bluuebunny/crossref_metadata_2025_split huggingface dataset:
Noninvasive Quantification of Blood Flow in Epicardial Coronary Arteries, Coronary Artery Bypass Grafts, and Anastomoses
Authors: Ferguson T. Bruce , Chen Cheng , Kim Sunghan , Jacobs Kenneth , Peng Zhiyong , Zhu Zhen , Buch Ashesh N. , Basham Jeffery C. 
Published: January 2017

Objective Direct flow measurement in native epicardial coronary arteries, bypass conduits, and anastomoses is severely limited by the invasiveness and inaccuracy of existing technologies. As a result, less than 25% of patients undergoing coronary artery bypass grafting (CABG) worldwide have any intraoperative evaluation performed. A simple, accurate, and noninvasive technology to directly quantify blood flow and rheology surrounding anastomotic sites is a critical unmet need in CABG. Methods Existing technology limitations drove development of a different technology solution. With an optical physics approach, flow in conduits and tissue can be quantified in real time with nonionizing broad-spectrum imaging as well as temporal and spatial analyses. Cardiac motion, calibration, and combining anatomy + physiology in imaging were challenges requiring solutions. Results This patented imaging technology was developed and tested in an established porcine cardiac experimental model and in clinical proof-of-concept studies. Flow velocities and flows in epicardial coronary arteries vary physiologically with the cardiac cycle and with acute ischemia, as predicted by previous studies using traditional technologies. Imaging data are captured from a 30-cm viewing distance, analyzed and displayed in real time as a video. The field of view enables capture of flow in the proximal and distal epicardial coronary, the conduit, at the anastomosis and in the distal myocardium simultaneously. Conclusions Rheologic flow interaction between conduit and native coronary at the anastomosis remains the most poorly understood technical aspect of CABG. A noninvasive, noncontact, no-risk imaging technology as simple as a snapshot can provide this critical physiologic information, validate and document intraoperative quality, and improve even further CABG outcomes.
Validating a Clinical Prediction Rule for Ventricular Shunt Malfunction
Authors: Boyle Tehnaz P. , Kimia Amir A. , Nigrovic Lise E. 
Published: January 2017

Objective
This study aims to validate a published ventricular shunt clinical prediction rule for the identification of children at low risk for ventricular shunt malfunction based on the absence of 3 high-risk clinical predictors (irritability, nausea or vomiting, and headache).

Methods
We identified children aged 21 years and younger with a ventricular shunt who presented between 2010 and 2013 to a single pediatric emergency department (ED) for evaluation of potential shunt malfunction. We defined a ventricular shunt malfunction as obstruction to cerebrospinal fluid flow requiring operative neurosurgical intervention within 72 hours of initial ED evaluation. We applied this ventricular shunt clinical prediction rule to the study population and report the test characteristics.

Results
We identified 755 ED visits for 294 children with potential ventricular shunt malfunction. Of these encounters, 146 (19%; 95% confidence interval [CI], 17%–22%) had a ventricular shunt malfunction. The ventricular shunt clinical prediction rule had a sensitivity of 99% (95% CI, 94%–100%), specificity of 7% (95% CI, 5%–9%), and negative predictive value of 95% (95% CI, 82%–99%). Two children with a ventricular shunt malfunction were misclassified as low risk by this clinical prediction rule.

Conclusions
Ventricular shunt malfunctions were common. Although children classified as low risk by the ventricular shunt clinical prediction rule were less likely to have a shunt malfunction, routine neuroimaging may still be required because exclusion of ventricular shunt malfunction may be difficult on clinical grounds alone.
Comparing the Outcomes of Reporting and Trigger Tool Methods to Capture Adverse Events in the Emergency Department
Authors: Lee Wen-Huei , Zhang Ewai , Chiang Charng-Yen , Yen Yung-Lin , Chen Ling-Ling , Liu Mei-Hsiu , Kung Chia-Te , Hung Shih-Chiang 
Published: January 2017

Background
Little is known about which methods are best for detecting adverse events in the emergency department (ED).

Objectives
This study compared the ability of trigger tool and reporting methods to capture adverse events in the ED and investigated the characteristics of the adverse events identified by each.

Methods
This 1-year prospective observational cohort study evaluated a monitoring system that combined 2 reporting methods and 5 trigger tool methods to capture adverse events in the ED of an academic medical center. Measurement outcomes included the number, type, and physical impact of the captured adverse events.

Results
Among 69,327 adult nontrauma ED visits, 285 adverse events were identified. Of these adverse events, 77.2% were identified using reporting methods, 26% using trigger tool methods, and 3.2% using both methods. Most patients (81.7%) incurred temporary, minor physical impacts. Of the adverse events that occurred, 86.7% were related to clinical performance. Compared with reporting methods, trigger tool methods had a lower positive predictive rate to identify adverse events (odds ratio [OR], 0.1; 95% confidence interval [CI], 0.09–0.16), a greater proportion of adverse events occurring during the preinterventation and postintervention phases (OR, 17.0; 95% CI, 8.48–34.16), and more cases of severe physical impact or death (OR, 5.4; 95% CI, 2.62–11.10).

Conclusions
The reporting methods more effectively captured greater numbers of adverse events, whereas the adverse events captured by the trigger tool methods were more likely to be severe physical impacts. The combined use of the different methods had synergistic benefits for monitoring adverse events in the ED.
Reporting correct p-values in VEGAS analyses
Authors: Hecker Julian , Maaser Anna , Prokopenko Dmitry , Fier Heide Loehlein , Lange Christoph 
Published: January 2017

AbstractVEGAS (versatile gene-based association study) is a popular methodological framework to perform gene-based tests based on summary statistics from single-variant analyses. The approach incorporates linkage disequilibrium information from reference panels to account for the correlation of test statistics. The gene-based test can utilize three different types of tests. In 2015, the improved framework VEGAS2, using more detailed reference panels, was published. Both versions provide user-friendly web- and offline-based tools for the analysis. However, the implementation of the popular top-percentage test is erroneous in both versions. The p-values provided by VEGAS2 are deflated/anti-conservative. Based on real data examples, we demonstrate that this can increase substantially the rate of false positive findings and can lead to inconsistencies between different test options. We also provide code that allows the user of VEGAS to compute correct p-values.
HeterozygousRFX6protein truncating variants are associated with Maturity-Onset Diabetes of the Young (MODY) with reduced penetrance
Authors: Patel Kashyap A , Kettunen Jarno , Laakso Markku , Stančáková Alena , Laver Thomas W , Colclough Kevin , Johnson Matthew B. , Abramowicz Marc , Groop Leif , Miettinen Päivi J. , Shepherd Maggie H , Flanagan Sarah E , Ellard Sian , Inagaki Nobuya , Hattersley Andrew T , Tuomi Tiinamaija , Cnop Miriam , Weedon Michael N 
Published: January 2017

AbstractFinding new genetic causes of monogenic diabetes can help to understand development and function of the human pancreas. We aimed to find novel protein–truncating variants causing Maturity–Onset Diabetes of the Young (MODY), a subtype of monogenic diabetes. We used a combination of next–generation sequencing of MODY cases with unknown aetiology along with comparisons to the ExAC database to identify new MODY genes. In the discovery cohort of 36 European patients, we identified two probands with novelRFX6heterozygous nonsense variants.RFX6protein truncating variants were enriched in the MODY discovery cohort compared to the European control population within ExAC (odds ratio, OR=131, P=l×l0‐4). We found similar results in non–Finnish European (n=348, OR=43, P=5×l0‐5) and Finnish (n=80, OR=22, P=1×l0‐6) replication cohorts. The overall meta–analysis OR was 34 (P=l×l0‐16).RFX6heterozygotes had reduced penetrance of diabetes compared to commonHNF1AandHNF4A–MODY mutations (27%, 70% and 55% at 25 years of age, respectively). The hyperglycaemia resulted from beta–cell dysfunction and was associated with lower fasting and stimulated gastric inhibitory polypeptide (GIP) levels. Our study demonstrates that heterozygousRFX6protein truncating variants are associated with MODY with reduced penetrance.
Kaizen within Kaizen Teams: Continuous and Process Improvements in a Spanish municipality
Authors: Suárez‐Barraza1 Manuel F. , Lingham Tony 
Published: January 2017

PurposeAs organizations become more team oriented, research on teams continues to increase especially involving how teams contribute to organizational performance and effectiveness. Although there has been existing research on Kaizen teams in the private sector, very little research has included Kaizen teams in the public sector. In this paper, we present a method to study Kaizen teams in a local Spanish government that have been using Kaizen teams for more than ten years.Design/methodology/approachQuantitative research was adopted for this study. Twenty teams participated in the study by filling out the Team Learning and Development Inventory (TLI) proposed by Lingham (2004). In addition, we interviewed members of the teams in
order to clarify and assure our quantitative results.FindingsBased on the findings, we propose that Kaizen teams should practice both Continuous (CI) and Process Improvements (PI) in their projects. We also propose that Kaizen teams should not be teams skilled only at developing better improvement processes (both CI and PI) for the organization but that such teams should also be skilled at engaging in team development using both CI and PI processes internally – a Kaizen within Kaizen teams approach.Research limitationsIts based in one case study. However, it is working paper and the research project still is developing.Practical ImplicationsServe as a guide to practitioners (Public managers) who desire to understand how their Kaizen teams involves both internal (conversational spaces) and external (methodology) perspectives that would contribute to both team and organizational effectiveness. In this paper, we focus on the Internal Processes (both CI and PI) using the TLI as an effective method for Kaizen teams to engage in the Kaizen process.Originality/valueThis study is one of the first to look at team’s performance using Team Learning and Development Inventory in Spain’s public sector. It is also the first to mention about the relationship of the team’s performance and the implementation of process improvement methodologies in Spain local government environment.
Gastronomy management
Authors: Bernardo Merce , Escalante Raúl , Roca Joan , Arbussà Anna 
Published: January 2017

PurposeThe purpose of this paper is to analyze and compare the existing management system standards in the gastronomy sector.Design/methodology/approachOn the basis of secondary data, the most implemented management system standards within this sector are analyzed, namely, the ISO 9001 focusing on the sector of “hotels and restaurants,” the ISO 22000, the “Q” Spanish tourism-specific standard, and the Michelin stars system.FindingsThe results, although descriptive, show the differences among them. Regarding the content, the main difference between the documented management system standards and the Michelin stars system is in the evaluation and certification process, as it is known and planned in the former group but not in the latter. The scope is also different, as the former group refers mainly to the process and the latter to results. The diffusion results confirm the increase in sectoral management system standards.Originality/valueAlthough studies analyzing the importance of sectoral standards have been published, this study is one of the first focusing on four different management system standards in the gastronomy sector. Implications for both practitioners and academia are also discussed.
Enhancement of ester formation in Camembert cheese by addition of ethanol
Authors: Hong Qing , Wang Gang , Zhang Qiuxiang , Tian Fengwei , Xiao‐Ming Liu , Zhao Jianxin , Chen Yong‐Quan , Zhang Hao , Chen Wei 
Published: January 2017

Ethyl esters are often detected at trace levels in Camembert cheese. This study investigated how the addition of ethanol prior to cheesemaking influenced the composition, texture and flavour profile of Camembert compared to a control cheese manufactured under identical conditions without ethanol. No statistical differences were observed in the composition, microbes or textures of the experimental and control cheeses. However, more ethyl esters and a significantly enhanced fruity flavour perception were reported for the experimental cheeses compared to the control. The addition of 400–1200 μg/g of ethanol may be applied in the production of Camembert cheese to enhance fruity flavour.
Hospital Variation in Utilization of Life‐Sustaining Treatments among Patients with Do Not Resuscitate Orders
Authors: Walkey Allan J. , Weinberg Janice , Wiener Renda Soylemez , Cooke Colin R. , Lindenauer Peter K. 
Published: January 2017

ObjectiveTo determine between‐hospital variation in interventions provided to patients with do not resuscitate (DNR) orders.Data Sources/SettingUnited States Agency of Healthcare Research and Quality, Healthcare Cost and Utilization Project, California State Inpatient Database.Study DesignRetrospective cohort study including hospitalized patients aged 40 and older with potential indications for invasive treatments: in‐hospital cardiac arrest (indication for CPR), acute respiratory failure (mechanical ventilation), acute renal failure (hemodialysis), septic shock (central venous catheterization), and palliative care. Hierarchical logistic regression to determine associations of hospital “early” DNR rates (DNR order placed within 24 hours of admission) with utilization of invasive interventions.Data Collection/Extraction MethodsCalifornia State Inpatient Database, year 2011.Principal FindingsPatients with DNR orders at high‐DNR‐rate hospitals were less likely to receive invasive mechanical ventilation for acute respiratory failure or hemodialysis for acute renal failure, but more likely to receive palliative care than DNR patients at low‐DNR‐rate hospitals. Patients without DNR orders experienced similar rates of invasive interventions regardless of hospital DNR rates.ConclusionsHospitals vary widely in the scope of invasive or organ‐supporting treatments provided to patients with DNR orders.
A systematic review and meta‐analysis of prospective transition from major depression to bipolar disorder
Authors: Ratheesh A. , Davey C. , Hetrick S. , Alvarez‐Jimenez M. , Voutier C. , Bechdolf A. , McGorry P. D. , Scott J. , Berk M. , Cotton S. M. 
Published: January 2017

ObjectiveSome people with major depressive disorder (MDD) may be at a pre‐onset stage for bipolar disorder (BD), where early identification or prevention efforts may be feasible. We aimed to identify rates and characteristics predictive of transition to BD in prospective follow‐up studies of people with MDD.MethodsUsing a systematic search strategy, we identified studies with a diagnostic ascertainment of MDD and BD of an adequate standard, and where the minimum length of follow‐up was 6 months. We examined the incidence and point prevalence of BD and the pooled odds ratios (OR) for baseline predictors.ResultsFrom 5554 unique publications, 56 were included. Nearly a quarter of adults (22.5%) and adolescents with MDD followed up for a mean length of 12–18 years developed BD, with the greatest risk of transition being in the first 5 years. The meta‐analysis identified that transition from MDD to BD was predicted by family history of BD (OR = 2.89, 95% CI: 2.01–4.14, N = 7), earlier age of onset of depression (g = −0.33, SE = 0.05, N = 6) and presence of psychotic symptoms (OR = 4.76, 95% CI: 1.79–12.66, N = 5).ConclusionsParticipants with the identified risk factors merit closer observation and may benefit from prevention efforts, especially if outcomes broader than BD are considered.
Deletion of 2.7 kb near HOXD3 in an Arabian horse with occipitoatlantoaxial malformation
Authors: Bordbari M. H. , Penedo M. C. T. , Aleman M. , Valberg S. J. , Mickelson J. , Finno C. J. 
Published: January 2017

SummaryIn the horse, the term occipitoatlantoaxial malformation (OAAM) is used to describe a developmental defect in which the first cervical vertebra (atlas) resembles the base of the skull (occiput) and the second cervical vertebra (axis) resembles the atlas. Affected individuals demonstrate an abnormal posture and varying degrees of ataxia. The homeobox (HOX) gene cluster is involved in the development of both the axial and appendicular skeleton. Hoxd3‐null mice demonstrate a strikingly similar phenotype to Arabian foals with OAAM. Whole‐genome sequencing was performed in an OAAM‐affected horse (OAAM1) and seven unaffected Arabian horses. Visual inspection of the raw reads within the region of HOXD3 identified a 2.7‐kb deletion located 4.4 kb downstream of the end of HOXD4 and 8.2 kb upstream of the start of HOXD3. A genotyping assay revealed that both parents of OAAM1 were heterozygous for the deletion. Additional genotyping identified two of 162 heterozygote Arabians, and the deletion was not present in 371 horses of other breeds. Comparative genomics studies have revealed that this region is highly conserved across species and that the entire genomic region between Hoxd4 and Hoxd3 is transcribed in mice. Two additional Arabian foals diagnosed with OAAM (OAAM 2 and 3) were genotyped and did not have the 2.7‐kb deletion. Closer examination of the phenotype in these cases revealed notable variation. OAAM3 also had facial malformations and a patent ductus arteriosus, and the actual malformation at the craniocervical junction differed. Genetic heterogeneity may exist across the HOXD locus in Arabian foals with OAAM.
Methodological quality, completeness of reporting and use of systematic reviews as evidence in clinical practice guidelines for paediatric overweight and obesity
Authors: Nissen T. , Wayant C. , Wahlstrom A. , Sinnett P. , Fugate C. , Herrington J. , Vassar M. 
Published: January 2017

SummaryPaediatric obesity rates remain high despite extensive efforts to prevent and treat obesity in children. We investigated the quality of the methodology and reporting within systematic reviews (SRs) underpinning paediatric content in US clinical practice guidelines (CPGs). In June 2016 we searched guideline clearinghouses and professional organization websites for guidelines published by national or professional organizations in the United States from January 2007 onwards. In our primary, a priori analysis, we used PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analyses) and AMSTAR (A Measurement Tool to Assess Systematic Reviews) instruments to score SRs and meta‐analyses that included paediatric populations and were cited by included CPGs. In a secondary, post hoc analysis, we determined the extent to which US CPGs use available, relevant SRs and meta‐analyses compared with non‐US CPGs. Eight US‐based CPGs with 27 references to 22 unique SRs were found. AMSTAR and PRISMA scores were low overall, with only three SRs having ‘high’ methodological quality. Items dealing with bias assessments and search strategies had especially low scores. US CPGs were also older on average and cited fewer SRs than their international counterparts. Low quality scores and dated guidelines should be a cause for concern among practicing clinicians and a call to action for future guideline developers, publishers and research institutions.
HIV encephalopathy with bilateral lower limb spasticity: gross motor function and antiretroviral therapy
Authors: Mann Theresa N , Laughton Barbara , Donald Kirsten A , Langerak Nelleke G 
Published: January 2017

AimTo describe gross motor function in children with bilateral lower limb (BLL) spasticity due to human immunodeficiency virus encephalopathy (HIVE), and to investigate the association between age, CD4 percentage, and viral load at initiation of antiretroviral therapy (ART) and current gross motor function.MethodThirty ambulant children with HIVE and BLL spasticity were recruited. Clinical parameters, including ART, were obtained from medical records. Gross motor function was assessed using the 88‐item Gross Motor Function Measure (GMFM‐88).ResultsThe participant group was comprised of 14 males and 16 females (median age 8y; interquartile range [IQR] 7–11y). ART was initiated at a median age of 7 months (IQR 5–11mo) with a median CD4 percentage of 4.7% (IQR 2.3–8.0) and viral load of log10 6.0 (IQR 5.6–6.4). The median total GMFM‐88 score was 89% (IQR 78–94%), with a wide range of scores in the ‘Standing’ domain (26–97%) and ‘Walking, Running, and Jumping’ domain (8–99%). No associations were detected between age at initiation of ART, CD4 percentage, or viral load and total GMFM‐88 score.InterpretationLimitations in gross motor function in children with HIVE and BLL spasticity range from mild to severe. ART initiation factors were not able to predict functional status in this sample.
Dapagliflozin in patients with type 1 diabetes: Apost hoc analysis of the effect of insulin dose adjustments on 24‐hour continuously monitored mean glucose and fasting β‐hydroxybutyrate levels in a phase IIa pilot study
Authors: Henry Robert R. , Dandona Paresh , Pettus Jeremy , Mudaliar Sunder , Xu John , Hansen Lars 
Published: January 2017

AimsTo investigate the effects of total daily insulin dose (TDD) reductions on 24‐hour continuously monitored mean glucose and fasting β‐hydroxybutyrate (a marker for diabetic ketosis/ketoacidosis [DKA]) levels, using patient‐level data from a 14‐day, pilot study of dapagliflozin in type 1 diabetes (T1DM).MethodsA post hoc exploratory correlation analysis was performed to determine the relationship between change in TDD and (1) 24‐hour mean glucose, assessed by continuous glucose monitoring, and (2) fasting β‐hydroxybutyrate, in 70 patients with T1DM receiving insulin and dapagliflozin (1, 2.5, 5 or 10 mg) or placebo. The pharmacodynamic effect of dapagliflozin was estimated as a virtual “insulin dose” using 24‐hour urinary glucose excretion values and a recognized insulin‐to‐carbohydrate counting technique.ResultsTrends for correlations were observed between change in TDD and 24‐hour glucose (day 7: r = −0.264, P = .056) and β‐hydroxybutyrate (day 7: r = −0.187, P = .133; day 14: r = −0.274, P = .047). The pharmacodynamic effect of dapagliflozin 5 or 10 mg was estimated as equivalent to ~20% of baseline TDD. Higher mean and maximum β‐hydroxybutyrate levels were observed on days 7 and 14 in patients with a TDD reduction >20% vs ≤20%.ConclusionsOver 14 days, decreasing the insulin dose diminished the glucose‐lowering effect of dapagliflozin–insulin combination therapy and increased levels of β‐hydroxybutyrate. While insulin dose adjustments should always be individualized, these analyses suggest that, as a general rule, TDD reduction in dapagliflozin‐treated patients with T1DM should not exceed 20%, to ensure glycaemic control does not deteriorate and to mitigate the potential for an increased risk of DKA.