bluuebunny/crossref_metadata_2025_split huggingface dataset:
Short-term load forecasting coupled with weather profile generation methodology
Authors: Zhu Guangya , Chow Tin-Tai , Tse Norman 
Published: November 2017

Short-term building load forecasting is indispensable in daily operation of future intelligent/green buildings, particularly in formulating system control strategies and assessing the associated environmental impacts. Most previous research works have been focused on studying the advancement in forecasting techniques, but not as much on evaluating the availability of influential factors like the predicted weather profile in the coming hours. This article proposes an improved procedure to predict the building load 24 hours ahead, together with a backup weather profile generating method. The quality of the proposed weather profile generation model and the forecasting procedures were examined through a case study of application to university academic buildings. The results showed that the load forecasting accuracy with the application of either the real weather data on record or of the predicted weather data from the profile generation model is very much similar. This indicates that the weather prediction model is suitable for applying to building load forecasting. Besides, the comparisons between different sets of input data illustrated that the forecasting accuracy can be improved through the input data filtering and regrouping procedures. Practical application: A weather profile prediction technique for use in building energy forecasting was introduced. This can be coupled to a building energy use forecasting model for predicting the hourly consumption profile of the next day. This prediction time span can be crucial for formulating the daily operation plan of the utility systems or for smart micro-grid applications. The appropriateness of the methodology was evaluated through a case study.
Can imaging kinetic parameters of dynamic contrast-enhanced magnetic resonance imaging be valuable in predicting clinicopathological prognostic factors of invasive breast cancer?
Authors: Wang Cuiyan , Wei Wei , Santiago Lumarie , Whitman Gary , Dogan Basak 
Published: November 2017

Background Intrinsic molecular profiling of breast cancer provides clinically relevant information that helps tailor therapy directed to the specific tumor subtype. We hypothesized that dynamic contrast-enhanced MRI (DCE-MRI) derived quantitative kinetic parameters (CD-QKPs) may help predict molecular tumor profiles non-invasively. Purpose To determine the association between DCE-MRI (CD-QKPs) and breast cancer clinicopathological prognostic factors. Material and Methods Clinicopathological factors in consecutive women with biopsy-confirmed invasive breast cancer who underwent breast DCE-MRI were retrospectively reviewed. Analysis of variance was used to examine associations between prognostic factors and CD-QKPs. Fisher’s exact test was used to investigate the relationship between kinetic curve type and prognostic factors. Results A total of 198 women with invasive breast cancer were included. High-grade and HER2+ tumors were more likely to have a washout type curve while luminal A tumors were less likely. High-grade was significantly associated with increased peak enhancement (PE; P = 0.01), enhancement maximum slope (MS; P = 0.03), and mean enhancement ( ME, P = 0.03), while high clinical lymph node stage (cN3) was significantly associated with increased MS and time to peak (tP; P = 0.01). HER2+ tumors were associated with a higher PE ( P = 0.03) and ME ( P = 0.06) than HER2- counterparts, and ER-/HER2+ tumors showed higher PE and ME values than ER+/HER2- tumors ( P = 0.06). Conclusion DCE-MRI time-intensity CD-QKPs are associated with high tumor grade, advanced nodal stage, and HER2+ status, indicating their utility as imaging biomarkers.
Sick leave before and after the age of 65 years among those in paid work in Sweden in 2000 or 2005: a register-based cohort study
Authors: Farrants Kristin , Kjeldgård Linnea , Marklund Staffan , Head Jenny , Alexanderson Kristina 
Published: November 2017

Objective With pressure for older people to remain in work, research is needed on how people aged over 65 years fare in the labour market. However, few studies have focused on sick leave among older workers, especially those over the standard retirement age. This study investigated changes in sick-leave patterns among people aged over 65 years still in work. Methods All individuals in Sweden who turned 65 years old in 2000 or 2005 were followed from 1995 to 2010. The mean number of sick-leave days per year was measured for those who remained in paid work past the age of 65 years. Results Those over 65 years still working had fewer sick-leave days before the age of 65 years than those who retired. They also had fewer sick-leave days after 65 years than before. There were fewer socioeconomic differences after 65 years than before, but these differences were greater for workers over 65 years in the 2005 cohort. Conclusions Although there were more people over 65 years in paid work in 2005, sick-leave days and socioeconomic differences in sick leave were lower in this age group. Sick-leave days and socioeconomic differences in sick leave were greater in the 2005 cohort.
Treatment Profile and 1-Year Mortality Among Nontraumatic Intensive Care Unit Patients With Alcohol-Related Health Problems
Authors: Hietanen Siiri , Ala-Kokko Tero , Ohtonen Pasi , Käkelä Riikka , Niemelä Solja , Liisanantti Janne H. 
Published: November 2017

Background: Long-term excessive use of alcohol leads to severe complications, which often require treatment in an intensive care unit (ICU). The aim of this study was to report on the associations between alcohol-related health problems and treatment profile, as well as 1-year mortality among patients with nontrauma-related ICU admissions. Methods: Information on the history of alcohol-related health problems or excessive alcohol use and ICU treatment was collected retrospectively from electronic medical records and ICU patient data management systems at Oulu University Hospital, Finland. Information on 1-year mortality was obtained from the Finnish Population Register Center. Results: According to the medical records, in a total of 899 admissions, 32.9% (n = 296) of patients had a history of alcohol-related problems. In the alcohol group, intoxications were more frequent and respiratory and cardiovascular causes were less frequent, compared to those without alcohol-related problems. Patients without alcohol-related problems had a higher rate of previous comorbidities compared with the alcohol group. There were no differences concerning age, severity of illness scores, length of stay, or intensive care outcome. Mortality during the 1-year follow-up was 32.8% in total: 35.1% among those without alcohol-related history and 28.0% in the alcohol group ( P = .041). The difference in mortality appeared during the first month following admission and remained throughout the follow-up period. The highest 1-year mortality (59.3%) was observed among patients with alcohol-related liver disease. Conclusion: Every third patient admitted to ICU used alcohol excessively or had alcohol-related diseases, and those patients with alcohol-related liver disease had the poorest 1-year survival rate. We found higher long-term mortality in nonalcohol-related admissions, which can be explained by the case mix, including a lower rate of chronic diseases, such as malignancies and coronary artery disease, and a higher rate of low-risk admission diagnoses in the alcohol group.
Disagreement in Estimates of Kidney Function for Drug Dosing in Obese Inpatients
Authors: Higdon Emily A. , Kimmons Lauren A. , Duhart Benjamin T. , Hudson Joanna Q. 
Published: November 2017

Background: The Cockcroft-Gault (CG), Modification of Diet in Renal Disease (MDRD), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations are used to estimate kidney function. However, utility has been questioned in the obese population. Objective: To evaluate differences in estimates of kidney function in obese patients and implications for drug dosing. Methods: This was a retrospective study of adult inpatients with a body mass index ≥30 kg/m2 and stable kidney function. Patients were categorized based on creatinine clearance (CrCl): group 1—CrCl ≥ 60 mL/min and group 2—CrCl 15 to 59 mL/min. Mean estimates of kidney function and recommended doses of 8 renally eliminated medications were compared. Results: For the 166 patients included, mean estimates using CG, MDRD, and CKD-EPI for group 1 were 87 (23) mL/min, 91 (21) mL/min, and 96 (23) mL/min, respectively. Group 2 estimates were 42 (13) mL/min, 51 (15) mL/min, and 51 (16) mL/min, respectively. MDRD and CKD-EPI estimates were significantly higher than CG in 125 (75%) and 140 (84%) patients, respectively. Dose discrepancies were most often due to higher dose recommendations using MDRD or CKD-EPI compared to CG. Conclusion: Careful consideration of the method used to estimate kidney function, the method used for developing dosing recommendations, and the risk–benefit profile is warranted when designing drug regimens in obese individuals.
A Survey of Knowledge and Attitudes of Nurses About Pain Management in End-Stage Liver Disease in a Geriatric Palliative Care Unit
Authors: Perri Giulia-Anna , Yeung Herman , Green Yoel , Bezant Abby , Lee Carman , Berall Anna , Karuza Jurgis , Khosravani Houman 
Published: November 2017

Background: Palliative care is often initiated late for patients with end stage liver disease (ESLD) with pain being a common morbidity that is under-treated throughout the disease trajectory. When admitted to a palliative care unit (PCU), nurses play a pivotal role and must be highly informed to ensure effective pain management. The aim of this study is to determine the baseline level of knowledge and attitudes of PCU nurses regarding pain management in patients with ESLD. Methods: A descriptive, cross-sectional self-administered survey design was used for this study. The sample comprised 35 PCU nurses working at a continuing chronic care facility in Toronto, Ontario, Canada. Data on the knowledge and attitudes of the nurses regarding pain management in patients with ESLD, was obtained using a modified version of the “Nurses Knowledge and Attitudes Survey Regarding Pain” (NKASRP) tool. Results: Thirty-one PCU nurses were included for the analysis, giving a response rate of 89%. The mean total percentage score for the nurses on the modified version of the NKASRP was 72%. Only 26% of the nurse participants obtained a passing score of 80% or greater. There were no significant differences in mean total scores by age, gender, years of nursing experience or education level. Conclusions: The findings of this study provide important information about the inadequate knowledge and attitude in nurses regarding pain management for patients with ESLD. It is suggested that targeted educational programs and quality improvement initiatives in pain management for patients with ESLD could improve knowledge and attitudes for PCU nurses.
Palliative Care Processes Embedded in the ICU Workflow May Reserve Palliative Care Teams for Refractory Cases
Authors: Mun Eluned , Umbarger Lillian , Ceria-Ulep Clementina , Nakatsuka Craig 
Published: November 2017

Context: Palliative Care Teams have been shown to be instrumental in the early identification of multiple aspects of advanced care planning. Despite an increased number of services to meet the rising consultation demand, it is conceivable that the numbers of palliative care consultations generated from an ICU alone could become overwhelming for an existing palliative care team. Objective: Improve end-of-life care in the ICU by incorporating basic palliative care processes into the daily routine ICU workflow, thereby reserving the palliative care team for refractory situations. Methods: A structured, palliative care, quality-improvement program was implemented and evaluated in the ICU at Kaiser Permanente Medical Center in Hawaii. This included selecting trigger criteria, a care model, forming guidelines, and developing evaluation criteria. Main Outcome Measures: These included the early identification of the multiple features of advanced care planning, numbers of proactive ICU and palliative care family meetings, and changes in code status and treatment upon completion of either meeting. Results: Early identification of Goals-of-Care, advance directives, and code status by the ICU staff led to a proactive ICU family meeting with resultant increases in changes in code status and treatment. The numbers of palliative care consultations also rose, but not significantly. Conclusions: Palliative care processes could be incorporated into a daily ICU workflow allowing for integration of aspects of advanced care planning to be identified in a systematic and proactive manner. This reserved the palliative care team for situations when palliative care efforts performed by the ICU staff were ineffective.
Race as a Predictor of Palliative Care Referral Time, Hospice Utilization, and Hospital Length of Stay: A Retrospective Noncomparative Analysis
Authors: Worster Brooke , Bell Declan Kennedy , Roy Vibin , Cunningham Amy , LaNoue Marianna , Parks Susan 
Published: November 2017

Background: Palliative care is associated with significant benefits, including reduced pain and suffering, an increased likelihood of patients dying in their preferred location, and decreased health-care expenditures. Racial and ethnic disparities are well-documented in hospice use and referral patterns; however, it is unclear whether these disparities apply to inpatient palliative care services. Objective: To determine if race is a significant predictor of time to inpatient palliative care consult, patient enrollment in hospice, and patients’ overall hospital length of stay among patients of an inpatient palliative care service. Design: Retrospective noncomparative analysis. Setting: Urban academic medical center in the United States. Patients: 3207 patients referred to an inpatient palliative care service between March 2006 and April 2015. Measurements: Time to palliative care consult, disposition of hospice/not hospice (excluding patients who died), and hospital length of stay among patients by racial (Asian, black, Native American/Eskimo, Hispanic, white, Unknown) and ethnic (Hispanic/Latino, non-Hispanic, Unknown) background. Results: Race was not a significant predictor of time to inpatient palliative care consult, discharge to hospice, or hospital length of stay. Similarly, black/white, Hispanic/white, and Asian/white variables were not significant predictors of hospice enrollment ( Ps > .05). Limitations: Study was conducted at 1 urban academic medical center, limiting generalizability; hospital race and ethnicity categorizations may also limit interpretation of results. Conclusions: In this urban hospital, race was not a predictor of time to inpatient palliative care service consult, discharge to hospice, or hospital length of stay. Confirmatory studies of inpatient palliative care services in other institutions are needed.
Race/Ethnicity as a Predictor for Location of Death in Patients With Acute Neurovascular Events
Authors: Salomon Say , Chuang Elizabeth , Bhupali Deepa , Labovitz Daniel 
Published: November 2017

Background: Site of death is an important quality indicator for patients with terminal illness. Racial and ethnic disparities exist in the quality of end-of-life care. This study explores the site of death of patients admitted for and dying of complications of acute neurovascular events in a hospital network in an urban, low-income, predominantly minority community. Methods: This is a retrospective cohort study of patients admitted to 1 of 3 general hospitals that are part of an academic medical center in Bronx, New York, with the diagnosis of acute ischemic stroke, intracerebral hemorrhage, or subarachnoid hemorrhage who died during the index admission or were discharged with hospice services. The main outcome was location of death (palliative care inpatient unit [IPU] at the medical center or hospice services at discharge vs death on any other IPU). Results: A total of 655 patients admitted with acute neurovascular events from January 1, 2009, to March 1, 2015, died or were discharged with hospice services and were included in the analysis. Of those patients, 238 (36.3%) were black, 233 (35.5%) were Hispanic, and 184 (28.1%) were white. A total of 178 (24.4%) died on the palliative care unit or were discharged with hospice services, including 55 black patients (23.1%), 52 (28.3%) white patients, and 53 (22.7%) Hispanic patients. These differences were not statistically significant, even when controlling for confounders. Conclusion: This study did not show a difference in site of death in our institution by race or ethnicity, which is considered an important quality end-of-life care metric.
Association Between Nursing Visits and Hospital-Related Disenrollment in the Home Hospice Population
Authors: Phongtankuel Veerawat , Adelman Ronald D. , Trevino Kelly , Abramson Erika , Johnson Phyllis , Oromendia Clara , Henderson Charles R. , Reid M. C. 
Published: November 2017

Background: Over 10% of hospice patients experience a transition out of hospice care during the last months of life. Hospice transitions from home to hospital (ie, hospital-related hospice disenrollment) result in fragmented care, which can be burdensome for patients and caregivers. Nurses play a major role in delivering home hospice care, yet little is known about the association between nursing visits and disenrollment. Objectives: The study’s purpose is to examine the association between the average number of nursing visits per week and hospital-related disenrollment in the home hospice population. We hypothesize that more nursing visits per week will be associated with reduced odds for disenrollment. Design: A retrospective cohort study using Medicare data. Participants: Medicare hospice beneficiaries who were ≥18 years old in 2012. Outcome measured: Hospitalization within 2 days of hospice disenrollment. Results: The sample included 115 103 home hospice patients, 6450 (5.6%) of whom experienced a hospital-related disenrollment. The median number of nursing visits per week was 2 (interquartile range 1.3-3.2), with a mean of 2.5 (standard deviation ±1.6). There was a decreased likelihood of a hospital-related disenrollment when comparing enrollments that had <3 nursing visits per week on average to 3 to <4 visits (odds ratio [OR] 0.39; P value <.001), 4 to <5 visits (OR 0.29; P value <.001), and 5+ visits (OR 0.21; P value <.001). Conclusions: More nursing visits per week was associated with a decreased likelihood of a hospital-related hospice disenrollment. Further research is needed to understand what components of nursing care influence care transitions in the home hospice setting.
Compassion Fatigue Among Palliative Care Clinicians: Findings on Personality Factors and Years of Service
Authors: O’Mahony Sean , Ziadni Maisa , Hoerger Michael , Levine Stacie , Baron Aliza , Gerhart James 
Published: November 2017

Objectives: Palliative medicine is a rewarding field, but providers encounter patient trauma on a routine basis. Compassion fatigue, marked by burnout, secondary traumatic stress, and low satisfaction may result. However, professionals differ markedly in how they respond to patient trauma. The objective of the current study was to determine whether personality traits of neuroticism and agreeableness relate to aspects of compassion fatigue, after accounting for time spent working in the field. Methods: Sixty-six palliative medicine physicians, nurses, social workers, and chaplains completed validated measures of personality traits, compassion fatigue, and work background. Results: Providers who had worked longer reported higher levels of satisfaction and lower levels of burnout. Neuroticism demonstrated strong significant associations with secondary traumatic stress and burnout ( Ps < .001). Agreeableness was significantly and strongly associated with compassion satisfaction ( P < .001). These associations held after accounting for years spent working in the field. Significance of Results: Personality traits of neuroticism and agreeableness may convey risk and resilience, respectively, for palliative care professionals. More research is needed to determine if assessing personality traits can help identify providers at risk for adverse reactions to patient trauma.
Nurses’ Interest in Independently Initiating End-of-Life Conversations and Palliative Care Consultations in a Suburban, Community Hospital
Authors: Mehta Ambereen K. , Wilks Steven , Cheng M. Jennifer , Baker Karen , Berger Ann 
Published: November 2017

Background: Patients who receive early palliative care consults have clinical courses and outcomes more consistent with their goals. Nurses have been shown to be advocates for early palliative care involvement and are able to lead advanced care planning discussions. Objective: The purpose of this study was to assess whether after a brief educational session, nurses at a suburban, community hospital could demonstrate knowledge of palliative care principles, would want to independently initiate end-of-life conversations with patients and families, and would want to place specialty palliative care consults. Design: Four 1 hour presentations were made at 4 nursing leadership council meetings from November through December 2015. Anonymous pre- and post-presentation surveys were distributed and collected in person. Setting/Participant: Nonprofit, suburban, community hospital in Maryland. Participants were full-time or part-time hospital employees participating in a nursing leadership council who attended the presentation. Measurements: We compared responses from pre- and post-presentation surveys. Results: Fifty nurses (19 departments) completed pre-presentation surveys (100% response rate) and 49 nurses completed post-presentation surveys (98% response rate). The average score on 7 index questions increased from 71% to 90%. After the presentations, 86% strongly agreed or agreed that nurses should be able to independently order a palliative care consult and 88% strongly agreed or agreed with feeling comfortable initiating an end-of-life conversation. Conclusion: Brief educational sessions can teach palliative care principles to nurses. Most participants of the study would want to be able to directly consult palliative care and would feel comfortable initiating end-of-life conversations after this educational session.