bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring completeness in clinical data research networks with DQe-c
Authors: Estiri Hossein , Stephens Kari A , Klann Jeffrey G , Murphy Shawn N 
Published: September 2017

AbstractObjectiveTo provide an open source, interoperable, and scalable data quality assessment tool for evaluation and visualization of completeness and conformance in electronic health record (EHR) data repositories.Materials and MethodsThis article describes the tool’s design and architecture and gives an overview of its outputs using a sample dataset of 200 000 randomly selected patient records with an encounter since January 1, 2010, extracted from the Research Patient Data Registry (RPDR) at Partners HealthCare. All the code and instructions to run the tool and interpret its results are provided in the Supplementary Appendix.ResultsDQe-c produces a web-based report that summarizes data completeness and conformance in a given EHR data repository through descriptive graphics and tables. Results from running the tool on the sample RPDR data are organized into 4 sections: load and test details, completeness test, data model conformance test, and test of missingness in key clinical indicators.DiscussionOpen science, interoperability across major clinical informatics platforms, and scalability to large databases are key design considerations for DQe-c. Iterative implementation of the tool across different institutions directed us to improve the scalability and interoperability of the tool and find ways to facilitate local setup.ConclusionEHR data quality assessment has been hampered by implementation of ad hoc processes. The architecture and implementation of DQe-c offer valuable insights for developing reproducible and scalable data science tools to assess, manage, and process data in clinical data repositories.
Origins of carbon-enhanced metal-poor stars
Authors: Sharma Mahavir , Theuns Tom , Frenk Carlos S. , Cooke Ryan J. 
Published: September 2017

AbstractWe investigate the nature of carbon-enhanced metal-poor (CEMP) stars in Milky Way (MW) analogues selected from the eagle cosmological hydrodynamical simulation. The stellar evolution model in eagle includes the physics of enrichment by asymptotic giant branch (AGB) stars, winds from massive stars, and Type Ia and Type II supernovae (SNe). In the simulation, star formation in young MW progenitors is bursty due to efficient stellar feedback, which enables poor metal mixing leading to the formation of CEMP stars with extreme abundance patterns. Two classes of CEMP stars emerge: those mostly enriched by low-metallicity Type II SNe with low Fe yields that drive galactic outflows, and those mostly enriched by AGB stars when a gas-poor galaxy accretes pristine gas. The first class resembles CEMP-no stars with high [C/Fe] and low [C/O], the second class resembles CEMP-s stars overabundant in s-process elements and high values of [C/O]. These two enrichment channels explain several trends seen in data: (i) the increase in the scatter and median of [C/O] at low and decreasing [O/H], (ii) the trend of stars with very low [Fe/H] or [C/H] to be of type CEMP-no and (iii) the reduction in the scatter of [α/Fe] with atomic number in metal-poor stars. In this interpretation, CEMP-no stars were enriched by the stars that enabled galaxies to reionize the Universe.
Dispositional Mindful Attention in Relation to Negative Affect, Tobacco Withdrawal, and Expired Carbon Monoxide On and After Quit Day
Authors: Paulus Daniel J. , Langdon Kirsten J. , Wetter David W. , Zvolensky Michael J. 
Published: September 2017

Background:
Mindfulness (or “Mindful Attention”) has been described as the presence or absence of attention to, and awareness of, what is occurring in the present moment. Among smokers, greater mindfulness is associated with greater effect stability and reduced cue-induced craving. While studies have shown that mindfulness is associated with other smoking-related factors such as reduced withdrawal symptoms using cross-sectional data, relatively little is known about the associations between baseline mindful attention and future abstinence-related effect/withdrawal. The current study sought to examine whether levels of mindful attention before cessation predicts negative affect, withdrawal, and level of expired carbon monoxide (CO) on quit day, and also 3 and 7 days after quitting, during a self-quit attempt.

Methods:
Data from 58 adults (mean age = 34.9; 65.5% male) participating in a self-quit study were available for analysis. Self-report measures of mindful attention, negative affect, and withdrawal symptoms were collected. Biochemical measurement of expired CO was also collected. Dependent variables were assessed on quit day, and also 3 and 7 days after quitting. Covariates included age, race, sex, self-reported level of cigarette dependence, and smoking status through 7 days. Multivariate regression was used to evaluate the association of baseline mindful attention in relation to the studied outcomes.

Results:
Greater mindful attention predicted lower negative affect and reduced withdrawal at all 3 time-points. Mindful attention did not predict levels of expired CO.

Conclusions:
The findings suggest that mindful attention before or during smoking-cessation treatment may help to reduce negative affect and withdrawal, which serve as barriers to cessation for many smokers.
Predictors of Adherence to Psychological Treatment for Insomnia and Pain
Authors: Koffel Erin , Vitiello Michael V. , McCurry Susan M. , Rybarczyk Bruce , Von Korff Michael 
Published: September 2017

Objectives:
Poor adherence to psychological treatment for insomnia is common and limits treatment gains. Very little is known about predictors of adherence among patients with chronic pain, although adherence is theorized to be more critical and more challenging for these patients. This secondary data analysis examines predictors of drop-out and therapy nonattendance in an osteoarthritis population receiving psychological treatment for insomnia and pain.

Methods:
Data were analyzed from the “Lifestyles” trial, a randomized controlled trial of a 6-week group cognitive behavioral pain coping skills intervention (CBT-P), group cognitive-behavioral therapy for pain and insomnia (CBT-PI), and an education only attention control group (EOC). The current analysis focuses on 122 participants randomized to CBT-PI from 6 primary care clinics. Measures of treatment acceptability, demographics, and symptoms were collected at baseline. Factor analysis was used to clarify the boundaries of these domains, and hierarchical regression was used to examine the incremental predictive power of these patient characteristics on therapy attendance.

Results:
Ratings of treatment acceptability were distinct from demographic and medical variables and baseline symptoms. Treatment acceptability was significantly related to session attendance and drop-out (rs ranging from 0.24 to 0.32) and was also one of the strongest predictors of session attendance (β=0.20; P<0.05).

Discussion:
Perceptions of treatment acceptability early in treatment represent a potentially modifiable target to enhance adherence to psychological treatment for insomnia and pain among patients with chronic pain. This work represents an important step towards understanding how to best maximize sleep treatments for this patient population.
Systematic Changes in the National Surgical Quality Improvement Program Database Over the Years Can Affect Comorbidity Indices Such as the Modified Frailty Index and Modified Charlson Comorbidity Index for Lumbar Fusion Studies
Authors: Shultz Blake N. , Ottesen Taylor D. , Ondeck Nathaniel T. , Bovonratwet Patawut , McLynn Ryan P. , Cui Jonathan J. , Grauer Jonathan N. 
Published: September 2017

Study Design.
Retrospective cohort study of prospectively collected data.

Objective.
The aim of this study was to investigate the influence of changes in the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database over the years on the calculation of the modified Frailty Index (mFI) and the modified Charlson Comorbidity Index (mCCI) for posterior lumbar fusion studies.

Summary of Background Data.
Multiple studies have utilized the mFI and/or mCCI and showed them to be predictors of adverse postoperative outcomes. However, changes in the NSQIP database have resulted in definition changes and/or missing data for many of the variables included in these indices. No studies have assessed the influence of different methods of treating missing values when calculating these indices on such studies.

Methods.
Elective posterior lumbar fusions were identified in NSQIP from 2005 to 2014. The mFI was calculated for each patient using three methods: treating conditions for which data was missing as not present, dropping patients with missing values, and normalizing by dividing the raw score by the number of variables collected. The mCCI was calculated by the first two of these methods. Mean American Society of Anesthesiologists (ASA) scores used for comparison.

Results.
In total, 19,755 patients were identified. Mean ASA score increased between 2005 and 2014 from 2.27 to 2.50 (+10.1%). For each of the methods of data handling noted above, mean mFI over the years studied increased by 33.3%, could not be calculated, and increased by 183.3%, respectively. Mean mCCI increased by 31.2% and could not be calculated respectively.

Conclusion.
Systematic changes in the NSQIP database have resulted in missing data for many of the variables included in the mFI and the mCCI and may affect studies utilizing these indices. These changes can be understood in the context of ASA trends, and raise questions regarding the use of these indices with data available in later NSQIP years.

Level of Evidence: 3
Update on second trimester medical abortion
Authors: Lerma Klaira , Shaw Kate A. 
Published: September 2017

Purpose of review
To review recent literature on second trimester abortion with medical methods.

Recent findings
Across studies published in the recent past, it is apparent that women prefer shorter procedures and procedure times. Several randomized controlled trials have confirmed adding mifepristone to the second trimester medication abortion regimen results in shorter abortion intervals from first misoprostol administration to complete fetal expulsion. A study of simultaneous administration of mifepristone and misoprostol yielded shorter mean ‘total’ abortion times, presenting several logistical advantages. Recent studies on the continuous dosing of misoprostol have produced critical evidence to support continued dosing until expulsion. These studies had a more practical design compared with previous protocols that capped the number of misoprostol doses.

Summary
Second trimester surgical abortion is well tolerated and increasingly expeditious. Further research is needed to refine second trimester medical abortion methods, specific to the mifepristone, misoprostol dosing interval. A 12-hour mifepristone to misoprostol interval may be the optimal interval balancing patient preferences and logistical considerations. Pragmatic dosing, including continuous dosing of misoprostol, could yield results that better inform clinical guidelines and reduce burden on patient, provider, and health facility.
Abortion in the media
Authors: Conti Jennifer A. , Cahill Erica 
Published: September 2017

Purpose of review
To review updates in how abortion care is depicted and analysed though various media outlets: news, television, film, and social media.

Recent findings
A surge in recent media-related abortion research has recognized several notable and emerging themes: abortion in the news media is often inappropriately sourced and politically motivated; abortion portrayal in US film and television is frequently misrepresented; and social media has a new and significant role in abortion advocacy.

Summary
The portrayal of abortion onscreen, in the news, and online through social media has a significant impact on cultural, personal, and political beliefs in the United States. This is an emerging field of research with wide spread potential impact across several arenas: medicine, policy, public health.
The Dosimetric Demise of 97MNB
Authors: Snyder Sandra F. , Eckerman Keith F. 
Published: September 2017

Abstract
Radionuclide differences between ICRP Publication 38 and its succeeding work, ICPR Publication 107, are reviewed. The specific example of the isomer 97mNb is discussed, examining how dose reporting for this nuclide can be an issue.
Signal transducer and activator of transcription gain-of-function primary immunodeficiency/immunodysregulation disorders
Authors: Consonni Filippo , Dotta Laura , Todaro Francesca , Vairo Donatella , Badolato Raffaele 
Published: September 2017

Purpose of review
To describe primary immunodeficiencies caused by gain-of-function (GOF) mutations of signal transducer and activator of transcription (STAT) genes, a group of genetically determined disorders characterized by susceptibility to infections and, in many cases, autoimmune manifestations.

Recent findings
GOF mutations affecting STAT1 result in increased STAT tyrosine phosphorylation and secondarily increased response to STAT1-signaling cytokines, such as interferons. In contrast, STAT3 hyperactivity is not usually related to hyperphosphorylation but rather to increased STAT3-mediated transcriptional activity. In both cases, heterozygous STAT1 and STAT3 GOF mutations trigger a distinct set of genes in target cells that lead to abnormal functioning of antimicrobial response and/or autoimmunity and result in autosomal dominant diseases.

Summary
Clinical manifestations of patients with STAT1 GOF are characterized by mucocutaneous candidiasis and recurrent lower tract respiratory infections. In addition, many patients have thyroiditis, type 1 diabetes mellitus, autoimmune cytopenias, cancer or aneurysms. Patients with germline STAT3 GOF mutations have an increased frequency of early-onset multiorgan autoimmunity (i.e. autoimmune enteropathy, type 1 diabetes mellitus, autoimmune interstitial lung disease and autoimmune cytopenias), lymphoproliferation, short stature and, less frequently, severe recurrent infections. Treatment options range from antimicrobial therapy, intravenous or subcutaneous immunoglobulin and immunosuppressive drugs. Some patients with STAT1 GOF disorder have undergone hematopoietic stem cell transplantation, although these have been difficult because of the underlying proinflammatory milieu from the mutation.
The Impact of Telemedicine on Pediatric Critical Care Triage*
Authors: Harvey Jillian B. , Yeager Brooke E. , Cramer Christina , Wheeler David , McSwain S. David 
Published: September 2017

Objective:
To examine the relationship between pediatric critical care telemedicine consultation to rural emergency departments and triage decisions. We compare the triage location and provider rating of the accuracy of remote assessment for a cohort of patients who receive critical care telemedicine consultations and a similar group of patients receiving telephone consultations.

Design:
Retrospective evaluation of consultations occurring between April 2012 and March 2016.

Setting:
Pediatric critical care telemedicine and telephone consultations in 52 rural healthcare settings in South Carolina.

Patients:
Pediatric patients receiving critical care telemedicine or telephone consultations.

Intervention:
Telemedicine consultations.

Measurements and Main Results:
Data were collected from the consulting provider for 484 total consultations by telephone or telemedicine. We examined the providers’ self-reported assessments about the consultation, decision-making, and triage outcomes. We estimate a logit model to predict triage location as a function of telemedicine consult age and sex. For telemedicine patients, the odds of triage to a non-ICU level of care are 2.55 times larger than the odds for patients receiving telephone consultations (p = 0.0005). Providers rated the accuracy of their assessments higher when consultations were provided via telemedicine. When patients were transferred to a non-ICU location following a telemedicine consultation, providers indicated that the use of telemedicine influenced the triage decision in 95.7% of cases (p < 0.001). For patients transferred to a non-ICU location, an increase in transfers to a higher level of care within 24 hours was not observed.

Conclusion:
Pediatric critical care telemedicine consultation to community hospitals is feasible and results in a reduction in PICU admissions. This study demonstrates an improvement in provider-reported accuracy of patient assessment via telemedicine compared with telephone, which may produce a higher comfort level with transporting patients to a lower level of care. Pediatric critical care telemedicine consultations represent a promising means of improving care and reducing costs for critically ill children in rural areas.
Potential Acceptability of a Pediatric Ventilator Management Computer Protocol*
Authors: Sward Katherine A. , Newth Christopher J. L. , Khemani Robinder G. , Page Kent , Meert Kathleen L. , Carcillo Joseph A. , Shanley Thomas P. , Moler Frank W. , Pollack Murray M. , Dalton Heidi J. , Wessel David L. , Berger John T. , Berg Robert A. , Harrison Rick E. , Doctor Allan , Dean J. Michael , Holobkov Richard , Jenkins Tammara L. , Nicholson Carol E. 
Published: September 2017

Objectives:
To examine issues regarding the granularity (size/scale) and potential acceptability of recommendations in a ventilator management protocol for children with pediatric acute respiratory distress syndrome.

Design:
Survey/questionnaire.

Setting:
The eight PICUs in the Collaborative Pediatric Critical Care Research Network.

Participants:
One hundred twenty-two physicians (attendings and fellows).

Interventions:
None.

Measurements and Main Results:
We used an online questionnaire to examine attitudes and assessed recommendations with 50 clinical scenarios. Overall 80% of scenario recommendations were accepted. Acceptance did not vary by provider characteristics but did vary by ventilator mode (high-frequency oscillatory ventilation 83%, pressure-regulated volume control 82%, pressure control 75%; p = 0.002) and variable adjusted (ranging from 88% for peak inspiratory pressure and 86% for Fio
2 changes to 69% for positive end-expiratory pressure changes). Acceptance did not vary based on child size/age. There was a preference for smaller positive end-expiratory pressure changes but no clear granularity preference for other variables.

Conclusions:
Although overall acceptance rate for scenarios was good, there was little consensus regarding the size/scale of ventilator setting changes for children with pediatric acute respiratory distress syndrome. An acceptable protocol could support robust evaluation of ventilator management strategies. Further studies are needed to determine if adherence to an explicit protocol leads to better outcomes.
Objectively Measured Physical Activity and Falls in Well-Functioning Older Adults
Authors: Nastasi Anthony J. , Ahuja Alka , Zipunnikov Vadim , Simonsick Eleanor M. , Ferrucci Luigi , Schrack Jennifer A. 
Published: September 2017

Objective
Previous work demonstrates the consequences of falling in older adults and the potential of physical activity (PA) to reduce falls, but few studies have used accelerometer-measured PA to compare overall and time-of-day activity patterns of nonfallers, fallers, or subgroups of fallers.

Methods
In 840 participants (mean age, 66.7; s = 13.2; range, 26–97) of the Baltimore Longitudinal Study of Aging between 2007 and 2014, PA was measured objectively with Actiheart accelerometers and falling status (faller/nonfaller) was assessed during an in-person interview. Differences in daily PA and PA by time-of-day were assessed using multiple linear regression. Differences in PA (multiple linear regression), and functional status (χ2) were further examined in subgroups of “risky” or “normal” fallers.

Results
Overall, fallers and nonfallers exhibited similar daily (β = 22.6, P = 0.48) and time-specific PA; however, those who fell doing risky activities were more active overall (β = 243.8, P = 0.002), during the morning (β = 77.3, P = 0.004), afternoon (β = 78.4, P = 0.001), and late afternoon/evening (β = 56.3, P = 0.006) than those who fell doing normal activities. Risky fallers were significantly higher functioning than normal fallers.

Conclusions
Persons who fell while engaging in normal activities exhibited lower PA overall and throughout most of the day, and were of lower functional status than persons who fell while engaging in risky or unusual activities, suggesting that engagement in risky or unusual PA is associated with higher functional ability and lower falls risk in older persons.
Checklist for the preparation and review of pain clinical trial publications: a pain-specific supplement to CONSORT
Authors: Gewandter Jennifer S. , Eisenach James C. , Gross Robert A. , Jensen Mark P. , Keefe Francis J. , Lee David A. , Turk Dennis C. 
Published: September 2017

Abstract

Introduction:
Randomized clinical trials (RCTs) are considered the gold standard when assessing the efficacy of interventions because randomization of treatment assignment minimizes bias in treatment effect estimates. However, if RCTs are not performed with methodological rigor, many opportunities for bias in treatment effect estimates remain. Clear and transparent reporting of RCTs is essential to allow the reader to consider the opportunities for bias when critically evaluating the results. To promote such transparent reporting, the Consolidated Standards of Reporting Trials (CONSORT) group has published a series of recommendations starting in 1996. However, a decade after the publication of the first CONSORT guidelines, systematic reviews of clinical trials in the pain field identified a number of common deficiencies in reporting (eg, failure to identify primary outcome measures and analyses, indicate clearly the numbers of participants who completed the trial and were included in the analyses, or report harms adequately).

Objectives:
To provide a reporting checklist specific to pain clinical trials that can be used in conjunction with the CONSORT guidelines to optimize RCT reporting.

Methods:
Qualitative review of a diverse set of published recommendations and systematic reviews that addressed the reporting of clinical trials, including those related to all therapeutic indications (eg, CONSORT) and those specific to pain clinical trials.

Results:
A checklist designed to supplement the content covered in the CONSORT checklist with added details relating to challenges specific to pain trials or found to be poorly reported in recent pain trials was developed.

Conclusion:
Authors and reviewers of analgesic RCTs should consult the CONSORT guidelines and this checklist to ensure that the issues most pertinent to pain RCTs are reported with transparency.