bluuebunny/crossref_metadata_2025_split huggingface dataset:
External Ventricular Catheters: Is It Appropriate to Use an Open/Monitor Position to Adequately Trend Intracranial Pressure in a Neuroscience Critical Care Environment?
Authors: Sunderland Nicole E. , Villanueva Nancy E. , Pazuchanics Susan J. 
Published: August 2016

ABSTRACT
Intracranial pressure (ICP) monitoring can be an important assessment tool in critically and acutely ill patients. An external ventricular drain offers a comprehensive way to monitor ICP and drain cerebrospinal fluid. The Monro-Kellie hypothesis, Pascal’s principle, and fluid dynamics were used to formulate an assumption that an open/monitor position on the stopcock is an adequate trending measure for ICP monitoring while concurrently draining cerebrospinal fluid. Data were collected from 50 patients and totaled 1053 separate number sets. The open/monitor position was compared with the clamped position every hour. An order for “open to drain” was needed for appropriate measurement and nursing care. Results showed the absolute average differences between open/monitor and clamped positions at 1.6268 mm Hg. This finding suggests that it is appropriate to use an open/monitor position via an external ventricular drain for adequate trending of patients’ ICP.
Barriers and Facilitators to Physical Activity Participation for Men with Transtibial Osteomyoplastic Amputation: A Thematic Analysis
Authors: Crawford Derek A. , Hamilton Toby B. , Dionne Carol P. , Day Jonathan D. 
Published: August 2016

ABSTRACT

Background
Lower-limb amputation (LLA) results in participation restrictions in major life activities in personal, work, and leisure environments. By participating in significantly less physical activity (PA) than those who are otherwise healthy, people with LLA are at risk for developing secondary chronic health conditions. Barriers and facilitators to PA participation for those with conventional LLA are well documented. However, these factors are not well understood for those with transtibial osteomyoplastic amputation (TOA).

Purpose
The aim of this study was to qualitatively investigate the barriers and facilitators to PA participation in the TOA population.

Design
This study is an observational, qualitative research using thematic analysis.

Methods
Semistructured interviews were utilized to collect information-rich data from nine men with TOA.

Results
The participants reported minimal body structure impairments but still experience impairment to body functions. Participants reported that they were limited during running and resistance exercises during before and after the actual amputation surgery. The majority of participants value PA benefits as they relate to prevention of chronic disease but fail to recognize potential benefits on function. An individual's motivation to participate can serve as both a facilitator and barrier to PA. Having the opportunity to socialize during PA is important to these participants. The quality of postoperative care program has a direct influence on the long-term PA participation for these participants.

Conclusions
People with TOA continue to experience body function impairment, activity limitations, and participation restrictions. The health care team can play a significant role in the adoption of a physically active lifestyle for people with TOA.
Efficacy and Safety of Lamivudine Versus Entecavir for Treating Chronic Hepatitis B Virus–related Acute Exacerbation and Acute-on-Chronic Liver Failure
Authors: Huang Kuang-Wei , Tam Ka-Wai , Luo Jiing-Chyuan , Kuan Yi-Chun 
Published: August 2016

Background:
Oral nucleos(t)ide analogs are recommended for patients with chronic hepatitis B virus (HBV)-related acute exacerbation (AE) and acute-on-chronic liver failure (ACLF). The efficacy and safety of administering entecavir (ETV) and lamivudine (LAM) to such patients remain unclear.

Methods:
A comprehensive literature search was performed to select studies published before December 2015 on therapy involving ETV or LAM for chronic HBV-related AE with or without ACLF. The main outcomes were short-term (within 4 mo) and long-term (beyond 4 mo) mortality. The secondary outcomes were virological and biochemical responses, ACLF recurrence, and safety.

Results:
Three prospective and 8 retrospective cohort studies involving 1491 patients were selected. An overall analysis revealed comparable short-term and long-term mortality rates among all patients who received ETV or LAM [short term: risk ratio (RR)=0.99; 95% confidence interval (CI), 0.78-1.27; long term: RR=0.82; 95% CI, 0.45-1.52]. However, in patients with ACLF, ETV yielded a more favorable long-term outcome than did LAM (RR=0.60; 95% CI, 0.45-0.80). Furthermore, ETV resulted in more efficient virological and biochemical responses than did LAM regarding the HBV DNA undetectable rate (RR=1.34; 95% CI, 1.09-1.63), HBV DNA reduction rate (weighted mean difference=−0.41; 95% CI, −0.69 to −0.13), and serum alanine aminotransferase normalization rate (RR=1.13; 95% CI, 1.05-1.21).

Conclusions:
ETV and LAM treatments exerted similar effects on the mortality rate of patients with chronic HBV-related AE with or without ACLF. However, ETV yielded a more favorable long-term outcome than did LAM in patients with ACLF; ETV was associated with greater clinical improvements. Additional larger, long-term randomized controlled trials are required to confirm these conclusions.
Hospital Use of Observation Stays
Authors: Venkatesh Arjun K. , Wang Changqin , Ross Joseph S. , Altaf Faseeha K. , Suter Lisa G. , Vellanky Smitha , Grady Jacqueline N. , Bernheim Susannah M. 
Published: August 2016

Background:
The Centers for Medicare and Medicaid Services publicly reports hospital risk-standardized readmission rates (RSRRs) as a measure of quality and performance; mischaracterizations may occur because observation stays are not captured by current measures.

Objectives:
To describe variation in hospital use of observation stays, the relationship between hospitals observation stay use and RSRRs.

Materials and Methods:
Cross-sectional analysis of Medicare fee-for-service beneficiaries discharged after acute myocardial infarction (AMI), heart failure, or pneumonia between July 2011 and June 2012. We calculated 3 hospital-specific 30-day outcomes: (1) observation rate, the proportion of all discharges followed by an observation stay without a readmission; (2) observation proportion, the proportion of observation stays among all patients with an observation stay or readmission; and (3) RSRR.

Results:
For all 3 conditions, hospitals’ observation rates were <2.5% and observation proportions were <12%, although there was variation across hospitals, including 28% of hospital with no observation stay use for AMI, 31% for heart failure, and 43% for pneumonia. There were statistically significant, but minimal, correlations between hospital observation rates and RSRRs: AMI (r=−0.02), heart failure (r=−0.11), and pneumonia (r=−0.02) (P<0.001). There were modest inverse correlations between hospital observation proportion and RSRR: AMI (r=−0.34), heart failure (r=−0.26), and pneumonia (r=−0.21) (P<0.001). If observation stays were included in readmission measures, <4% of top performing hospitals would be recategorized as having average performance.

Conclusions:
Hospitals’ observation stay use in the postdischarge period is low, but varies widely. Despite modest correlation between the observation proportion and RSRR, counting observation stays in readmission measures would minimally impact public reporting of performance.
Regional Variation of Cost of Care in the Last 12 Months of Life in Switzerland
Authors: Panczak Radoslaw , Luta Xhyljeta , Maessen Maud , Stuck Andreas E. , Berlin Claudia , Schmidlin Kurt , Reich Oliver , von Wyl Viktor , Goodman David C. , Egger Matthias , Zwahlen Marcel , Clough-Gorr Kerri M. 
Published: August 2016

Background:
Health care spending increases sharply at the end of life. Little is known about variation of cost of end of life care between regions and the drivers of such variation. We studied small-area patterns of cost of care in the last year of life in Switzerland.

Methods:
We used mandatory health insurance claims data of individuals who died between 2008 and 2010 to derive cost of care. We used multilevel regression models to estimate differences in costs across 564 regions of place of residence, nested within 71 hospital service areas. We examined to what extent variation was explained by characteristics of individuals and regions, including measures of health care supply.

Results:
The study population consisted of 113,277 individuals. The mean cost of care during last year of life was 32.5k (thousand) Swiss Francs per person (SD=33.2k). Cost differed substantially between regions after adjustment for patient age, sex, and cause of death. Variance was reduced by 52%–95% when we added individual and regional characteristics, with a strong effect of language region. Measures of supply of care did not show associations with costs. Remaining between and within hospital service area variations were most pronounced for older females and least for younger individuals.

Conclusions:
In Switzerland, small-area analysis revealed variation of cost of care during the last year of life according to linguistic regions and unexplained regional differences for older women. Cultural factors contribute to the delivery and utilization of health care during the last months of life and should be considered by policy makers.
Cannabis and Pediatric Inflammatory Bowel Disease
Authors: Hoffenberg Edward J. , Newman Heike , Collins Colm , Tarbell Sally , Leinwand Kristina 
Published: August 2016

ABSTRACTThe trend toward decriminalization of cannabis (marijuana) continues sweeping across the United States. Colorado has been a leader of legalization of medical and recreational cannabis use. The growing public interest in the medicinal properties of cannabis and its use by patients with a variety of illnesses including inflammatory bowel disease (IBD) makes it important for pediatric gastroenterologists to understand this movement and its potential effect on patients. This article describes the path to legalization and “medicalization” of cannabis in Colorado and the public perception of safety despite the known adverse health effects of use. We delineate the mammalian endocannabinoid system and our experience of caring for children and adolescents with IBD in an environment of increasing awareness and acceptance of its use. We then summarize the rationale for considering that cannabis may have beneficial and harmful effects for patients with IBD. Finally, we highlight the challenges federal laws impose on conducting research on cannabis in IBD. The intent of this article is to inform health care providers about the issues around cannabis use and research in adolescents and young adults with IBD.
Development and Validation of the Human Papillomavirus Attitudes and Beliefs Scale in a National Canadian Sample
Authors: Perez Samara , Shapiro Gilla K. , Tatar Ovidiu , Joyal-Desmarais Keven , Rosberger Zeev 
Published: August 2016

Background
Parents' human papillomavirus (HPV) vaccination decision-making is strongly influenced by their attitudes and beliefs toward vaccination. To date, psychometrically evaluated HPV vaccination attitudes scales have been narrow in their range of measured beliefs and often limited to attitudes surrounding female HPV vaccination. The study aimed to develop a comprehensive, validated and reliable HPV vaccination attitudes and beliefs scale among parents of boys.

Methods
Data were collected from Canadian parents of 9- to 16-year-old boys using an online questionnaire completed in 2 waves with a 7-month interval. Based on existing vaccination attitudes scales, a set of 61 attitude and belief items were developed. Exploratory and confirmatory factor analyses were conducted. Internal consistency was evaluated with Cronbach's α and stability over time with intraclass correlations.

Results
The HPV Attitudes and Beliefs Scale (HABS) was informed by 3117 responses at time 1 and 1427 at time 2. The HABS contains 46 items organized in 9 factors: Benefits (10 items), Threat (3 items), Influence (8 items), Harms (6 items), Risk (3 items), Affordability (3 items), Communication (5 items), Accessibility (4 items), and General Vaccination Attitudes (4 items). Model fit at time 2 were: χ2/df = 3.13, standardized root mean square residual = 0.056, root mean square error approximation (confidence interval) = 0.039 (0.037–0.04), comparative fit index = 0.962 and Tucker-Lewis index = 0.957. Cronbach’s αs were greater than 0.8 and intraclass correlations of factors were greater than 0.6.

Conclusions
The HABS is the first psychometrically-tested scale of HPV attitude and beliefs among parents of boys available for use in English and French. Further testing among parents of girls and young adults and assessing predictive validity are warranted.
Estimating Utility Weights for the Vision Related Quality of Life Index
Authors: Chen Gang , Finger Robert P. , Holloway Edith Eva , Iezzi Angelo , Richardson Jeff 
Published: August 2016

ABSTRACT

Purpose
The VisQoL instrument was constructed as a vision-specific addition to the AQoL-6D multi-attribute utility instrument. The composite instrument, the AQoL-7D, was assigned utility scores that are the basis for now estimating VisQoL utilities when it is used as a stand-alone instrument. This study aimed to construct mapping functions that allow utility scores to be assigned to the Vision Related Quality of Life (VisQoL) instrument, a stand-alone vision-specific quality-of-life measure.

Methods
A sample of 164 patients completed the AQoL-7D, which includes the VisQoL. Mapping algorithms between VisQoL and AQoL-7D were then derived using two econometric methods, ordinary least squares estimator and generalized linear model (GLM). Two model specifications were considered with either six VisQoL raw item values or VisQoL overall dimension value as the key independent variables. The predictive performance of each method on each model specification was assessed using the mean absolute error (MAE) and intraclass correlation coefficient (ICC). Both internal and external validation tests (using a second, independent sample of 164 patients) were performed.

Results
The mapping algorithms derived from the GLM had superior properties to the ordinary least squares–based algorithms in both internal and external validation tests. The ICC values ranged from 0.851 to 0.913, and the MAE ranged from 0.043 to 0.052 for two model specifications, based on two econometric methods. However, predicted utilities tend to over-predict/under-predict the lowest/highest observed utility.

Conclusions
Mapping algorithms predicting AQoL-7D utility based on six VisQoL items or VisQoL dimension value have been developed. The algorithm can be used to estimate quality adjusted life years. This allows the VisQoL to be used in cost utility analyses.
Hospital Volume and Mortality in Mechanically Ventilated Children: Analysis of a National Inpatient Database in Japan*
Authors: Sasaki Ryuji , Yasunaga Hideo , Matsui Hiroki , Michihata Nobuaki , Fushimi Kiyohide 
Published: August 2016

Objectives:
To evaluate the relationship between annual hospital volume of mechanical ventilation in children and mortality.

Design:
A retrospective analysis.

Setting:
Japanese hospitals (n = 641) in the Japanese Diagnosis Procedure Combination database from July 2010 to March 2013.

Patients:
Patients 15 years old or younger receiving mechanical ventilation during hospitalization.

Interventions:
None.

Measurements and Main Results:
A total of 26,981 mechanically ventilated pediatric patients were identified. They were categorized into four subgroups based on the quartiles of mean annual hospital volume of mechanical ventilation in children. Multivariable logistic regression analyses were performed to examine the effects of hospital volume on 30-day mortality, with adjustment for patient and hospital characteristics. Compared with the low volume group (≤ 34 per year), the odds ratios (95% CI) for 30-day mortality of low-medium (35–80), medium-high (81–165), and high (≥ 166) volume groups were 0.63 (0.50–0.79), 0.56 (0.42–0.74), and 0.57 (0.50–0.79), respectively. Subgroup analyses of surgical and nonsurgical patients showed similar trends.

Conclusions:
In mechanically ventilated pediatric patients divided by hospital volume quartiles, all three higher volume groups had lower mortality than the lowest volume group.
Childhood Bullying Victimization and Overweight in Young Adulthood: A Cohort Study
Authors: Baldwin Jessie R. , Arseneault Louise , Odgers Candice , Belsky Daniel W. , Matthews Timothy , Ambler Antony , Caspi Avshalom , Moffitt Terrie E. , Danese Andrea 
Published: August 2016

ABSTRACT

Objective
To test whether bullied children have an elevated risk of being overweight in young adulthood and whether this association is: (1) consistent with a dose-response relationship, namely, its strength increases with the chronicity of victimization; (2) consistent across different measures of overweight; (3) specific to bullying and not explained by co-occurring maltreatment; (4) independent of key potential confounders; and (5) consistent with the temporal sequence of bullying preceding overweight.

Method
A representative birth cohort of 2,232 children was followed to age 18 years as part of the Environmental Risk Longitudinal Twin Study. Childhood bullying victimization was reported by mothers and children during primary school and early secondary school. At the age-18 follow-up, we assessed a categorical measure of overweight, body mass index, and waist-hip ratio. Indicators of overweight were also collected at ages 10 and 12. Co-twin body mass and birth weight were used to index genetic and fetal liability to overweight, respectively.

Results
Bullied children were more likely to be overweight than non-bullied children at age 18, and this association was (1) strongest in chronically bullied children (odds ratio = 1.69; 95% confidence interval [CI] = 1.21–2.35); (2) consistent across measures of overweight (body mass index: b = 1.12; 95% CI = 0.37–1.87; waist-hip ratio: b = 1.76; 95% CI = 0.84–2.69); (3) specific to bullying and not explained by co-occurring maltreatment; (4) independent of child socioeconomic status, food insecurity, mental health, and cognition, and pubertal development; and (5) not present at the time of bullying victimization, and independent of childhood weight and genetic and fetal liability.

Conclusion
Childhood bullying victimization predicts overweight in young adulthood.
Ectopic Hepatocellular Carcinoma Occurring in the Bile Duct and Extending to the Gallbladder
Authors: Cheng Mei Qing , Zeng Dan , Huang Hui , Tang Xiao Feng , Xu Zuo Feng 
Published: August 2016

Abstract
Ectopic hepatocellular carcinoma (HCC) is rare and there has been no report on ectopic HCC arising from both the bile duct and the gallbladder. It is difficult to establish a correct diagnosis for this kind of HCC based on preoperative imaging. All of the preoperative imaging examinations misdiagnosed the HCC as cholangiocarcinoma in our case. However, via retrospective analysis of this case, we found that the patient was positive for hepatitis virus markers and that a tumor marker (α-fetoprotein) was significantly elevated. Therefore, diagnosis of HCC with significantly elevated α-fetoprotein (>200 μg/L) is highly likely, particularly with chronic hepatitis and excluding pregnancy and tumor of genital system.
The Value of Active Ultrasound Surveillance for Patients With Small Testicular Lesions
Authors: Li Qian , Vij Abhinav , Hahn Peter F. , Xiang Feixiang , Samir Anthony E. 
Published: August 2016

Abstract
This study aimed to determine whether active ultrasound surveillance may obviate the need for surgical resection in selected patients with small testicular lesions (STLs). A retrospective 11-year review was conducted of adults who were diagnosed with an STL on scrotal ultrasonography and who either had orchiectomy or sonographic follow-up during a period of at least 3 months. A total of 101 subjects were enrolled. Ultrasound findings, clinical features, histopathology/follow-up imaging were recorded. Logistic regression analysis was performed to select independent risk factors for the diagnosis of malignancy. Seventeen (16.8%) subjects underwent immediate surgery, 8 (7.9%) of 101 underwent surgery after ultrasound follow-up, and 76 (75.3%) of 101 were followed with ultrasound only. The follow-up period ranged from 1 to 7 months in the 8 patients who ultimately underwent surgery after ultrasound follow-up and from 6 to 84 months in the 76 patients followed up with ultrasound only. All 15 malignant cases underwent immediate surgery without follow-up sonography. The frequency of lesions, either benign at surgery or stable on ultrasound, was 85.1% (86 of 101; 95% confidence interval, 77%–91%). Logistic regression analysis showed that lesion size was the only independent risk factor for malignancy in hypoechoic STLs (P < 0.05). Most of the STLs were stable on serial sonograms and likely benign. Active ultrasound surveillance may be an appropriate management strategy in patients with STLs.
Sonographic Pulmonary Abnormalities in Fetuses With Hypoplastic Left Heart Syndrome and Intact Atrial Septum Undergoing Attempted Atrial Septostomy In Utero
Authors: Mackesy Meaghan M. , Kalish Brian T. , Tworetzky Wayne , Sanders Stephen , Al-Ibraheemi Alyaa , Wilkins-Haug Louise , Lock James , Marshall Audrey , Benson Carol B. 
Published: August 2016

Abstract
Fetuses with hypoplastic left heart syndrome (HLHS) and intact atrial septum are a particular subset of HLHS neonates with high perinatal mortality. The reported mortality in these patients is 50% to 70%, even with prenatal diagnosis. Prenatal left atrial and pulmonary venous hypertension results in abnormal pulmonary vascular and parenchymal development. The goal of this study was to compare the sonographic appearance of the lungs in fetuses with HLHS/intact atrial septum to neonatal outcome and/or pathology in cases where in utero intervention was performed to open the atrial septum. We found that lung inhomogeneity on ultrasound corresponded to peripheral lymphatic dilatation at autopsy and was associated with a dismal prognosis even when in utero intervention was successful.
Modified Hand-Sewn Closure With Retroperitoneal Tissue-covering Method Prevents Pancreatic Fistula in Laparoscopic Distal Pancreatectomy
Authors: Ji Wenbin , Wang Youlong , Wang Lie , Tan Huamin , Tan Jingwang 
Published: August 2016

Background:
In laparoscopic distal pancreatectomy, the stapler transection of the pancreas remains the preferred method; however, pancreatic fistula continues to be a critical unsolved problem. The aim of this study was to compare complications associated with distal pancreatectomy, especially regarding the formation of pancreatic fistula, with particular attention to the stapler and hand-sewn closure technique.

Patients and Methods:
Between January 2004 and June 2012, 47 patients underwent laparoscopic distal pancreatectomy. These patient’s pancreatic bodies were similar, and they were subjected to closure of the pancreatic stump either by stapler (Staple group, n=21) or by a modified hand-sewn technique (Sewn group, n=26), and were subsequently retrospectively reviewed.

Results:
The incidence of PF was significantly higher in the “Staple group” compared with the “Sewn group.” Likewise, the amylase levels in the drainage fluid, were significantly higher in the “Staple group” compared with the “Sewn group.” Patients in the Sewn group had shorter median hospital stay compared with those in the Sewn group (5 vs. 8 d, P<0.001).

Conclusions:
The 2-layer hand-sewn technique is a simple method, and it significantly decreased the incidence of PF and hospital stay compared with the use of staples in laparoscopy.