bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health Insurers’ Claims and Premiums Under the Affordable Care Act: Evidence on the Effects of Bright Line Regulations
Authors: Callaghan Sandra Renfro , Plummer Elizabeth , Wempe William F. 
Published: January 2019

AbstractThe Affordable Care Act's medical loss ratio (MLR) provisions require that health insurers spend a minimum percentage of premiums on medical costs, thereby limiting administrative costs and profits. Analyses of annual MLR changes indicate that plans both below and above the minimum MLR manage their ratios toward the minimum standard. Our finding that plans with excess MLR manage their MLRs downward suggests that compliant plans exploit their MLR “cushions,” thus increasing profits while typically continuing to satisfy the MLR requirement. We show that 52 percent of noncompliant plans in a given year subsequently become compliant, while 14 percent of compliant plans subsequently become noncompliant.
Market Price of Longevity Risk for a Multi‐Cohort Mortality Model With Application to Longevity Bond Option Pricing
Authors: Xu Yajing , Sherris Michael , Ziveyi Jonathan 
Published: January 2019

AbstractWe introduce a multi‐cohort continuous time affine mortality model and, along with an affine arbitrage‐free term structure model, determine implied market prices of longevity risk in the BlackRock CoRI Retirement Indexes. These indexes provide a daily level of estimated cost of lifetime retirement income for 20 cohorts in the United States. Individuals can invest in BlackRock funds that track the indexes that are quoted on the NYSE. We use our model to derive closed‐form expressions for prices of European options on longevity zero‐coupon bonds and show the impact of stochastic mortality on long‐term longevity bond option prices.
Intravenous infusion of magnesium sulfate and its effect on horses with trigeminal‐mediated headshaking
Authors: Sheldon Shara A. , Aleman Monica , Costa Lais Rosa R. , Santoyo Ana C. , Howey Quinn , Madigan John E. 
Published: January 2019

BackgroundTrigeminal‐mediated headshaking results from low‐threshold firing of the trigeminal nerve resulting in apparent facial pain. Magnesium may have neuroprotective effects on nerve firing that potentially dampen signs of neuropathic pain. This hypothesis has not been investigated in horses with trigeminal‐mediated headshaking.ObjectiveTo investigate head‐shaking behavior in affected horses after IV magnesium sulfate infusion.AnimalsSix geldings with trigeminal‐mediated headshaking.MethodsProspective randomized crossover study. Horses were controlled for diet and infused IV with 5% dextrose solution (DS; control solution at 2 mL/kg body weight [BW]) and MgSO450% solution (MSS at 40 mg/kg BW). Head‐shaking behavior was recorded at times T0 (baseline, before infusion) and T15, T30, T60, and T120 minutes post‐infusion. Venous blood variables such as pH, HCO3−, standard base excess (SBE), Na+, Cl−, K+, Ca2+, Mg2+, total magnesium (tMg), glucose, and lactate were measured; strong ion difference (SID) and anion gap (AG) were calculated for each time point.ResultsBlood variables including pH, Na+, Cl−, K+, SID, AG, lactate, Ca2+, tMg, and Mg2+had significant changes with MSS as compared to DS treatment. Glucose, SBE, and HCO3−did not have significant changes. A 29% reduction in head‐shaking rate occurred after MSS treatment but no change occurred after DS treatment.Conclusions and Clinical ImportanceAdministration of MSS IV increased plasma total and ionized magnesium concentrations and significantly decreased head‐shaking behavior in horses with trigeminal‐mediated headshaking.
A controlled randomized clinical trial to assess postoperative analgesia after thiopental–isoflurane anaesthesia or total intravenous anaesthesia with alfaxalone in dogs
Authors: Bennell Paula M. , Whittem Ted , Tudor Elizabeth 
Published: January 2019

AbstractAlfaxalone, a synthetic neuroactive steroid, has been attributed with properties including sedation, anaesthesia and analgesia. The clinical relevance of any analgesic properties of alfaxalone has not been demonstrated. This study was a prospective, blinded, randomized, negative control clinical trial in 65 healthy dogs presented for ovariohysterectomy. Anaesthesia was induced and maintained, for Group 1 (TIVA) dogs (n = 30) with intravenous alfaxalone alone and for Group 2 dogs (n = 35) with thiopental followed by isoflurane in 100% oxygen inhalation. After ovariohysterectomy, quantitative measures of pain or nociception were recorded at 15 min intervals for 4 hr using three independent scoring systems, a composite measure pain scale (CMPS), von Frey threshold testing and measures of fentanyl rescue analgesia. The meanCMPSscores of Group 2 (THIO/ISO) dogs remained higher than Group 1 (TIVA) dogs from 15 to 135 min post‐surgery but this difference was not statistically significant. There were no significant differences between groups in the proportions of dogs requiring rescue fentanyl analgesia, the total fentanyl dose used or the time to first fentanyl dose. The Von Frey threshold testing was found to be unsuitable for measurement of pain in this experimental model. When administered as total intravenous anaesthesia, alfaxalone did not provide analgesia in the postoperative period.
Feedback‐Seeking Behavior in Language Learning: Basic Components and Motivational Antecedents
Authors: PAPI MOSTAFA , RIOS ANGEL , PELT HUNTER , OZDEMIR ESRA 
Published: January 2019

AbstractThis study investigated the concept of corrective feedback in second language learning as a learning resource, recasting it as feedback‐seeking behavior. Dweck's (1999) mindsets, Korn and Elliot's (2016) achievement goals, and Ashford's (1986) model of feedback‐seeking behavior were re‐operationalized in the context of language learning. Questionnaire data from 287 college students studying foreign languages in the United States confirmed that learners make calculated decisions regarding whether to seek feedback, by what method, and from what source, based on their own perceptions of the costs and values associated with different feedback‐seeking strategies, which are, in turn, largely predicted by the learners’ language mindsets and achievement goals. Learners with a growth language mindset and development‐approach goals sought feedback using both monitoring and inquiry methods and from teachers and others. Learners with a fixed language mindset and demonstration goals sought feedback only by method of inquiry but from different sources depending on the valence (approach vs. avoidance) of their goals.
Lipid‐polymorphism of plant thylakoid membranes. Enhanced non‐bilayer lipid phases associated with increased membrane permeability
Authors: Ughy Bettina , Karlický Václav , Dlouhý Ondřej , Javornik Uroš , Materová Zuzana , Zsiros Ottó , Šket Primož , Plavec Janez , Špunda Vladimír , Garab Győző 
Published: January 2019

Earlier experiments, using 31P‐NMR and time‐resolved merocyanine fluorescence spectroscopy, have shown that isolated intact, fully functional plant thylakoid membranes, in addition to the bilayer phase, contain three non‐bilayer (or non‐lamellar) lipid phases. It has also been shown that the lipid polymorphism of thylakoid membranes can be characterized by remarkable plasticity, i.e. by significant variations in 31P‐NMR signatures. However, changes in the lipid‐phase behaviour of thylakoids could not be assigned to changes in the overall membrane organization and the photosynthetic activity, as tested by circular dichroism and 77 K fluorescence emission spectroscopy and the magnitude of the variable fluorescence of photosystem II, which all showed only marginal variations. In this work, we investigated in more detail the temporal stability of the different lipid phases by recording 31P‐NMR spectra on isolated thylakoid membranes that were suspended in sorbitol‐ or NaCl‐based media. We observed, at 5°C during 8 h in the dark, substantial gradual enhancement of the isotropic lipid phases and diminishment of the bilayer phase in the sorbitol‐based medium. These changes compared well with the gradually increasing membrane permeability, as testified by the gradual acceleration of the decay of flash‐induced electrochromic absorption changes and characteristic changes in the kinetics of fast chlorophyll a‐fluorescence transients; all variations were much less pronounced in the NaCl‐based medium. These observations suggest that non‐bilayer lipids and non‐lamellar lipid phases play significant roles in the structural dynamics and functional plasticity of thylakoid membranes.
Approaches to understanding and interpreting the risks of red blood cell transfusion in neonates
Authors: Keir A. K. , New H. , Robitaille N. , Crighton G. L. , Wood E. M. , Stanworth S. J. 
Published: January 2019

SUMMARYIn this review, we explore how to assess potential harm related to neonatal transfusion practice. We consider different sources of information, including passive or active surveillance systems such as registries, observational studies, randomised trials and systematic reviews. Future research directions are discussed.
Short‐ and long‐term outcome after transcondylar screw placement to treat humeral intracondylar fissure in dogs
Authors: Chase Damian , Sul Rui , Solano Miguel , Calvo Ignacio , Joslyn Steven , Farrell Michael 
Published: January 2019

AbstractObjectiveTo describe the postoperative complications and long‐term functional outcome after surgical management of humeral intracondylar fissure (HIF) by transcondylar screw (TCS) placement.Study designRetrospective study.Sample populationNineteen dogs (26 elbows)MethodsMedical records (2000–2009) were reviewed for dogs with a diagnosis of HIF according to results of computed tomography and treated by TCS placement at a single referral institution. Collected data included signalment, surgical technique, surgical duration, surgeon experience, use of antibiotics, and the presence and nature of any complications. Owner questionnaire, orthopedic examination, and pressure platform analysis were used to assess long‐term outcome. The relationship between these variables was statistically analyzed.ResultsIn total, 18 of 26 surgically managed elbows were diagnosed with a postoperative complication; 11 of these consisted of a surgical site infection (SSI). No risk factors for short‐term complications or long‐term outcome were identified. Dogs with an SSI (n = 11) were 28 times more likely to have an unsatisfactory long‐term outcome than dogs without an SSI (n = 8). Symmetry indices (SI) between thoracic and pelvic limbs did not return to published normal values. There was no difference in the SI of dogs with HIF and a surgically repaired contralateral humeral condylar fracture.ConclusionPlacement of a TCS was commonly associated with short‐term complications, affecting long‐term outcome.Clinical significanceThe high complication rate after placement of lateromedial TCS provides evidence to justify the development of alternative strategies to manage HIF.
Perioperative characteristics, histological diagnosis, and outcome in cats undergoing surgical treatment of primary hyperparathyroidism
Authors: Singh Ameet , Giuffrida Michelle A. , Thomson Christopher B. , Baum Jared , Kramek Betty , Liptak Julius M. , Hyndman Philip , Ringwood Brendon , Smeak Daniel , Ham Kathleen , Berg John , Thieman‐Mankin Kelley , Blois Shauna L. , Boston Sarah E. 
Published: January 2019

AbstractObjectiveTo report perioperative characteristics, complications, histopathologic diagnosis and outcome in cats undergoing surgical treatment for primary hyperparathyroidism (PHPT).Study designMulti‐institutional, retrospective case series.AnimalsThirty‐two client‐owned cats.MethodsMedical records of cats treated with surgical removal of 1 or more parathyroid gland(s) with confirmed histopathologic evaluation were reviewed. Cats were divided into preoperative ionized calcium (iCa) groups corresponding to the 33rd, 67th, and 100th percentiles of the preoperative iCa results of the study population. Follow‐up consisted of phone conversation with owners or primary veterinarian.ResultsIonized calcium was above reference range in all cats (median 1.8 mmol/L [interquartile range, 1.5–1.9]). Abnormal tissue was excised after cervical exploration in all cats. The most common histopathologic diagnoses were parathyroid adenoma in 20 of 32 (62.5%) cats and parathyroid carcinoma in 7 of 32 (21.9%) cats. At discharge, 6 of 32 (18.8%) cats had hypercalcemia, 5 of 32 (15.6%) had hypocalcemia, and 21 of 32 (65.6%) were normocalcemic. Preoperative iCa did not correlate with postoperative iCa. The median follow‐up time was 332 days (range, 7–3156). Overall median survival time was 1109 days (95% CI, 856–1332). Survival time was not associated with preoperative iCa group, hypocalcemia at discharge, hypercalcemia at discharge, or diagnosis of carcinoma.ConclusionIn this cohort of cats, parathyroid adenoma was the most common cause of PHPT, and surgical treatment resulted in very good median survival time. Preoperative iCa was not predictive of postoperative hypocalcemia.Clinical significanceSurgical parathyroidectomy for treatment of PHPT in cats provides a favorable prognosis.
Update regarding xenotransplantation in Japan
Authors: Shimoda Masayuki , Matsumoto Shinichi 
Published: January 2019

AbstractTo overcome the donor shortage, a promising solution could be xenotransplantation. The pig is generally considered the most suitable donor species for xenotransplantation. A clinical xenotransplantation has not been conducted in Japan. However, many progresses have recently been made in this field. Japan has regulations for conducting cell xenotransplantation and guidelines to prevent zoonosis. Most Japanese patients and their family members have a positive opinion about islet xenotransplantation. A grant for clinical islet xenotransplantation research and development has been approved, and germ‐free pigs have been developed. Further research may bring the successful application of xenotransplantation closer to reality.
Public health burden of pre-diabetes and diabetes in Luxembourg: finding from the 2013–2015 European Health Examination Survey
Authors: Bocquet Valéry , Ruiz-Castell Maria , de Beaufort Carine , Barré Jessica , de Rekeneire Nathalie , Michel Georges , Donahue Richard P , Kuemmerle Andrea , Stranges Saverio 
Published: January 2019

ObjectiveThe aim of this study was to determine the burden and risk factors of prediabetes and diabetes in the general adult population of Luxembourg.DesignCross-sectional survey between 2013 and 2015.SettingData were collected as part of the European Health Examination Survey in Luxembourg (EHES-LUX).Participants1451 individuals were recruited in a random sample of the 25–64-year-old population of Luxembourg.OutcomesDiabetes was defined by a glycaemic biomarker (fasting plasma glucose (FPG) ≥7.0 mmol/L), self-reported medication and medical diagnosis; prediabetes by a glycaemic biomarker (FPG 5.6–6.9 mmol/L), no self-reported medication and no medical diagnosis. Undiagnosed diabetes was defined only from the glycaemic biomarker; the difference between total and undiagnosed diabetes was defined as diagnosed diabetes. Odds of diabetes and prediabetes as well as associated risk factors were estimated.ResultsThe weighted prevalence of prediabetes and diabetes was 25.6% and 6.5%, respectively. Nearly 4.8% (men: 5.8%; women: 3.8%) were diagnosed diabetes and 1.7% (men: 2.6%; women: 0.7%) were undiagnosed diabetes. The multivariable-adjusted OR (MVOR) for diabetes risk were: age 1.05 (95% CI 1.01 to 1.09), family history of diabetes 3.24 (1.95–5.38), abdominal obesity 2.63 (1.53–4.52), hypertension 3.18 (1.76–5.72), one-unit increase of triglycerides 1.16 (1.10–1.22) and total cholesterol 0.74 (0.64–0.86). The MVOR for prediabetes risk were: age 1.04 (95% CI 1.02 to 1.06), male sex 1.84 (1.30–2.60), moderate alcohol consumption 1.38 (1.01–1.89), family history of diabetes 1.52 (1.13–2.05), abdominal obesity 1.44 (1.06–1.97), second-generation immigrants 0.61 (0.39–0.95) and a one-unit increase of serum high-density lipoprotein cholesterol 0.70 (0.54–0.90).ConclusionsIn Luxembourg, an unexpectedly high number of adults may be affected by prediabetes and diabetes. Therefore, these conditions should be addressed as a public health priority for the country, requiring measures for enhanced detection and surveillance, which are currently lacking, especially in primary care settings.
Psychosocial factors associated with coping behaviour after inpatient treatment for substance use disorder: a systematic review study protocol
Authors: Johannessen Dagny Adriaenssen , Nordfjærn Trond , Geirdal Amy Østertun 
Published: January 2019

IntroductionMuch is known about factors associated with coping with abstinence from substance use. The planned systematic review aims to summarise available studies exploring the change in psychosocial factors associated with coping after long-term (≥3 months) inpatient treatment for substance use disorder (SUD). Examples ofpsychosocial factorsof interest are social support, housing, activity (eg, employment and education) mental health and quality of life.Coping behaviourcan be understood as responses or actions taken in a stressful situation, particularly how psychosocial factors affect a person’s coping behaviour with abstinence from substances in everyday life (characterised as a stressful situation).Methods and analysisA set of text words were developed based on the population (people with SUD), exposure (long-term inpatient SUD treatment), outcome (psychosocial factors) and study design (prospective cohort studies) of interest. A systematic search will be conducted in eight electronic databases: Campbell Collaboration Library, Cochrane Library, EMBASE, Epistemonikos, Medline, PsychINFO, Social Sciences Citation Index and SocINDEX. The titles and abstracts will be screened for relevance before a pre-piloted data collection form will be used to evaluate eligibility and extract data from the search results. The planned review will include peer-reviewed study reports published in English or Scandinavian language.Ethics and disseminationThe target group, people with SUD, might be considered as vulnerable. Based on this, the population will be the group of interest in the planned systematic review of studies that have already been conducted. Patients and the general public will not be involved in the development of this systematic review. The results will be summarised in a study report and submitted to a peer-reviewed international journal. Additionally, results will be disseminated in the mass media and at international research conferences.PROSPERO registration numberCRD42018087408.
Developing a comprehensive understanding of elder abuse prevention in immigrant communities: a comparative mixed methods study protocol
Authors: Guruge Sepali , Sidani Souraya , Matsuoka Atsuko , Man Guida , Pirner Diane 
Published: January 2019

IntroductionOlder adults are the fastest growing age group in Canada. Elder abuse has significant individual and societal implications, so it is critical to address. While interest in this topic is increasing, little is known about the risk factors for elder abuse in immigrant communities in Canada, or about culturally relevant strategies to address these risk factors.Methods and analysisThis mixed-methods study is guided by the intersectionality and ecological frameworks. We will include two long-term (ie, established) and two recent immigrant communities from East Asian and South Asian communities in the Greater Toronto Area: Chinese, Korean, Punjabi and Tamil. Through structured group interviews, we will first identify factors that contribute to elder abuse within and across each of the immigrant communities and then explore culturally relevant strategies to address those risk factors. Group interviews will be conducted separately with five stakeholder groups in each of the four languages: older women, older men, family members, community leaders and service providers. Quantitative and qualitative data will be analysed at the level of the particular interview groups, subgroups and communities, and will be integrated across communities to identify common and unique risk factors and strategies to address elder abuse.Ethics and disseminationThe study protocol has received ethics approval from the two universities associated with the research team. Given the comprehensive approach to incorporate local knowledge and expert contributions from multi-level stakeholders, the empirical and theoretical findings will facilitate practice change and improve the well-being of older men and women in immigrant communities.
Regional differences in chlamydia and gonorrhoeae positivity rate among heterosexual STI clinic visitors in the Netherlands: contribution of client and regional characteristics as assessed by cross-sectional surveillance data
Authors: Götz Hannelore M , van Oeffelen Louise AAM , Hoebe Christian J P A , van Benthem Birgit HB 
Published: January 2019

ObjectivesTo assess to what extent triage criteria, client and regional characteristics explain regional differences inChlamydia trachomatis(Ct) andNeisseria gonorrhoeae(Ng) positivity in sexually transmitted infection (STI) clinics.DesignRetrospective cross-sectional study on the Dutch STI surveillance database of all 24 STI clinics.ParticipantsSTI clinic visits of heterosexual persons in 2015 with a Ct (n=101 495) and/or Ng test (n=101 081).Primary outcome measureCt and Ng positivity and 95% CI was assessed for each STI clinic. Two-level logistic regression analyses were performed to calculate the percentage change in regional variance (PCV) after adding triage criteria (model 1), other client characteristics (model 2) and regional characteristics (model 3) to the empty model. The contribution of single characteristics was determined after removing them from model 3.ResultsCt positivity was 14.9% and ranged from 12.6% to 20.0% regionally. Ng positivity was 1.7% and ranged from 0.8% to 3.8% regionally. For Ct, the PCV was 11.7% in model 1, 32.2% in model 2% and 59.3% in model 3. Age, notified for Ct (triage), level of education (other characteristics) and regional degree of urbanisation (region) explained variance most. For Ng, the PCV was 38.7% in model 1, 61.2% in model 2% and 69.1% in model 3. Ethnicity (triage), partner in risk group, level of education and neighbourhood (other characteristics) and regional socioeconomic status (SES) explained variance most. A significant part of regional variance remained unexplained.ConclusionsRegional variance was explained by differences in client characteristics, indicating that triage and self-selection influence positivity rates in the surveillance data.Clustering of Ng in low SES regions additionally explained regional variance in Ng; targeted interventions in low SES regions may assist Ng control. Including educational level as triage criterion is recommended. Studies incorporating prevalence data are needed to assess whether regional clustering underlies unexplained regional variance.