bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimizing the Lee-Carter Approach in the Presence of Structural Changes in Time and Age Patterns of Mortality Improvements
Authors: Li Hong , Li Johnny Siu-Hang 
Published: May 2017

AbstractResearchers using the Lee-Carter approach have often assumed that the time-varying index evolves linearly and that the parameters describing the age pattern of mortality decline are time-invariant. However, as several empirical studies suggest, the two assumptions do not seem to hold when the calibration window begins too early. This problem gives rise to the question of identifying the longest calibration window for which the two assumptions hold true. To address this question, we contribute a likelihood ratio–based sequential test to jointly test whether the two assumptions are satisfied. Consistent with the mortality structural changes observed in previous studies, our testing procedure indicates that the starting points of the optimal calibration windows for most populations fall between 1960 and 1990. Using an out-of-sample analysis, we demonstrate that in most cases, models that are estimated to the optimized calibration windows result in more accurate forecasts than models that are fitted to all available data or data beyond 1950. We further apply the proposed testing procedure to data over different age ranges. We find that the optimal calibration windows for age group 0–49 are generally shorter than those for age group 50–89, indicating that mortality at younger ages might have undergone (another) structural change in recent years.
Clinical Decision Support and the Electronic Health Record—Applications for Physiatry
Authors: Shoolin Joel S. 
Published: May 2017

AbstractClinical decision support (CDS) is a process that provides information to assist the user in decision making for evaluation and treatment. Although many think only of rules and alerts, CDS is much more than that. Order sets, clinical documents, information fields, and medication sentences are just a few other CDS tools to be considered. CDS has been shown to improve care. Forming the third point of the triangle, CDS, along with process redesign and workflow considerations, improves care and helps create successful outcomes. Failure to address all 3 of these elements creates a less‐than‐perfect and potentially dangerous result. Examples of the application of CDS in the field of physical medicine and rehabilitation remain limited. This field has a huge opportunity to use CDS to enhance patient care, and is an open area for CDS development and research.
Using Technology to Enhance Patient‐Physician Interactions
Authors: Voran David 
Published: May 2017

AbstractThe computer is an integral part of a clinical office examination room. How a physician simultaneously uses the computer and interacts with patients will either enhance or deter patient engagement in areas of health maintenance and rehabilitation. With the growing emphasis on patient‐centered care and management of chronic health conditions, patient engagement plays an ever‐increasing role in U.S. health care. This paper reviews and discusses the 4 broad factors that influence the traditional physician‐patient examination room interaction: physician computer/technology skills and dexterity, verbal and nonverbal communication, design and spatial arrangement, and hardware considerations. If used effectively, in‐room technology will both enhance patient care and engender a greater degree of patient trust in their provider.
Selection and Implementation of an Electronic Health Record
Authors: Fletcher Grant S. , Payne Thomas H. 
Published: May 2017

AbstractElectronic health records (EHRs) are now the standard of practice in most communities, because of transition to reimbursement that increasingly focuses on risk sharing and quality measurement, and government EHR incentive programs. The selection and implementation of an EHR is one of the most important decisions a practice faces. Organizing the search for an EHR that fits a practice, negotiating a contract, planning and successfully implementing an EHR are best accomplished with a well‐informed, strong, multidisciplinary team using project management techniques. Focusing on the best match between your practice's needs and available commercial systems, and creating a strong relationship with your vendor will be key to leveraging the EHR to improve the experience of your patients and the quality of care they receive, and to the efficiency of your practice.
Social Media and Web Presence for Patients and Professionals: Evolving Trends and Implications for Practice
Authors: Barreto Jose E. , Whitehair Curtis L. 
Published: May 2017

AbstractThe use of social media has become very instinctive to many. It has become part of a daily routine. Enhanced communication, liberated expressions of self, becoming updated with all the trends and news, and marketing promotion are only some of the reasons why most people use social media. Health care providers including physicians should take advantage of these platforms for professional purposes. Social media extends far beyond the famous platforms such as Facebook, Twitter, Pinterest, and Instagram, used mostly for social connections. There are sites dedicated to serve professionals, for example, LinkedIn, or even physician‐specific forums such as Sermo. The physical medicine and rehabilitation community has a forum (Phyzforum) created by the American Academy of Physical Medicine and Rehabilitation to share questions, comments, and ideas. Moreover, there are broadcast media (Podcast) and blogging sites (WordPress) used by many physiatrists. Surveys show that physicians actively use an average of 2‐4 hours of professional‐leaning networking sites per week; for example, 44% of physicians use Sermo and 42% use LinkedIn. The participation also extends to more popular sites, with 40%, 25%, and 20% physician participation in YouTube, Blogging, and Twitter, respectively. There are numerous guidelines available for medical practitioners pertaining to professional use of social media. Strategies such as timing of postings and posting content as well as methods to maintain your online reputation are discussed. Various benefits and potential pitfalls with regards to social media use are also analyzed, including how to engage followers and addressing negative comments and reviews.
Phase II clinical trials of anti–amyloid β antibodies: When is enough, enough?
Authors: Gold Michael 
Published: May 2017

AbstractEfforts to develop new therapies to combat Alzheimer's disease suffer from extraordinarily high failure rates that make it difficult to justify continued investment in the field. Although there are a number of plausible explanations for this extremely high attrition rate, one of the explanations that has received little attention is the lack of compelling data from Phase II studies for compounds that have been pushed into Phase III trials and then have failed. An analysis of publicly available data from the Phase II studies for bapineuzumab and solanezumab indicates that neither compound produced compelling evidence of drug‐like behavior that would justify their progression into pivotal trials. The published data suggest that sponsors took decisions to move these compounds into Phase III on the basis of vastly limited data that were rife with type I error and probably driven by commercial concerns. The continued push to move compounds that are not likely to succeed in later stage clinical trials threatens to erode trust in the clinical research enterprise making it much harder to properly test truly promising compounds.
Factors associated with failure of emergency wait-time targets for high acuity discharges and intensive care unit admissions
Authors: Cheng Ivy , Zwarenstein Merrick , Kiss Alex , Castren Maaret , Brommels Mats , Schull Michael 
Published: May 2017

ABSTRACTObjectiveOntario established emergency department length-of-stay (EDLOS) targets but has difficulty achieving them. We sought to determine predictors of target time failure for discharged high acuity patients and intensive care unit (ICU) admissions.MethodsThis was a retrospective, observational study of 2012 Sunnybrook Hospital emergency department data. The main outcome measure was failing to meet government EDLOS targets for high acuity discharges and ICU emergency admissions. The secondary outcome measures examined factors for low acuity discharges and all admissions, as well as a run chart for 2015 – 2016 ICU admissions. Multiple logistic regression models were created for admissions, ICU admissions, and low and high acuity discharges. Predictor variables were at the patient level from emergency department registries.ResultsFor discharged high acuity patients, factors predicting EDLOS target failure were having physician initial assessment duration (PIAD)>2 hours (OR 5.63 [5.22-6.06]), consultation request (OR 10.23 [9.38-11.14]), magnetic resonance imaging (MRI) (OR 19.33 [12.94-28.87]), computed tomography (CT) (OR 4.24 [3.92-4.59]), and ultrasound (US) (OR 3.47 [3.13-3.83]). For ICU admissions, factors predicting EDLOS target failure were bed request duration (BRD)>6 hours (OR 364.27 [43.20-3071.30]) and access block (AB)>1 hour (OR 217.27 [30.62-1541.63]). For discharged low acuity patients, factors predicting failure for the 4-hour target were PIAD>2 hours (OR 15.80 [13.35-18.71]), consultation (OR 20.98 [14.10-31.22]), MRI (OR 31.68 [6.03-166.54]), CT (OR 16.48 [10.07-26.98]), and troponin I (OR 13.37 [6.30-28.37]).ConclusionSunnybrook factors predicting failure of targets for high acuity discharges and ICU admissions were hospital-controlled. Hospitals should individualize their approach to shortening EDLOS by analysing its patient population and resource demands.
Wine, Women, Men, and Type II Error
Authors: Bodington Jeffrey C. 
Published: May 2017

AbstractMore than forty published works show that women and men differ in their taste preferences for sweet, salt, sour, bitter, fruit, and other flavors. Despite those differences, dozens of state fair and other wine competitions determine winners' ribbons, medals, scores, and ranks by pooling the opinions of female and male judges. This article examines twenty-three blind wine tastings during which female and male judges scored more than nine hundred wines. Two-sample t-test results show that the gender-specific distributions of scores do have similar means and standard deviations. Exact p-values for two-sample chi-square tests show that the distributions of men's and women's scores are not significantly different, and exact p-values for likelihood ratio tests of Plackett-Luce model results show that the genders' preference orders are not significantly different. The correlation coefficient between women's and men's scores is weakly positive in 90 percent of the tastings. On that evidence, indications that the genders prefer different wines are difficult to detect. If such differences do exist, as the nonwine literature implies, the results of this analysis show that those differences are small compared to non-gender-related idiosyncratic differences between individuals and random expressions of preference. The potential for accept-a-false-null-hypothesis Type II error when pooling female and male judges' wine-related opinions appears to be small. (JEL Classifications: A10, C10, C00, C12, D12)
Decreased, but still sufficient, iodine intake of children and adults in the Netherlands
Authors: Verkaik-Kloosterman Janneke , Buurma-Rethans Elly J. M. , Dekkers Arnold L. M. , van Rossum Caroline T. M. 
Published: May 2017

AbstractSufficient I intake is important for the synthesis of thyroid hormones, which play an important role in normal growth and development. Our aim was to estimate habitual I intake for the Dutch population and the risk of inadequate or excessive intakes. Further, we aimed to provide an insight into the dietary sources of I and the association with socio-demographic factors. Data from the Dutch National Food Consumption Survey 2007–2010 (n3819; 7–69 years), and from the Dutch food and supplement composition tables were used to estimate habitual I intake with a calculation model. Contribution of food groups to I intake were computed and multiple linear regression was used to examine associations of intakes with socio-demographic factors. A total of ≤2 % of the population had an intake below the estimated average requirement or above the upper level. The main sources of I were bread containing iodised salt (39 %), dairy products (14 %) and non-alcoholic drinks (6 %). I intake (natural sources only, excluding iodised salt and supplements) was positively associated with (parental) education, which could at least partly be attributed to a higher consumption of dairy products. Among children, the consumption of bread, often containing iodised bakery salt, was positively associated with parental education. The I intake of the Dutch population (7–69 years) seems adequate, although it has decreased since the period before 2008. With the current effort to reduce salt intake and changing dietary patterns (i.e. less bread, more organic foods) it is important to keep a close track on the I status, important sources and potential risk groups.
EVALUATION CRITERIA OF PATIENT AND PUBLIC INVOLVEMENT IN RESOURCE ALLOCATION DECISIONS: A LITERATURE REVIEW AND QUALITATIVE STUDY
Authors: Rosenberg-Yunger Zahava R.S. , Bayoumi Ahmed M. 
Published: May 2017

Objectives: We developed specific evaluation criteria to assess patient and public involvement in resource allocation decisions in health care.Methods: We reviewed the literature from health and other sectors relevant to stakeholder involvement and conducted twenty-seven key informant interviews with stakeholders knowledgeable about patient and public involvement in Canadian drug resource allocation decisions. We used an inductive qualitative thematic approach to analyze the interviews with codes and categories developed directly from individuals’ interview transcripts.Results: Integrating respondents’ comments and the literature review, we identified nine evaluation criteria of patient and the public involvement in healthcare resource allocation decision making: clarity regarding rationale and roles of patient and public members, sufficient support, adequate representation of relevant views, fair decision-making processes, legitimacy of committee processes, adequate opportunity for participation, meaningful degree of participation, noticeable effect on decisions, and considerations of the efficiency of patient and public involvement.Conclusions: Our results will help to develop methods to evaluate patient and public involvement in healthcare decision making.
Girls’ and boys’ trajectories of appearance anxiety from age 10 to 15 years are associated with earlier maturation and appearance-related teasing
Authors: Zimmer-Gembeck Melanie J. , Webb Haley J. , Farrell Lara J. , Waters Allison M. 
Published: May 2017

AbstractAdolescents’ appearance-related concerns can provoke increasing emotional, social, and eating-related problems. The aims of this five-wave (2.5-year), multiple-informant longitudinal study were to (a) examine growth trajectories of appearance anxiety symptoms and appearance esteem, (b) identify whether trajectories differed by gender, and (c) examine several launching factors including parent-reported physical maturation, peer-rated physical appearance, body mass index, and appearance teasing by parents and peers. Participants were 387 adolescents (44% boys) aged 10 to 13 years at the first assessment. Steep growth in appearance anxiety symptoms was found for both girls and boys, but there was no average change in appearance esteem. Girls had more elevated appearance anxiety symptoms and lower appearance esteem than boys, girls’ body mass index was associated with symptoms, and earlier physical maturation and teasing about appearance, alone and in combination, were associated with growth in appearance anxiety symptoms for girls and boys. Earlier maturing boys who were highly teased by parents, but even more so when teased by peers, were at utmost risk for elevated appearance anxiety symptoms and increasing symptoms over time. In contrast, all girls exhibited elevated or increasing appearance anxiety symptoms across time, with the exception of girls with the latest maturation who also reported little teasing about their appearance.
Predictors of health-related quality of life in children with chronic heart disease
Authors: Niemitz Mandy , Gunst Diana C. M. , Hövels-Gürich Hedwig H. , Hofbeck Michael , Kaulitz Renate , Galm Christoph , Berger Felix , Nagdyman Nicole , Stiller Brigitte , Borth-Bruhns Thomas , Konzag Ines , Balmer Christian , Goldbeck Lutz 
Published: May 2017

AbstractObjectiveChronic paediatric heart disease is often associated with residual symptoms, persisting functional restrictions, and late sequelae for psychosocial development. It is, therefore, increasingly important to evaluate the health-related quality of life of children and adolescents with chronic heart disease. The aim of this study was to determine medical and socio-demographic variables affecting health-related quality of life in school-aged children and adolescents with chronic heart disease.Patients and methodsThe Pediatric Cardiac Quality of Life Inventory was administered to 375 children and adolescents and 386 parental caregivers. Medical information was obtained from the charts. The socio-demographic information was provided by the patients and caregivers.ResultsGreater disease severity, low school attendance, current cardiac medication, current parental employment, uncertain or limited prognosis, history of connection to a heart–lung machine, number of nights spent in a hospital, and need for treatment in a paediatric aftercare clinic independently contributed to lower health-related quality of life (self-report: R2=0.41; proxy-report: R2=0.46). High correlations between self-reports and parent-proxy reports indicated concordance regarding the evaluation of a child’s health-related quality of life.ConclusionsBeyond medical treatment, integration into school is important to increase health-related quality of life in children and adolescents surviving with chronic heart disease. Regular screening of health-related quality of life is recommended to identify patients with special needs.
Survivin, a key player in cancer progression, increases in obesity and protects adipose tissue stem cells from apoptosis
Authors: Ejarque Miriam , Ceperuelo-Mallafré Victòria , Serena Carolina , Pachón Gisela , Núñez-Álvarez Yaiza , Terrón-Puig Margarida , Calvo Enrique , Núñez-Roa Catalina , Oliva-Olivera Wilfredo , Tinahones Francisco J , Peinado Miguel Angel , Vendrell Joan , Fernández-Veledo Sonia 
Published: May 2017

AbstractAdipose tissue (AT) has a central role in obesity-related metabolic imbalance through the dysregulated production of cytokines and adipokines. In addition to its known risk for cardiovascular disease and diabetes, obesity is also a major risk for cancer. We investigated the impact of obesity for the expression of survivin, an antiapoptotic protein upregulated by adipokines and a diagnostic biomarker of tumor onset and recurrence. In a cross-sectional study of 111 subjects classified by body mass index, circulating levels of survivin and gene expression in subcutaneous AT were significantly higher in obese patients and positively correlated with leptin. Within AT, survivin was primarily detected in human adipocyte-derived stem cells (hASCs), the adipocyte precursors that determine AT expansion. Remarkably, survivin expression was significantly higher in hASCs isolated from obese patients that from lean controls and was increased by proinflammatory M1 macrophage soluble factors including IL-1β. Analysis of survivin expression in hASCs revealed a complex regulation including epigenetic modifications and protein stability. Surprisingly, obese hASCs showed survivin promoter hypermethylation that correlated with a significant decrease in its mRNA levels. Nonetheless, a lower level of mir-203, which inhibits survivin protein translation, and higher protein stability, was found in obese hASCs compared with their lean counterparts. We discovered that survivin levels determine the susceptibility of hASCs to apoptotic stimuli (including leptin and hypoxia). Accordingly, hASCs from an obese setting were protected from apoptosis. Collectively, these data shed new light on the molecular mechanisms governing AT expansion in obesity through promotion of hASCs that are resistant to apoptosis, and point to survivin as a potential new molecular player in the communication between AT and tumor cells. Thus, inhibition of apoptosis targeting survivin might represent an effective strategy for both obesity and cancer therapy.
Cytoplasmic RAP1 mediates cisplatin resistance of non-small cell lung cancer
Authors: Xiao Lu , Lan Xiaoying , Shi Xianping , Zhao Kai , Wang Dongrui , Wang Xuejun , Li Faqian , Huang Hongbiao , Liu Jinbao 
Published: May 2017

AbstractCytotoxic chemotherapy agents (e.g., cisplatin) are the first-line drugs to treat non-small cell lung cancer (NSCLC) but NSCLC develops resistance to the agent, limiting therapeutic efficacy. Despite many approaches to identifying the underlying mechanism for cisplatin resistance, there remains a lack of effective targets in the population that resist cisplatin treatment. In this study, we sought to investigate the role of cytoplasmic RAP1, a previously identified positive regulator of NF-κB signaling, in the development of cisplatin resistance in NSCLC cells. We found that the expression of cytoplasmic RAP1 was significantly higher in high-grade NSCLC tissues than in low-grade NSCLC; compared with a normal pulmonary epithelial cell line, the A549 NSCLC cells exhibited more cytoplasmic RAP1 expression as well as increased NF-κB activity; cisplatin treatment resulted in a further increase of cytoplasmic RAP1 in A549 cells; overexpression of RAP1 desensitized the A549 cells to cisplatin, and conversely, RAP1 depletion in the NSCLC cells reduced their proliferation and increased their sensitivity to cisplatin, indicating that RAP1 is required for cell growth and has a key mediating role in the development of cisplatin resistance in NSCLC cells. The RAP1-mediated cisplatin resistance was associated with the activation of NF-κB signaling and the upregulation of the antiapoptosis factor BCL-2. Intriguingly, in the small portion of RAP1-depleted cells that survived cisplatin treatment, no induction of NF-κB activity and BCL-2 expression was observed. Furthermore, in established cisplatin-resistant A549 cells, RAP1 depletion caused BCL2 depletion, caspase activation and dramatic lethality to the cells. Hence, our results demonstrate that the cytoplasmic RAP1–NF-κB–BCL2 axis represents a key pathway to cisplatin resistance in NSCLC cells, identifying RAP1 as a marker and a potential therapeutic target for cisplatin resistance of NSCLC.
MicroRNA-23b functions as an oncogene and activates AKT/GSK3β/β-catenin signaling by targeting ST7L in hepatocellular carcinoma
Authors: Zhuang Likun , Wang Xin , Wang Zusen , Ma Xiang , Han Bing , Zou Hao , Wu Zehua , Dong Sheng , Qu Zhiqiang , Zang Yunjin , Wu Liqun 
Published: May 2017

AbstractHepatocellular carcinoma (HCC) is a malignant tumor and threatens human life worldwide, whereas the etiology and pathogenesis of HCC have not been fully determined. In the past few years, many microRNAs (miRNAs) have been proved to have important roles in tumorigenesis of HCC. In this study, we found that miR-23b was significantly upregulated in tumor tissues of HCC patients. Functional tests showed that miR-23b could promote HCC cell proliferation and metastasis in vitro and in vivo. Then, mechanistic investigations suggested that ST7L was a direct target of miR-23b and involved in the promotion effects of miR-23b on HCC tumorigenesis and metastasis. Furthermore, our study indicated that ST7L could interact with the carboxyl terminal region of AKT and suppress AKT/GSK3β/β-catenin pathway in HCC cells. In conclusion, our study revealed important roles of miR-23b and ST7L in progression of HCC.