bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of an electronic health record structured discharge summary to provide real time adverse event reporting in thoracic surgery
Authors: Graham Andrew J , Ocampo Wrechelle , Southern Danielle A , Falvi Anthony , Sotiropoulos Dina , Wang Bruce , Lonergan Kevin , Vito Biraboneye , Ghali William A , McFadden Sean Daniel Patrick 
Published: January 2019

BackgroundThe reporting of adverse events (AE) remains an important part of quality improvement in thoracic surgery. The best methodology for AE reporting in surgery is unclear. An AE reporting system using an electronic discharge summary with embedded data collection fields, specifying surgical procedure and complications, was developed. The data are automatically transferred daily to a web-based reporting system.MethodsWe determined the accuracy and sustainability of this electronic real time data collection system (ERD) by comparing the completeness of record capture on procedures and complications with coded discharge data (administrative data), and with the standard of chart audit at two intervals. All surgical procedures performed for 2 consecutive months at initiation (Ti) and 1 year later (T1yr) were audited by an objective trained abstractor. A second abstractor audited 10% of the charts.ResultsThe ERD captured 71/72 (99%) of charts at Ti and 56/65 (86%) at T1yr. Comparing the presence/absence of complications between ERD and chart audit demonstrated at Ti a high sensitivity and specificity, positive predictive value (PPV) of 95.5%, negative predictive value (NPV) of 93.9% with a kappa of 0.872 (95% CI 0.750 to 0.994), and at T1yr a sensitivity, specificity, PPV and NPV of 100% with a kappa of 1.0 (95% CI 1.0). Comparing the presence/absence of complications between administrative data and chart audit at Ti demonstrated a low sensitivity, high specificity and a kappa of 0.471 (95% CI 0.256 to 0.686), and at T1yr a low sensitivity, high specificity of 85% and a kappa of 0.479 (95% CI 0.245 to 0.714).ConclusionsWe found that the ERD can provide accurate real time AE reporting in thoracic surgery, has advantages over previous reporting methodologies and is an alternative system for surgical clinical teams developing AE reporting systems.
Blockade of a Laminin-411–Notch Axis with CRISPR/Cas9 or a Nanobioconjugate Inhibits Glioblastoma Growth through Tumor-Microenvironment Cross-talk
Authors: Sun Tao , Patil Rameshwar , Galstyan Anna , Klymyshyn Dmytro , Ding Hui , Chesnokova Alexandra , Cavenee Webster K. , Furnari Frank B. , Ljubimov Vladimir A. , Shatalova Ekaterina S. , Wagner Shawn , Li Debiao , Mamelak Adam N. , Bannykh Serguei I. , Patil Chirag G. , Rudnick Jeremy D. , Hu Jethro , Grodzinski Zachary B. , Rekechenetskiy Arthur , Falahatian Vida , Lyubimov Alexander V. , Chen Yongmei L. , Leoh Lai S. , Daniels-Wells Tracy R. , Penichet Manuel L. , Holler Eggehard , Ljubimov Alexander V. , Black Keith L. , Ljubimova Julia Y. 
Published: January 2019

Abstract

There is an unmet need for the treatment of glioblastoma multiforme (GBM). The extracellular matrix, including laminins, in the tumor microenvironment is important for tumor invasion and progression. In a panel of 226 patient brain glioma samples, we found a clinical correlation between the expression of tumor vascular laminin-411 (α4β1γ1) with higher tumor grade and with expression of cancer stem cell (CSC) markers, including Notch pathway members, CD133, Nestin, and c-Myc. Laminin-411 overexpression also correlated with higher recurrence rate and shorter survival of GBM patients. We also showed that depletion of laminin-411 α4 and β1 chains with CRISPR/Cas9 in human GBM cells led to reduced growth of resultant intracranial tumors in mice and significantly increased survival of host animals compared with mice with untreated cells. Inhibition of laminin-411 suppressed Notch pathway in normal and malignant human brain cell types. A nanobioconjugate potentially suitable for clinical use and capable of crossing blood–brain barrier was designed to block laminin-411 expression. Nanobioconjugate treatment of mice carrying intracranial GBM significantly increased animal survival and inhibited multiple CSC markers, including the Notch axis. This study describes an efficient strategy for GBM treatment via targeting a critical component of the tumor microenvironment largely independent of heterogeneous genetic mutations in glioblastoma.

Significance: Laminin-411 expression in the glioma microenvironment correlates with Notch and other cancer stem cell markers and can be targeted by a novel, clinically translatable nanobioconjugate to inhibit glioma growth.
Postprogression Outcomes for Osimertinib versus Standard-of-Care EGFR-TKI in Patients with Previously Untreated EGFR-mutated Advanced Non–Small Cell Lung Cancer
Authors: Planchard David , Boyer Michael J. , Lee Jong-Seok , Dechaphunkul Arunee , Cheema Parneet K. , Takahashi Toshiaki , Gray Jhanelle E. , Tiseo Marcello , Ramalingam Suresh S. , Todd Alexander , McKeown Astrid , Rukazenkov Yuri , Ohe Yuichiro 
Published: January 2019

Abstract

Purpose:
In the phase III FLAURA study, third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) osimertinib significantly improved progression-free survival (PFS) versus standard-of-care (SoC) EGFR-TKI (gefitinib or erlotinib) in patients with previously untreated EGFR (exon 19 deletion or L858R) mutation-positive advanced non–small cell lung cancer (NSCLC). Interim overall survival (OS) data were encouraging, but not formally statistically significant at current maturity (25%). Here we report exploratory postprogression outcomes.

Patients and Methods:
Patients were randomized 1:1 to receive osimertinib (80 mg orally, once daily) or SoC EGFR-TKI (gefitinib 250 mg or erlotinib 150 mg, orally, once daily). Treatment beyond disease progression was allowed if the investigator judged ongoing clinical benefit. Patients receiving SoC EGFR-TKI could cross over to receive osimertinib after independently confirmed objective disease progression with documented postprogression T790M-positive mutation status.

Results:
At data cutoff (June 12, 2017), 138 of 279 (49%) and 213 of 277 (77%) patients discontinued osimertinib and SoC EGFR-TKI, respectively, of whom 82 (59%) and 129 (61%), respectively, started a subsequent treatment. Median time to discontinuation of any EGFR-TKI or death was 23.0 months [95% confidence interval (CI), 19.5–not calculable (NC)] in the osimertinib arm and 16.0 months (95% CI, 14.8–18.6) in the SoC EGFR-TKI arm. Median second PFS was not reached (95% CI, 23.7–NC) in the osimertinib arm and 20.0 months (95% CI, 18.2–NC) in the SoC EGFR-TKI arm [hazard ratio (HR), 0.58; 95% CI, 0.44–0.78; P = 0.0004].

Conclusions:
All postprogression endpoints showed consistent improvement with osimertinib versus SoC EGFR-TKI, providing further confidence in the interim OS data.
A prática do manual do proprietário da edificação: uma classificação conforme a NBR14037
Authors: Moreira Lorena Claudia de Souza , Tonoli Julio Gattei , Ruschel Regina Coeli 
Published: January 2019

A qualificação da documentação técnica produzida é relevante para potencializar a comunicação no processo ao longo das etapas de projeto e execução. Neste contexto, o Manual de uso, operação e manutenção das edificações, também conhecido como Manual do Proprietário (MP), é o documento que contempla todas as informações necessárias para guiar as atividades de manutenibilidade e uso da edificação. Dessa forma, o Manual do Proprietário é um documento essencial para o esclarecimento de dúvidas relativas a edificação. De acordo com a Associação Brasileira de Normas Técnicas (ABNT) a NBR 14037 - Diretrizes para elaboração de manuais de uso, operação e manutenção das edificações - Requisitos para elaboração e apresentação dos conteúdos - tem por finalidade orientar os usuários da edificação sobre suas características técnicas; recomendar procedimentos no intuito de uma melhor utilização da edificação; propor atividades de manutenção; precaver o surgimento de falhas e acidentes decorrentes do mau uso e contribuir para a longevidade da edificação. Assim sendo, este artigo tem como objetivo classificar os manuais do proprietário segundo as recomendações da NBR 14037, sua forma de desenvolvimento, formato de entrega e tipo do manual de acordo com o uso e padrão da edificação. O método de pesquisa empregado foi o levantamento. Como contribuição, são apresentados os resultados do levantamento realizado por região do país, por padrão da edificação e por item da NBR 14037. Na verificação de aderência dos manuais à NBR 14037, constatou-se que os itens do manual não têm uma abordagem igualitária e, pontualmente, o quesito manutenção requer um maior cuidado por parte das construtoras e incorporadoras pesquisadas. Comprovou-se que o conteúdo que envolve garantias e assistência técnica obteve a melhor classificação, entre os manuais de proprietário apresentados, estando respaldado pelo Código de Defesa do Consumidor. Ademais, observou-se uma maior recorrência do manual impresso, desenvolvido pela própria construtora e uma distinção do manual de acordo com o uso e padrão da edificação. Por fim, conclui-se que o manual do proprietário, no levantamento realizado, apresenta deficiências que demandam melhorias tanto na forma de apresentação, quanto na mídia e no seu conteúdo.
Dinâmicas de Apoio ao Processo de Projeto Arquitetônico: a experiência com o Baralho da Escola no ambiente de ensino de projeto.
Authors: Deliberador Marcella Savioli , Kowaltowski Doris Catharine Cornelie Knatz , Taralli Cibele H. 
Published: January 2019

Os estudos sobre o processo de projeto em arquitetura permanecem como foco das pesquisas cujo enfoque é a melhoria da qualidade do edifício construído. Pesquisas recentes continuam avançando nos estudos sobre as questões cognitivas do cérebro humano e podem colaborar para o entendimento do processo criativo, inclusive na área de projeto arquitetônico. Diversas e novas formas de apoio às etapas do processo de projeto em arquitetura vem sendo estudadas, dando atenção às questões da cognição, da criatividade, da colaboração, da organização da informação e da produtividade e gestão das etapas, com o objetivo de melhorar a qualidade do produto final. Este artigo apresenta um estudo desenvolvido como parte do doutorado de uma das autoras sobre a importância da utilização dessas novas formas de apoio ao processo de projeto, levantando dinâmicas capazes de colaborar com o ambiente de ensino de projeto. Tais dinâmicas mostram-se dispersas pela literatura e em formatos variados, como jogos de tabuleiro, de cartas, grupos focais, brainstormings, ferramentas eletrônicas, entre outras. Apresenta-se revisão bibliográfica sobre essas técnicas disponíveis e a experiência de uso do jogo Baralho da Escola- Desembaralhando a Arquitetura Escolar no ambiente de ensino foi selecionada como estudo de caso para esta pesquisa. Testes com essa ferramenta foram utilizados com alunos de terceiro ano de arquitetura e urbanismo, da Universidade de São Paulo e sua utilização mostrou-se muito favorável, facilitando o aprendizado de programa arquitetônico. O formato do jogo propiciou maior foco dos participantes, por meio de uma discussão ampla e bastante produtiva. A experiência com a ferramenta do Baralho da Escola demonstrou que dinâmicas desse tipo podem ser incluídas no ambiente de ensino, tornando mais efetivo o ensino de conceitos através de maneiras mais criativas e engajadoras, facilitam o aprendizado.
Regional Decadal Climate Predictions Using an Ensemble of WRF Parameterizations Driven by the MIROC5 GCM
Authors: Strobach Ehud , Bel Golan 
Published: January 2019

AbstractRegional climate models (RCMs) are expected to provide better representations of the climate dynamics because of their higher spatial resolutions. Here, we generated an ensemble of decadal (2006–36) RCM predictions for the area of Israel, which spans a considerable climatic gradient and comprises complex terrain. We used the WRF Model forced by the MIROC5 global climate model (GCM). The ensemble was generated by choosing different combinations of radiation, microphysics, surface layer, and planetary boundary layer parameterizations. The simulation results were compared with meteorological station data for the first simulated decade. For the minimum surface temperature, all the RCM configurations performed better than the driving GCM, while for the maximum surface temperature, only three out of eight configurations improved the predictions. The RCM configurations had higher errors in predicting the precipitation, but four configurations had comparable errors to the GCM. For the next two decades, the ensemble average predicts an increase of 0.51° and 0.40°C decade−1 for the average daily minimum and maximum surface temperatures, respectively. No significant change is predicted in the precipitation. We found that all the parameterizations affect the predictions of the surface temperatures and precipitation [e.g., the CAM radiation scheme simulates colder temperatures than the RRTM for GCMs (RRTMG)] but the PBL and surface layer scheme has the largest effect on the errors. Spectral nudging was found to have a considerable effect on the deviations of the precipitation predicted by the WRF configurations from the predictions of the GCM and a much smaller effect on the surface temperature predictions.
Steep Posterior Tibial Slope, Anterior Tibial Subluxation, Deep Posterior Lateral Femoral Condyle, and Meniscal Deficiency Are Common Findings in Multiple Anterior Cruciate Ligament Failures: An MRI Case-Control Study
Authors: Grassi Alberto , Macchiarola Luca , Urrizola Barrientos Francisco , Zicaro Juan Pablo , Costa Paz Matias , Adravanti Paolo , Dini Francesco , Zaffagnini Stefano 
Published: January 2019

Background: Tibiofemoral anatomic parameters, such as tibial slope, femoral condyle shape, and anterior tibial subluxation, have been suggested to increase the risk of anterior cruciate ligament (ACL) reconstruction failure. However, such features have never been assessed among patients experiencing multiple failures of ACL reconstruction. Purpose: To compare the knee anatomic features of patients experiencing a single failure of ACL reconstruction with those experiencing multiple failures or with intact ACL reconstruction. Study: Case-control study; Level of evidence, 3. Methods: Twenty-six patients who experienced failure of revision ACL reconstruction were included in the multiple-failure group. These patients were matched to a group of 25 patients with failure of primary ACL reconstruction and to a control group of 40 patients who underwent primary ACL reconstruction with no failure at a minimum follow-up of 24 months. On magnetic resonance imaging (MRI), the following parameters were evaluated: ratio between the height and depth of the lateral and medial femoral condyles, the lateral and medial tibial plateau slopes, and anterior subluxation of the lateral and medial tibial plateaus with respect to the femoral condyle. The presence of a meniscal lesion during each procedure was evaluated as well. Anatomic, demographic, and surgical characteristics were compared among the 3 groups. Results: The patients in the multiple-failure group had significantly higher values of lateral tibial plateau slope ( P < .001), medial tibial plateau slope ( P < .001), lateral tibial plateau subluxation ( P < .001), medial tibial plateau subluxation ( P < .001), and lateral femoral condyle height/depth ratio ( P = .038) as compared with the control group and the failed ACL reconstruction group. Moreover, a significant direct correlation was found between posterior tibial slope and anterior tibial subluxation for the lateral ( r = 0.325, P = .017) and medial ( r = 0.421, P < .001) compartments. An increased anterior tibial subluxation of 2 to 3 mm was present in patients with a meniscal defect at the time of the MRI as compared with patients who had an intact meniscus for both the lateral and the medial compartments. Conclusion: A steep posterior tibial slope and an increased depth of the lateral femoral condyle represent a common finding among patients who experience multiple ACL failures. Moreover, higher values of anterior subluxation were found among patients with repeated failure and those with a medial or lateral meniscal defect.
Allostatic Load and Biomarkers of Stress in the Preterm Infant: An Integrative Review
Authors: Casavant Sharon G. , Cong Xiaomei , Fitch Roslyn H. , Moore James , Rosenkrantz Ted , Starkweather Angela 
Published: January 2019

Background: Every year, an estimated 15 million babies are born preterm (<37 weeks’ gestational age) globally. These preterm infants are exposed to repeated stressful and often painful procedures as part of routine life-saving care within the neonatal intensive care unit (NICU). Low thresholds for tactile and nociceptive input make it more difficult for neonates to discriminate between noxious and nonnoxious stimuli, which can result in continuous activation of stress responses in an attempt to achieve stability through adaptation, or allostasis. Rapidly reoccurring stressors can render stress-response systems over- or underactive, creating wear and tear, or allostatic load. A better understanding of biomarkers related to allostatic load might aid in early detection and prevention/alleviation of allostatic load in this population. Purpose: To identify stress biomarkers that have been studied in preterm infants at different time points in the NICU and as long-term outcome measures. Method/search Strategy: Systematic searches were conducted of PubMed, CINAHL, SCOPUS, and PsychInfo databases. Findings/results: Twenty-one studies met inclusion criteria for this review. Several putative biomarkers were identified, including cortisol levels, epigenetic markers, brain microstructure, markers of oxidative stress, and the brain–gut–microbiome axis. Conclusion: The interaction of disease with therapeutic interventions may inadvertently increase infant allostatic load. In addition to human studies, future research should leverage newly available large data sets to conduct additional analyses.
Minimal clinically important difference of improvement on the Arm Function in Multiple Sclerosis Questionnaire (AMSQ)
Authors: van Munster Caspar EP , Kaya Levent , Obura Morgan , Kalkers Nynke F , Uitdehaag Bernard MJ 
Published: January 2019

Background: The Arm Function in Multiple Sclerosis Questionnaire (AMSQ) has been developed to assess upper extremity function of patients with multiple sclerosis (MS). A minimal clinically important difference (MCID) value has not been determined yet. Objective: The objective of this study is to determine an MCID for AMSQ. Methods: We used the sensitivity- and specificity-based approach with dichotomized global perceived effect as an anchor. Results: The receiver operating characteristic (ROC) curve yielded an optimal threshold value of 14.5 (sensitivity 0.68 and specificity 0.79). The area under the ROC curve value was 0.77. Conclusion: We identified an MCID of 15 points for the AMSQ (range 31–186).
How do patients enter the healthcare system after the first onset of multiple sclerosis symptoms? The influence of setting and physician specialty on speed of diagnosis
Authors: Barin Laura , Kamm Christian P , Salmen Anke , Dressel Holger , Calabrese Pasquale , Pot Caroline , Schippling Sven , Gobbi Claudio , Müller Stefanie , Chan Andrew , Rodgers Stephanie , Kaufmann Marco , Ajdacic-Gross Vladeta , Steinemann Nina , Kesselring Jürg , Puhan Milo A , von Wyl Viktor ,   for the Swiss Multiple Sclerosis Registry
Published: January 2019

Background: Diagnosing multiple sclerosis (MS) early is crucial to avoid future disability. However, potentially preventable delays in the diagnostic cascade from contact with a physician to definite diagnosis still occur and their causes are still unclear. Objective: To identify the possible causes of delays in the diagnostic process. Methods: We analyzed the data of the Swiss MS Registry. With logistic regression, we modeled the time from the first contact to the first consultation (contact-to-evaluation time, ⩽1 month/>1 month) and the evaluation-to-diagnosis time (⩽6 months/>6 months). Potential factors were health system characteristics, sociodemographic variables, first symptoms, and MS type. Results: We included 522 participants. Mostly, general practitioners (67%) were contacted first, without delaying the diagnosis. In contrast, first symptoms and MS type were the major contributors to delays: gait problems were associated with longer contact-to-evaluation times, depression as a concomitant symptom with longer evaluation-to-diagnosis times, and having primary progressive MS prolonged both phases. In addition, living in mountainous areas was associated with longer contact-to-evaluation times, whereas diagnosis after 2000 was associated with faster diagnoses. Conclusion: For a quicker diagnosis, awareness of MS as a differential diagnosis of gait disorders and the co-occurrence of depression at onset should be raised, and these symptoms should be attentively followed.
Health Care Going Online: Help Seeking Behavior by Patients for Sexual Problems—Analysis of Online Queries on Sexual Health
Authors: Deshpande Sandip , Aiyappa Jaya , Mishra Sadhana , Naik Seema , Jain Samiksha , Rajesh Mamtha , Padhye Snehal , Kunte Hemal , Bhat Vidya 
Published: January 2019

Background and Objective: Health care industry is going through a renaissance with the advances in mobile Internet technology. Health care seeking has become easier for people and there are multiple providers offering online consultations and counselling. Sexual medicine is still an unrecognized specialty in India. People suffering from sexual health problems and dysfunctions have a lot of stigma approaching health care professionals. With the coming in of Internet-based services, people are finding it easier to seek help online anonymously. As an industry this is likely to continue to grow and offer opportunities to people in distress to seek help. Methodology: In the present study, we have done a retrospective analysis of 500 queries that were posted privately to the principal author. Results focused on the demographic details, the nature of the problem and an analysis of the content of the queries. The study discusses how the findings may be used to better understand the perceptions, concerns, and stated needs of people accessing online portals for sexual problems. This should also help equip counsellors interested in this field. Results: The study clearly brought out the gender differences among those accessing online health care portals for sexual issues. A majority of the queries were from men asking about issues related to size and curvature of penis, masturbation, premature ejaculation, erectile dysfunction. Many of these queries stemmed from the lack of correct scientific knowledge which led to health anxieties including frustration, depression, and low self-esteem.