuracy rates of 80–98%, 85–99%, and 84–99%, respectively.ConclusionsSmall discrepancies were observed between the manual and automated delineations. These might have risen from the variability in the practitioners’ definitions of ROIs or from imaging artifacts that reduced the tissue resolution.
How thalamic relays might orchestrate supervised deep training and symbolic computation in the brain
Authors: Hayworth Kenneth J. , Marblestone Adam H. 
Published: April 2018

AbstractThe thalamus appears to be involved in the flexible routing of information among cortical areas, yet the computational implications of such routing are only beginning to be explored. Here we create a connectionist model of how selectively gated cortico-thalamo-cortical relays could underpin both symbolic and sub-symbolic computations. We first show how gateable relays can be used to create a Dynamically Partitionable Auto-Associative Network (DPAAN) (Hayworth, 2012) consisting of a set of cross-connected cortical memory buffers. All buffers and relays in a DPAAN are trained simultaneously to have a common set of stable attractor states that become the symbol vocabulary of the DPAAN. We show via simulations that such a DPAAN can support operations necessary for syntactic rule-based computation, namely buffer-to-buffer copying and equality detection. We then provide each DPAAN module with a multilayer input network trained to map sensory inputs to the DPAAN’s symbol vocabulary, and demonstrate how gateable thalamic relays can provide recall and clamping operations to train this input network by Contrastive Hebbian Learning (CHL) (Xie and Seung, 2003). We suggest that many such DPAAN modules may exist at the highest levels of the brain’s sensory hierarchies and show how a joint snapshot of the contents of multiple DPAAN modules can be stored as a declarative memory in a simple model of the hippocampus. We speculate that such an architecture might first have been ‘discovered’ by evolution as a means to bootstrap learning of more meaningful cortical representations feeding the striatum, eventually leading to a system that could support symbolic computation. Our model serves as a bridging hypothesis for linking controllable thalamo-cortical information routing with computations that could underlie aspects of both learning and symbolic reasoning in the brain.