bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identifying Children with Special Health Care Needs Using Medicaid Data in New York State Medicaid Managed Care
Authors: Miller Lauren S. , Wu Meng , Schettine Anne M. , Cogan Lindsay W. 
Published: September 2018

ObjectiveThe ability to identify children with special health care needs (CSHCN) is crucial to evaluate disparities in the quality of health care for children in Medicaid Managed Care. We developed and assessed the accuracy of a new method to classify CSHCN.Data SourcesSecondary data analysis was conducted using NYS Medicaid administrative data and the Children with Chronic Conditions Screener (CCC Screener).Study DesignThis study included 5,907 NYS Medicaid beneficiaries (17 years old or younger) whose parents completed the CCC Screener in 2014. Medicaid administrative data were used to create a risk score to assess the risk of special needs, and a cut point was identified to differentiate between children with versus without special needs. Diagnostic accuracy of the method was assessed using sensitivity and specificity analyses.Principal FindingsApplying the CCC Screener as the “gold standard,” the risk score correctly classified the majority of CSHCN as positive (sensitivity = 75 percent) and the majority of the children without special needs as negative (specificity = 79 percent). This method demonstrated decent diagnostic ability (AUC = 0.77).ConclusionsOur method can identify CSHCN in the NYS Medicaid Managed Care population and will help the State monitor the quality of care for this vulnerable population.
Predictive modeling of housing instability and homelessness in the Veterans Health Administration
Authors: Byrne Thomas , Montgomery Ann Elizabeth , Fargo Jamison D. 
Published: September 2018

ObjectiveTo develop and test predictive models of housing instability and homelessness based on responses to a brief screening instrument administered throughout the Veterans Health Administration (VHA).Data Sources/Study SettingElectronic medical record data from 5.8 million Veterans who responded to the VHA's Homelessness Screening Clinical Reminder (HSCR) between October 2012 and September 2015.Study DesignWe randomly selected 80% of Veterans in our sample to develop predictive models. We evaluated the performance of both logistic regression and random forests—a machine learning algorithm—using the remaining 20% of cases.Data Collection/Extraction MethodsData were extracted from two sources: VHA's Corporate Data Warehouse and National Homeless Registry.Principal FindingsPerformance for all models was acceptable or better. Random forests models were more sensitive in predicting housing instability and homelessness than logistic regression, but less specific in predicting housing instability. Rates of positive screens for both outcomes were highest among Veterans in the top strata of model‐predicted risk.ConclusionsPredictive models based on medical record data can identify Veterans likely to report housing instability and homelessness, making the HSCR screening process more efficient and informing new engagement strategies. Our findings have implications for similar instruments in other health care systems.
Spatial and Scope Effects: Valuations of Coastal Management Practices
Authors: Spencer‐Cotton Alaya , Kragt Marit E. , Burton Michael 
Published: September 2018

AbstractWe explore how values for environmental management in the Kimberley region of Australia respond to changes in spatial scale and attribute scope. A discrete choice experiment was conducted that included the impacts of management on marine no‐take areas, Aboriginal rangers, recreational facilities, and coastal development. A split sample single‐site design was used to estimate values for the Kimberley region as a whole, and for two separate smaller sub‐regions, allowing us to test for spatial preference heterogeneity. Management outcomes for different regions were displayed on a map to show respondents explicitly where outcomes would occur. We show that willingness to pay results are similar between the two smaller sub‐regions, and that willingness to pay for the attributes increased when management occurred at the larger geographical scale. However, respondents were somewhat insensitive to changes in the scope of the two cardinal attributes: area of no‐take and number of rangers. We discuss the implications of this spatial and scope insensitivity for choice experiment research.
Association of Low Serum Potassium Levels and Risk for All‐Cause Mortality in Patients With Chronic Kidney Disease: A Systematic Review and Meta‐Analysis
Authors: Zhang Ying , Chen Ping , Chen Juan , Wang Li , Wei Yong , Xu Dongmei 
Published: September 2018

AbstractDyskalemia is a risk factor for mortality in patients without CKD, but the effect of hypokalemia in patients with CKD remains uncertain. PubMed, Embase, Cochrane, and Ovid databases were searched from inception to December 31, 2017 for studies that reported all‐cause and cardiovascular mortality or events in patients with CKD (any stage). Pooled hazard ratios (HR) and corresponding 95% CI were calculated. A total of 11 clinical studies enrolling 57 234 subjects with CKD were included in the meta‐analysis. Compared with control serum potassium (SK) levels, low SK (SK <4.0 mEq/L) was associated with higher risk of all‐cause mortality in a random‐effects model (HR = 1.57; 95% CI: 1.25–1.97). Moderate low SK (<3.5 mEq/L) increased risk of all‐cause mortality by 105%. Mild low SK (3.5~4.0 mEq/L) also increased all‐cause mortality risk (HR = 1.18, 95% CI: 1.11–1.26). Low SK was also associated with increased cardiovascular mortality (HR = 1.40, 95% CI: 1.22–1.62) and ESRD risk (HR = 1.35, 95% CI: 1.18–1.54). SK <4.0 mEq/L was associated with higher mortality risk in CKD patients, especially in those with SK <3.5 mEq/L. Additional prospective studies will be necessary to explore this relationship, as well as whether correcting hypokalemia decreases mortality in patients with CKD.
Plasma Exchange Downregulates Activated Monocytes and Restores Regulatory T Cells in Kawasaki Disease
Authors: Koizumi Keiichi , Hoshiai Minako , Moriguchi Takeshi , Katsumata Nobuyuki , Toda Takako , Kise Hiroaki , Hasebe Yohei , Kono Yosuke , Sunaga Yuto , Yoshizawa Masashi , Watanabe Atsushi , Harii Norikazu , Goto Junko , Kagami Keiko , Abe Masako , Matsuda Kenichi , Sugita Kanji 
Published: September 2018

AbstractIn Kawasaki disease (KD), the effect of plasma exchange (PE) on immune cells has not been fully elucidated. Therefore, we examined the changes in the number of CD14+ CD16+ activated monocytes, regulatory T (Treg), and T‐helper type 17 (Th17) cells in KD patients treated with PE. The percentage of total monocytes and subclasses of lymphocytes, including CD4+ and CD8+ T cells, and CD19+ B cells, showed no significant difference before and after PE. However, the percentage of CD14+ CD16+ monocytes in total leukocytes decreased significantly after PE (1.1% ± 1.5% vs. 2.1% ± 2.3%, P < 0.05). Furthermore, while the percentage of Th17 cells in CD4+ T cells did not change, the percentage of Treg cells in CD4+ T cells increased significantly after PE (11.1% ± 5.1% vs. 8.0% ± 4.4%, P < 0.05). Therefore, PE downregulates activated monocytes and upregulates Treg cells toward normal levels and thus attenuates inflammation in KD.
Byproduct Generated During the Elaboration Process of Isotonic Beverage as a Natural Source of Bioactive Compounds
Authors: Gonçalves E.C.B.A. , Lozano‐Sanchez J. , Gomes S. , Ferreira M.S.L. , Cameron L.C. , Segura‐Carretero A. 
Published: September 2018

AbstractAgro‐industrial byproducts are considered good sources of macronutrients and phytochemicals. Fruit and vegetable residues (FVR), obtained after the production of an isotonic beverage, have previously been characterized containing 80% insoluble dietary fibers from total fibers (48.4%), 26% available carbohydrates, 9.5% proteins and 5% lipids. Nevertheless, fruit and vegetables provide phytochemicals which have been related to human health such as phenolic compounds. The loss of specific compounds over the production process is related to their partitioning between fruit and vegetables and byproducts. However, phenolic profile of FVR remains unknown. This work is focused on the evaluation of FVR as a natural source of these bioactive compounds. For this purpose, pressurized liquid extraction (PLE) has been proposed as extraction technique for recovering phenolic compounds from FVR. The experimental variables were temperature and percentage of solvent (ethanol and water). Phenolic compounds extracts were characterized by UPLC‐ESI‐Q‐TOF‐MS and a discussion about phenolic and macronutrient interactions was established. Globally, 88 compounds were tentatively identified: phenolic acids (28), flavonoids (32), and other polyphenols (28). The PLE conditions applied yielded different breaking matrix‐analyte interactions leading to an increase in the number of compounds. The highest phenolic acids content was achieved with high temperature while lower temperatures were more efficient in extracting flavonoid. By establishing the phenolics profile in food byproducts such as FVR, it is possible to more effectively apply these byproducts as nutraceutical, food or pharmaceutical ingredients.Practical ApplicationFlow diagram of bioactive compounds recovering from isotonic beverage byproduct is proposed using pressurized liquid extraction. The plant‐bioactives mechanism relies on fruit and vegetable byproducts changes under different extraction conditions. The obtained extracts can most effectively be applied as nutraceuticals or as ingredients in food or pharmaceutical inputs.
Introducing ribosomal tandem repeat barcoding for fungi
Authors: Wurzbacher Christian , Larsson Ellen , Bengtsson‐Palme Johan , Van den Wyngaert Silke , Svantesson Sten , Kristiansson Erik , Kagami Maiko , Nilsson R. Henrik 
Published: September 2018

AbstractSequence comparison and analysis of the various ribosomal genetic markers are the dominant molecular methods for identification and description of fungi. However, new environmental fungal lineages known only from DNA data reveal significant gaps in our sampling of the fungal kingdom in terms of both taxonomy and marker coverage in the reference sequence databases. To facilitate the integration of reference data from all of the ribosomal markers, we present three sets of general primers that allow for amplification of the complete ribosomal operon from the ribosomal tandem repeats. The primers cover all ribosomal markers: ETS, SSU, ITS1, 5.8S, ITS2, LSU and IGS. We coupled these primers successfully with third‐generation sequencing (PacBio and Nanopore sequencing) to showcase our approach on authentic fungal herbarium specimens (Basidiomycota), aquatic chytrids (Chytridiomycota) and a poorly understood lineage of early diverging fungi (Nephridiophagidae). In particular, we were able to generate high‐quality reference data with Nanopore sequencing in a high‐throughput manner, showing that the generation of reference data can be achieved on a regular desktop computer without the involvement of any large‐scale sequencing facility. The quality of the Nanopore generated sequences was 99.85%, which is comparable with the 99.78% accuracy described for Sanger sequencing. With this work, we hope to stimulate the generation of a new comprehensive standard of ribosomal reference data with the ultimate aim to close the huge gaps in our reference datasets.
A dedicated target capture approach reveals variable genetic markers across micro‐ and macro‐evolutionary time scales in palms
Authors: de La Harpe Marylaure , Hess Jaqueline , Loiseau Oriane , Salamin Nicolas , Lexer Christian , Paris Margot 
Published: September 2018

AbstractUnderstanding the genetics of biological diversification across micro‐ and macro‐evolutionary time scales is a vibrant field of research for molecular ecologists as rapid advances in sequencing technologies promise to overcome former limitations. In palms, an emblematic, economically and ecologically important plant family with high diversity in the tropics, studies of diversification at the population and species levels are still hampered by a lack of genomic markers suitable for the genotyping of large numbers of recently diverged taxa. To fill this gap, we used a whole genome sequencing approach to develop target sequencing for molecular markers in 4,184 genome regions, including 4,051 genes and 133 non‐genic putatively neutral regions. These markers were chosen to cover a wide range of evolutionary rates allowing future studies at the family, genus, species and population levels. Special emphasis was given to the avoidance of copy number variation during marker selection. In addition, a set of 149 well‐known sequence regions previously used as phylogenetic markers by the palm biological research community were included in the target regions, to open the possibility to combine and jointly analyse already available data sets with genomic data to be produced with this new toolkit. The bait set was effective for species belonging to all three palm sub‐families tested (Arecoideae, Ceroxyloideae and Coryphoideae), with high mapping rates, specificity and efficiency. The number of high‐quality single nucleotide polymorphisms (SNPs) detected at both the sub‐family and population levels facilitates efficient analyses of genomic diversity across micro‐ and macro‐evolutionary time scales.
Applicability and Clinical Validity of Nursing Outcomes Classification in a Nursing Intervention of Nutritional Counseling for Patients With Malnutrition
Authors: Vázquez‐Sánchez María Ángeles , Valero‐Cantero Inmaculada , Carrión‐Velasco Yolanda , Castro‐López Pilar , Suárez‐Cadenas Ernesto , Casals Cristina 
Published: September 2018

PURPOSETo determine the applicability of the Nursing Outcomes Classification (NOC) after nutritional counseling intervention in malnourished patients.METHODSProspective, randomized, open‐label study in 106 hospital patients with malnutrition. The NOC indicators evaluated were 162202 and 180201.FINDINGSThe intervention group significantly increased both NOC indicator scores compared with the control group, these indicators significantly correlated with body mass index, Malnutrition Universal Screening Tool, and Barthel's Index.CONCLUSIONThe NOC indicators are sensitive to patients’ changes in clinical practice, and correlate well with other indicators in this context.IMPLICATIONS FOR NURSING PRACTICEThe NOC can be used to assess malnourished patients in the clinical setting.
Development of a Novel Computerized Clinical Decision Support System to Improve Adolescent Sexual Health Care Provision
Authors: Miller Melissa K. , Mollen Cynthia , Behr Kelli , Dowd M. Denise , Miller Elizabeth , Satterwhite Catherine L. , Stancil Stephani , Allen Nancy , Michael Jeffery , Inboriboon P. Charles , Park Andrew , Goggin Kathy 
Published: September 2018

AbstractObjectiveThe objective was to develop an acceptable clinical decision support (CDS) system to facilitate evidence‐based sexual health care for adolescents in the emergency department (ED).MethodsIn this multiphased iterative process, we engaged an expert group to synthesize evidence on a wide range of sexual health services (e.g., contraception, condoms, identification and treatment of previously diagnosed sexually transmitted infection). We created a computerized questionnaire and embedded our decision tree, utilizing patient‐entered responses to create tailored, evidence‐based recommendations, and embedded links to study‐related resources such as the emergency contraception (EC) quick guide. We utilized mixed methodology to explore perspectives of adolescents aged 14 to 19 years and clinicians at two general and two pediatric EDs after they interacted with the system. Clinicians reported usefulness (Likert scale 1 = not at all, 4 = very); adolescents reported acceptability. We used the chi‐square test to compare responses between subgroups. We collected adolescents’ verbatim responses to open‐ended questions; clinicians self‐entered responses. Four authors independently generated themes from qualitative responses before compiling key findings and achieving consensus on final themes.ResultsAmong 57 clinicians (23 physicians, 23 nurses, 11 nurse practitioners; 54% female; 65% aged < 40 years), the mean system usefulness rating was 3.4 ± 0.7. Sex, age, clinician role, or ED type were not associated with rating the system “somewhat/very” useful. Clinicians identified barriers (e.g., time constraints) that could be overcome by implementation considerations (e.g., training) as well as benefits including improved care. For future assessments, providers preferred computer (65%) over face‐to‐face interview (26%). Among 57 adolescents (mean age = 16.2 years; 75% female; 56% sexually experienced), nearly all (95%) reported that it was “very/somewhat easy” to complete the computerized questionnaire and to understand the questions. Most adolescents understood the EC quick guide and correctly identified that ulipristal, compared to levonorgestrel, required a prescription and was more effective. For future assessments, adolescents preferred computer (69%) over face‐to‐face interviews (9%).ConclusionsWe developed a sexual health CDS system that is easy to use and can facilitate evidence‐based care to reduce health outcome gaps. Evaluation of system impact on service delivery and, ultimately, health outcomes is needed.
Identifying a neuroanatomical signature of schizophrenia, reproducible across sites and stages, using machine learning with structured sparsity
Authors: de Pierrefeu A. , Löfstedt T. , Laidi C. , Hadj‐Selem F. , Bourgin J. , Hajek T. , Spaniel F. , Kolenic M. , Ciuciu P. , Hamdani N. , Leboyer M. , Fovet T. , Jardri R. , Houenou J. , Duchesnay E. 
Published: September 2018

ObjectiveStructural MRI (sMRI) increasingly offers insight into abnormalities inherent to schizophrenia. Previous machine learning applications suggest that individual classification is feasible and reliable and, however, is focused on the predictive performance of the clinical status in cross‐sectional designs, which has limited biological perspectives. Moreover, most studies depend on relatively small cohorts or single recruiting site. Finally, no study controlled for disease stage or medication's effect. These elements cast doubt on previous findings’ reproducibility.MethodWe propose a machine learning algorithm that provides an interpretable brain signature. Using large datasets collected from 4 sites (276 schizophrenia patients, 330 controls), we assessed cross‐site prediction reproducibility and associated predictive signature. For the first time, we evaluated the predictive signature regarding medication and illness duration using an independent dataset of first‐episode patients.ResultsMachine learning classifiers based on neuroanatomical features yield significant intersite prediction accuracies (72%) together with an excellent predictive signature stability. This signature provides a neural score significantly correlated with symptom severity and the extent of cognitive impairments. Moreover, this signature demonstrates its efficiency on first‐episode psychosis patients (73% accuracy).ConclusionThese results highlight the existence of a common neuroanatomical signature for schizophrenia, shared by a majority of patients even from an early stage of the disorder.
A scoping review of caries risk management protocols in Australia and New Zealand
Authors: Amarasena N , Haag D , Peres KG 
Published: September 2018

AbstractTo identify and map the caries risk management protocols with multiple strategies, which were used in Australia and New Zealand and reported in the existing literature, a scoping review was carried out by electronically searching PubMed, Web of Science, Scopus, Embase and Dentistry and Oral Science. Studies on caries risk management protocols, written in English, limited to Australia and New Zealand and published up to March 2018 were included in the review. There was no restriction on participants’ age. Of 257 studies identified, seven were included in the review. These seven studies were reported in Australia and all but six were based on the caries management system (CMS). There were two descriptive studies, one 3‐year multicentre cluster randomized controlled trial (RCT), one 2 to 4‐year post‐RCT follow‐up and two cost‐effective evaluations based on Markov decision analytic models. While concentrating on assessing individual behavioural risk factors for dental caries, studies indicated that the CMS would be more cost‐effective if its protocol was properly adhered to. Future studies on caries risk management protocols are suggested to consider both the individual characteristics and the social context of different population groups in view of enhancing the effectiveness of oral care.
Negative or positive density‐dependence in movements depends on climatic seasons: The case of a Neotropical marsupial
Authors: Delciellos Ana Cláudia , Prevedello Jayme Augusto , Ribeiro Suzy Emidio , Cerqueira Rui , Vieira Marcus Vinícius 
Published: September 2018

AbstractOne of the major challenges in animal ecology is to understand the factors and processes driving movement behaviour. Although density may influence movement patterns, the occurrence and nature of density‐dependence in animal movements are still unclear, particularly whether it may vary among populations of a species, or across time within a population. Here, we evaluate the occurrence and nature of density‐dependence in the movements of a Neotropical marsupial, the Grey four‐eyed opossum Philander frenatus (Didelphidae, Didelphimorphia). We quantified fine‐scale path tortuosity of individuals inhabiting continuous forest areas and forest fragments, in different climatic seasons (humid vs. super‐humid). We also determined the relative importance of population size compared to sex and body mass on movements, using a model‐selection approach. In forest fragments, path tortuosity increased with population size in the super‐humid season, but decreased in the humid season. In the continuous forest, path tortuosity was affected only by sex and body mass, being slightly higher in males and negatively related to body mass. The occurrence of density‐dependence on movements only in forest fragments is likely to reflect the higher overall density of P. frenatus in small forest fragments. The variation in the nature of density‐dependence between climatic seasons is likely to reflect a trade off between foraging over large areas (humid season, low resource availability) versus avoiding agonistic encounters (super‐humid season, high resource availability). Our results show that (i) density‐dependence in movements may be context‐dependent occurring only in areas of relatively high overall population density; and (ii) density may affect movements in different ways at different climatic seasons.
Changes in resuscitation and end‐of‐life documentation in older patients’ clinical case notes: A comparison of 2011 and 2017 practice
Authors: Dignam Colette , Brown Margaret , Thompson Campbell H 
Published: September 2018

ObjectiveTo compare 2011 and 2017 documentation of resuscitation decisions in older patients, including the frequency and clarity of documentation.MethodsThe clinical case notes of 130 patients aged 70 years and over were examined to identify how resuscitation decisions are discussed and documented at a major teaching hospital. Results were compared to 2011 data.ResultsThe proportion of patients with a documented order significantly increased, from 34 to 63%, with a concurrent increased number of patients identified as Not For Cardiopulmonary Resuscitation (Not for CPR). The standardised documentation has also improved rates of documented discussion, legibility and identification of the involved doctor.ConclusionThe Resuscitation Plan 7‐Step Pathway has markedly improved the frequency of documented discussion, the rate of recorded Not For CPR status and clarity of documentation. There is scope for improvement as this policy is embraced across South Australia.