bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identifying opportunities in EHR to improve the quality of antibiotic allergy data
Authors: Moskow Jaclynn M , Cook Nicole , Champion-Lippmann Carisa , Amofah Saint Anthony , Garcia Angela S 
Published: November 2015

AbstractBackground Antimicrobial resistance is a growing, global public health crisis, due in large part to the overuse and misuse of antibiotics. Understanding medication allergy data and allergy reactions that are documented in electronic health records (EHRs) can help to identify opportunities to improve the quality of documentation of beta-lactam allergies, thus potentially reducing the prescribing of alternative antibiotics.Methods Medication allergies and allergy reactions recorded in the EHR for 319 051 patients seen across 32 community health centers were reviewed. Patients with a beta-lactam allergy recorded in their EHR were identified. Free text, as well as standardized allergy and allergy reaction fields, were analyzed.Results Among patients, 9.1% ( n  = 29 095) had evidence of a beta-lactam allergy recorded in their EHR. Women, white, and non-Hispanic patients were more likely to have a documented allergy compared to men, black, and Hispanic patients. Among all patients with a documented beta-lactam allergy, 36.2% had an empty or missing allergy reaction description in their EHR.Conclusions Findings suggest that current EHR documentation practices among the health centers reviewed do not provide enough information on allergic reactions to allow providers to discern between true allergies and common, but anticipated, drug side effects. Improved EHR documentation guidance, training that reinforces the use of standardized data and more detailed recording of allergic reactions, combined with initiatives to address patient barriers including health literacy, may help to improve the accuracy of drug allergies in patients’ records. These initiatives, combined with antimicrobial stewardship programs, can help to reduce inappropriate prescribing of alternative antibiotics when beta-lactam antibiotics are first-line and can be tolerated.
VERTIcal Grid lOgistic regression (VERTIGO)
Authors: Li Yong , Jiang Xiaoqian , Wang Shuang , Xiong Hongkai , Ohno-Machado Lucila 
Published: November 2015

Objective To develop an accurate logistic regression (LR) algorithm to support federated data analysis of vertically partitioned distributed data sets.
Material and Methods We propose a novel technique that solves the binary LR problem by dual optimization to obtain a global solution for vertically partitioned data. We evaluated this new method, VERTIcal Grid lOgistic regression (VERTIGO), in artificial and real-world medical classification problems in terms of the area under the receiver operating characteristic curve, calibration, and computational complexity. We assumed that the institutions could “align” patient records (through patient identifiers or hashed “privacy-protecting” identifiers), and also that they both had access to the values for the dependent variable in the LR model (eg, that if the model predicts death, both institutions would have the same information about death).
Results The solution derived by VERTIGO has the same estimated parameters as the solution derived by applying classical LR. The same is true for discrimination and calibration over both simulated and real data sets. In addition, the computational cost of VERTIGO is not prohibitive in practice.
Discussion There is a technical challenge in scaling up federated LR for vertically partitioned data. When the number of patients m is large, our algorithm has to invert a large Hessian matrix. This is an expensive operation of time complexity O(m3) that may require large amounts of memory for storage and exchange of information. The algorithm may also not work well when the number of observations in each class is highly imbalanced.
Conclusion The proposed VERTIGO algorithm can generate accurate global models to support federated data analysis of vertically partitioned data.
Chemical synthesis of proteins using hydrazide intermediates
Authors: Huang Yi-Chao , Fang Ge-Min , Liu Lei 
Published: November 2015

AbstractProtein chemical synthesis offers useful and otherwise-difficulty-to-obtain biomacromolecules for biological and pharmaceutical studies. Recently, the hydrazide chemistry has drawn attentions in this field as peptide or protein hydrazides can be used as key intermediates for different synthesis and modification purposes. Besides being a traditional bioorthogonal chemical handle, a hydrazide group can serve as a readily accessible precursor of a thioester. This strategy significantly improves the efficiency and scope of native chemical ligation for protein chemical synthesis. Here we review the chemical transformations of peptide or protein hydrazides and total/semi/enzymatic protein synthesis methods involving peptide or protein hydrazides. Several examples of protein chemical synthesis using peptide hydrazides as key intermediates are described.
The Impact of Posttraumatic Stress Disorder on Physiological Arousal, Disability, and Sensory Pain Thresholds in Patients With Chronic Whiplash
Authors: Dunne-Proctor Rachael L. , Kenardy Justin , Sterling Michele 
Published: November 2015

Objective:
Whiplash-associated disorders (WAD) are common and incur substantial personal and economic costs. Research has shown that persistent posttraumatic stress reactions predict poorer functional recovery in WAD; however, the specific mechanism through which this occurs is unclear. The current study is the first to examine the direct impact of posttraumatic stress disorder (PTSD) symptoms in WAD using laboratory tested pain measures.

Materials and Methods:
A mixed experimental design was used to examine the impact of exposure to accident cues on chronic WAD individuals with (n=33) and without (n=39) PTSD. Groups were compared at baseline and postaccident cue on self-reported pain and negative effect and laboratory tested arousal and sensory pain threshold measures.

Results:
At baseline, WAD individuals with PTSD reported greater disability, negative effect, pain, arousal, and lower pain thresholds than those without PTSD. As expected, exposure to accident cues resulted in greater increases in arousal and negative effect for those with PTSD. Changes in sensory pain thresholds revealed a hyperalgesic effect in cold pain thresholds for the PTSD group compared with the No PTSD group and mixed findings for pressure pain thresholds.

Discussion:
Findings from the current study highlight the negative impact of PTSD on both physical and psychological outcomes in chronic WAD. From a clinical perspective, data suggest that patients exposed to accident cues may experience arousal that lowers their threshold to certain pain stimuli. Further investigation of effective multidisciplinary interventions and in particular the treatment of PTSD in WAD is identified as an important area of further investigation.
Patient-controlled Analgesia With Propacetamol-Fentanyl Mixture for Prevention of Postoperative Nausea and Vomiting in High-risk Patients Undergoing Spine Surgery: A Randomized Controlled Trial
Authors: Kim Eun Jung , Shim Jae-Kwang , Soh Sarah , Song Jong Wook , Lee Se Ryeon , Kwak Young-Lan 
Published: November 2015

Background:
This randomized trial evaluated the effect of intravenous patient-controlled analgesia (IV-PCA) based on fentanyl mixed with either propacetamol or an equivalent volume of normal saline on postoperative nausea and vomiting (PONV) in highly susceptible patients undergoing spinal surgery.

Materials and Methods:
One hundred eight nonsmoking female patients were randomly and evenly allocated to receive IV-PCA with either propacetamol (4 g) or normal saline mixed to fentanyl (20 μg/kg). Primary study outcome was PONV incidence at 24 hours postsurgery. Secondary outcomes were nausea severity, pain intensity (100-mm visual analog scale), use of rescue antiemetics and analgesics, patient satisfaction, and adverse events at 6, 12, and 24 hours postsurgery.

Results:
Postsurgery, the propacetamol versus normal saline group had lower PONV incidence at 24 hours (41% vs. 66%, P=0.011); pain intensity at rest and rescue analgesic requirements at 6 to 12 hours (30±15 vs. 41±19, P=0.008; and 25% vs. 49%, P=0.036, respectively) and at 12 to 24 hours (25±15 vs. 35±17, P=0.008; and 19% vs. 42%, P=0.044, respectively); and higher patient satisfaction score (6.4±1.4 vs. 5.7±1.8, P=0.028).

Conclusions:
In patients undergoing spinal surgery and at risk of developing PONV, continuous IV-PCA based on propacetamol mixed to fentanyl, relative to fentanyl alone, effectively reduced the incidence of PONV, pain intensity at rest, and additional use of rescue analgesics with higher patient satisfaction.
Which Pediatric Orthopaedic Procedures Have the Greatest Risk of Adverse Outcomes?
Authors: Basques Bryce A. , Lukasiewicz Adam M. , Samuel Andre M. , Webb Matthew L. , Bohl Daniel D. , Smith Brian G. , Grauer Jonathan N. 
Published: November 2015

Background:
Quality improvement in orthopaedic surgery has received increasing attention; however, there is insufficient information available about the perioperative safety of many common pediatric orthopaedic procedures. This study aimed to characterize the incidence of adverse events in a national pediatric patient sample to understand the risk profiles of common pediatric orthopaedic procedures, and to identify patients and operations that are associated with increased rates of adverse outcomes.

Methods:
A retrospective cohort study was conducted using the prospectively collected American College of Surgeons National Surgical Quality Improvement Program (NSQIP) Pediatric database. Pediatric patients who underwent 29 different orthopaedic procedures were identified in the 2012 NSQIP Pediatric database. The occurrence of any adverse event, infection, return to the operating room, and readmission within 30 days, were reported for each procedure. Multivariate regression was then used to identify the association of patient and operative characteristics with the occurrence of each adverse outcome.

Results:
A total of 8975 pediatric patients were identified. Supracondylar humerus fracture fixation was the most common procedure performed in this sample (2274 patients or 25.57% of all procedures), followed by posterior spinal fusion (1894 patients or 21.10% of all procedures). Adverse events occurred in 352 patients (3.92% of all patients). Four deaths were noted (0.04% of all patients), which only occurred in patients with nonidiopathic scoliosis undergoing spinal fusion. Infections occurred in 143 patients (1.59%), and 197 patients (2.19%) were readmitted within 30 days. Multiple patient characteristics and procedures were found to be associated with each adverse outcome studied.

Conclusions:
Spinal fusion, multiaxial external fixation, and fasciotomy were procedures associated with increased rates of adverse outcomes within 30 days. Patients with obesity, ASA class ≥3, and impaired cognitive status also had increased rates of adverse outcomes. The results from this study of a large, national sample of pediatric orthopaedic patients are important for benchmarking and highlight areas for quality improvement.

Level of Evidence:
Level III—Prognostic.
Do Intraocular Pressure Measurements Under Anesthesia Reflect the Awake Condition?
Authors: Gofman Nina , Cohen Barak , Matot Idit , Cattan Anat , Dotan Gad , Stolovitch Chaim , Ela-Dalman Noa 
Published: November 2015

Background:
Anesthesia or sedation is needed when intraocular pressure (IOP) measurement is required in certain circumstances. The effect of different anesthetic regimens on the IOP is still debatable. We aimed to evaluate alterations in the IOP under anesthesia with either propofol or different end-tidal concentrations of sevoflurane, when compared with the awake state.

Methods:
The IOP was measured in both eyes of 20 adult patients undergoing extraocular ophthalmic surgeries at 5 timepoints: before the induction of general anesthesia (under topical anesthesia), after the induction using propofol target-controlled infusion, and under 3 end-tidal concentrations of sevoflurane (0.5%, 2%, and 5%), either in a decreasing (group A) or an increasing (group B) concentration order.

Results:
With either propofol or sevoflurane anesthesia, the IOP did not differ significantly from the measurement performed during the awake state (no anesthesia), regardless of the concentration of sevoflurane used (in the range of 0.5% to 5%) or the order of sevoflurane administration (from low to high concentration or vice versa).

Conclusions:
These data suggest that propofol and sevoflurane are valid anesthetic agents for the evaluation of IOP in adults when anesthesia is needed.
The Influence of Scleral Flap Thickness, Shape, and Sutures on Intraocular Pressure (IOP) and Aqueous Humor Flow Direction in a Trabeculectomy Model
Authors: Samsudin Amir , Eames Ian , Brocchini Steve , Khaw Peng Tee 
Published: November 2015

Purpose:
Intraocular pressure and aqueous humor flow direction determined by the scleral flap immediately after trabeculectomy are critical determinants of the surgical outcome. We used a large-scale model to objectively measure the influence of flap thickness and shape, and suture number and position on pressure difference across the flap and flow of fluid underneath it.

Methods:
The model exploits the principle of dynamic and geometric similarity, so while dimensions were up to 30× greater than actual, the flow had similar properties. Scleral flaps were represented by transparent 0.8- and 1.6-mm-thick silicone sheets on an acrylic plate. Dyed 98% glycerin, representing the aqueous humor was pumped between the sheet and plate, and the equilibrium pressure measured with a pressure transducer. Image analysis based on the principle of dye dilution was performed using MATLAB software.

Results:
The pressure drop across the flap was larger with thinner flaps, due to reduced rigidity and resistance. Doubling the surface area of flaps and reducing the number of sutures from 5 to 3 or 2 also resulted in larger pressure drops. Flow direction was affected mainly by suture number and position, it was less toward the sutures and more toward the nearest free edge of the flap. Posterior flow of aqueous humor was promoted by placing sutures along the sides while leaving the posterior edge free.

Conclusion:
We demonstrate a new physical model which shows how changes in scleral flap thickness and shape, and suture number and position affect pressure and flow in a trabeculectomy.
Analysis of a Standardized Perioperative Pain Management Order Set in Highly Opioid-Tolerant Patients
Authors: Isaacs Alex N. , Knight Kellie L. , Nisly Sarah A. 
Published: November 2015

Objective
The aim was to assess a standardized order set for perioperative pain management in highly opioid-tolerant patients undergoing elective orthopedic surgery.

Methods
This retrospective chart review evaluated a pain order set in highly opioid-tolerant patients undergoing elective total knee or total hip arthroplasty from January 2010 through August 2012. Based on the date of the surgery, patients were allocated into preimplementation or postimplementation order set groups. The primary outcome assessed whether an adjustment in daily opioid dosage was required within the first 48 hours postoperatively. Secondary outcomes included pain scores, length of hospitalization, and safety outcomes.

Results
Sixty patients were included in the analysis. An adjustment to postoperative opioid therapy occurred in 62% of the patients in the preimplementation group and in 56% of postimplementation group patients (P = 0.786). There were no differences in median pain scores 48 hours postoperatively (P = 0.348). Cumulative toxicity was increased after order set implementation compared with previous patients (44% versus 5%, P < 0.005); however, opioid doses held for sedation was the only individual toxicity to reach statistical significance (P = 0.011).

Conclusions
This study is the first to evaluate a standardized order set for pain management in highly opioid-tolerant patients undergoing elective orthopedic surgery. The order set demonstrated similar efficacy to previous treatment modalities, but opioid-induced sedation was of concern with the order set. After the initial analysis, the order set was modified to minimize opioid-induced sedation. Continual safety analysis is warranted for quality improvement to enhance perioperative pain management in highly opioid-tolerant patients.
Reconstitution of CO2regulation of SLAC1 anion channel and function of CO2-permeable PIP2;1 aquaporin as carbonic anhydrase 4 interactor
Authors: Wang Cun , Hu Honghong , Qin Xue , Zeise Brian , Xu Danyun , Rappel Wouter-Jan , Boron Walter F. , Schroeder Julian I. 
Published: November 2015

ABSTRACTDaily dark periods cause an increase in the leaf CO2concentration (Ci) and the continuing atmospheric [CO2] rise also increasesCi. ElevatedCicauses closing of stomatal pores thus regulating gas exchange of plants. The molecular signaling mechanisms leading to CO2-induced stomatal closure are only partially understood. Here we demonstrate that high intracellularenhances currents mediated by the guard cell S-type anion channel SLAC1 when co-expressing either of the protein kinases OST1, CPK6 or CPK23 inXenopusoocytes. Split-ubiquitin screening identified the PIP2;1 aquaporin as an interactor of theβCA4 carbonic anhydrase, which was confirmed in split luciferase, bimolecular fluorescence complementation and co-immunoprecipitation experiments. PIP2;1 exhibited CO2permeability. Co-expression ofβCA4 and PIP2;1 with OST1-SLAC1 or CPK6/23-SLAC1 enabled extracellular CO2enhancement of SLAC1 anion channel activity. An inactive PIP2;1 point mutation was identified which abrogated water and CO2permeability and extracellular CO2regulation of SLAC1 activity inXenopusoocytes. These findings identify the CO2-permeable PIP2;1 aquaporin as key interactor of carbonic anhydrases, show functional reconstitution of extracellular CO2signaling to ion channel regulation and implicate SLAC1 as a bicarbonate-responsive protein in CO2regulation of S-type anion channels.
MicrobiomeGWAS: a tool for identifying host genetic variants associated with microbiome composition
Authors: Hua Xing , Song Lei , Yu Guoqin , Goedert James J. , Abnet Christian C. , Landi Maria Teresa , Shi Jianxin 
Published: November 2015

AbstractThe microbiome is the collection of all microbial genes and can be investigated by sequencing highly variable regions of 16S ribosomal RNA (rRNA) genes. Evidence suggests that environmental factors and host genetics may interact to impact human microbiome composition. Identifying host genetic variants associated with human microbiome composition not only provides clues for characterizing microbiome variation but also helps to elucidate biological mechanisms of genetic associations, prioritize genetic variants, and improve genetic risk prediction. Since a microbiota functions as a community, it is best characterized by beta diversity, that is, a pairwise distance matrix. We develop a statistical framework and a computationally efficient software package, microbiomeGWAS, for identifying host genetic variants associated with microbiome beta diversity with or without interacting with an environmental factor. We show that score statistics have positive skewness and kurtosis due to the dependent nature of the pairwise data, which makes P-value approximations based on asymptotic distributions unacceptably liberal. By correcting for skewness and kurtosis, we develop accurateP-value approximations, whose accuracy was verified by extensive simulations. We exemplify our methods by analyzing a set of 147 genotyped subjects with 16S rRNA microbiome profiles from non-malignant lung tissues. Correcting for skewness and kurtosis eliminated the dramatic deviation in the quantile-quantile plots. We provided preliminary evidence that six established lung cancer risk SNPs were collectively associated with microbiome composition for both unweighted (P=0.0032) and weighted (P=0.011) UniFrac distance matrices. In summary, our methods will facilitate analyzing large-scale genome-wide association studies of the human microbiome.
Descriptive sensory analysis and consumer acceptability of lucerne (Medicago sativa L.)
Authors: Mielmann Annchen , Bothma Carina , Hugo A , Hugo Celia J 
Published: November 2015

Purpose
– A lack of available literature exists about sensory data on lucerne (which is mainly used for animal feed) as an underutilised protein source for human consumption in South Africa (SA). Developing tasteless lucerne products is meaningless. Therefore, the purpose of this paper is to determine the descriptive sensory profile and consumers’ acceptability of lucerne.

Design/methodology/approach
– Three lucerne cultivars and one spinach beet (Beta vulgaris var. cicla L.) cultivar were used: first, to determine sensory descriptive attributes by generic descriptive analysis; and second, to determine consumers’ acceptance of lucerne, which were evaluated for degree of liking for aroma, taste, mouthfeel and overall acceptability with a nine-point hedonic scale. Principal component analysis of attributes for all the lucerne cultivars was applied to identify any factors differentiating between these cultivars.

Findings
– “SA Standard” showed the lowest value, of the lucerne samples, for fibrous appearance, chewy and fibrous mouthfeel, bitter taste and bitter and metallic aftertaste. “SA Standard” was the most acceptable lucerne cultivar, indicating its application in future studies to profile new emerging cultivars.

Originality/value
– No sensory analysis studies have been performed on South African lucerne cultivars to determine their sensory acceptability. These cultivars could have potential for food nutritionists, food scientists and food product developers and the commercial market.
Hotel gastronomy as viewed by customers
Authors: Kapera Izabela 
Published: November 2015

Purpose
– The purpose of this paper is to discuss the significance of hotel restaurants from the customer perspective, assess customer expectations, and provide guidelines for growth in the hotel restaurant industry.

Design/methodology/approach
– A total of 301 hotel guests staying at 26 hotels located in Malopolskie Voivodeship were surveyed. The research study also evaluated customer opinions of hotel restaurants and specific customer suggestions in the area of service quality. The survey participants were asked to rate the hotel in which they had actually stayed and its accompanying restaurant.

Findings
– Research has shown that 96 percent of hotel guests took advantage of hotel restaurant services while staying at their hotel. Breakfast was the most common service rendered by each studied hotel restaurant (90 percent). In addition, 44 percent of survey participants said that their choice of hotel is in part driven by the quality of restaurant services. The two key factors for hotel restaurant patrons are food quality and courteous service.

Research limitations/implications
– These type of data are very valuable to the hotel industry, as the number of hotel restaurant studies is limited.

Practical implications
– An understanding of customer expectations with respect to hotel restaurants, which are today perceived as integral parts of the total hotel experience, is useful in terms of developing the total offering for each given hotel in order to build competitive advantage.

Social implications
– Such research also has implications for hospitality and tourism in that it relates to the understanding of host-guest relationships.

Originality/value
– A review of the research literature suggests that hotel restaurants are not studied very often and shows the lack of research papers in this area.