bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of the microbiome, probiotics, and ‘dysbiosis therapy’ in critical illness
Authors: Wischmeyer Paul E. , McDonald Daniel , Knight Rob 
Published: June 2016

Purpose of review
Loss of ‘health-promoting’ microbes and overgrowth of pathogenic bacteria (dysbiosis) in ICU is believed to contribute to nosocomial infections, sepsis, and organ failure (multiple organ dysfunction syndrome). This review discusses new understanding of ICU dysbiosis, new data for probiotics and fecal transplantation in ICU, and new data characterizing the ICU microbiome.

Recent findings
ICU dysbiosis results from many factors, including ubiquitous antibiotic use and overuse. Despite advances in antibiotic therapy, infections and mortality from often multidrug-resistant organisms (i.e., Clostridium difficile) are increasing. This raises the question of whether restoration of a healthy microbiome via probiotics or other ‘dysbiosis therapies’ would be an optimal alternative, or parallel treatment option, to antibiotics. Recent clinical data demonstrate probiotics can reduce ICU infections and probiotics or fecal microbial transplant (FMT) can treat Clostridium difficile. This contributes to recommendations that probiotics should be considered to prevent infection in ICU. Unfortunately, significant clinical variability limits the strength of current recommendations and further large clinical trials of probiotics and FMT are needed. Before larger trials of ‘dysbiosis therapy’ can be thoughtfully undertaken, further characterization of ICU dysbiosis is needed. To addressing this, we conducted an initial analysis demonstrating a rapid and marked change from a ‘healthy’ microbiome to an often pathogen-dominant microbiota (dysbiosis) in a broad ICU population.

Summary
A growing body of evidence suggests critical illness and ubiquitous antibiotic use leads to ICU dysbiosis that is associated with increased ICU infection, sepsis, and multiple organ dysfunction syndrome. Probiotics and FMT show promise as ICU therapies for infection. We hope future-targeted therapies using microbiome signatures can be developed to correct ‘illness-promoting’ dysbiosis to restore a healthy microbiome post-ICU to improve patient outcomes.
Racial/Ethnic and Socioeconomic Differences in Colorectal and Breast Cancer Treatment Quality
Authors: Popescu Ioana , Schrag Deborah , Ang Alfonso , Wong Mitchell 
Published: June 2016

Background:Despite a large body of research showing racial/ethnic and socioeconomic disparities in cancer treatment quality, the relative role of physician-level variations in care is unclear.Objective:To examine the effect of physicians on disparities in breast and colorectal cancer care.Subjects:Linked SEER Medicare data were used to identify Medicare beneficiaries diagnosed with colorectal and breast cancer during 1995–2007 and their treating physicians.Research Design:We identified treating physicians from Medicare claims data. We measured the use of NIH guideline–recommended therapies from SEER and Medicare claims data, and used logistic models to examine the relationship between race/ethnicity, socioeconomic status, and cancer quality of care. We used physician fixed effects to account for between-physician variations in treatment.Results:Minority and low socioeconomic status beneficiaries with breast and colorectal cancer were less likely to receive any recommended treatments as compared with whites. Overall, between-physician variation explained <20% of the total variation in quality of care. After accounting for between-physician differences, median household income explained 14.3%, 18.4%, and 13.2% of the variation in use of breast-conserving surgery, chemotherapy, and radiation for breast cancer, and 13.7%, 12.9%, and 12.6% of the within-physician variation in use of colorectal surgery, chemotherapy, and radiation for colorectal cancer, whereas race and ethnicity explained <2% of the within-physician variation in cancer care.Conclusions:Between-physician variations partially explain racial disparities in cancer care. Residual within-physician disparities may be due to differences in patient-provider communication, patient preferences and treatment adherence, or unmeasured clinical severity.
Measuring Workplace Climate in Community Clinics and Health Centers
Authors: Friedberg Mark W. , Rodriguez Hector P. , Martsolf Grant R. , Edelen Maria O. , Vargas Bustamante Arturo 
Published: June 2016

Background:
The effectiveness of community clinics and health centers’ efforts to improve the quality of care might be modified by clinics’ workplace climates. Several surveys to measure workplace climate exist, but their relationships to each other and to distinguishable dimensions of workplace climate are unknown.

Objective:
To assess the psychometric properties of a survey instrument combining items from several existing surveys of workplace climate and to generate a shorter instrument for future use.

Materials and Methods:
We fielded a 106-item survey, which included items from 9 existing instruments, to all clinicians and staff members (n=781) working in 30 California community clinics and health centers, receiving 628 responses (80% response rate). We performed exploratory factor analysis of survey responses, followed by confirmatory factor analysis of 200 reserved survey responses. We generated a new, shorter survey instrument of items with strong factor loadings.

Results:
Six factors, including 44 survey items, emerged from the exploratory analysis. Two factors (Clinic Workload and Teamwork) were independent from the others. The remaining 4 factors (staff relationships, quality improvement orientation, managerial readiness for change, and staff readiness for change) were highly correlated, indicating that these represented dimensions of a higher-order factor we called “Clinic Functionality.” This 2-level, 6-factor model fit the data well in the exploratory and confirmatory samples. For all but 1 factor, fewer than 20 survey responses were needed to achieve clinic-level reliability >0.7.

Conclusions:
Survey instruments designed to measure workplace climate have substantial overlap. The relatively parsimonious item set we identified might help target and tailor clinics’ quality improvement efforts.
Outcome-specific Charlson Comorbidity Indices for Predicting Poor Inpatient Outcomes Following Noncardiac Surgery Using Hospital Administrative Data
Authors: Moodley Yoshan 
Published: June 2016

Background:
A need exists for adapting existing perioperative risk stratification methods such as the Charlson Comorbidity Index (CCI) for application with hospital administrative data in noncardiac surgery populations.

Objective:
Develop and validate outcome-specific CCIs for predicting inpatient mortality, and cardiac and renal morbidity in noncardiac surgery patients using hospital administrative data.

Methods:
We used hospital administrative data from the 2010 and 2011 California State Inpatient Database (SID) to develop (derivation cohort: 2010 SID, n=177,280) and validate (validation cohort: 2011 SID, n=179,145) 3 outcome-specific CCIs. Along with the 17 CCI comorbidities, the clinical importance and weighted point scores for age, male sex, race, emergent admission, and high-risk surgery were also determined from the coefficients of a logistic regression model. Cumulative outcome-specific CCI, CCI, and age-adjusted CCI (AACCI) scores were calculated for each patient. Receiver-operator characteristic curve analyses were used to determine the prognostic accuracy (area under the curve) of each outcome-specific CCIs, the CCI, and the AACCI. Risk was stratified according to cumulative point scores for each outcome-specific CCI, and posttest probabilities for each risk category were calculated.

Results:
All outcome-specific CCIs showed good performance as a prognostic tools (area under the curve>0.800 for all) and performed better than the CCI and AACCI. We attached clinical relevance to a given cumulative point score by determining posttest probabilities for each outcome-specific index.

Conclusions:
We successfully adapted and validated 3 outcome-specific CCIs for use in noncardiac surgery patients based on ICD-9 and hospital admission data. Further validation of these outcome-specific CCIs is warranted.
Baseline CD4 Count and Adherence to Antiretroviral Therapy: A Systematic Review and Meta-Analysis
Authors: Bock Peter , James Anelet , Nikuze Alliance , Peton Neshaan , Sabapathy Kalpana , Mills Edward , Fidler Sarah , Ford Nathan 
Published: June 2016

Background:
In light of recent changes to antiretroviral treatment (ART) guidelines of the World Health Organization and ongoing concerns about adherence with earlier initiation of ART, we conducted a systematic review of published literature to review the association between baseline (pre-ART initiation) CD4 count and ART adherence among adults enrolled in ART programs worldwide.

Methods:
We performed a systematic search of English language original studies published between January 1, 2004 and September 30, 2015 using Medline, Web of Science, LILACS, AIM, IMEMR, and WPIMR databases. We calculated the odds of being adherent at higher CD4 count compared with lower CD4 count according to study definitions and pooled data using random effects models.

Results:
Twenty-eight articles were included in the review and 18 in the meta-analysis. The odds of being adherent was marginally lower for patients in the higher CD4 count group (pooled odds ratio, 0.90; 95% confidence interval, 0.84 to 0.96); however, the majority of studies found no difference in the odds of adherence when comparing CD4 count strata. In analyses restricted to comparisons above and below a CD4 count of 500 cells per microliter, there was no difference in adherence (pooled odds ratio, 1.01; 95% confidence interval: 0.97 to 1.05).

Conclusions:
This review was unable to find consistent evidence of differences in adherence according to baseline CD4 count. Although this is encouraging for the new recommendations to treat all HIV-positive individuals irrespective of CD4 count, there is a need for additional high-quality studies, particularly among adults initiating ART at higher CD4 cell counts.
Closing the Gap in Antiretroviral Initiation and Viral Suppression: Time Trends and Racial Disparities
Authors: Haines Charles F. , Fleishman John A. , Yehia Baligh R. , Lau Bryan , Berry Stephen A. , Agwu Allison L. , Moore Richard D. , Gebo Kelly A. 
Published: June 2016

Background:
In the current antiretroviral (ART) era, the evolution of HIV guidelines and emergence of new ART agents might be expected to impact the times to ART initiation and HIV virologic suppression. We sought to determine if times to AI and virologic suppression decreased and if disparities exist by age, race/ethnicity, and HIV risk.

Methods:
We performed a retrospective cohort study of data from 12 sites of the HIV Research Network, a consortium of US clinics caring for HIV-infected patients. HIV-infected adults (≥18 year old) newly presenting for care between 2003 and 2013 were included in this study. Times to AI and virologic suppression were defined as time from enrollment to AI and HIV RNA <400 copies per milliliter, respectively. We conducted time-to-event analyses using competing risk regression in the HIV Research Network cohort from 2003 to 2012 in 2-year intervals, with follow-up through 2013.

Results:
Among 15,272 participants, 76.9% were male, 48.4% black, and 10.9% were injection drug use with median age of 38 years (interquartile range: 29–46 years). The adjusted subdistribution hazards ratios (SHRs) for AI and virologic suppression each increased for years 2007–2008 [SHR 1.23 (1.16–1.30), and SHR 1.25 (1.17–1.34), respectively], 2009–2010 [1.55 (1.46–1.64), and 1.54 (1.43–1.65), respectively], and 2011–2012 [1.94 (1.83–2.07), and 1.73 (1.61–1.86), respectively] compared with 2003–2004. Blacks had a lower probability of AI than whites and Hispanics.

Conclusions:
Since 2007, times from enrollment to AI and virologic suppression have decreased significantly compared with 2003–2004, but persisting disparities should be addressed.
Rationale for local treatment in the management of metastatic prostate cancer
Authors: Gandaglia Giorgio , Fossati Nicola , Dell’Oglio Paolo , Moschini Marco , Cucchiara Vito , Suardi Nazareno , Mottrie Alexandre , Mirone Vincenzo , Montorsi Francesco , Briganti Alberto 
Published: June 2016

Purpose of review
To evaluate the rationale supporting the role of local treatment in the management of patients with metastatic prostate cancer (PCa).

Recent findings
Not all patients with metastatic PCa share the same prognosis, in which selected individuals with oligometastatic PCa might benefit from local therapies. These men would harbor a biologically different disease as compared with their counterparts with widespread metastases. Local treatment would eliminate the source of tumor-promoting factors, destroy the origin of metastatic cells, and stop the self-seeding process. Moreover, decreasing tumor burden would eventually allow for an improved response to systemic therapies. Recent clinical studies support an oncologic role of surgery or radiotherapy in metastatic PCa. However, their retrospective nature limits the relevance of these findings. Results of ongoing trials assessing the impact of local treatment in metastatic patients are needed to comprehensively address its role.

Summary
Preclinical observations provide a rationale for treatment of the primary tumor in selected patients with metastatic PCa. However, available clinical evidence comes from retrospective investigations, and only results of ongoing randomized trials would clarify the role of local treatment in the metastatic setting.
A phenome-wide examination of neural and cognitive function
Authors: Poldrack RA , Congdon E , Triplett W , Gorgolewski KJ , Karlsgodt KH , Mumford JA , Sabb FW , Freimer NB , London ED , Cannon TD , Bilder RM 
Published: June 2016

AbstractThis data descriptor outlines a shared neuroimaging dataset from the UCLA Consortium for Neuropsychiatric Phenomics, which focused on understanding the dimensional structure of memory and cognitive control (response inhibition) functions in both healthy individuals (138 subjects) and individuals with neuropsychiatric disorders including schizophrenia (58 subjects), bipolar disorder (49 subjects), and attention deficit/hyperactivity disorder (45 subjects). The dataset includes an extensive set of task-based fMRI assessments, resting fMRI, structural MRI, and high angular resolution diffusion MRI. The dataset is shared through the OpenfMRI project, and is formatted according to the Brain Imaging Data Structure (BIDS) standard.
Unsupervised Learning of Temporal Features for Word Categorization in a Spiking Neural Network Model of the Auditory Brain
Authors: Higgins Irina , Stringer Simon , Schnupp Jan 
Published: June 2016

AbstractThe nature of the code used in the auditory cortex to represent complex auditory stimuli, such as naturally spoken words, remains a matter of debate. Here we argue that such representations are encoded by stable spatio-temporal patterns of firing within cell assemblies known as polychronous groups, or PGs. We develop a physiologically grounded, unsupervised spiking neural network model of the auditory brain with local, biologically realistic, spike-time dependent plasticity (STDP) learning, and show that the plastic cortical layers of the network develop PGs which convey substantially more information about the speaker independent identity of two naturally spoken word stimuli than does rate encoding that ignores the precise spike timings. We furthermore demonstrate that such informative PGs can only develop if the input spatio-temporal spike patterns to the plastic cortical areas of the model are relatively stable.Author SummaryCurrently we still do not know how the auditory cortex encodes the identity of complex auditory objects, such as words, given the great variability in the raw auditory waves that correspond to the different pronunciations of the same word by different speakers. Here we argue for temporal information encoding within neural cell assemblies for representing auditory objects. Unlike the more traditionally accepted rate encoding, temporal encoding takes into account the precise relative timing of spikes across a population of neurons. We provide support for our hypothesis by building a neurophysiologically grounded spiking neural network model of the auditory brain with a biologically plausible learning mechanism. We show that the model learns to differentiate between naturally spoken digits “one” and “two” pronounced by numerous speakers in a speaker-independent manner through simple unsupervised exposure to the words. Our simulations demonstrate that temporal encoding contains significantly more information about the two words than rate encoding. We also show that such learning depends on the presence of stable patterns of firing in the input to the cortical areas of the model that are performing the learning.
Macau and Brazil: from the World Trade Organization to a major gaming city
Authors: Spooner Paul B 
Published: June 2016

Purpose– The purpose of this paper is to review the present status and relationship of Macau to Brazil and to a provide the historical context for that relationship.Design/methodology/approach– This paper takes the approach of interviews, an extensive review of Portuguese and English language periodicals of Macau, Brazil, USA extending back to 1950s, and a review of the key secondary literature.Findings– Efforts to promote a relationship between Macau and Brazil since 1961 have been laudable, but have not resulted in either a meaningful economic relationship or systematic cultural links.Practical implications– Trade-wise Hong Kong is much better positioned to interface with Brazil than Macau. Brazil established strategic trade and diplomatic relations with China 25 years prior to Macau’s return to China in 1999 and without any intermediation by the city.Social implications– A strategic plan is needed to develop Macau’s links to Brazil based upon that country’s vast array of cultural strengths, which include sports, music, dance, religion, language, education, cuisine, environment resources, technology and the presence of a significant Macanese Diaspora.Originality/value– There is a shortage of analysis on the status of the relationship of Brazil to China, Macau and the Lusophone world.
Sustainable development and social policy: a case of indigenous villages in Hong Kong
Authors: Ma Kwok Wai 
Published: June 2016

Purpose
– The purpose of this paper is to illustrate the issues relating to sustainable development (SD) in the context of indigenous village development in Hong Kong.

Design/methodology/approach
– A case study approach is used in this research. In addition to literature review, qualitative data, primarily collected through personal interviews with various stakeholders were the main source of input.

Findings
– The Small House Policy (SHP) case illustrates an unsustainable policy. It underscores the interrelatedness among the relevant systems – social/cultural, economic, political and environmental – in the context of SD. In the short term, the government can at least expedite the construction of sewage facilities for the villages. Furthermore, the government can consider elevating the penalty and tightening policing/patrolling in village environs to discourage the illegal sale of “ding” rights and small houses. In the longer term, the government needs to put the rural area in order. Identifying means to zone planning would be a possible direction on this front.

Originality/value
– Through examining the case of SHP relating to the indigenous villages in Hong Kong, the complexity of SD is thoroughly revealed.
How to maintain peaceful Sino-US relations
Authors: Wang Weiwei 
Published: June 2016

Purpose
– In light of China’s rapid development and the USA’s “Pivot to Asia” policy, both China and the USA need to view each other objectively and cooperate with each other in order to keep their relations peaceful. The paper aims to discuss these issues.

Design/methodology/approach
– A literature review has been undertaken to prove that power transition theory is not sufficient for the adequate analysis of Sino-US relations.

Findings
– Considering its empirical and theoretical defects, power transition theory, which it has been generally considered can be used to explain China’s future development and the future course of Sino-US relations, cannot be used to explain and forecast Sino-US relations scientifically.

Originality/value
– Power transition theory cannot be used to explain and forecast Sino-US relations scientifically, considering its empirical and theoretical defects.
Improving relationships in project teams in Malaysia
Authors: Ling Florence Y.Y. , Khoo Wei Wey 
Published: June 2016

Purpose
– The purpose of this paper is to investigate relational practices that can improve construction project outcomes in Malaysia.

Design/methodology/approach
– Based on the literature review, a questionnaire was designed containing 14 relational practices that were identified and grouped under five relational norms. Using a survey questionnaire, data were collected from clients, consultants and contractors in Malaysia’s construction industry. In-depth interviews were conducted to validate the statistical findings.

Findings
– When contracts are adjustable to address uncertainties, the projects concerned have better cost and quality outcomes. A better schedule outcome is correlated with coordinating and monitoring plans jointly. Open communication and sharing trustworthy project information have been found to produce better client-consultant and consultant-contractor relationships at the end of a project. When parties maintain a social relationship outside of a project, relationships between clients, contractors and consultants also improve significantly.

Research limitations/implications
– The findings are not easily generalisable due to the relatively small sample size, low response rate and the data being collected from only three regions in Malaysia.

Practical implications
– Clients need to take the lead in adopting relational practices, as these may give rise to warmer relationships and better project outcomes. Showing too much commitment and flexibility may harm the project schedule because of the frequent changes.

Originality/value
– This study found that the theory of relational contracting norms applies to Malaysia’s construction industry. The parties do not rely strictly on contract conditions but embrace role integrity, preserve relations and harmony to avoid relational conflict, and achieve their goals through proper means.