bluuebunny/crossref_metadata_2025_split huggingface dataset:
How healthcare systems evaluate their advance care planning initiatives: Results from a systematic review
Authors: Biondo Patricia D , Lee Lydia D , Davison Sara N , Simon Jessica E ,   on behalf of the Advance Care Planning Collaborative Research and Innovation Opportunities Program (ACP CRIO)
Published: February 2016

Background: Advance care planning initiatives are being implemented across healthcare systems around the world, but how best to evaluate their implementation is unknown. Aim: To identify gaps and/or redundancies in current evaluative strategies to help healthcare systems develop future evaluative frameworks for ACP. Design: Systematic review. Methods: Peer-reviewed and gray literature searches were conducted till February 2015 to answer: “What methods have healthcare systems used to evaluate implementation of advance care planning initiatives?” A PICOS framework was developed to identify articles describing the implementation and evaluation of a health system–level advance care planning initiative. Outcome measures were mapped onto a conceptual quality indicator framework based on the Institute of Medicine and Donabedian models of healthcare quality. Results: A total of 46 studies met inclusion criteria for analysis. Most articles reported on single parts of a healthcare system (e.g. continuing care). The most common outcome measures pertained to document completion, followed by healthcare resource use. Patient-, family-, or healthcare provider-reported outcomes were less commonly measured. Concordance measures (e.g. dying in place of choice) were reported by only 26% of studies. The conceptual quality indicator framework identified gaps and redundancies in measurement and is presented as a potential foundation from which to develop a comprehensive advance care planning evaluation framework. Conclusion: Document completion is frequently used to evaluate advance care planning program implementation; capturing the quality of care appears to be more difficult. This systematic review provides health system administrators with a comprehensive summary of measures used to evaluate advance care planning and may identify gaps in evaluation within their local context.
Antipsychotic polypharmacy and augmentation strategies prior to clozapine initiation: a historical cohort study of 310 adults with treatment-resistant schizophrenic disorders
Authors: Thompson Joseph V , Clark Joanne M , Legge Sophie E , Kadra Giouliana , Downs Johnny , Walters James TR , Hamshere Marian L , Hayes Richard D , Taylor David , MacCabe James H 
Published: February 2016

Rationale: Antipsychotic polypharmacy (APP) is commonly used in schizophrenia despite a lack of robust evidence for efficacy, as well as evidence of increased rates of adverse drug reactions and mortality. Objectives: We sought to examine APP and the use of other adjunctive medications in patients with treatment-resistant schizophrenic disorders (ICD-10 diagnoses F20–F29) immediately prior to clozapine initiation, and to investigate clinical and sociodemographic factors associated with APP use in this setting. Methods: Analysis of case notes from 310 patients receiving their first course of clozapine at the South London and Maudsley NHS Trust (SLaM) was undertaken using the Clinical Record Interactive Search (CRIS) case register. Medication taken immediately prior to clozapine initiation was recorded, and global clinical severity was assessed at time points throughout the year prior to medication assessment using the Clinical Global Impression – Severity scale (CGI-S). Logistic regression was used to investigate factors associated with APP. Results: The point prevalence of APP prior to clozapine initiation was 13.6% ( n=42), with 32.6% of subjects prescribed adjuvant psychotropic medications. APP was associated with increasing number of adjuvant medications (odds ratio (OR) 1.97, 95% confidence interval (CI) 1.27–3.06), concurrent depot antipsychotic prescription (OR 2.64, CI 1.24–5.62), concurrent antidepressant prescription (OR 4.40, CI 1.82–10.63) and a CGI-S over the previous year within the two middle quartiles (Quartile 2 vs 1 OR 6.19, CI 1.81–21.10; Quartile 3 vs 1 OR 4.45, CI 1.29–15.37; Quartile 4 vs 1 OR 1.88, CI 0.45–7.13). Conclusions: APP and augmentation of antipsychotics with antidepressants, mood stabilizers and benzodiazepines are being employed in treatment-resistant schizophrenia prior to clozapine. The conservative APP rate observed may have been influenced by an initiative within SLaM that reduced APP rates during the study window. Efforts to reduce the use of poorly evidenced prescribing should focus on adjuvant medications as well as APP.
Expanding the Supply of Pasteurized Donor Milk
Authors: Perrin Maryanne Tigchelaar , Goodell L. Suzanne , Fogleman April , Pettus Hannah , Bodenheimer Amanda L. , Palmquist Aunchalee E. L. 
Published: February 2016

Background: Lactating women in the United States have several options for what they do with excess breast milk, including donating to milk banks that serve medically fragile infants, sharing directly with families seeking milk, and selling to individuals or for-profit entities. The World Health Organization and the US Surgeon General have issued calls to increase access to pasteurized donor milk for medically fragile infants. Objective: To explore how lactating women with a surplus of breast milk come to the decision to share their milk with a peer rather than donate to a milk bank. Methods: A qualitative design using a grounded theory approach was employed. Semistructured telephone interviews were conducted with 27 women who had shared milk with a peer but not with a milk bank. Results: Five dominant themes were identified: a strong belief in the value of breast milk, unexpected versus planned donation, sources of information regarding milk exchange, concerns and knowledge gaps about milk banks, and helping and connecting. Conclusions: This research offers insights into potential strategies for promoting milk bank donation among peer-to-peer milk sharers, including developing donor education campaigns focused on knowledge gaps regarding milk banks and developing health care professional referral programs that can reduce barriers associated with the convenience of milk bank donation.
Physician health and wellbeing provide challenges to patient safety and outcome quality across the careerspan
Authors: Williams Betsy White , Flanders Philip 
Published: February 2016

Objective: Age correlated changes in mental and physical capacity have contributed to increasing concerns about older physicians’ clinical competence. This paper explores the relationship between age and health in a clinical population referred for fitness for duty evaluations. Methods: Fifty cases from an evaluation center performing fitness for duty evaluations were randomly selected. Cases were reviewed for referral reason, demographic information, diagnosis, and recommendations. Results: Age ranged from 28–70 (median age of 51, mode of 45). Eighty-eight percent of cases had a diagnosed medical condition with potential cognitive sequellae. Conclusion: While the literature supports performance concerns in aging practitioners, health independent of age, appears to be an important contributing factor. A screening process considering biopsychosocial reserve and professional load while applicable to older clinicians would optimally be implemented for physicians across their careerspan.
Aripiprazole long-acting injection: promising but more evidence needed
Authors: Keks Nicholas A , Hope Judy , Culhane Christine 
Published: February 2016

Objective: Aripiprazole long acting injection (ALAI) is now available, and this paper aims to assist clinicians in deciding when to use ALAI. Conclusion: Aripiprazole is a partial dopamine agonist with low sedation, relatively favourable metabolic profile and a tendency to lower, rather than raise, prolactin. Available for over a decade, aripiprazole has been increasingly recognised by many clinicians as a useful option in the treatment of psychoses. ALAI is a suspension of crystalline aripiprazole in water which takes 5–7 days to reach steady state after an initial intramuscular injection. Monthly injections achieve steady state in four months. Studies have demonstrated that ALAI is effective in aripiprazole-responsive patients. ALAI was generally well tolerated, but more prone to cause extrapyramidal side-effects than the oral form. ALAI has not been compared with other depots. Although the recommended starting dose is 400 mg, it is likely that there will be significant inter-individual dose variation. Dose optimisation in each patient will be necessary for best effectiveness and tolerability. ALAI is currently appropriate for aripiprazole-responsive patients who need a depot, but clinicians are likely to try ALAI in patients who have been on other depots, particularly in whom weight gain and hyperprolactinaemia have been problematic.
Medical student teaching in the private sector – An overlooked opportunity?
Authors: Galletly Cherrie A , Turnbull Carol , Goldney Robert 
Published: February 2016

Objective: One in four psychiatric beds in Australia are located in the private sector, and more than half of Australian psychiatrists undertake private work. However, nearly all medical student teaching in psychiatry takes place in public hospitals. This paper explores the learning opportunities in the private sector. We report the South Australian experience; medical students have been taught in Ramsay Health Care (SA) Mental Health facilities for more than 23 years. Conclusions: Our experience demonstrates that clinical teaching in private hospitals is sustainable and well accepted by students, patients and clinicians. The private sector has the capacity to make a much greater contribution to medical student training in psychiatry.
The Relationship Between Plasma Whole Blood Viscosity and Cardiovascular Events in Patients With Chronic Kidney Disease
Authors: Celik Turgay , Yilmaz Mahmut Ilker , Balta Sevket , Ozturk Cengiz , Unal Hilmi Umut , Aparci Mustafa , Karaman Murat , Demir Mustafa , Yildirim A. Osman , Saglam Mutlu , Kilic Selim , Eyileten Tayfun , Aydin İbrahim , Iyisoy Atila 
Published: February 2016

Background: Plasma levels of estimated whole blood viscosity (eWBV) have been increased by endothelial inflammation. Because there were no consistent data for assessing the eWBV levels for prediction of cardiovascular event (CVE) in patients with chronic kidney disease (CKD). We aimed to investigate the relationship between plasma eWBV levels and CVEs in patients with CKD. Materials and Methods: We conducted a prospective, cross-sectional, long-term follow-up study, assessing the relationship between plasma eWBV levels and CVE (either fatal or nonfatal) in patients with newly diagnosed CKD. We also evaluated estimated glomerular filtration rate (eGFR), pentraxin 3 (PTX3), high-sensitivity C-reactive protein (hsCRP), and flow-mediated dilatation (FMD). Results: Study patients were divided into 2 groups: patients with CVE and patients without CVE. The eWBV levels were higher in patients with CVE. Additionally, PTX3 and hsCRP were higher, and FMD and eGFR were lower in patients with CVE compared to those without CVE. According to the Cox regression analysis, WBV, plasma asymmetric dimethylarginine levels, FMD, hsCRP, eGFR, systolic blood pressure, calcium, and history of diabetes were independent predictors of CVEs in patients with CKD. Kaplan Meier survival curves were generated to establish the impact of the WBV on the cumulative survival of the cohort. Patients with eWBV values higher than 5.2 centipoise (cP) had lower survival rates when compared to patients with eWBV values lower than 5.2 cP (log rank = 4.49 df = 1 P = .034). Conclusion: In conclusion, plasma eWBV levels may increase the presence of lower eGFR and affect CVE in patients with CKD independent of classical and unconventional risk factors.
First-line lesional aspiration in acute stroke thrombectomy using a novel intermediate catheter: Initial experiences with the SOFIA
Authors: Kabbasch C , Möhlenbruch M , Stampfl S , Mpotsaris A , Behme D , Liebig T 
Published: February 2016

Introduction Five randomized controlled trials (RCTs) on endovascular therapy (EVT) of stroke have proven a clinical benefit over conservative treatment or IV-thrombolysis alone. Lesional clot aspiration with a dedicated system can achieve revascularization without an additional retriever (a direct-aspiration first-pass technique, ADAPT), and the SOFIA has been shown to be both safe and efficacious in a multicentric retrospective study. We have evaluated a subset of these data acquired in two major stroke centers with regard to using the SOFIA for first-line lesional aspiration. Methods Thirty patients with large-vessel occlusions treated with first-line lesional aspiration were identified. Procedural data, clot length, reperfusion success (mTICI), procedural timings, complications, and clinical status at admission, discharge and at 90 days were analyzed. Results The median baseline NIHSS was 16. IV thrombolysis was administered in 15/30 patients. Ninety-three percent of occlusions were in the anterior circulation. TICI ≥ 2b was achieved in 90% of multimodality treatments; lesional aspiration was successful in 67% within a median time of 20 minutes. The highest first-attempt success rate was in MCA occlusions (median time to recanalization 10 minutes). There were no device-related events. Symptomatic intracerebral hemorrhage (sICH) occurred in 10%, but never with sole lesional aspiration. Embolization to new territories was recorded in 1/30 (3%). Median discharge NIHSS was 7; 30% were mRS ≤ 2 at discharge and 43% at 90-day follow-up. Conclusions Lesional aspiration with SOFIA is in line with published data. The SOFIA may be used as a first-line device, aiming at fast recanalization by sole aspiration with good safety and efficacy. If unsuccessful, it converts into part of a stent retriever-based multimodality treatment.
Incidence and risk factors of infections associated with peripheral intravenous catheters
Authors: Serane Tiroumourougane , Kothendaraman Bhuvaneswari 
Published: February 2016

Aim: To study the incidence and risk factors of bacterial colonisation of peripheral venous catheters during the early neonatal period. Design: Prospective observational clinical study. Setting: Level II neonatal intensive care unit. Patients: Consecutive neonates in whom peripheral catheter was inserted were recruited. Methods: The insertion site was cleaned with isopropyl alcohol and chlorhexidine for 30 s consecutively. A needleless catheter access device was attached to peripheral catheters. A dedicated observer reviewed the catheter sites regularly for complications. On removal, the tip of the catheter was cut under sterile conditions and sent to the laboratory for culture. Only catheters indwelling for >12 h were sent for culture. Findings: Bacteria were isolated from 22 out of 154 catheter tips. Methicillin-sensitive Staphylococcus aureus (n = 13) was the most common organism constituting more than 50% of isolates. In five out of 22 isolates, the organism from the catheter tip was identical to the one from the skin. Systemic sepsis at enrolment was positively associated with colonisation of peripheral catheter. None of the neonates developed peripheral catheter-related bloodstream infection. Conclusion: When proper infection control measures are in place, risk of peripheral venous catheter-related infection appears extremely low in spite of frequent colonisation of the catheter.
Cardiac surgery and phenprocoumon therapy— Is preoperative normalization of the international normalized ratio necessary?
Authors: Essa Yasin , Amorim Paulo , Färber Gloria , Hoyer Heike , Hofmann Michael , Doenst Torsten 
Published: February 2016

Objectives: Patients on phenprocoumon presenting for surgery are often converted to heparin preoperatively. We assessed the impact of this conversion on outcome in cardiac surgery patients. Methods: From November 2007 to September 2013, 115 patients with phenprocoumon therapy presented for surgery and were operated either before or after the international normalized ratio (INR) had normalized (group A, INR > 1.3, n = 71; group B, INR ⩽ 1.3, n = 44 at day of surgery; group C, matched control cohort without preoperative phenprocoumon, INR ⩽ 1.3, n = 60). Results: Patients received a mix of cardiac surgical procedures (including valves, coronary artery bypass grafting, ventricular assist devices, and transplantation) without intergroup differences. Surgery was emergent in 11%, 2%, and 13% in groups A, B, and C, respectively (p = 0.2). Preoperative hospital stay was longest in group B (p < 0.01). Hospital mortality was high with 26% in group A (EuroSCORE 22 ± 22), 13% in group B (EuroSCORE 17 ± 16), and 7% in group C (EuroSCORE 10 ± 15) p < 0.01. Mean chest tube drainage (first 24 h) was lowest in group C (mean/min/max, A: 1096/350/4750 mL; B 1086/300/4100 mL; C 757/120/2170 mL, p = 0.03), and preoperative hemoglobin was highest (A: 7.5 ± 1.2, B: 7.5 ± 1.4, C: 8.1 ± 1.2 mmol/L, p = 0.01). If transfusion was required, patients in group A received more red blood cells (mean units, A: 4.5 ± 8; B: 3.5 ± 6; C: 1.5 ± 3, p = 0.02). By multivariate analysis, preoperative INR was not an independent predictor of postoperative bleeding (p = 0.8). Only low preoperative fibrinogen predicted increased chest tube drainage, independent of phenprocoumon (p = 0.01). Conclusion: Patients presenting for cardiac surgery with preoperative phenprocoumon represent a high-risk population. Bleeding complications for these patients are higher but do not seem to be influenced by preoperative INR. Our data question the need for conversion to heparin.
MUC1-C drives MYC in multiple myeloma
Authors: Tagde Ashujit , Rajabi Hasan , Bouillez Audrey , Alam Maroof , Gali Reddy , Bailey Shannon , Tai Yu-Tzu , Hideshima Teru , Anderson Kenneth , Avigan David , Kufe Donald 
Published: February 2016

Key PointsMUC1-C induces MYC gene transcription in MM cells. Targeting MUC1-C downregulates MYC expression and its transcriptional program.
Anti–factor VIII IgA as a potential marker of poor prognosis in acquired hemophilia A: results from the GTH-AH 01/2010 study
Authors: Tiede Andreas , Hofbauer Christoph J. , Werwitzke Sonja , Knöbl Paul , Gottstein Saskia , Scharf Rüdiger E. , Heinz Jürgen , Groß Jürgen , Holstein Katharina , Dobbelstein Christiane , Scheiflinger Fritz , Koch Armin , Reipert Birgit M. 
Published: February 2016

Key Points
This study is the first to assess the prognostic value of FVIII-specific antibody data in patients with AHA. Anti-FVIII IgA, but not immunoglobulin G, autoantibodies at baseline are potential predictors of recurrence and poor outcome of AHA.
A two-layer integration framework for protein complex detection
Authors: Ou-Yang Le , Wu Min , Zhang Xiao-Fei , Dai Dao-Qing , Li Xiao-Li , Yan Hong 
Published: February 2016

Abstract
Background
Protein complexes carry out nearly all signaling and functional processes within cells. The study of protein complexes is an effective strategy to analyze cellular functions and biological processes. With the increasing availability of proteomics data, various computational methods have recently been developed to predict protein complexes. However, different computational methods are based on their own assumptions and designed to work on different data sources, and various biological screening methods have their unique experiment conditions, and are often different in scale and noise level. Therefore, a single computational method on a specific data source is generally not able to generate comprehensive and reliable prediction results.

Results
In this paper, we develop a novel Two-layer INtegrative Complex Detection (TINCD) model to detect protein complexes, leveraging the information from both clustering results and raw data sources. In particular, we first integrate various clustering results to construct consensus matrices for proteins to measure their overall co-complex propensity. Second, we combine these consensus matrices with the co-complex score matrix derived from Tandem Affinity Purification/Mass Spectrometry (TAP) data and obtain an integrated co-complex similarity network via an unsupervised metric fusion method. Finally, a novel graph regularized doubly stochastic matrix decomposition model is proposed to detect overlapping protein complexes from the integrated similarity network.

Conclusions
Extensive experimental results demonstrate that TINCD performs much better than 21 state-of-the-art complex detection techniques, including ensemble clustering and data integration techniques.
Detecting false positive sequence homology: a machine learning approach
Authors: Fujimoto M. Stanley , Suvorov Anton , Jensen Nicholas O. , Clement Mark J. , Bybee Seth M. 
Published: February 2016

Abstract
Background
Accurate detection of homologous relationships of biological sequences (DNA or amino acid) amongst organisms is an important and often difficult task that is essential to various evolutionary studies, ranging from building phylogenies to predicting functional gene annotations. There are many existing heuristic tools, most commonly based on bidirectional BLAST searches that are used to identify homologous genes and combine them into two fundamentally distinct classes: orthologs and paralogs. Due to only using heuristic filtering based on significance score cutoffs and having no cluster post-processing tools available, these methods can often produce multiple clusters constituting unrelated (non-homologous) sequences. Therefore sequencing data extracted from incomplete genome/transcriptome assemblies originated from low coverage sequencing or produced by de novo processes without a reference genome are susceptible to high false positive rates of homology detection.

Results
In this paper we develop biologically informative features that can be extracted from multiple sequence alignments of putative homologous genes (orthologs and paralogs) and further utilized in context of guided experimentation to verify false positive outcomes. We demonstrate that our machine learning method trained on both known homology clusters obtained from OrthoDB and randomly generated sequence alignments (non-homologs), successfully determines apparent false positives inferred by heuristic algorithms especially among proteomes recovered from low-coverage RNA-seq data. Almost ~42 % and ~25 % of predicted putative homologies by InParanoid and HaMStR respectively were classified as false positives on experimental data set.

Conclusions
Our process increases the quality of output from other clustering algorithms by providing a novel post-processing method that is both fast and efficient at removing low quality clusters of putative homologous genes recovered by heuristic-based approaches.
Draft genome sequence of Sphingomonas paucimobilis strain LCT-SP1 isolated from the Shenzhou X spacecraft of China
Authors: Pan Lei , Zhou Hong , Li Jia , Huang Bing , Guo Jun , Zhang Xue-Lin , Gao Long-Cheng , Xu Chou , Liu Chang-Ting 
Published: February 2016

AbstractSphingomonas paucimobilis strain LCT-SP1 is a glucose-nonfermenting Gram-negative, chemoheterotrophic, strictly aerobic bacterium. The major feature of strain LCT-SP1, isolated from the Chinese spacecraft Shenzhou X, together with the genome draft and annotation are described in this paper. The total size of strain LCT-SP1 is 4,302,226 bp with 3,864 protein-coding and 50 RNA genes. The information gained from its sequence is potentially relevant to the elucidation of microbially mediated corrosion of various materials.