bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perceived group discrimination and psychological well‐being in ethnic minority adolescents
Authors: Stevens Gonneke W. J. M. , Thijs Jochem 
Published: August 2018

AbstractFew studies have examined the relation of perceived group discrimination and psychological well‐being. Yet, there are theoretical reasons to expect such a relation, and members of ethnic minorities usually perceive higher levels of group discrimination than personal discrimination. In this research, we investigated the associations between perceived group discrimination and several indicators of psychological well‐being among 354 Moroccan‐Dutch adolescents controlling for perceived personal discrimination and testing the extent to which ethnic group identification moderated these associations. Our results showed that higher perceived group discrimination was associated with higher parent‐ and adolescent‐reported internalizing (e.g., fear, worries) and externalizing problems (e.g., anger, aggression) but not with lower personal self‐esteem. For personal self‐esteem a negative association with perceived personal discrimination was found. Moreover, for adolescents with a strong ethnic group identification, there was no relationship between perceived group discrimination and parent‐ and adolescent‐reported internalizing problems, while for those with a weak ethnic group identification, perceived group discrimination was associated with more parent‐ and adolescent‐reported internalizing problems. Conversely, perceived group discrimination was unrelated to personal self‐esteem among low identifiers, but positively related to it among high identifiers. Results indicate that minority group members can be negatively affected by discrimination, even if they do not experience it at first hand. Thus, future research on the psychological effects of discrimination should include group perceptions.
Longitudinal evaluation of periodontitis and development of cognitive decline among older adults
Authors: Nilsson Helena , Sanmartin Berglund Johan , Renvert Stefan 
Published: August 2018

AbstractAimTo determine whether having periodontitis is associated with cognitive decline among older adults.Material and MethodsA prospective population study of older adults, Swedish National Study on Ageing and Care, (SNAC) provided repeated registrations of cognitive functions. Cognitive decline was defined as ≥3‐points deterioration from a predetermined level at baseline, using the Mini‐Mental State Examination (MMSE). Between 2001 and 2003, 715 individuals had a medical as well as a clinical and radiographic dental examination. The individuals were re‐examined after 6 years. Periodontitis was defined as ≥4 mm bone loss at ≥30% of tooth sites. Social variables were captured from questionnaires.ResultsThe multivariate logistic regression analysis demonstrated a statistically significant association between prevalence of periodontitis and cognitive decline after adjustments of confounding factors of importance.ConclusionsA history of periodontitis may be of importance for cognitive functions among older adults.
Direct medical costs for patients with type 2 diabetes in 16 tertiary hospitals in urban China: A multicenter prospective cohort study
Authors: Li Xiang , Xu Zhangrong , Ji Linong , Guo Lixin , Liu Jing , Feng Kun , Xu Yushan , Zhu Dalong , Jia Weiping , Ran XinWu , Chen Limin , Zhao Shi , Shi Bingying , Zhu Jun , Shan Zhongyan , Zhou Zhiguang , Zeng Longyi , Weng Jianping ,   the cooperative group on Direct Medical Cost Investigation of Diabetes in Chinese Urban Tertiary Hospitals, Chinese Diabetes Society
Published: August 2018

AbstractAims/IntroductionTo investigate the direct medical costs for patients with type 2 diabetes in China and to examine the influencing factors.Materials and MethodsIn the present multicenter study, 1,070 patients with type 2 diabetes from 16 tertiary hospitals in 14 major cities of China were enrolled. Patient data and direct medical costs were collected during a follow‐up period of 6 months at intervals of 1 month. The log‐transformed direct medical costs were fitted by a generalized estimation equation to indicator variables for demographics, metabolic control, treatments, complications and comorbidities.ResultsData of 871 participants were included in the analysis. The mean annual total direct medical costs and outpatient medical costs were $1,990.20 and $1,687.20 respectively. The average costs per inpatient per admission were $2,127.10. The share of out‐of‐pocket for total medical costs, outpatient costs and cost per inpatient per admission were 45.4, 46.3 and 26.0% respectively. Independent determinants of total medical costs were diabetes duration, dyslipidemia and diabetic complications, such as neuropathy and nephropathy, as well as diabetes treatment, such as the use of glucagon‐like peptide‐1 receptor agonists. Costs showed prominent variation across centers.ConclusionsDiabetes is imposing a growing economic burden in patients with type 2 diabetes in China. Diabetes‐related complications and comorbidities have a great impact on the medical costs. As different health policies, economic development and regional health inequalities also have an important influence on the direct medical cost, healthcare reform needs to optimize resource allocation in health service delivery systems, and provide more equitable and affordable healthcare.
Use of Home‐Based Medical Care and Disparities
Authors: Yao Nengliang (Aaron) , Ritchie Christine , Cornwell Thomas , Leff Bruce 
Published: August 2018

ObjectivesTo examine the volume of home‐based medical care (HBMC) visits made to frail older adults between 2011 and 2014 and sex, racial, ethnic, frailty‐related comorbidity, and geographic disparities in HBMC use.DesignObservational study using secondary data.Setting5% Medicare claims for 2011 to 2014.ParticipantsMedicare beneficiaries.MeasurementsUsage rates of HBMC of frail Medicare beneficiaries were compared using descriptive statistics and multivariate logistic regression.ResultsFrom 2011 to 2014, use of HBMC increased from 8.7% to 10.1% in beneficiaries with medium comorbidity and from 14.2% to 15.7% in those with high comorbidity. After adjustment for multiple factors, blacks were 21% more likely (95% confidence interval (CI)=17–25%, p<.001) to use HBMC, and Asians were 31% less likely (95% CI=24–38%, p<.001) to use HBMC than whites. Women were 24% more likely (95% CI=21–27%, p<.001) to use HBMC than men. Rural residents were 78% less likely (95% CI=76–79%) than those in the largest metropolitan county to receive HBMC. Nurse practitioners made 40% of HBMC visits to rural residents, and internists made 32% of HBMC visits in large metropolitan counties. There were substantial geographic variations in the use of HBMC in frail older adults; the national usage rate was 11%, and 7 states had rates less than 5%.ConclusionAlthough there was a small increase in the use of HBMC between 2011 and 2014, the majority of eligible home‐limited individuals have not received medical care at home, particularly rural residents and those living in underserved states. More HBMC practices are needed, and programs may need to integrate telemedicine to expand HBMC in rural communities.
Comparative Effectiveness of 2 Interventions for Hispanic Caregivers of Persons with Dementia
Authors: Luchsinger José A. , Burgio Louis , Mittelman Mary , Dunner Ilana , Levine Jed A. , Hoyos Carolina , Tipiani Dante , Henriquez Yefrenia , Kong Jian , Silver Stephanie , Ramirez Mildred , Teresi Jeanne A. 
Published: August 2018

ObjectivesTo compare the effectiveness of 2 caregiver interventions with known efficacy: the Resources for Enhancing Caregiver Health‐Offering Useful Treatment (REACH‐OUT) and the New York University Caregiver Intervention (NYUCI).Design1:1 randomized pragmatic trial.SettingNew York City.ParticipantsInformal Hispanic caregivers of persons with dementia (N=221; mean age 58.2, 82.8% female, 63.3% adult children, 31.7% spouses).InterventionParticipants were randomized to 6 months of NYUCI (n=110) or REACH‐OUT (n=111), balanced on characteristics at baseline. All participants were referred for social supportive services.MeasurementsThe primary outcomes were changes between baseline and 6 months in depressive symptoms, measured using the Geriatric Depression Scale (GDS), and caregiver burden, measured using the Zarit Caregiver Burden Scale (ZCBS).ResultsThere were no differences in outcomes between NYUCI and REACH‐OUT. Both interventions showed a reduction in burden (REACH‐OUT: 5.2 points, 95% confidence interval (CI)=2.2–8.1, p<.001; NYUCI: 4.6‐points, 95% CI=1.7–7.5, p=.002). There were no significant changes on the GDS. Effects for the ZCBS were significant only for spouses and older caregivers.ConclusionAlthough there were no significant intervention group differences, both interventions resulted in significantly reduced burden for Hispanic caregivers at 6 months, particularly for spouses and older caregivers.
Effect of oropharyngeal colostrum therapy in the prevention of necrotising enterocolitis among very low birthweight neonates: A meta‐analysis of randomised controlled trials
Authors: Garg B. D. , Balasubramanian H. , Kabra N. S. , Bansal A. 
Published: August 2018

AbstractBackgroundNecrotising enterocolitis (NEC) is one of the most common life‐threatening emergencies of the gastrointestinal tract in preterm neonates. The present study aimed to determine the efficacy of oropharyngeal colostrum with respect to reducing NEC in preterm neonates.MethodsA literature search was conducted for various randomised control trials by searching the Cochrane Central Register of Controlled Trials, PubMed, EMBASE and ongoing clinical trials. Randomised or quasi‐randomised trials comparing oropharyngeal colostrum versus placebo in neonates (birthweight ≤ 1500 g or gestational age ≤ 32 weeks) were included in the review. The methodological quality of each trial was independently reviewed by the authors. For categorical and continuous variables, typical estimates for relative risk and typical estimates for weighted mean difference were calculated, respectively. A random effect model was assumed for meta‐analysis.ResultsIn total, four eligible trials were included in the review. Oropharyngeal colostrum therapy was not associated with a statistically significant reduction in the incidence of NEC stage ≥2 [typical relative risk (RR) = 0.64; 95% confidence interval (CI) = 0.27–1.49], mortality from any cause (typical RR = 0.86; 95% CI = 0.15–4.80) and time to reach full feed [typical weighted mean difference (WMD) = −3.26; 95% CI = −8.87 to 2.35]. Duration of hospital stay was significantly less in the control group (typical WMD = 9.77; 95% CI = 3.96–15.59).ConclusionsThe current evidence is insufficient for recommending oropharyngeal colostrum as a routine clinical practice in the prevention of NEC. We emphasise the need for large randomised controlled trials with an adequate sample size and validated clinical outcomes in preterm neonates.
Introducing a novel model: The special theory of relativity for attractiveness to define a natural and pleasing outcome following cosmetic treatments
Authors: Dayan Steven , Romero Diana H. 
Published: August 2018

SummaryA meteoric expansion in esthetic medicine followed the introduction of nonsurgical cosmetic neuromodulators and fillers in the early 2000s, which has been recently declining. The initial inertia has likely been tempered by the cosmetically interested patient's fear of appearing unnatural. Defining a natural outcome is a mission essential to the advancement of esthetic medicine; however, achieving a natural result following cosmetic intervention is a misnomer and a logically flawed endeavor that cannot exist. The ever elusive “natural” that is loudly desired by the populous, and ardently pursued by both industry and physicians, can only be an interpreted deduction. To better define a natural outcome, a novel model based on the theory of relativity is suggested. Attractiveness consists of a 3‐dimensional area defined by beauty, genuineness, and self‐esteem. When all three variables are at a maximum, a desirable attractive appearance is achieved that can be interpreted as “natural.” Similar to the time‐space dilemma, attractiveness is relative, dynamic, and highly dependent on the position of the projector and the interpreter. The 3D cube of attractiveness is therefore contained within a 4th dimension that takes into account the perspective of the judger. It is hoped that by realizing a new theory of what defines a natural outcome, esthetic medicine will be prepared to meet the needs of future generations.
Motor blocks and operative deliveries with ropivacaine and fentanyl for labor epidural analgesia: A meta‐analysis
Authors: Zhang Yang , Qin Qing‐Rong , Hui Liang‐Tu 
Published: August 2018

AbstractAimAim of this study was to estimate the incidence of motor blocks, instrumental deliveries and cesarean deliveries with ropivacaine and fentanyl in epidural analgesia for labor and to identify factors affecting the outcomes.MethodsElectronic databases were searched for original research papers by using appropriate medical subject heading terms and keywords. Effect sizes of individual studies were pooled under random effects model to obtain weighted overall effect size/s. Metaregression analyses were performed to evaluate the factors affecting motor block and cesarean delivery incidences.ResultsThirty studies (2851 women; age 27.42 years [95% CI 26.56, 28.26]) were included. Concentrations of drugs (weighted average) were: 0.095% [0.08, 0.11] ropivacaine and 0.000215% [0.00018, 0.00025] fentanyl. Overall, incidences of motor blocks, instrumental deliveries and cesarean deliveries were 14.36% [13.47, 15.26]; 25.55% [22.38, 28.71] and 12.45% [11.17, 13.73], respectively. Maternal age was significantly positively associated with motor blocks as well as cesarean deliveries. Second stage of labor duration was also positively associated with motor block and instrumental delivery incidences. Cervical diameter at trial entry was significantly negatively associated with cesarean deliveries. Fentanyl concentration as well as total usage were associated negatively with instrumental delivery but positively with cesarean delivery incidence.ConclusionEpidural analgesia for labor with ropivacaine and fentanyl is associated with the incidence of approximately 14% motor blocks, 25% instrumental deliveries and 12% cesarean deliveries. Age, duration of the second stage of labor, cervical dilatation at initiation of neuraxial analgesia and dose of fentanyl may affect obstetric outcome.
A novel totally biodegradable device for effective atrial septal defect closure: A 2‐year study in sheep
Authors: Lu Wenxin , Ouyang Wenbin , Wang Shouzheng , Liu Yao , Zhang Fengwen , Wang Weiwei , Pan Xiangbin 
Published: August 2018

ObjectiveTo evaluate the feasibility, efficacy, and safety of a fully biodegradable poly lactic acid (PLA)‐based occluder for atrial septal defect (ASD) closure in an animal model.MethodsASDs, approximately 12‐mm in diameter, were generated in sheep (n = 18) by needle puncture and balloon dilatation. For ASD closure, occluders were implanted by percutaneous transcatheter approach under echocardiographic guidance. Outcomes were evaluated by transthoracic echocardiography, electrocardiography, blood testing, and histology within the follow‐up period ranging from 1 month to 2 years.ResultsAll occluders were successfully implanted. During follow‐up, no animal died; rectal temperatures, blood test results, and electrocardiograms were within normal ranges; and transthoracic echocardiograms, macroscopic studies, and histopathological and electron microscopic examination demonstrated that the occluders were well positioned, with no shifting, residual shunts, severe inflammation, thrombus formation, atrioventricular valve insufficiency, cardiac erosion or arrhythmias. The occluders gradually embedded into the endocardial tissue of the hosts with complete endothelialization and disk absorption at 12 months, and a distinct molecular weight decrease of the framework (to 9% of initial) at 24 months after implantation.ConclusionsIn a sheep model, the use of totally biodegradable occluders appears feasible, efficacious and safe for ASD closure. Studies in humans are ongoing.
Immediate loading at single crowns and 2‐unit bridges supported by implants installed in a healed alveolar bony ridge or immediately after tooth extraction. An experimental study in dogs
Authors: Viganò Paolo , Lang Niklaus P. , Cesaretti Gianfranco , Bengazi Franco , Omori Yuki , Botticelli Daniele 
Published: August 2018

SummaryTo evaluate presumptive differences in osseointegration at implants installed in healed sites or extraction sockets, supporting either crowns or bridges that were functionally loaded or left unloaded. In six dogs, the mesial roots of the first mandibular molars were treated endodontically. Bilaterally, the teeth were hemisected, and the distal roots extracted. First and second mandibular premolars were extracted as well. After 3 months, the mandibular third and fourth distal roots were extracted after endodontic treatment of the mesial roots. Four implants were installed bilaterally, two in the healed sites corresponding to the second premolar and first molar regions, and two into the extraction sockets. Cobalt‐chrome single crowns were prepared and installed in the two most anterior implants, and bridges at the two most posterior implants, bilaterally. A 3‐unit bridge was applied to the premolars in the upper jaw only at the loaded sites. All prostheses had a flat occlusal surface and contacts in centric occlusion only at the loaded sites. Three months later, biopsies were retrieved for histological analysis. Higher levels of osseointegration and bone density were observed at the unloaded sites, both at implants installed in healed and post‐extraction sites. However, only at implants installed in the post‐extraction sites and supporting single crowns, the difference in bone‐to‐Implant contact was statistically significant. In implant installation immediately following extraction or delayed after three months, osseointegration and bone density were not affected by occlusal contact schemes.
Insurance Covenants in Corporate Credit Agreements
Authors: Nini Greg 
Published: August 2018

ABSTRACTIn a large sample of private credit agreements of publicly traded firms, nearly all agreements contain at least a boilerplate provision requiring the borrower to purchase insurance. In about 80 percent of the agreements, the insurance covenant is more explicit. Four additional features of the insurance covenant are quite common: requirements of coverage for specific risks, naming the lender as a loss payee, mandating that any insurance proceeds be used to repay the loan, and explicit permission for the borrower to self‐insure. Credit agreements contain more stringent insurance requirements for borrowers that pose higher credit risk. The insurance requirements are strongly positively correlated with the loan being secured by collateral, which suggests that insurance creates value by protecting lenders from unexpected changes in seniority that might happen following the destruction of collateral. Insurance covenants are an important ingredient of credit agreements designed to create a very safe claim for senior, secured lenders.
Insurance Fraud in a Rothschild–Stiglitz World
Authors: Martin Boyer M. , Peter Richard 
Published: August 2018

AbstractIn this article, we model a competitive insurance market where policyholders privately have information about their probability of accident ex ante and know the state of the world ex post. We combine costly state verification without commitment and arguments from insurance contracting under adverse selection to characterize the resulting allocations. Insurance fraud convexifies the insurer's zero expected profit condition, which can lead to complete unraveling with low risks dropping out of the market. The standard case, however, involves rationing of low risks, which raises their probability of fraud and their success rate when committing it. As a result, adverse selection increases fraud in the economy. We also show that cross‐subsidization from low risks to high risks mitigates the fraud externality. Our results highlight that adverse selection and insurance fraud interact in nontrivial ways and have the potential to aggravate each other.
The determination of public tuition fees in a mixed education system: A majority voting model
Authors: Lasram Hejer , Laussel Didier 
Published: August 2018

AbstractWe study the determination of public tuition fees through majority voting in a vertical differentiation model where agents' returns on educational investment differ and public and private universities coexist and compete in tuition fees. The private university offers higher educational quality than its competitor, incurring higher unit cost per trained student. The tuition fee for the state university is fixed by majority voting while that for the private follows from profit maximization. Then agents choose to train at the public university or the private one or to remain uneducated. The tax per head adjusts in order to balance the state budget. Because there is a private alternative, preferences for education are not single‐peaked and no single‐crossing condition holds. An equilibrium is shown to exist, which is one of three types: high tuition fee (the “ends” are a majority), low tuition fee (the “middle” is a majority), or mixed (votes tie). The cost structure determines which equilibrium obtains. The equilibrium tuition is either greater (majority at the ends) or smaller (majority at the middle) than the optimal one.
Influences of salinity on the physiology and distribution of the Arctic coralline algae, Lithothamnion glaciale (Corallinales, Rhodophyta)
Authors: Schoenrock Kathryn M. , Bacquet Marion , Pearce Danni , Rea Brice R. , Schofield J. Edward , Lea James , Mair Doug , Kamenos Nicholas 
Published: August 2018

In Greenland, free‐living red coralline algae contribute to and dominate marine habitats along the coastline. Lithothamnion glaciale dominates coralline algae beds in many regions of the Arctic, but never in Godthåbsfjord, Greenland, where Clathromorphum sp. is dominant. To investigate environmental impacts on coralline algae distribution, calcification and primary productivity were measured in situ during summers of 2015 and 2016, and annual patterns of productivity in L. glaciale were monitored in laboratory‐based mesocosm experiments where temperature and salinity were manipulated to mimic high glacial melt. The results of field and cold‐room measurements indicate that both L. glaciale and Clathromorphum sp. had low calcification and photosynthetic rates during the Greenland summer (2015 and 2016), with maximum of 1.225 ± 0.17 or 0.002 ± 0.023 μmol CaCO3 · g−1 · h−1 and −0.007 ±0.003 or −0.004 ± 0.001 mg O2 · L−1 · h−1 in each species respectively. Mesocosm experiments indicate L. glaciale is a seasonal responder; photosynthetic and calcification rates increase with annual light cycles. Furthermore, metabolic processes in L. glaciale were negatively influenced by low salinity; positive growth rates only occurred in marine treatments where individuals accumulated an average of 1.85 ± 1.73 mg · d−1 of biomass through summer. These results indicate high freshwater input to the Godthåbsfjord region may drive the low abundance of L. glaciale, and could decrease species distribution as climate change increases freshwater input to the Arctic marine system via enhanced ice sheet runoff and glacier calving.