bluuebunny/crossref_metadata_2025_split huggingface dataset:
Death Certification Errors and the Effect on Mortality Statistics
Authors: McGivern Lauri , Shulman Leanne , Carney Jan K. , Shapiro Steven , Bundock Elizabeth 
Published: November 2017

Objective: Errors in cause and manner of death on death certificates are common and affect families, mortality statistics, and public health research. The primary objective of this study was to characterize errors in the cause and manner of death on death certificates completed by non–Medical Examiners. A secondary objective was to determine the effects of errors on national mortality statistics. Methods: We retrospectively compared 601 death certificates completed between July 1, 2015, and January 31, 2016, from the Vermont Electronic Death Registration System with clinical summaries from medical records. Medical Examiners, blinded to original certificates, reviewed summaries, generated mock certificates, and compared mock certificates with original certificates. They then graded errors using a scale from 1 to 4 (higher numbers indicated increased impact on interpretation of the cause) to determine the prevalence of minor and major errors. They also compared International Classification of Diseases, 10th Revision (ICD-10) codes on original certificates with those on mock certificates. Results: Of 601 original death certificates, 319 (53%) had errors; 305 (51%) had major errors; and 59 (10%) had minor errors. We found no significant differences by certifier type (physician vs nonphysician). We did find significant differences in major errors in place of death ( P < .001). Certificates for deaths occurring in hospitals were more likely to have major errors than certificates for deaths occurring at a private residence (59% vs 39%, P < .001). A total of 580 (93%) death certificates had a change in ICD-10 codes between the original and mock certificates, of which 348 (60%) had a change in the underlying cause-of-death code. Conclusions: Error rates on death certificates in Vermont are high and extend to ICD-10 coding, thereby affecting national mortality statistics. Surveillance and certifier education must expand beyond local and state efforts. Simplifying and standardizing underlying literal text for cause of death may improve accuracy, decrease coding errors, and improve national mortality statistics.
A Generic Simulation Model of the Relative Cost-Effectiveness of ICU Versus Step-Down (IMCU) Expansion
Authors: Mahmoudian-Dehkordi Amin , Sadat Somayeh 
Published: November 2017

Background: Many jurisdictions are facing increased demand for intensive care. There are two long-term investment options: intensive care unit (ICU) versus step-down or intermediate care unit (IMCU) capacity expansion. Relative cost-effectiveness of the two investment strategies with regard to patient lives saved has not been studied to date. Methods: We expand a generic system dynamics simulation model of emergency patient flow in a typical hospital, populated with empirical evidence found in the medical and hospital administration literature, to estimate the long-term effects of expanding ICU versus IMCU beds on patient lives saved under a common assumption of 2.1% annual increase in hospital arrivals. Two alternative policies of expanding ICU by two beds versus introducing a two-bed IMCU are compared over a ten-year simulation period. Russel equation is used to calculate total cost of patients’ hospitalization. Using two possible values for the ratio of ICU to IMCU cost per inpatient day and four possible values for the percentage of patients transferred from ICU to IMCU found in the literature, nine scenarios are compared against the baseline scenario of no capacity expansion. Results: Expanding ICU capacity by two beds is demonstrated as the most cost-effective scenario with an incremental cost-effectiveness ratio of 3684 (US $) per life saved against the baseline scenario. Sensitivity analyses on the mortality rate of patients in IMCU, direct transfer of IMCU-destined patients to the ward upon completing required IMCU length of stay in the ICU, admission of IMCU patient to ICU, adding two ward beds, and changes in hospital size do not change the superiority of ICU expansion over other scenarios. Conclusions: In terms of operational costs, ICU beds are more cost effective for saving patients than IMCU beds. However, capital costs of setting up ICU versus IMCU beds should be considered for a complete economic analysis.
A Multicenter Survey of House Staff Knowledge About Sepsis and the “Surviving Sepsis Campaign Guidelines for Management of Severe Sepsis and Septic Shock”
Authors: Watkins Richard R. , Haller Nairmeen , Wayde Melinda , Armitage Keith B. 
Published: November 2017

Background: We aimed to assess the knowledge, attitudes, and perceptions of resident physicians regarding sepsis in general and the Surviving Sepsis Campaign Guidelines in particular. Methods: After institutional review board approval, we surveyed internal medicine (IM) and emergency medicine (EM) house staff from 3 separate institutions. House staff were notified of the survey via e-mail from their residency director or chief resident. The survey was Internet-based (using http://www.surveymonkey.com ), voluntary, and anonymous. The Surviving Sepsis Campaign Guidelines were used to develop the survey. The survey was open between December 2015 and April 2016. No incentives for participation were given. Reminder e-mails were sent approximately every 3 to 4 weeks to all eligible participants. Comparisons of responses were evaluated using the N-1 2-proportion test. Results: A total of 133 responses were received. These included 84 from IM house staff, 27 from EM house staff, and 22 who selected “other.” Eighty (101/126) percent reported managing at least 1 patient with sepsis in the preceding 30 days, 85% (97/114) rated their knowledge of the Surviving Sepsis Guidelines as “very familiar” or at least “somewhat familiar,” and 84% (91/108) believed their training in the diagnosis and management of sepsis was “excellent” or at least “good.” However, 43% (47/108) reported not receiving any feedback on their treatment of patients with sepsis in the last 30 days, while 24% (26/108) received feedback once. Both IM and EM house staff received comparable rates of feedback (62% vs 48%, respectively; P = .21). For the 3 questions that directly tested knowledge of the guidelines, the scores of the IM and EM house staff were similar. Notably, <20% of both groups correctly identified diagnostic criteria for sepsis. Conclusion: Additional education of IM and EM house staff on the Surviving Sepsis Campaign Guidelines is warranted, along with more consistent feedback regarding their diagnosis and management of sepsis.
Driving the Future: A Management Flight Simulator of the US Automobile Market
Authors: Keith David R. , Naumov Sergey , Sterman John 
Published: November 2017

Background. A significant gap exists in the United States between ambitious regulatory goals requiring firms to introduce hybrid and electric vehicles, and consumer adoption of these technologies to date. However, the interventions required to close this gap are not obvious due to the complex feedbacks and time delays that govern alternative fuel vehicle (AFV) diffusion. Purpose. The purpose of this article is to introduce Driving the Future (DtF), a free, web-based management flight simulator to explore the effects of automaker strategies and public policies on the US automotive market. Method. We develop a behavioral, dynamic model portraying multiple automobile and fuel types, fueling infrastructure, and consumer choices, enabling users to rapidly experiment with how a wide array of decisions and assumptions shape the dynamics of AFV diffusion out to 2050. Results. We describe how the simulator can be used to explore various scenarios for AFV adoption, and discuss how the simulator can help improve mental models and decision-making. We present evidence from classroom and online experiments, demonstrating that the simulation is both effective in developing users’ understanding of AFV diffusion dynamics, and enjoyable to use.
Managing Pain in Patients With Chronic Medical Illnesses and Serious Mental Illnesses
Authors: O’Mahony Sean , Bines Steven , Gerhart James , Bagwell Erin , Marlene McHugh , Card Ariel 
Published: November 2017

Objectives: This study investigated the use of opioid treatment plans that included the implementation of opioid dependence risk with a validated screening tool and opioid dependence risk tool (UDT) in a noncancer palliative pain clinic. Methods: We retrospectively reviewed the medical records for diagnostic information, information on analgesic medications, daily morphine equivalent dose, presence of pain management agreements and opioid dependence risk tools (ORT), and UDT. We recorded hospital days and emergency department visits. Results: Seventy-four patients were followed for a mean of 15.9 months. Ninety-three percent of patients had pain management agreements and 74% had ORT. The median score was 8: consistent with a high risk. More than half had UDT and 17.6% of patients had unexpected findings. Fifty-nine percent of patients had a psychiatric diagnosis. Hospital days and emergency department visits decreased by more than 30% ( P = .015 and P = .019). Significance of Findings: Both mental health problems and aberrant drug use were common in patients seen in a noncancer palliative care clinic. There were significant reductions in acute care utilization in the 12 months post intake in the clinic.
Serum cystatin C is associated with subclinical atherosclerosis in patients with type 2 diabetes: A retrospective study
Authors: Chung Yu Kyung , Lee Young Ju , Kim Kye Whon , Cho Ryu Kyoung , Chung Seung Min , Moon Jun Sung , Yoon Ji Sung , Won Kyu Chang , Lee Hyoung Woo 
Published: November 2017

Background: The aim of this study was to investigate the association between the serum cystatin C level and cardiovascular disease risk in patients with type 2 diabetes mellitus. Methods: We studied 523 patients with type 2 diabetes mellitus and calculated estimated 10-year risk of atherosclerotic cardiovascular disease (%). Subclinical atherosclerosis was defined as brachial-ankle pulse wave velocity ⩾1700 ms, indicating the presence of arterial stiffness. Results: Cystatin C level was significantly higher in the subclinical atherosclerosis group (brachial-ankle pulse wave velocity ⩾ 1700 ms) than in the non-subclinical atherosclerosis group (brachial-ankle pulse wave velocity < 1700 ms) (7.54 ± 3.15 mg/L vs 10.04 ± 5.12 mg/L, p < 0.001). Subclinical atherosclerosis was mainly determined by age, duration of diabetes and cystatin C level, but not by serum creatinine, 10-year risk of atherosclerotic cardiovascular disease score and estimated glomerular filtration rate in the multiple linear regression analysis. In addition, an increase in cystatin C level was independently associated with the risk of subclinical atherosclerosis after adjusting for age, sex, duration of diabetes, smoking, hypertension, 10-year risk of atherosclerotic cardiovascular disease risk score, serum creatinine level, total cholesterol, high-density lipoprotein cholesterol and haemoglobin A1c (odds ratio = 1.200, 95% confidence interval: 1.04–1.38, p = 0.011). Conclusion: Serum cystatin C level was significantly associated with subclinical atherosclerosis. This result suggests that an increase in cystatin C level could be a valuable surrogate marker for the risk of cardiovascular disease in patients with type 2 diabetes mellitus.
Local Radiotherapy Affects Drug Pharmacokinetics—Exploration of a Neglected but Significant Uncertainty of Cancer Therapy
Authors: Chen Yu-Jen , Tsai Tung-Hu , Wang Li-Ying , Hsieh Chen-Hsi 
Published: November 2017

Purpose: Concurrent chemoradiation therapy is the mainstay of treatment for many types of malignancies. However, concurrent chemoradiation therapy is associated with a greater number of systemic adverse effects than radiotherapy or chemotherapy alone. Summary: Pharmacokinetics is the study of a drug and/or its metabolite kinetics in the body, including absorption, distribution, metabolism, and elimination. The incidences of adverse effects are markedly higher in patients who receive concurrent chemoradiation therapy than in those who receive either radiotherapy or chemotherapy alone. This phenomenon implies that irradiation affects the pharmacokinetics of cytotoxic agents, namely the radiotherapy–pharmacokinetic phenomenon. Experimental animal studies have shown that local irradiation affects the systemic pharmacokinetics of 5-fluorouracil and cisplatin at both low dose (simulating generous dose distributed to normal tissues) and daily practice dose (mimicking therapeutic dose to target volumes). These effects are significant in the circulation of blood and lymphatic system as well as in the hepatobiliary excretion. Furthermore, recent studies have demonstrated that matrix metalloproteinase-8 plays an important role in the radiotherapy–pharmacokinetic phenomenon. Conclusion: In the present review, we provide a general overview of the radiotherapy–pharmacokinetic phenomenon and discuss the possible mechanisms governing the phenomenon.
Unilateral changes in walking surface compliance evoke dorsiflexion in paretic leg of impaired walkers
Authors: Skidmore Jeffrey , Artemiadis Panagiotis 
Published: November 2017

Introduction Gait impairments due to stroke impact millions of individuals throughout the world. Despite the growing interest in automating gait therapy with robotic devices, there is no clear evidence that robot-assisted gait therapy is superior to traditional treadmill-based therapy. Methods This work investigates the effect of perturbations to the compliance of the walking surface on the paretic leg of impaired walkers. Using a novel robotic device, the variable stiffness treadmill, we apply perturbations to the compliance of the walking surface underneath the non-paretic leg of two hemi-paretic walkers and analyze the kinematic and neuromuscular response of the contralateral (paretic) leg with motion capture and surface electromyography systems. Results We present results of evoked muscle activity (predominately tibialis anterior) and increased dorsiflexion in the paretic leg during the swing phase of gait at stiffness values of 60 kN/m and less for all subjects. Conclusions This work provides evidence for the first time of reducing the drop-foot effect in the impaired leg of hemiparetic walkers in response to unilateral perturbations to the compliance of the treadmill platform, thus providing direction for targeted robot-assisted gait rehabilitation.
Do Magnetic Resonance Imaging Characteristics of Full-Thickness Rotator Cuff Tears Correlate With Sleep Disturbance?
Authors: Reyes Bryan A. , Hull Brandon R. , Kurth Alexander B. , Kukowski Nathan R. , Mulligan Edward P. , Khazzam Michael S. 
Published: November 2017

Background: Many patients with rotator cuff tears suffer from nocturnal shoulder pain, resulting in sleep disturbance. Purpose: To determine whether rotator cuff tear size correlated with sleep disturbance in patients with full-thickness rotator cuff tears. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Patients with a diagnosis of unilateral full-thickness rotator cuff tears (diagnosed via magnetic resonance imaging [MRI]) completed the Pittsburgh Sleep Quality Index (PSQI), a visual analog scale (VAS) quantifying their shoulder pain, and the American Shoulder and Elbow Surgeons (ASES) questionnaire. Shoulder MRI scans were analyzed for anterior-posterior tear size (mm), tendon retraction (mm), Goutallier grade (0-4), number of tendons involved (1-4), muscle atrophy (none, mild, moderate, or severe), and humeral head rise (present or absent). Bivariate correlations were calculated between the MRI characteristics and baseline survey results. Results: A total of 209 patients with unilateral full-thickness rotator cuff tears were included in this study: 112 (54%) female and 97 (46%) male (mean age, 64.1 years). On average, shoulder pain had been present for 24 months. The mean PSQI score was 9.8, and the mean VAS score was 5.0. No significant correlations were found between any of the rotator cuff tear characteristics and sleep quality. Only tendon retraction had a significant correlation with pain. Conclusion: Although rotator cuff tears are frequently associated with nocturnal pain and sleep disruption, this study demonstrated that morphological characteristics of full-thickness rotator cuff tears, such as size and tendon retraction, do not correlate with sleep disturbance and have little to no correlation with pain levels.
Glucose-Dependent Insulinotropic Polypeptide (GIP) Inhibits Bone Resorption Independently of Insulin and Glycemia
Authors: Christensen Mikkel B , Lund Asger , Calanna Salvatore , Jørgensen Niklas R , Holst Jens J , Vilsbøll Tina , Knop Filip K 
Published: November 2017

Abstract

Context
The gut hormone glucose-dependent insulinotropic polypeptide (GIP) causes postprandial insulin release and inhibits bone resorption assessed by carboxy-terminal collagen crosslinks (CTX).

Objective
To study if GIP affects bone homeostasis biomarkers independently of insulin release and glycemic level.

Design
Randomized, double-blinded, crossover study with 5 study days.

Patients
Ten male C-peptide-negative patients with type 1 diabetes.

Interventions
On 3 matched days with “low glycemia” (plasma glucose in the interval 3 to 7 mmol/L for 120 minutes), we administered intravenous (IV) GIP (4 pmol × kg−1 × min−1), glucagon-like peptide 1 (1 pmol × kg−1 × min−1), or placebo (saline), and on 2 matched days with “high glycemia” (plasma glucose 12 mmol/L for 90 minutes), we administered either GIP or saline.

Main Outcome Measures
CTX, procollagen type 1 N-terminal propeptide (P1NP), and parathyroid hormone (PTH).

Results
During low glycemia: GIP progressively suppressed CTX from baseline by up to 59 ± 18% compared with 24 ± 10% during saline infusion (P &lt; 0.0001). Absolute values of P1NP and PTH did not differ between days. During high glycemia: GIP suppressed CTX from baseline by up to 59 ± 19% compared with 7 ± 9% during saline infusion (P &lt; 0.0001). P1NP did not differ between days. GIP suppressed PTH after 60 minutes compared with saline (P &lt; 0.01), but this difference disappeared after 90 minutes.

Conclusions
Short-term GIP infusions robustly reduce bone resorption independently of endogenous insulin secretion and during both elevated and low plasma glucose, but have no effect on P1NP or PTH after 90 minutes.
Phase 1 Study of High-Specific-Activity I-131 MIBG for Metastatic and/or Recurrent Pheochromocytoma or Paraganglioma
Authors: Noto Richard B , Pryma Daniel A , Jensen Jessica , Lin Tess , Stambler Nancy , Strack Thomas , Wong Vivien , Goldsmith Stanley J 
Published: November 2017

Abstract

Context
No therapies are approved for the treatment of metastatic and/or recurrent pheochromocytoma or paraganglioma (PPGL) in the United States.

Objective
To determine the maximum tolerated dose (MTD) of high-specific-activity I-131 meta-iodobenzylguanidine (MIBG) for the treatment of metastatic and/or recurrent PPGL.

Design
Phase 1, dose-escalating study to determine the MTD via a standard 3 + 3 design, escalating by 37 MBq/kg starting at 222 MBq/kg.

Setting
Three centers.

Patients
Twenty-one patients were eligible, received study drug, and were evaluable for MTD, response, and toxicity.

Intervention
Open-label use of high-specific-activity I-131 MIBG therapy.

Main Outcome Measures
Dose-limiting toxicities, adverse events, radiation absorbed dose estimates, radiographic tumor response, biochemical response, and survival.

Results
The MTD was determined to be 296 MBq/kg on the basis of two observed dose-limiting toxicities at the next dose level. The highest mean radiation absorbed dose estimates were in the thyroid and lower large intestinal wall (each 1.2 mGy/MBq). Response was evaluated by total administered activity: four patients (19%), all of whom received &gt;18.5 GBq of study drug, had radiographic tumor responses of partial response by Response Evaluation Criteria in Solid Tumors. Best biochemical responses (complete or partial response) for serum chromogranin A and total metanephrines were observed in 80% and 64% of patients, respectively. Overall survival was 85.7% at 1 year and 61.9% at 2 years after treatment. The majority (84%) of adverse events were considered mild or moderate in severity.

Conclusions
These findings support further development of high-specific-activity I-131 MIBG for the treatment of metastatic and/or recurrent PPGL at an MTD of 296 MBq/kg.
Continuous outcome logistic regression for analyzing body mass index distributions
Authors: Lohse Tina , Rohrmann Sabine , Faeh David , Hothorn Torsten 
Published: November 2017

Body mass indices (BMIs) are applied to monitor weight status and associated health risks in populations. Binary or multinomial logistic regression models are commonly applied in this context, but are only applicable to BMI values categorized within a small set of defined ad hoc BMI categories. This approach precludes comparisons with studies and models based on different categories. In addition, ad hoc categorization of BMI values prevents the estimation and analysis of the underlying continuous BMI distribution and leads to information loss. As an alternative to multinomial regression following ad hoc categorization, we propose a continuous outcome logistic regression model for the estimation of a continuous BMI distribution. Parameters of interest, such as odds ratios for specific categories, can be extracted from this model post hoc in a general way. A continuous BMI logistic regression that describes BMI distributions avoids the necessity of ad hoc and post hoc category choice and simplifies between-study comparisons and pooling of studies for joint analyses. The method was evaluated empirically using data from the Swiss Health Survey.
Optimization of Battery Charging and Purchasing at Electric Vehicle Battery Swap Stations
Authors: Schneider Frank , Thonemann Ulrich W. , Klabjan Diego 
Published: November 2017

An operator of a network of battery swap stations for electric vehicles must make a long-term investment decision on the number of batteries and charging bays in the system and periodic short-term decisions on when and how many batteries to recharge. Both decisions must be made concurrently, because there exists a trade-off between the long-term investment in batteries and charging bays, and short-term expenses for operating the system. Costs for electric energy as well as demand rates for batteries are stochastic: We consider an infinite time horizon for operation of the system. We derive an optimization problem, which cannot be solved optimally in a reasonable time for real world instances. By optimally solving various small problem instances, we show the mechanics of the model and the influence of its parameters on the optimal cost. We then develop a near-optimal solution heuristic based on Monte Carlo sampling following the ideas of approximate dynamic programming for the infinite horizon dynamic program. We show that operating battery swap stations in a network where lateral transshipments are allowed can substantially decrease expected operating costs. The online appendix is available at https://doi.org/10.1287/trsc.2017.0781