bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using Evidence to Inform State Health Policy Making: Lessons from Four States Comparing Obamacare and Infant Mortality
Authors: Jones David K. , Louis Christopher J. 
Published: March 2018

AbstractHow does the use of evidence by policy makers differ for issues that are highly politicized compared to those that are not? Does the answer depend on whether the venue for policy making is the legislative or the executive branch? We explore these dynamics through state-level case studies of two different types of issues: what type of health insurance exchange to establish as part of the implementation of the Affordable Care Act (Idaho and Mississippi), and how to reduce infant mortality (Florida and Georgia). We highlight four sets of issues critical to understanding the use of evidence: (1) characteristics of a policy, (2) characteristics of the policy makers, (3) characteristics of the producers and disseminators of evidence, and (4) different ways evidence can be used. Barriers for academics to contribute directly to policy making change for politicized issues, particularly in the legislative branch. Under these circumstances, intermediary groups such as ideological think tanks become a trusted source of information. Policy makers themselves are a key source of evidence on less politicized issues in the executive branch. Academics wanting to inform politicized policy making need to appreciate and be comfortable with the blurry line between instrumental and rhetorical uses of evidence.
Hypotheses and Hope: Policy Analysis and Cost Controls (or Not) in the Affordable Care Act
Authors: White Joseph 
Published: March 2018

Abstract
Cost control choices for the Affordable Care Act are a logical topic for this special issue because of both the policy and political importance of the choices and what they illustrate about the use of policy analysis in policy making. This article argues that the common trope that research-based evidence is ignored because of “politics” misunderstands the patterns of policy analysis. Politicians did listen to interest groups, voters, and their own attitudes, but the visibility and credentials of different policy analyses were also important. The advice structure and validation of ideas for budgetary decisions also differed distinctly from that for choices about how to control overall health care spending. This article illustrates patterns of influence with regard to three types of cost controls: price regulation, limits on insurance, and an aspirational agenda of system reengineering measures such as accountable care organizations, pay for performance, and cost-effectiveness analysis. Even the meaning of evidence for some measures (e.g., reengineering) was different from that for others (e.g., price regulation). Being heavily promoted by the most prestigious policy experts did not mean ideas were either well supported by evidence or politically safe. The question may be more why politicians listened to some analysts than why they do not listen to analysis.
Technocratic Dreams, Political Realities: The Rise and Demise of Medicare's Independent Payment Advisory Board
Authors: Oberlander Jonathan , Spivack Steven B. 
Published: March 2018

Abstract
Enacted as part of the 2010 Patient Protection and Affordable Care Act, the Independent Payment Advisory Board (IPAB) was hailed by many analysts as a major innovation in US health policy making and cost control. The board promised to put a brake on Medicare spending through an extraordinary combination of budgetary discipline, expert advice, uncommon legislative procedures, and administrative delegation. IPAB embodied the aspirations of technocracy: the board would rise above partisanship and interest group pressures, formulating Medicare policy recommendations based on evidence and reason rather than politics. The special legislative rules and administrative powers associated with IPAB were to be an antidote to both congressional inaction and micromanagement. Those aspirations resonated with many politicians, policy makers, and health services researchers. Yet IPAB has fallen far short of the aspirations and enthusiasm that accompanied its establishment. It has remained in political purgatory, paralyzed by controversy and partisanship. We explore why IPAB has failed to live up to the hype and what the IPAB story tells us about the promise and limits of technocracy in US health care policy.
The Immediate Effect of Foot Orthoses on Subtalar Joint Mechanics and Energetics
Authors: MAHARAJ JAYISHNI N. , CRESSWELL ANDREW G. , LICHTWARK GLEN A. 
Published: March 2018

ABSTRACT

Purpose
Foot orthoses maybe used in the management of musculoskeletal disorders related to abnormal subtalar joint (STJ) pronation. However, the precise mechanical benefits of foot orthoses for preventing injuries associated with the STJ are not well understood. The aim of this study was to investigate the immediate effect of foot orthoses on the energy absorption requirements of the STJ and subsequently tibialis posterior (TP) muscle function.

Methods
Eighteen asymptomatic subjects with a pes planus foot posture were prescribed custom-made foot orthoses made from a plaster cast impression. Participants walked at preferred and fast velocities barefoot, with athletic footwear and with athletic footwear plus orthoses, as three-dimensional motion capture, force data, and intramuscular electromyography of the TP muscle were simultaneously collected. Statistical parametric mapping was used to identify time periods across the stride cycle during which footwear with foot orthoses significantly differed to barefoot and footwear only.

Results
During early stance, footwear alone and footwear with orthoses significantly reduced TP muscle activation (1%–12%), supination moments (3%–21%), and energy absorption (5%–12%) at the STJ, but had no effect on STJ pronation displacement.

Conclusions
The changes in TP muscle activation and STJ energy absorption were primarily attributed to footwear because the addition of foot orthoses provided little additional effect. We speculate that these results are most likely a result of the compliant material properties of footwear. These results suggest that athletic footwear may be sufficient to absorb energy in the frontal plane and potentially reducing any benefit associated with the addition of foot orthoses.
Caffeine, CYP1A2 Genotype, and Endurance Performance in Athletes
Authors: GUEST NANCI , COREY PAUL , VESCOVI JASON , EL-SOHEMY AHMED 
Published: March 2018

ABSTRACT

Purpose
Many studies have examined the effect of caffeine on exercise performance, but findings have not always been consistent. The objective of this study was to determine whether variation in the CYP1A2 gene, which affects caffeine metabolism, modifies the ergogenic effects of caffeine in a 10-km cycling time trial.

Methods
Competitive male athletes (n = 101; age = 25 ± 4 yr) completed the time trial under three conditions: 0, 2, or 4 mg of caffeine per kilogram body mass, using a split-plot randomized, double-blinded, placebo-controlled design. DNA was isolated from saliva and genotyped for the −163A > C polymorphism in the CYP1A2 gene (rs762551).

Results
Overall, 4 mg·kg−1 caffeine decreased cycling time by 3% (mean ± SEM) versus placebo (17.6 ± 0.1 vs 18.1 ± 0.1 min, P = 0.01). However, a significant (P <0.0001) caffeine–gene interaction was observed. Among those with the AA genotype, cycling time decreased by 4.8% at 2 mg·kg−1 (17.0 ± 0.3 vs 17.8 ± 0.4 min, P = 0.0005) and by 6.8% at 4 mg·kg−1 (16.6 ± 0.3 vs 17.8 ± 0.4 min, P < 0.0001). In those with the CC genotype, 4 mg·kg−1 increased cycling time by 13.7% versus placebo (20.8 ± 0.8 vs 18.3 ± 0.5 min, P = 0.04). No effects were observed among those with the AC genotype.

Conclusion
Our findings show that both 2 and 4 mg·kg−1 caffeine improve 10-km cycling time, but only in those with the AA genotype. Caffeine had no effect in those with the AC genotype and diminished performance at 4 mg·kg−1 in those with the CC genotype. CYP1A2 genotype should be considered when deciding whether an athlete should use caffeine for enhancing endurance performance.
Advances in understanding the molecular basis of skin fragility
Authors: Has Cristina 
Published: March 2018

Skin fragility refers to a large group of conditions in which the ability of the skin to provide protection against trivial mechanical trauma is diminished, resulting in the formation of blisters, erosions, wounds, or scars. Acquired and physiological skin fragility is common; genetic disorders are rare but give insight into the molecular mechanisms ensuring skin stability. The paradigm is represented by inherited epidermolysis bullosa. This review is focused on recent advances in understanding the molecular basis of genetic skin fragility, including emerging concepts, controversies, unanswered questions, and opinions of the author. In spite of the advanced knowledge on the genetic causes of skin fragility, the molecular pathology is still expanding. Open questions in understanding the molecular basis of genetic skin fragility are the following: what are the causes of phenotypes which remain genetically unsolved, and what are the molecular modifiers which might explain phenotypic differences among individuals with similar mutations? New mutational mechanisms and new genes have recently been discovered and are briefly described here. Comprehensive next-generation sequencing-based genetic testing improved mutation detection and facilitated the identification of the genetic basis of unclear and new phenotypes. Characterization of the biochemical and cell biological consequences of the genetic variants is challenging and laborious but may represent the basis for personalized therapeutic approaches. Molecular modifiers of skin fragility have been uncovered in particular animal and genetic models but not in larger cohorts of patients. This scientific progress is the basis for revisions of the epidermolysis bullosa classification and for innovative therapeutic approaches designed for this intractable condition.
Seqfam: A python package for analysis of Next Generation Sequencing DNA data in families
Authors: Frampton Matthew , Schiff Elena R. , Pontikos Nikolas , Segal Anthony W. , Levine Adam P. 
Published: March 2018

This article introduces seqfam, a python package which is primarily designed for analysing next generation sequencing (NGS) DNA data from families with known pedigree information in order to identify rare variants that are potentially causal of a disease/trait of interest. It uses the popular and versatile Pandas library, and can be straightforwardly integrated into existing analysis code/pipelines. Seqfam can be used to verify pedigree information, to perform Monte Carlo gene dropping, to undertake regression-based gene burden testing, and to identify variants which segregate by affection status in families via user-defined pattern of occurrence rules. Additionally, it can generate scripts for running analyses in a “MapReduce pattern” on a computer cluster, something which is usually desirable in NGS data analysis and indeed “big data” analysis in general. This article summarises how seqfam’s main user functions work and motivates their use. It also provides explanatory context for example scripts and data included in the package which demonstrate use cases. With respect to verifying pedigree information, software exists for efficiently calculating kinship coefficients, so seqfam performs the necessary extra steps of mapping pedigrees and kinship coefficients to expected and observed degrees of relationship respectively. Gene dropping and the application of variant pattern of occurrence rules in families can provide evidence for a variant being causal. The authors are unaware of other software which performs these tasks in familial cohorts, so seqfam fulfils this need. Gene burden rather than single marker tests are often used to detect rare causal variants due to greater power. Seqfam may be an attractive alternative to existing gene burden testing software due to its flexibility, particularly in grouping and aggregating variants.
Phylogenetic relationships and generic reassessment of Proustia and allies (Compositae: Nassauvieae)
Authors: Sancho Gisela , Katinas Liliana , Viera Barreto Jessica N. , Moreira-Muñoz Andrés , Luebert Federico 
Published: March 2018

AbstractProustia is a small southern Andean genus of shrubs, vines and small trees, which are characteristic elements of Chilean and Argentine Andean forests, thickets and desert scrubs. Since Proustia possesses an unusual and characteristic morphology within the Nassauvieae, its circumscription as well as its phylogenetic placement is decisive in understanding the evolution of the tribe. Berylsimpsonia, from the Caribbean, was segregated from Proustia, which currently only includes three species. Lophopappus, another Andean genus, has been closely related to Proustia in sharing style and corolla features that are unusual in the Nassauvieae. The purpose of this work is to evaluate the placement of Proustia within the Nassauvieae, its relationships with Berylsimpsonia and Lophopappus, and the relationships of its species using molecular data and phylogenetic methods. This is the first comprehensive analysis of Proustia. We have included in our study the three currently accepted species of Proustia and seven of its ten infraspecific taxa. For each taxon of Proustia, one to seven accessions were analyzed. Species of Lophopappus and Berylsimpsonia, as well as 16 species belonging to 13 genera of Nassauvieae were also analyzed. We sequenced the nuclear ribosomal ITS and ETS, and the plastid regions ndhF, 5’ trnK–matK, trnL–trnF, and trnL(UAG)–rpl32. Unlike other previous studies, Proustia is not sister to the rest but nested in the tribe in our analyses. Berylsimpsonia vanillosma and P. ilicifolia are distantly related to P. pyrifolia, the type of the genus. According to nuclear DNA data, the infraspecific taxa of P. cuneifolia were recovered all in a well–supported clade, although based on the plastid data P. pyrifolia does not form a lineage separate from P. cuneifolia. Lophopappus is the genus most closely related to Proustia. Regarding the evolution of styles, our results suggest multiple origins of atypical stylar features in the Nassauvieae. As a result of our analyses we propose the segregation of Proustia ilicifolia into the new genus Spinoliva. Morphological data are consistent with the segregation of Proustia and Lophopappus as separate genera. Two species of Proustia, P. cuneifolia and P. pyrifolia are recognized. Three lectotypifications, one neotypification, two new combinations and five rank changes are proposed.
Use of photograph-based telemedicine in postoperative wound assessment to diagnose or exclude surgical site infection
Authors: Totty Joshua P. , Harwood Amy E. , Wallace Tom , Smith George E. , Chetter Ian C. 
Published: March 2018

Objective: This study aims to assess whether a clinician reviewing photographs of a wound was an acceptable substitute for clinical review in order to identify or exclude surgical site infection (SSI). Method: We undertook a mixed methods study consisting of a qualitative public involvement exercise and a prospective, non-randomised, single-centre study of patients undergoing clean or clean-contaminated vascular surgery. For the qualitative study, two semi-structured focus group interviews were conducted. For the prospective study, patients were invited to attend a wound review at 5–7 days and 30 days postoperatively. At review, wounds were scored by a study nurse or doctor, according to the ASEPSIS scale. Anonymised wound photographs were taken and independently reviewed, and ASEPSIS scored by two independent investigators blinded to the original ‘clinical review’ ASEPSIS score. Results: In the qualitative study, three female patients were interviewed across two dates. Emerging themes included the burden of SSI, hospital follow-up and telemedical follow-up. A total of 37 patients with a mean age of 61.14 years were included in the quantitative analysis. There was a total of 53 wound reviews. There was >85% agreement between photograph and clinical reviewers in all categories except erythema. The specificity of photograph review for diagnosis of SSI was 90%. The intraclass correlation coefficient for total ASEPSIS score was R=0.806 (95% CI 0.694, 0.881), indicating strong reliability between reviewers. Conclusion: Our data shows that, in the assessment of SSI, there is good correlation between face-to-face clinical and remote photographic review. Incorporating this method of wound assessment into a postoperative follow-up care pathway may save patients and clinicians from unnecessary hospital visits, particularly when conducting health research.
A Life-Cycle Assessment of Forest Resources of the Pacific Northwest, USA*
Authors: Oneil Elaine , Puettmann Maureen E. 
Published: March 2018

Abstract
Life-cycle inventory (LCI) and life-cycle assessment (LCA) were used to provide quantitative assessments of the environmental impacts of forest management activities that are required to produce feedstock for wood products such as lumber, engineered panels, and pulp. Primary and secondary data were gathered for the Pacific Northwest Douglas-fir region of the United States to produce an attributional LCA that includes planting, growing, and harvesting trees that are destined for use in wood manufacturing. Using the Tool for the Reduction and Assessment of Chemical and other environmental Impacts (TRACI) method, under average management conditions, forest operations can expect to generate from 10 to 18 kg CO2 equivalent (CO2 eq) per cubic meter (m3) of logs ready to leave the landing for the manufacturing facility, depending on the amount of forest residues that are piled and burned. This same cubic meter of log plus bark will have sequestered 960 kg CO2 eq during its growth cycle, for a net greenhouse gas sink of 942 to 950 kg CO2 eq per m3. Forest management impacts are from 1 to 13 percent of the total impacts from the cradle to gate for global warming potential and the potential to increase smog, eutrophication, and acidification. Upstream impacts associated with the production of herbicides are reflected in the ozone potential impact category. These LCA results can be used as upstream processes for wood manufacturers interested in developing Environmental Product Declarations for products that use these resources as inputs.
‘I pledge you!’: Disability, monstrosity and sacrifice in Wytches
Authors: Diamond Aidan Dubhain 
Published: March 2018

Abstract
In the introduction to Freakery (1996), editor and disabilities scholar, Rosemarie Garland Thomson, charts a shift in the West’s cultural perception of and relation to ‘freaks’, arguing that the extraordinary body once viewed with wonder became, over the course of the nineteenth century, a site of error. Michel Foucault ([1984] 2010) identifies the same trend on a broader scale, demonstrating that during the eighteenth and nineteenth centuries, certain populations – the mad, the criminal, the impoverished, the queer – were rewritten as a social disease blighting normative society. This social equation endures to this day; one has only to scan recent blockbusters to identify the monstrous body as evil, the deformed body as deficient and expendable and, by contrast, the able body as the practically un-killable hero. In this context, the thematic achievement of Scott Snyder et al.’s Wytches (2015) is notable for its refusal to adhere to this equation, and further for its articulation of a positive alternative to it. Wytches, a Gothic horror from the first page, inverts the Victorian equation of horror with madness and monstrosity. While the comic’s eponymous antagonists are unquestionably monstrous, inhuman, and child-eating to boot, they are easily escaped and mainly act in response to the vile, selfish morality of the townsfolk they neighbour. This article first reviews theories of difference and othering as articulated by Rosemarie Garland Thomson and Michel Foucault, and expands understandings of ‘freakery’ and difference to include not just the corporeal but also the mental via Foucault, Sigmund Freud, Julia Kristeva, Max Nordau and Roy Porter. It then argues that Wytches’ monstrous use of normative bodies against the dedicated rescue of its neuroatypical protagonist by abled and disabled characters alike, subtly and compellingly re-inscribing the freaked body not only as a heroic body but as a wondrous one, and argues fiercely against the long-standing social equation of difference and innate evil.
Datos preliminares del hallazgo de una sepultura humana del Holoceno Antiguo en el área de Zug (Tiris, Sahara Occidental)
Authors: Sáenz de Buruaga Andoni 
Published: March 2018

Se presenta el hallazgo de un esqueleto humano, parcialmente expuesto en superficie, documentado en el fondo de una sebja interdunar situada en el erg de Azefal, en el extremo SE del Sahara Occidental. Su posición secuencial en un antiguo depósito estratigráfico y la datación absoluta de un pequeño fragmento óseo del individuo inhumado, precisan su cronología en una fase avanzada del Holoceno antiguo, concretamente a mediados del IX milenio calB.P. El dato conlleva una alta relevancia científica pues, en el momento actual de la investigación, constituye la referencia antropológica y sepulcral más antigua del Holoceno del Occidente del Sahara.
Estrategias metodológicas para la toma de conciencia en las personas de la Secretaría de Educación de San Andrés, frente al Sistema de Gestión de la Calidad
Authors: Mclean Chaves Ximena 
Published: March 2018

La organización es un sistema social que contiene elementos interrelacionados y que interactúan entre sí para lograr un objetivo en común, entre estos elementos se encuentran las personas, es en ellas donde descansa buena parte el éxito o el fracaso de una entidad. Se necesita un talento humano consciente de la política de calidad, los objetivos de calidad pertinentes y de su contribución a la eficacia del Sistema de Gestión de la Calidad, incluidos los beneficios de una mejora del desempeño y las implicaciones del incumplimiento de los requisitos del Sistema de Gestión de la Calidad (NTC ISO 9001:2015). Este estudio busca proponer estrategias para fortalecer la toma de conciencia frente al Sistema de Gestión de la Calidad de la Secretaría de Educación de San Andrés Isla con el fin de que este logre sus propósitos. Para responder a los objetivos de la investigación, se aplica a los funcionarios encuestas previamente validadas por expertos, con lo cual se busca analizar el estado del personal frente al Sistema de Gestión de la Calidad antes y después de la aplicación de las estrategias. Las estrategias aplicadas son autoridad y responsabilidad y comunicación interna, estas llevadas a los funcionarios a través de talleres en donde se aplica la técnica gund ho enfocada en el direccionamiento estratégico, la gerencia por procesos en donde se tiene el control sobre el trabajo que se realiza y el reconocimiento al trabajo.