bluuebunny/crossref_metadata_2025_split huggingface dataset:
Phenotyping congenital anomalies in England and Scotland: a comparison of three coding clusters using retrospective hospital data
Authors: Wijlaars Linda , Zylbersztejn Ania , Verfürden Maximiliane , Gilbert Ruth , Hardelid Pia 
Published: April 2017

ABSTRACT
ObjectivesWe aimed to compare prevalence rates of complex congenital anomalies (CCAs) in the first two years of life in England and Scotland using two published CCA diagnosis code lists (phenotypes) developed to identify children who require high levels of healthcare.
ApproachWe developed birth cohorts of singleton, hospital live births between 1998-2011 using birth registration, hospitalisation and mortality register datasets from England (n=8,157,213) and from Scotland (n=731,377) from. Children were followed up until 2 years of age.
We compared prevalence rates of congenital anomalies using two code lists developed to identify CCAs: a UK chronic condition code list developed by Hardelid et al. and a US medical complexity code list developed by Feudtner et al. Children were classified as having a CCA if a diagnosis code was included in any admission during follow-up as a primary or subsidiary diagnosis.
To assess the level of healthcare attention required, we compared the proportion of children who had at least one re-admission to hospital in the first two years of life.
ResultsRates of CCAs in England and Scotland were higher using the Hardelid phenotype (2.8% for both countries) than when using the Feudtner phenotype (1.8% in England and 1.5% in Scotland). Rates of CCAs increased in both England and Scotland between 1998 and 2011. The increase was more notable using the Hardelid phenotype (37.2% and 20.2%, in England and Scotland, respectively) compared to the Feudtner phenotype (35.6% and 13.0%). Prevalence rates using the Hardelid phenotype were similar to EUROCAT figures. The proportion of children with at least one re-admission to hospital was higher in the Feudtner code list (69.2% in England and 84.8% in Scotland), than for Hardelid’s code list (67.9% and 72.0% in England and Scotland, respectively). The proportions of children with any of the CCA phenotypes were higher than compared to children without CCAs (24.4% in England and 25.8% in Scotland).
ConclusionPrevalence of CCAs and associated hospital use vary depending on choice of CCA code list. Our findings suggest that Feudtner’s code list identifies children with higher level of healthcare needs. The impact of coding methods for defining CCAs in administrative hospital records should be explored and externally validated when comparing prevalence of CCAs and associated hospital use between countries.
The impact of coding method for defining CCAs in administrative hospital records should be explored and externally validated when comparing prevalence and admission rates between countries.
Improving the Accuracy of Length of stay Risk Adjustment Models using Linked Data
Authors: Sajobi Tolulope , Lu Mingshan , Jiang Jason , Quan Hude 
Published: April 2017

ABSTRACT
BackgroundHospital length of stay (LOS) is a widely used measure for assessing cross-jurisdiction health system performance and informs resource allocation decisions. However, the accuracy of existing LOS risk adjustment models are limited, because they are mostly derived from administrative data, which mostly contain clinical/diagnostic information but lack detailed information on relevant demographic, socio-economic (SES), and self-reported health-related quality of life (HRQOL) risk factors, which have been shown to improve the accuracy of LOS risk adjustment models. The study investigates the relative contribution of demographic, socio-economic, and health status risk factors derived through data linkage in improving the accuracy of LOS risk adjustment models.
MethodsPopulation-based data on 8000 individuals hospitalized for coronary heart disease were obtained from Alberta Provincial Project on Outcomes Assessment in Coronary Heart Disease (APPROACH) registry and linked to Alberta Discharge Abstract Database (DAD). SES was measured using multi-domain measure of SES derived from area-level census information, while the health-related quality of life outcome was measured using the Seattle Angina Questionnaire. LOS risk adjustment model based on hierarchical logistic regression models was developed to assess relative impact of each SES measure and HRQOL measure improving the predictive accuracy of LOS adjustment models. The relative impact of each predictor was assessed by its adjusted odds ratio (OR) and improvement over the predictive accuracy of a reference model that included patients’ clinical risk factors only.
ResultMore than 80% of the hospitalized individuals had prolonged LOS more than 10 days. The HRQOL and single-domain measures of SES had significant impact in accurately predicting LOS. But the inclusion of the multi-domain measure SES did not significantly improve the accuracy of LOS risk adjustment models
ConclusionUsing large population-based Canadian data, our study suggests that the inclusion of patients’ SES and health status information through data linkage can improve the accuracy of LOS risk adjustment models. The development of more accurate risk adjustment models can aid the identification of individuals at risk of prolonged LOS and comparison of health system performance across several cross-jurisdictions.
Measuring medication adherence: standardized definitions are needed to allow for comparisons
Authors: Tang Karen , Quan Hude , Rabi Doreen 
Published: April 2017

ABSTRACTObjectivesThough pharmacy claims data are commonly used to study medication adherence, there remains no standard operational definition for adherence especially for patients on multiple medications. Even when studies use the same terminology, the actual methods of calculating adherence can differ drastically. It is unclear whether the use of different definitions results in different conclusions regarding adherence and associated outcomes. The objective of our study was to compare adherence rates and associations with mortality using different operational definitions of adherence, and using various methods of handling concurrent medication use.
ApproachWe conducted a cohort study of patients aged ≥65 years from Manitoba, Canada, with incident hypertension diagnosed in 2004 and followed to 2009. We calculated adherence rates to anti-hypertensive medications using different operational definitions of medication adherence (including interval and prescription based medication possession ratios [MPR] and proportion of days covered [PDC]). For those on concurrent medications, we calculated adherence rates using the different methods of handling concurrent medication use, for each definition. We used logistic regression to determine the association between adherence and mortality for each operational definition.
ResultsAmong 2199 patients, 24.1% to 90.5% and 71.2% to 92.7% were considered adherent when using fixed interval and prescription-based interval medication possession ratios [MPRi and MPRp] respectively, depending on how concurrent medications were handled. Adherence was inversely associated with death, with the strongest association for MPRp measures. This association was significant only when considering adherence to any hypertensive [aOR 0.70, 95% CI 0.51, 0.97], or when the mean of the class-specific MPRp’s [adjusted OR 0.71, 95% CI 0.53, 0.95] was used. No significant association existed when the highest or lowest class-specific MPRp was used as the adherence estimate.
ConclusionThe range of adherence estimates varies widely depending on the operational definition used. Given less variation in adherence rates and their stronger association against mortality, we recommend using prescription-based MPR’s to define medication adherence.
Discharge Communication and Patient Involvement are Associated with Unplanned Hospital Readmissions: Results from a Validated Hospital Experience Survey
Authors: Kemp Kyle , Santana Maria , Jolley Rachel , Southern Danielle , Quan Hude 
Published: April 2017

ABSTRACTObjectivesUnplanned hospital readmissions are an indicator of quality of care, and are associated with significant costs to healthcare systems. Previous research has shown that poor communication and discharge experiences are associated with higher readmission rates. This, however, has only been examined in the short-term, and in many instances, at the hospital-level. The purpose of the study was to examine the relationship between aspects of inpatient communication and discharge instructions and unplanned readmissions at the individual-level up to one-year post-discharge.
ApproachThe Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) telephone survey was completed by patients within 6 weeks of hospital discharge in Alberta, Canada. Survey data were linked to corresponding inpatient records using personal health number, discharge date, and facility codes. Unplanned readmissions (yes vs. no; all causes) from 43 to 365 days post-hospital discharge comprised the outcome variable. Independent variables included selected demographic characteristics, clinical variables, and five survey questions: a) patient involvement in their care decisions, b) receiving written information at discharge, c) understanding the purpose of taking medications, d) understanding responsibility for one’s health, and e) discussing help needed when returning home. Multivariate logistic regression was used to examine each question in the presence of the other predictors. Odds ratios and 95% confidence intervals were calculated.
ResultsFrom April 2011 to March 2014, 24,868 patients completed a survey which was successfully linked to the corresponding inpatient record. The cohort had a mean age of 52.8±19.8 years of age (range=18-100), and was predominantly female (65.4%). 18.6% of patients (n=4,620) experienced an unplanned hospital readmission within 43 to 365 days post-discharge. Patients who felt that they were not involved in their care decisions were more likely to be readmitted (OR=1.79; 95%CI: 1.59-2.01), as were patients who did not receive written information at discharge (OR=1.96; 95%CI: 1.83-2.11). Odds of unplanned readmissions did not differ according to understanding of medications (OR=1.08; 95%CI: 0.90-1.30), understanding responsibility for one’s health (OR=1.02; 95%CI: 0.86-1.20), or discussion of help needed when returning home (OR=1.03; 95%CI: 0.93-1.14).
ConclusionOur results demonstrate that a lack of patient involvement in their care and not receiving written information at discharge is associated with increased unplanned readmission rate up to one-year post-discharge. This present study provides an example of how patient-reported measures may be linked to individual-level administrative data to drive healthcare improvements. Future research examining patient-reported hospital experience and other health system measures is warranted.
Using probabilistically linked data to investigate the burden of Respiratory Syncytial Virus (RSV) in children <5 years of age on secondary care in England
Authors: Reeves Rachel , Hardelid Pia , Gilbert Ruth , Panagiotopoulos Nikolaos , Minaji Mehdi , Pebody Richard 
Published: April 2017

ABSTRACTObjectivesThis study aims to describe the burden of respiratory syncytial virus (RSV) in children <5 years of age on secondary care in England using linked laboratory surveillance and hospital admissions databases. We will compare our results with previous estimates of the burden of RSV in secondary care based on statistical modelling techniques.
ApproachNational laboratory surveillance data was probabilistically linked to the Hospital Episode Statistics (HES) database for children aged <5 years in England from 01/08/2010 to 31/07/2012. Linkage was based on NHS and hospital number, date of birth, sex and post code. Only records where the laboratory test was within one week of hospital admission were included. Using the linked data, we estimated the probability of a respiratory hospital admission being related to RSV based on patient characteristics, calendar week and diagnostic coding. We used these probabilities to estimate the national incidence of RSV-associated hospital admissions. Admission rates were calculated by age group (<1 year, 1-4 years) using Office for National Statistics (ONS) mid-year population estimates.
ResultsThere was an average of 11,289 RSV-positive laboratory records per year during the study period. Preliminary results indicate that 75% of RSV-positive laboratory records linked to a hospital admission. 92% of linked hospital admissions occurred between November and March each year. 76% of the linked hospital admissions were in children aged <1 year. There were significant differences in coding of RSV-associated hospital admissions by age, and over two-thirds of RSV-associated hospital admissions did not have a primary diagnosis indicating RSV as the cause of disease. We will present results on the number of linked hospital admissions, unlinked hospital admissions potentially caused by RSV and the total estimated number of RSV-associated hospital admissions, stratified by age, calendar week and primary diagnosis.
ConclusionThis study is the first to link laboratory and hospital data for RSV in England, and therefore the first to describe laboratory-confirmed RSV-associated hospital admissions on a national scale. Our approach to estimate the national incidence of admissions based on developing probability weights from a smaller, linked sample has applications not just for RSV but for other seasonal infections. In addition, with a World Health Organization (WHO) consultation last year estimating that an RSV vaccine will be available commercially within 5-10 years, the results of this study can be used in mathematical models of potential vaccine strategy, contributing to the identification of optimal target groups for a potential licensed vaccine.
Estilos de vida en estudiantes de una universidad pública
Authors: Olivero Pacheco Nancy , Benites Vega Juan Carlos , García Casique Alfredo , Bello Vidal Catalina 
Published: April 2017

El objetivo fue describir los estilos de vida en estudiantes de una universidad pública. La muestra se constituyó con 611 estudiantes, de las carreras profesionales de Sociología, Economía, Educación, Odontología, Contabilidad y Psicología que registraron matricula regular en el año 2015; a quienes se aplicó una encuesta válida y confiable. Fueron divididos en grupos de primero – segundo año y tercero – cuarto año de estudios. Encontramos que las dimensiones de la promoción de la salud, tales como: importancia de la salud, higiene corporal y la alimentación, basada en el consumo de frutas, verduras y pescado, acompañadas de actividad física, principalmente caminar y realizar actividades grupales, como pasear e ir al cine, determinan comportamientos de bajo riesgo en la salud. La gran mayoría de estudiantes tienen una visión clara de su Proyecto de Vida (68.74%), controla sus situaciones de estrés y no tienen problemas con su sexualidad (70.54%). Sin embargo, un alto porcentaje de estudiantes manifestaron tendencia a cuadros de ansiedad, depresión, o ambos. Y 43.3% tendrían un cuadro de depresión que requeriría tratamiento.Palabras claves: estilos de vida, estrés, proyecto de vida y salud
Late-time Cooling of Neutron Star Transients and the Physics of the Inner Crust
Authors: Deibel Alex , Cumming Andrew , Brown Edward F. , Reddy Sanjay 
Published: April 2017

Abstract
An accretion outburst onto a neutron star transient heats the neutron star’s crust out of thermal equilibrium with the core. After the outburst, the crust thermally relaxes toward equilibrium with the neutron star core, and the surface thermal emission powers the quiescent X-ray light curve. Crust cooling models predict that thermal equilibrium of the crust will be established

into quiescence. Recent observations of the cooling neutron star transient MXB 1659-29, however, suggest that the crust did not reach thermal equilibrium with the core on the predicted timescale and continued to cool after

into quiescence. Because the quiescent light curve reveals successively deeper layers of the crust, the observed late-time cooling of MXB 1659-29 depends on the thermal transport in the inner crust. In particular, the observed late-time cooling is consistent with a low thermal conductivity layer near the depth predicted for nuclear pasta that maintains a temperature gradient between the neutron star’s inner crust and core for thousands of days into quiescence. As a result, the temperature near the crust–core boundary remains above the critical temperature for neutron superfluidity, and a layer of normal neutrons forms in the inner crust. We find that the late-time cooling of MXB 1659-29 is consistent with heat release from a normal neutron layer near the crust–core boundary with a long thermal time. We also investigate the effect of inner crust physics on the predicted cooling curves of the accreting transient KS 1731-260 and the magnetar SGR 1627-41.
Mots de gorge
Authors: Menini Romain 
Published: April 2017

L’article propose une relecture du fameux chapitre xxxii du Pantagruel de Rabelais, intitulé « Comment Pantagruel de sa langue couvrit toute une armée, et de ce que l’auteur veit dedans sa bouche ». L’intertextualité néo-latine ou vernaculaire fournit de nouvelles pistes herméneutiques, qui sont autant de regards portés comme à la dérobée. À la lumière de l’expérience rabelaisienne de la philologie médicale, ainsi que des débats spécialisés de son temps, le détour par les villes de « Laryngues et Pharingues » fait notamment l’objet d’un commentaire anatomique. Le texte de Rabelais s’adresse à un « diligent lecteur », capable de savoir voir ce que l’épisode ne révèle qu’à mots couverts.
Challenges of access to water and sanitation for sustaining health: A case study from South 24 Parganas, West Bengal, India
Authors: Sehgal Meena , Gautam Sumit Kumar , Bajaj Priyanka , Guha Mayukhmala , Pandey Suneel 
Published: April 2017

The present study attempts to determine the access to clean water and sanitation essential for sustaining health. It attempts to identify socio-economic factors which influence access to clean water within the community. The absence of water-on- premises in a water abundant area of West Bengal, India showcases some of the challenges in progressing on Sustainable Development Goal-3.Eight villages were included in the study and a total of 597 households were enrolled for the study from 8000 households in the villages. The study includes descriptive analysis of water access and sanitation parameters, and regression analysis of socio-economic determinants of exposure. The results reveal that nearly half of the respondents belonged to Above Poverty Line (APL) while 42.71% were under Below Poverty Line (BPL). Although majority of the household had access to an improved source of water for drinking, 77.89 % of the households were using pond water for bathing, washing clothes, utensils and toilet and nearly 37% of households did not have any toilet facility. Regression analysis of use of pond water indicates that people living in mud huts (kutcha houses) and from religious minority groups were more likely to use ponds for washing utensils, clothes, bathing and defecated in open fields and use unimproved sources for drinking water. The study asserts the need to develop community level preventive measures such as access to clean water for personal and domestic use and sanitation facilities to protect health.
Evaluation of salt tolerance in selected Qatari halophytes at the two initial growth stages
Authors: Alhaddad Fedae A. , Abu-Dieyeh Mohammed H. 
Published: April 2017

Scarcity of water and availability of land for agricultural production are the most environmental issues that facing the (GCC) countries and Qatar one of them. Qatar lies in region which characterized by having high evaporation rate and minimum rate of precipitation, so the salt built on the soil in relatively high concentration. The natural vegetation of Qatar is scarce, scattered and limited to certain areas. Halophytes could play a major role to minimize adverse environmental impacts, such as global warming and the enhancement of primary productivity. The present study is kind of the first in screening for local halophytes to quantify their level of tolerance to saline environment. The outcome of this research is expected to serve future research in investigating halophyte economical values and their utilization of the salt effected lands in coastal and in inland areas of Qatar. Seven treatment levels of different concentrations of NaCl including the control treatment (0, 50, 100, 200, 400, 600 and 800 mM NaCl) were used to evaluate both seed germination stage and seedling growth of selected Qatari halophytes. Eight halophyte species were selected for the seed germination experiment those are: Salsola setifera, Halopeplis perfoliata, Caroxylon imbricatum, Suaeda aegyptiaca, Acacia tortilis, Limonium axillare, Tetraena qatarensis and Aeluropus lagopoides. In general the seed germination experiments showed a decrease in the rate of germination as the salt concentration increased. Most of the studied species had a degree of germination up to 200 mM NaCl. The recovery of seeds subjected to high salt concentration have shown a rapid high percentage recovery up to 94% after being subjected to 600 mM NaCl for Halopeplis perfoliata. Five halophytes species were selected to be used for the seedling growth experiments. The two measured parameters used to evaluate the effect of salt concentrations on seedling growth are plant height and dry weight (biomass) for both above and belowground parts. The obtained results from all measured parameters showed no significant differences among seedlings of Caroxylon imbricatum, Suaeda aegyptiaca and Tetraena qatarensis. In respect to different salinity concentrations, Our results indicated that future utilizing of these plants for any commercial product will be valuable to secure drinking water and food in Qatar.