bluuebunny/crossref_metadata_2025_split huggingface dataset:
National Databases for Neurosurgical Outcomes Research: Options, Strengths, and Limitations
Authors: Karhade Aditya V , Larsen Alexandra M G , Cote David J , Dubois Heloise M , Smith Timothy R 
Published: June 2017

Abstract

BACKGROUND
Quality improvement, value-based care delivery, and personalized patient care depend on robust clinical, financial, and demographic data streams of neurosurgical outcomes. The neurosurgical literature lacks a comprehensive review of large national databases.

OBJECTIVE
To assess the strengths and limitations of various resources for outcomes research in neurosurgery.

METHODS
A review of the literature was conducted to identify surgical outcomes studies using national data sets. The databases were assessed for the availability of patient demographics and clinical variables, longitudinal follow-up of patients, strengths, and limitations.

RESULTS
The number of unique patients contained within each data set ranged from thousands (Quality Outcomes Database [QOD]) to hundreds of millions (MarketScan). Databases with both clinical and financial data included PearlDiver, Premier Healthcare Database, Vizient Clinical Data Base and Resource Manager, and the National Inpatient Sample. Outcomes collected by databases included patient-reported outcomes (QOD); 30-day morbidity, readmissions, and reoperations (National Surgical Quality Improvement Program); and disease incidence and disease-specific survival (Surveillance, Epidemiology, and End Results-Medicare). The strengths of large databases included large numbers of rare pathologies and multi-institutional nationally representative sampling; the limitations of these databases included variable data veracity, variable data completeness, and missing disease-specific variables.

CONCLUSION
The improvement of existing large national databases and the establishment of new registries will be crucial to the future of neurosurgical outcomes research.
Data and Methodology
Authors: Cruces Guillermo , Fields Gary S. , Jaume David , Viollaz Mariana 
Published: June 2017

Abstract
This study is based on microeconomic data from more than 150 household surveys, five million households, and eighteen million persons contained in the SEDLAC—Socio-Economic Database for Latin America and the Caribbean. These data cover the following sixteen Latin American countries: Argentina, Bolivia, Brazil, Chile, Colombia, Costa Rica, Dominican Republic, Ecuador, El Salvador, Honduras, Mexico, Panama, Paraguay, Peru, Uruguay, and Venezuela. Based on these household surveys and the SEDLAC harmonization methodology, the study constructs comparable time series for a wide range of labour market, poverty, and income inequality indicators. It also employs aggregate macroeconomic indicators from two sources: the World Bank’s World Development Indicators and the United Nations Economic Commission for Latin America and the Caribbean’s database on social expenditure.
Conclusions from the Cross-Country Analysis
Authors: Cruces Guillermo , Fields Gary S. , Jaume David , Viollaz Mariana 
Published: June 2017

Abstract
In the great majority of Latin American countries in the 2000s, economic growth took place and brought about improvements in almost all labour market indicators and consequent reductions in poverty rates. Across these countries, economic growth was not all that mattered; external factors were particularly important for changes in labour market conditions, while reductions in poverty were strongly related to improvements in earnings and employment indicators. Although the 2008 crisis affected some countries differently from others, nearly all labour market indicators were at least as high or higher by 2012 than immediately before the crisis in all countries but one.
Ecuador
Authors: Cruces Guillermo , Fields Gary S. , Jaume David , Viollaz Mariana 
Published: June 2017

Abstract
Ecuador experienced moderate economic growth during the 2000s. The economy suffered a mild recession during the international crisis of 2008, but returned to pre-recession GDP per capita level in 2010. Most labour market indicators improved over the period. The only indicator that worsened was the employment structure by occupational position. Most labour market indicators were affected negatively by the international crisis but recovered their pre-crisis levels by 2012. The only exception was labour earnings for some employment categories. With the onset of the crisis of 2008, the poverty rate stopped falling, but it regained its downward trend from 2011 onwards.
El Salvador
Authors: Cruces Guillermo , Fields Gary S. , Jaume David , Viollaz Mariana 
Published: June 2017

Abstract
During the 2000s, El Salvador experienced slow economic growth for Latin American standards. The country underwent a recession during the international crisis of 2008, but returned to pre-recession output level in 2011. Changes in labour market conditions were mixed. The unemployment rate fell, and the mix of employment by occupations, economic sector, and education improved slightly. However, the employment mix by occupational position deteriorated, and the share of registered workers and earnings decreased. Most labour indicators were affected adversely by the crisis, and some have yet to return to pre-crisis levels. Most poverty and inequality indicators fell over the period.
Honduras
Authors: Cruces Guillermo , Fields Gary S. , Jaume David , Viollaz Mariana 
Published: June 2017

Abstract
During the 2000s Honduras grew less than the average Latin American country and labour market indicators moved, in general, in a worsening direction. The only exceptions were the reduction in the unemployment rate and the improvements in the mix of employment by occupational group and educational level. The country underwent a recession as a consequence of the international crisis of 2008, from which it had not fully recovered by 2012. Most labour market indicators were affected negatively by the crisis, and the majority of them had not recovered their pre-crisis levels by 2012. Poverty has been rising steadily since 2008.
Mexico
Authors: Cruces Guillermo , Fields Gary S. , Jaume David , Viollaz Mariana 
Published: June 2017

Abstract
During the 2000s Mexico grew less than the average for Latin America. Labour market indicators exhibited mixed changes, with improvements over the period for some of them and deterioration for others. While the composition of employment improved and poverty decreased, labour earnings fell and informality increased. The country was severely hurt by the international crisis of 2008, which affected in one way or another all population groups, but Mexico surpassed its pre-crisis output levels by 2012. Most labour market indicators were affected negatively by the crisis, and labour earnings and poverty indicators had not recovered their pre-crisis levels by 2012.
Peru
Authors: Cruces Guillermo , Fields Gary S. , Jaume David , Viollaz Mariana 
Published: June 2017

Abstract
The Peruvian economy performed exceptionally well between 2000 and 2012, with a growth performance that placed the country well above the regional average and an improvement in all labour market indicators. The chapter shows that the economy suffered a slowdown as a consequence of the international crisis of 2008, but Peru sustained positive GDP growth rates during that episode and had only a small reduction in gross domestic product per capita. The only labour market indicators impacted by the international crisis were the employment structure by educational level and the percentage of registered workers who suffered a slowdown in their improving trends.
Performance of a Modern Glucose Meter in ICU and General Hospital Inpatients: 3 Years of Real-World Paired Meter and Central Laboratory Results
Authors: Zhang Ray , Isakow Warren , Kollef Marin H. , Scott Mitchell G. 
Published: June 2017

Objective:
Due to accuracy concerns, the Food and Drug Administration issued guidances to manufacturers that resulted in Center for Medicare and Medicaid Services stating that the use of meters in critically ill patients is “off-label” and constitutes “high complexity” testing. This is causing significant workflow problems in ICUs nationally. We wished to determine whether real-world accuracy of modern glucose meters is worse in ICU patients compared with non-ICU inpatients.

Design:
We reviewed glucose results over the preceding 3 years, comparing results from paired glucose meter and central laboratory tests performed within 60 minutes of each other in ICU versus non-ICU settings.

Setting:
Seven ICU and 30 non-ICU wards at a 1,300-bed academic hospital in the United States.

Subjects:
A total of 14,763 general medicine/surgery inpatients and 20,970 ICU inpatients.

Interventions:
None.

Measurements and Main Results:
Compared meter results with near simultaneously performed laboratory results from the same patient by applying the 2016 U.S. Food and Drug Administration accuracy criteria, determining mean absolute relative difference and examining where paired results fell within the Parkes consensus error grid zones. A higher percentage of glucose meter results from ICUs than from non-ICUs passed 2016 Food and Drug Administration accuracy criteria (p < 10–10) when comparing meter results with laboratory results. At 1 minute, no meter result from ICUs posed dangerous or significant risk by error grid analysis, whereas at 10 minutes, less than 0.1% of ICU meter results did, which was not statistically different from non-ICU results.

Conclusions:
Real-world accuracy of modern glucose meters is at least as accurate in the ICU setting as in the non-ICU setting at our institution.
Effect of the Learning Curve on Visual and Refractive Outcomes of Small-Incision Lenticule Extraction
Authors: Chan Tommy C. Y. , Ng Alex L. K. , Cheng George P. M. , Woo Victor C. P. , Zhang Jiamei , Wang Yan , Jhanji Vishal 
Published: June 2017

Purpose:
To investigate the effect of the learning curve for small-incision lenticule extraction during the first 2 years of experience.

Methods:
Small-incision lenticule extraction was performed using the 500-kHz VisuMax femtosecond laser (Carl Zeiss Meditec) by the same surgeon. The initial 100 patients since the surgeon started operating independently were considered as group 1; the recent 100 patients were considered as group 2. The same laser settings and technique were used. The visual and refractive outcomes were compared between groups at postoperative 1 week and 6 months. Vector analysis was performed for eyes with astigmatic correction.

Results:
Two hundred right eyes of 200 patients were included. Age, preoperative corrected visual acuity, manifest refraction, and central corneal thickness were similar between groups (P ≤ 0.154). Postoperatively, the efficacy index at 1 week was better in group 2 (group 1: 0.85 ± 0.16 vs. group 2: 0.91 ± 0.10, P = 0.019) but was similar between groups at 6 months (group 1: 0.91 ± 0.14 vs. group 2: 0.94 ± 0.08, P = 0.181). The safety index was higher in group 2 at 1 week (group 1: 0.93 ± 0.10 vs. group 2: 0.95 ± 0.08, P = 0.045) and 6 months postoperatively (group 1: 0.97 ± 0.07 vs. group 2: 0.99 ± 0.03, P = 0.011). Vector analysis showed that postoperative residual astigmatism and misalignment of astigmatic correction were lower in group 2 than in group 1 (P ≤ 0.039) at 1 week and 6 months. The duration of docking and that of lenticule extraction was shorter in group 2 (P ≤ 0.034).

Conclusions:
Our study showed that faster visual recovery, better safety profile, and more accurate astigmatic correction could be attained with increasing surgical experience.
Corneal Stiffening by a Bacteriochlorophyll Derivative With Dextran and Near-Infrared Light: Effect of Shortening Irradiation Time up to 1 Minute
Authors: Brekelmans Jurriaan , Goz Alexandra , Dickman Mor M. , Brandis Alexander , Sui Xiaomeng , Wagner H. Daniel , Nuijts Rudy M. M. A. , Scherz Avigdor , Marcovich Arie L. 
Published: June 2017

Purpose:
The aim of this study is to determine the effect of variation of the exposure time of near-infrared irradiation on corneal stiffening after a bacteriochlorophyll derivative (WST11) with dextran (WST-D) application.

Methods:
One hundred four paired eyes of 3-month-old New Zealand White rabbits were included in this study. Fifty-two eyes (ex vivo n = 34, in vivo n = 18) were mechanically deepithelialized, treated topically with WST-D, and irradiated at 10 mW/cm2 using a diode laser at 755 nm for 1, 5, or 30 minutes. Untreated fellow eyes served as controls. Corneoscleral rings were removed immediately after treatment (ex vivo), or 1 month after treatment (in vivo). Corneal strips were cut and underwent biomechanical stress–strain measurements.

Results:
Ex vivo, the mean tangent elastic modulus was significantly higher in the treatment groups than in the control groups for 1, 5, and 30 minutes of irradiation, respectively, 6.06 MPa, 95% confidence interval (CI, 4.5–7.6) versus 14.02 MPa, 95% CI (10.2–17.8), n = 11, 4.8 MPa, 95% CI (3.9–5.7) versus 15.03 MPa, 95% CI (12–18.1), n = 11, and 7.8 MPa, 95% CI (5.6–10.02) versus 16.2 MPa, 95% CI (13.6–18.9), n = 11; P < 0.001 for all comparisons. In vivo, the mean elastic moduli in the treatment groups were significantly higher for 5 and 30 minutes of irradiation but not for 1 minute of irradiation, respectively, 11.4 MPa, 95% CI (8.5–14.2), versus 17.1 MPa, 95% CI (14.5–19.7), n = 5; P < 0.001, and 9.4 MPa, 95% CI (5.1–13.8) versus 16 MPa, 95% CI (13.1–19), n = 5; P < 0.01, and 11.3 MPa, 95% CI (6–16.6) versus 12.2 MPa, 95% CI (7.5–16.8), n = 5; P = 0.7.

Conclusions:
WST-D/near-infrared treatment using shortened irradiation time (1 minute ex vivo and 5 minutes in vivo) results in significant corneal stiffening, and this might provide an alternative to the currently applied riboflavin/ultraviolet A cross-linking.
The Use of 5-Aminosalicylic Acid in Children and Adolescents With Inflammatory Bowel Disease
Authors: Sokollik Christiane , Fournier Nicolas , Rizzuti David , Braegger Christian P. , Nydegger Andreas , Schibli Susanne , Spalinger Johannes 
Published: June 2017

Background:
In ulcerative colitis (UC) 5-aminosalicylic acid (5-ASA) is recommended as primary therapy for mild to moderate disease. Topical 5-ASA has been proven especially effective. In Crohn’s disease (CD) the evidence for a beneficial role of 5-ASA is weak. We investigated the use of topical and systemic 5-ASA therapy in children and adolescents with inflammatory bowel disease.

Materials and Methods:
Data of patients younger than 18 years, registered between April 2008 and December 2015 in the Swiss Inflammatory Bowel Disease Cohort, were analyzed.

Results:
Three hundred twenty pediatric inflammatory bowel disease patients were included; 189 with CD and 131 with UC. Over one third of UC patients [51 (39%)] received topical 5-ASA therapy and 43 (33%) received combination therapy during their disease course. UC patients with left-sided colitis or proctitis were more likely to receive topical or combination therapy as compared with patients with pancolitis (P<0.001 and <0.001, respectively). An increase in the use of topical 5-ASA therapy in UC patients was noted over time from 5% to 38%. Forty-seven percent of CD patients were treated with oral 5-ASA during their disease course. The usage was stable over time at approximately 15% to 20%.

Conclusions:
In recent years a very positive trend showing an increase in topical 5-ASA therapy in children and adolescents with UC has been observed. However topical therapy is still used with relative low frequency, especially in patients with a more extensive disease. Conversely, despite weak evidence supporting 5-ASA use in CD patients it has been frequently prescribed. Physicians should continue to encourage their UC patients to use topical therapy.
Predictors of Mortality in Cirrhosis Inpatients With Clostridium difficile Infection
Authors: Smith Elliot Z. , Northup Patrick G. , Argo Curtis K. 
Published: June 2017

Background:

Clostridium difficile is a bacterial pathogen associated with significant morbidity and mortality in patients with cirrhosis.

Goals:
Our primary aim is to identify variables that are predictive of poor outcomes in cirrhosis patients with C. difficile infection (CDI). We also aim to further characterize the risk factors for developing CDI and risk of mortality in this patient population.

Study:
A total of 200 subjects with a diagnosis of cirrhosis and CDI were matched to 200 cirrhosis inpatients without CDI. The groups were compared to evaluate variables associated with decreased survival for cirrhosis inpatients with CDI as well as risk factors for developing CDI.

Results:
Cirrhosis patients with CDI were more frequently prescribed antibiotics during their hospitalization (P=0.002) and cared for in an intensive care unit (ICU) (P<0.001). Preadmission proton pump inhibitor and spontaneous bacterial peritonitis (SBP) prophylactic antibiotic use were not significantly different between the 2 cohorts. CDI subjects had an increased 30-day mortality (44% vs. 28.5%, P=0.034), however overall mortality was not significantly different (P=0.2). The multivariable logistic regression model demonstrated an increased 30-day and overall mortality in the CDI population was independently associated with albumin <3 g/dL and ICU admission.

Conclusions:

C. difficile infections are associated with a significant increase in 30-day mortality, but not overall mortality. Risk factors of ICU admission and antibiotic exposure were associated with the diagnosis of CDI in cirrhosis patients. Hypoalbuminemia and ICU admission were found to be strong predictors of increased mortality in cirrhosis patients with CDI.
Early Infections and the Risk of Irritable Bowel Syndrome
Authors: Krajicek Edward J. , Almazar Ann E. , Larson Joseph J. , Atkinson Elizabeth J. , Talley Nicholas J. , Saito Yuri A. 
Published: June 2017

Goals:
The goal of this study is to evaluate the association between early life infections and subsequent adult onset irritable bowel syndrome (IBS).

Background:
Infections during adulthood are a known risk factor for adult-onset IBS. This investigation examined the role of childhood infections and infection risk factors in the development of IBS symptoms.

Study:
In total, 1010 subjects (509 outpatients with IBS, 501 matched controls) were mailed questionnaires regarding early-life infections during infancy (0 to 12 mo), toddler years (1 to 3 y), and child years (4 to 18 y). Comparisons between cases and controls were performed using logistic regression adjusting for age, gender, and somatization score.

Results:
Around 648 (64.2%) subjects responded. The median age was 51.3 years (range, 18.0 to 70.7 y) and 535 (83%) were female. Childhood (below 18 y) infections were common in cases and controls (98% vs. 98%; P=0.465), with no differences between cases and controls during infant, toddler, and child-age periods. For gastrointestinal infections experienced below 18 years, no differences were observed by infection type (bacterial, viral, or parasitic) or age group. Cases were more likely to report bronchitis by age 18 [43% vs. 25%; P=0.003; odds ratio, 1.73 (1.20-2.51)], but not other common infections. Regular antibiotic exposure was greater amongst cases (43%) than controls (30%) [P=0.09; odds ratio, 1.37 (0.96-1.96)]. The association between bronchitis and IBS case status remained significant after adjusting for antibiotic use (P=0.01).

Conclusions:
Greater early childhood gastrointestinal infections rates were not observed in adult individuals with IBS compared with adult controls. The study does not support a statistically significant link between early life infections and IBS aside from bronchitis.
Incidental Hippocampal Hyperintensity on Diffusion-weighted MRI
Authors: Jeong Moonyoung , Jin Jaehyun , Kim Jeong Hee , Moon Yeonsil , Choi Jin Woo , Kim Hahn Young 
Published: June 2017

Objectives:
Dot-like hippocampal hyperintensities (HHs) on diffusion-weighted MRI (DWI) have been reported as an interesting imaging finding of transient global amnesia (TGA) that is characterized by typical anterograde amnesia. However, we found that these dot-like HHs are occasionally seen in some patients without clinical symptoms of TGA.

Methods:
We identified 8 patients who did not show clinical symptoms of TGA, despite the presence of hippocampal lesions on DWI (No-TGA group, n=8). For the comparison group, 16 age-matched and sex-matched patients were selected from among patients who had been diagnosed with TGA (TGA group, n=16).

Results:
No significant difference was found in vascular risk factors, years of education, or underlying cognitive function between the 2 groups. More than half of the patients in each group performed preceding Valsalva-associated activities. Multiple hippocampal lesions or concomitant lesions in the cingulate gyrus were found only in the TGA group.

Conclusions:
Dot-like HHs on DWI can be observed without the typical symptoms of TGA. Valsalva maneuver–associated activities could produce asymptomatic hippocampal lesions. The symptoms of TGA may be presented on a spectrum, from no symptoms to mild vegetative symptoms or to the typical symptoms of TGA, depending on individual susceptibility.
Spectrum of Autonomic Nervous System Impairment in Sjögren Syndrome
Authors: Goodman Brent P. , Crepeau Amy , Dhawan Priya S. , Khoury Julie A. , Harris Lucinda A. 
Published: June 2017

Objective:
To describe the spectrum of autonomic dysfunction in a uniformly evaluated cohort of patients with Sjögren syndrome.

Methods:
A series of 13 patients underwent a comprehensive evaluation for suspected autonomic impairment, including a neurological examination, autonomic testing, and laboratory studies. A diagnosis of Sjögren syndrome was established as the cause of autonomic dysfunction in all. Clinical features, findings on autonomic testing, and laboratory results are described.

Results:
All patients in this series reported postural lightheadedness and syncope or near-syncope. Autonomic testing confirmed the presence of orthostatic hypotension on tilt-table testing in 5 patients and an excessive postural tachycardia and/or hypertensive response in 8 patients. Only 2 of the patients with orthostatic hypotension had a significant sensory neuropathy. Symptoms suggestive of gastrointestinal and genitourinary impairment were seen in nearly all patients, with abnormal motility testing (most frequently esophageal dysmotility) in 5 of 6 patients who underwent formal testing. Patients in this series treated with immune-modulating therapy experienced significant improvement.

Conclusions:
A diagnosis of Sjögren syndrome should be aggressively pursued in patients with signs and symptoms suggestive of autonomic nervous system impairment. Although the spectrum of adrenergic failure is variable, ranging from orthostatic hypotension to an excessive postural tachycardia, most patients do have symptoms of more generalized autonomic failure. Patients who were treated with immune-modulating therapy did improve.