bluuebunny/crossref_metadata_2025_split huggingface dataset:
A State-Based Analysis of Public Health Preparedness Programs in the United States
Authors: Beitsch Leslie M. , Kodolikar Samata , Stephens Tim , Shodell Daniel , Clawson Art , Menachemi Nir , Brooks Robert G. 
Published: July 2017

Objectives. Given the national effort to respond to the challenge of terrorism post-9/11, this study examined the organizational structure of state public health preparedness programs across the country, their administration, and the personnel and resources supported through federal cooperative agreements and state funds. Methods. In Fall 2004, the Association of State and Territorial Health Officials surveyed state public health preparedness directors of all 50 states and territories of the United States regarding the organizational structure, administration, personnel, and resources of the state public health preparedness programs. Results. Individuals representing 45 states and the District of Columbia responded to the web-based questionnaire for a response rate of 88.2%. States tended to subdivide their organizations into regions for preparedness purposes. More than half the established preparedness regions (53.8%) were created post-9/11. Preparedness program directors frequently reported directly to either the state health official (40.0%) or a deputy state health official (33.3%). Responsibility for both the Centers for Disease Control and Prevention (CDC) and Health Resources and Services Administration (HRSA) cooperative agreements was predominantly vested in one person (73.3%). Federal resources were found to support needed preparedness workforce (CDC mean=117.1 full-time equivalents [FTEs]; HRSA mean=10.6 FTEs). In addition, 36.6% of the states also contributed to the public health preparedness budget. Conclusions. This study of state public health agency preparedness provides new information about state-level organizational structure, administration, and support of preparedness programs. It offers the first comprehensive insights into the approaches states have adopted to build infrastructure and develop capacity through CDC and HRSA funding streams.
Trends in Mental Health and Chronic Condition Visits by Children Presenting for Care at U.S. Emergency Departments
Authors: Grupp-Phelan Jacqueline , Harman Jeffrey S. , Kelleher Kelly J. 
Published: July 2017

Objective. The purpose of this study was to compare the burden of mental health disorders to the burden of other chronic care conditions as measured by emergency department (ED) visits by children with respect to prevalence rates, time trends, and hospital admission rates. Methods. Data from the 1995–2001 National Hospital Ambulatory Medical Care Survey were used to assess the number of visits to emergency departments by children with a diagnosis of a mental health or chronic condition, a mental health-related reason for the visit, or a prescription or continuation of psychotropic medication. Results. From 1995 to 2001, there was an increase in the proportion of visits by children with mental health problems. During the same period, the proportion of visits by children with chronic illness appeared stable. Overall, mental health diagnoses made up approximately 5% of all U.S. emergency department visits by children, similar to the percentage of total visits for other chronic conditions (5.2%). Approximately 15% of visits in both the mental health and chronic condition groups ended in hospital admission compared to less than 5% in the overall group of ED visits by children. Conclusions. The burden of mental health related visits to U.S. EDs is growing at a faster rate than visits related to chronic conditions. Visit intensity, hospital admission, and medication utilization is just as intense as that for chronic conditions. Promoting provider mental health training and restructuring the ED visit to allow for rapid mental health assessment and immediate onsite or contiguous mental health care may be one way to improve outcomes for families and to position the ED as part of a larger integrated system of effective mental illness care.
Maternal Diet and Risk of Childhood Acute Lymphoblastic Leukemia
Authors: Kwan Marilyn L. , Jensen Christopher D. , Block Gladys , Hudes Mark L. , Chu Lisa W. , Buffler Patricia A. 
Published: July 2017

Objective. Intrauterine environmental factors, including maternal diet, may play an etiologic role in acute lymphoblastic leukemia (ALL), a common childhood cancer. Expanding on previous findings from phase 1 of the Northern California Childhood Leukemia Study (NCCLS), a population-based case-control study, we sought to further elucidate and replicate the relationships between maternal diet and ALL risk. Methods. We matched 282 case-control sets of children (205 pairs and 77 triplets) from phases 1 and 2 of the NCCLS on sex, date of birth, mother's race, Hispanic racial/ethnic status, and county of residence at birth. We used an interviewer-administered food frequency questionnaire to obtain information on maternal dietary intake in the 12 months prior to pregnancy. Results. Risk of ALL was inversely associated with maternal consumption of vegetable (adjusted odds ratio [AOR] = 0.65, 95% confidence interval [CI] 0.50, 0.84); protein sources (AOR=0.55, 95% CI 0.32, 0.96); fruit (AOR=0.81, 95% CI 0.65, 1.00); and legume food groups (AOR=0.75, 95% CI 0.59, 0.95). The risk reduction was strongest for consumption of the protein sources and vegetable food groups, independent of the child's diet up to age 2 years, and consistent across phases 1 and 2 of data collection for vegetable consumption. Conclusions. These data suggest that it may be prudent for women to consume a diet rich in vegetables and adequate in protein prior to and during pregnancy as a possible means of reducing childhood ALL risk in their offspring.
Mortality in Appalachian Coal Mining Regions: The Value of Statistical Life Lost
Authors: Hendryx Michael , Ahern Melissa M. 
Published: July 2017

Objectives. We examined elevated mortality rates in Appalachian coal mining areas for 1979–2005, and estimated the corresponding value of statistical life (VSL) lost relative to the economic benefits of the coal mining industry. Methods. We compared age-adjusted mortality rates and socioeconomic conditions across four county groups: Appalachia with high levels of coal mining, Appalachia with lower mining levels, Appalachia without coal mining, and other counties in the nation. We converted mortality estimates to VSL estimates and compared the results with the economic contribution of coal mining. We also conducted a discount analysis to estimate current benefits relative to future mortality costs. Results. The heaviest coal mining areas of Appalachia had the poorest socioeconomic conditions. Before adjusting for covariates, the number of excess annual age-adjusted deaths in coal mining areas ranged from 3,975 to 10,923, depending on years studied and comparison group. Corresponding VSL estimates ranged from $18.563 billion to $84.544 billion, with a point estimate of $50.010 billion, greater than the $8.088 billion economic contribution of coal mining. After adjusting for covariates, the number of excess annual deaths in mining areas ranged from 1,736 to 2,889, and VSL costs continued to exceed the benefits of mining. Discounting VSL costs into the future resulted in excess costs relative to benefits in seven of eight conditions, with a point estimate of $41.846 billion. Conclusions. Research priorities to reduce Appalachian health disparities should focus on reducing disparities in the coalfields. The human cost of the Appalachian coal mining economy outweighs its economic benefits.
Biomonitoring as an Intervention against Methylmercury Exposure
Authors: Knobeloch Lynda , Tomasallo Carrie , Anderson Henry 
Published: July 2017

Objectives. We evaluated the effectiveness of biomonitoring as an intervention against methylmercury exposure. Methods. During 2004, the Wisconsin Department of Health Services assessed fish consumption and methylmercury exposure among 2,031 men and women who responded to a statewide press release. People whose hair mercury levels exceeded 1 microgram per gram (μg/g) were advised to reduce their intake of large, predatory fish. Others were informed that mercury exposure was not an issue for them and were encouraged to continue to eat fish as part of a healthy diet. In 2008, follow-up questionnaires and hair sampling kits were mailed to all 2004 study participants. Results. Completed surveys and hair samples were received from 1,139 individuals. While overall fish intake for this group increased slightly, from 8,561 to 8,785 servings per month between 2004 and 2008, the intake rate was significantly reduced among people whose 2004 hair mercury levels were >1 μg/g, and 30% of the cohort reported eating different types offish or smaller fish in 2008. The number of people who had a hair mercury level >1 μg/g fell from 300 in 2004 to 206 in 2008. Conclusions. Hair mercury analysis and explanatory result letters appear to have had a long-term effect on methylmercury exposure and the selection of fish. These findings support the public health benefit of methylmercury screening in conjunction with results-based education among frequent consumers of commercial and sport-caught fish.
Secondhand Smoke Exposure in Young People and Parental Rules against Smoking at Home and in the Car
Authors: Cartmell Kathleen B. , Miner Christine , Carpenter Matthew J. , Vitoc Camelia S. , Biggers Sharon , Onicescu Georgiana , Hill Elizabeth G. , Nickerson Brenda C. , Alberg Anthony J. 
Published: July 2017

Objectives. Secondhand smoke (SHS) exposure is an important cause of morbidity in children. We assessed the impact of family rules about smoking in the home and car on SHS exposure prevalence in students in grades six to 12. Methods. We studied never-smoking young people ( n= 1,698) in the random sample cross-sectional South Carolina Youth Tobacco Survey, a 2006 survey of middle and high school students in South Carolina. Results. Overall, 40% of the students reported SHS exposure in either the home or car in the past week; among these, 85% reported exposure in cars. Subsequent analyses focused on students who lived with a smoker ( n=602). Compared with those whose families prohibited smoking in the home or car, SHS exposure prevalence was 30% ( p<0.0001) higher for households with smoke-free rules for only one place (home or car) and 36% ( p<0.0001) higher for households with no rules. Compared with students from households with strict rules, SHS exposure prevalence was 48% greater ( p<0.0001) among those with only partial rules against smoking in the home or car, and 55% ( p<0.0001) greater among those from households with no rules. Similarly, compared with students with strict family rules for home and car that were adhered to, SHS exposure prevalence was significantly higher ( p<0.0001) among students when only one or no rules were followed. Conclusions. Young people from families that made and enforced strong rules against smoking in homes and cars were much less likely to report SHS exposure. Parents would be wise to endorse and enforce strong smoke-free policies for both homes and cars.
The Effect of γ-Irradiation on Methoxy-Poly(Ethylene Glycol)s in Aqueous Solutions
Authors: Pietrucha Krystyna , Burczak Krystyna 
Published: July 2017

In this work the effects of γ-radiation on monomethoxy-poly(ethylene glycol)s, (MPEG)s, in aqueous solutions were studied. Polymers with two different nominal molecular weights, 2,000 and 5,000, have been used. The influence of dose and dose rate of radiation, initial polymer concentration and pH were investigated both in the absence and presence of oxygen. The gelation dose dependence on the concentration and molecular weight of polymers irradiated in deaerated solutions at natural pH 6.3 and at pH 8.4, with added bicarbonate ions, indicate that hydroxyl radicals from water radiolysis are the main precursors of macroradicals formed at MPEG molecules. Crosslinking efficiency and stability of MPEG networks formed under these pH conditions are markedly different. The sol fraction is related to the radiation dose according to the Charlesby-Pinner approach. At pH 6.3 degradation led to dissolution of the hydrogels. Permanent, tightly crosslinked networks resulted in deaerated alkaline solutions. The molecular weight between junction points ranged from ~300 to ~2200 g mol-1 and the corresponding mesh size was ~40-~150 Å. In acid deaerated and in oxygen-containing systems at natural pH, the effect of radical formation by γ-radiation was chain scission. The oxidative polymer degradation propagated in a chain-like process.
Systemic and bronchial inflammation following LPS inhalation in asthmatic and healthy subjects
Authors: Kitz Richard , Rose Markus A. , Borgmann Alexandra , Schubert Ralf , Zielen Stefan 
Published: July 2017

Background: Inhaled endotoxin is known to induce airway inflammation, causing bronchial hyper-reactivity. Objective: We characterized the response to lipopolysaccharide-inhalation by measuring exhaled nitric oxide (eNO) and inflammatory mediators. Patients and Methods : A total of 43 adult volunteers (13 asthmatics, 30 healthy controls) inhaled stepwise LPS every 30 min up to a cumulative dose of 100 µg (2.5, 10.5, 42, 45 µg). After each provocation and up to 24 h later, FEV1 was determined; the procedure was stopped when FEV1 declined more than 12.5%. We measured eNO, leucocytes, eosinophils, polymorphonuclear neutrophils (PMNs), C-reactive protein (CrP), lipopolysaccharide binding protein (LBP), eosinophilic cationic protein (ECP), leucotriene B4 (LTB4), thromboxane B2 (TXB2), and body temperature. Results: Initial eNO values were higher in asthmatics ( P < 0.01), but only increased in an asthmatic subgroup. Marked differences were observed in the systemic response to LPS inhalation. Significant increases were found for CrP, LBP, and PMNs. There was no correlation between FEV1 decrease and basal eNO levels. Conclusions: Inhalation of endotoxin was followed by clinical and laboratory signs of systemic inflammation, with asthmatics responding to the challenge similar as healthy subjects. Bronchial eNO increased only temporarily in asthmatics.
Role of ADP receptors on platelets in the growth of ovarian cancer
Authors: Cho Min Soon , Noh Kyunghee , Haemmerle Monika , Li Dan , Park Hyun , Hu Qianghua , Hisamatsu Takeshi , Mitamura Takashi , Mak Sze Ling Celia , Kunapuli Satya , Ma Qing , Sood Anil K. , Afshar-Kharghan Vahid 
Published: July 2017

Key Points
P2Y12 is important in the interaction between platelets and cancer cells. A P2Y12 inhibitor or P2Y12 deficiency reduces tumor growth in murine models of ovarian cancer.
Hematopoietic stem cell transplantation in 29 patients hemizygous for hypomorphic IKBKG/NEMO mutations
Authors: Miot Charline , Imai Kohsuke , Imai Chihaya , Mancini Anthony J. , Kucuk Zeynep Yesim , Kawai Tokomki , Nishikomori Ryuta , Ito Etsuro , Pellier Isabelle , Dupuis Girod Sophie , Rosain Jeremie , Sasaki Shinya , Chandrakasan Shanmuganathan , Pachlopnik Schmid Jana , Okano Tsubasa , Colin Estelle , Olaya-Vargas Alberto , Yamazaki-Nakashimada Marco , Qasim Waseem , Espinosa Padilla Sara , Jones Andrea , Krol Alfons , Cole Nyree , Jolles Stephen , Bleesing Jack , Vraetz Thomas , Gennery Andrew R. , Abinun Mario , Güngör Tayfun , Costa-Carvalho Beatriz , Condino-Neto Antonio , Veys Paul , Holland Steven M. , Uzel Gulbu , Moshous Despina , Neven Benedicte , Blanche Stéphane , Ehl Stephan , Döffinger Rainer , Patel Smita Y. , Puel Anne , Bustamante Jacinta , Gelfand Erwin W. , Casanova Jean-Laurent , Orange Jordan S. , Picard Capucine 
Published: July 2017

Key Points
Global survival rate was 74% at a median follow-up after HSCT of 57 months. Preexisting mycobacterial infection and colitis were associated with poor HSCT outcome.
Relation Between Narrow Networks and Providers of Cancer Care
Authors: Yasaitis Laura , Bekelman Justin E. , Polsky Daniel 
Published: July 2017

Purpose Health insurers offer plans covering a narrow subset of providers in an attempt to lower premiums and compete for consumers. However, narrow networks may limit access to high-quality providers, particularly those caring for patients with cancer. Methods We examined provider networks offered on the 2014 individual health insurance exchanges, assessing oncologist supply and network participation in areas that do and do not contain one of 69 National Cancer Institute (NCI)–Designated Cancer Centers. We characterized a network’s inclusion of oncologists affiliated with NCI-Designated Cancer Centers relative to oncologists excluded from the network within the same region and assessed the relationship between this relative inclusion and each network’s breadth. We repeated these analyses among networks offered in the same regions as the subset of 27 NCI-Designated Cancer Centers identified as National Comprehensive Cancer Network (NCCN) Cancer Centers. Results In regions containing NCI-Designated Cancer Centers, there were 13.7 oncologists per 100,000 residents and 4.9 (standard deviation [SD], 2.8) networks covering a mean of 39.4% (SD, 26.2%) of those oncologists, compared with 8.8 oncologists per 100,000 residents and 3.2 (SD, 2.1) networks covering on average 49.9% (SD, 26.8%) of the area’s oncologists ( P < .001 for all comparisons). There was a strongly significant correlation ( r = 0.4; P < .001) between a network’s breadth and its relative inclusion of oncologists associated with NCI-Designated Cancer Centers; this relationship held when considering only affiliation with NCCN Cancer Centers. Conclusion Narrower provider networks are more likely to exclude oncologists affiliated with NCI-Designated or NCCN Cancer Centers. Health insurers, state regulators, and federal lawmakers should offer ways for consumers to learn whether providers of cancer care with particular affiliations are in or out of narrow provider networks.
Illness Understanding of Oncology Patients in a Community-Based Cancer Institute
Authors: Sivendran Shanthi , Jenkins Sarah , Svetec Sarah , Horst Michael , Newport Kristina , Yost Kathleen J. , Yang Manshu 
Published: July 2017

Purpose: Several studies have demonstrated that patients have a poor understanding of prognosis, survival, and effectiveness of chemotherapy, particularly in the setting of advanced cancer. This study examines oncology patients’ understanding of their illness based on accurate reporting of stage at diagnosis and knowledge of cancer status (ie, free of cancer or in remission v active disease). Materials and Methods: Two hundred eight patients with cancer previously treated at our large community-based cancer institute participated in the Consumer-Based Cancer Care Value Index field survey. Electronic medical record documentation of stage at diagnosis and cancer status was compared with patients’ self-reported responses. Concordance of responses and variables influencing discordance were evaluated. Results: In 51.0% of patients, self-reported cancer stage matched the abstracted stage, with the highest concordance in patients with advanced cancer (72%) versus patients with stage I to III disease (36.4% to 61.5%). Unexpectedly, discordance was lower among patients with advanced cancer compared with patients with stage I to III cancer ( P = .0528). Patients who were concordant for cancer stage at diagnosis were significantly more likely to be female ( P = .001), be younger than age 65 years ( P = .01), have an income > $60,000 ( P = .03), and have more education ( P = .02). In 64.4% of patients, self-reported cancer status (ie, free of cancer or in remission v active disease) matched the abstracted status. Nearly 30% of patients were not sure about their status, even when they were free of cancer or in remission. Conclusion: Our findings confirm that more than one quarter of patients with advanced cancer have poor illness understanding and highlight that an even greater number of patients with early stage I to III cancer have poor illness understanding. These observations highlight the need to improve illness understanding for patients across the entire cancer continuum.
Cell models of arrhythmogenic cardiomyopathy: advances and opportunities
Authors: Sommariva Elena , Stadiotti Ilaria , Perrucci Gianluca L. , Tondo Claudio , Pompilio Giulio 
Published: July 2017

ABSTRACT
Arrhythmogenic cardiomyopathy is a rare genetic disease that is mostly inherited as an autosomal dominant trait. It is associated predominantly with mutations in desmosomal genes and is characterized by the replacement of the ventricular myocardium with fibrous fatty deposits, arrhythmias and a high risk of sudden death. In vitro studies have contributed to our understanding of the pathogenic mechanisms underlying this disease, including its genetic determinants, as well as its cellular, signaling and molecular defects. Here, we review what is currently known about the pathogenesis of arrhythmogenic cardiomyopathy and focus on the in vitro models that have advanced our understanding of the disease. Finally, we assess the potential of established and innovative cell platforms for elucidating unknown aspects of this disease, and for screening new potential therapeutic agents. This appraisal of in vitro models of arrhythmogenic cardiomyopathy highlights the discoveries made about this disease and the uses of these models for future basic and therapeutic research.
Results of early warning indicators for HIV/AIDS in 42 outpatient clinics in 25 northern provinces of Vietnam
Authors: Doan Linh Thuy Thi , Phuc Do Huyen , Nguyen Huong Lan Thi , Le Huong Thi , Pham Dung Kim 
Published: July 2017

Background: The emergence of HIV drug resistance (HIVDR) is an unavoidable consequence of antiretroviral therapy (ART), and HIVDR early warning indicators (EWIs) could specifically assess factors at individual clinics associated with HIVDR. Thus, the present study aimed to collect data on EWIs for HIV/AIDS at 42 outpatient clinics (OPCs) in 25 northern provinces and cities of Vietnam in 2012. Methods: A retrospective cohort study was conducted. Data was collected from 42 OPCs in 25 northern provinces between October and December 2012. The information was collected retrospectively from outpatient records from 2008 to 2011. Results: In total, 99.8% ART patients were prescribed the correct regimen when starting ART treatment. All facilities met the target of under 20% patients lost to follow-up at 12 months. A total of 33/42 facilities reached the goal for on-time appointment keeping and 37/42 facilities achieved the target of first-line retention after 12-month ARV treatment. Conclusions: EWIs should be performed routinely in HIV/AIDS facilities. The data collected will contribute to monitoring, supervision, periodic assessment, and future plans for HIV/AIDS care and treatment programs in the area.