bluuebunny/crossref_metadata_2025_split huggingface dataset:
Resolving Malpractice Claims after Tort Reform: Experience in a Self‐Insured Texas Public Academic Health System
Authors: Sage William M. , Harding Molly Colvard , Thomas Eric J. 
Published: November 2016

ObjectiveTo describe the litigation experience in a state with strict tort reform of a large public university health system that has committed to transparency with patients and families in resolving medical errors.Data Sources/Study SettingSecondary data collected from The University of Texas System, which self‐insures approximately 6,000 physicians at six health campuses across the state. We obtained internal case management data for all medical malpractice claims closed during 1 year before and 6 recent years following the enactment of state tort reform legislation.Study DesignWe retrospectively reviewed information about malpractice claimants, malpractice claims, and the process and outcome of dispute resolution.Data Collection/Extraction MethodsWe accessed an internal case management database, supplemented by both electronic and paper records compiled by the university's Office of General Counsel.Principal FindingsClosed claims dropped from 244 in 2001–2002 to an annual mean of 96 in 2009–2015, closures following lawsuits from 136 in 2001–2002 to an annual mean of 28 in 2009–2015, and paid claims from 60 in 2001 to an annual mean of 20 in 2009–2015. Patterns of resolution suggest efforts by the university to provide some compensation to injured patients in cases that were no longer economically viable for plaintiffs’ lawyers to litigate. The percentage of payments relating to cases in which lawsuits had been filed decreased from 82 percent in 2001–2002 to 47 percent in 2009–2012 and again to 29 percent in 2012–2015, although most paid claimants were represented by attorneys. Unrepresented patients received payment in 13 cases closed in 2009–2012 (22 percent of payments; mean amount $60,566) and in 24 cases closed in 2012–2015 (41 percent of payments; mean amount $109,410). Even after tort reform, however, claims that resulted in payment remained slow to resolve, which was worsened for claimants subject to Medicare secondary payer rules. Strict confidentiality became a more common condition of settlement, although restrictions were subsequently relaxed in order to further transparency and improve patient safety.ConclusionsMalpractice litigation risk diminished substantially for a public university health system in Texas following legal changes that reduced rights to sue and available damages. Health systems operating in a low‐tort environment should work with policy makers, plaintiffs’ attorneys, and patient groups to assist unrepresented patients, facilitate early mediation, limit nondisclosure obligations following settlement, and expedite the resolution of Medicare liens.
Complications of haemophilia in babies (first two years of life): a report from the Centers for Disease Control and Prevention Universal Data Collection System
Authors: Kulkarni R. , Presley R. J. , Lusher J. M. , Shapiro A. D. , Gill J. C. , Manco‐Johnson M. , Koerper M. A. , Abshire T. C. , DiMichele D. , Hoots W. K. , Mathew P. , Nugent D. J. , Geraghty S. , Evatt B. L. , Soucie J. M. 
Published: November 2016

AimTo describe the prevalence and complications in babies ≤2 years with haemophilia.MethodsWe used a standardized collection tool to obtain consented data on eligible babies aged ≤2 years with haemophilia enrolled in the Centers for Disease Control and Prevention Universal Data Collection System surveillance project at US Hemophilia Treatment Centers (HTCs).ResultsOf 547 babies, 82% had haemophilia A, and 70% were diagnosed within one month of birth. Diagnosis was prompted by known maternal carrier status (40%), positive family history (23%), bleeding (35%) and unknown 2%; 81% bled during the first two years. The most common events were bleeding (circumcision, soft tissue, oral bleeding) and head injury. There were 46 episodes of intracranial haemorrhage (ICH) in 37 babies (7%): 18 spontaneous, 14 delivery related, 11 traumatic, 2 procedure related and 1 unknown cause. Of the 176 central venous access devices (CVADs) in 148 (27%) babies, there were 137 ports, 22 surgically inserted central catheters and 20 peripherally inserted central catheters. Ports had the lowest complication rates. Inhibitors occurred in 109 (20%) babies who experienced higher rates of ICH (14% vs. 5%; P = 0.002), CVAD placement (61% vs. 19%; P < 0.001) and CVAD complications (44% vs. 26%; P < 0.001). The most common replacement therapy was recombinant clotting factor concentrates.ConclusionBleeding events in haemophilic babies ≤2 years were common; no detectable difference in the rates of ICH by the mode of delivery was noted. Neonatal factor exposure did not affect the inhibitor rates. Minor head trauma, soft tissue and oropharyngeal bleeding were the leading indications for treatment.
The Impact of Financing Constraints and Agency Costs on Corporate R&D Investment: Evidence from China
Authors: Lin Z. Jun , Liu Shengqiang , Sun Fangcheng 
Published: November 2016

AbstractThis study investigates the association between financing constraints/agency problem (agency costs) and corporate R&D investment in China by using the two‐tier stochastic frontier model initially developed by Kumbhakar and Parmeter (2009) in light of the Euler equation analysis framework. The results show that there is a significantly negative association between financing constraints and firms' R&D investments and a significantly positive relationship between agency costs and R&D investments. Thus, financing constraints lead to R&D underinvestment, while agency costs cause R&D overinvestment by the sample firms. However, government subsidies have a positive moderating effect on the relationships. The impact of financing constraints and agency costs on R&D investment varies slightly by firms in different geographical regions, industries, business ownerships, and years.
Do We Have the Right Performance Indicators for the Circular Economy?: Insight into the Swiss Waste Management System
Authors: Haupt Melanie , Vadenbo Carl , Hellweg Stefanie 
Published: October 2016

SummaryA material flow analysis of the 2012 Swiss waste management system is presented, highlighting the material content available from waste. Half of municipal solid waste (MSW) is materially recycled and the other half thermally treated with energy recovery. A key component of an industrial ecosystem is increasing the resource efficiency through circulating materials. Recycling rates (RRs), an indicator for the circulating behavior of materials, are often used as measure for the degree of circularity of an economy. This study provides an in‐depth analysis of the recycling of paper, cardboard, aluminum, tinplate, glass, and polyethylene terephthalate (PET) from MSW in Switzerland by splitting the RRs into closed‐ and open‐loop collection rate (CR) and RRs. Whereas CR refers to collected material that enters the recycling process, RRs measure the available secondary resources produced from recycling processes. For PET, the closed‐loop CR of 45% and the open‐loop CR of 40% compare to an RR of 31% and 37%, respectively (including exports and recycling of polyethylene and metals from collection). Official collection rates for paper and cardboard are very high (97%), whereas CR of 74% and 89% and RR of 59% and 81% for paper and cardboard, respectively, were found in the present study (including export). For a majority of the separately collected materials investigated, the rates that are determined are substantially lower than those that are officially communicated. Furthermore, given that official rates often do not provide information on the availability of secondary materials, the improvement potential for increased resource recovery is hidden.
Commands as Divine Attributes
Authors: Farahat Omar 
Published: November 2016

AbstractTheories of ethics that attempt to incorporate divine speech or commands as necessary elements in the construction of moral obligations are often viewed as vulnerable to a challenge based on the so‐called Euthyphro dilemma. According to this challenge, opponents of theistic ethics suppose that divine speech either informs one of a preexisting set of values and obligations, which makes it inconsequential, or is entirely arbitrary, which makes it irrational. This essay analyzes some of the debates on the nature of divine commands in eleventh‐century works of Islamic jurisprudence (uṣūl al‐fiqh). I show that Muʿtazilī jurisprudents advanced the view that divine commands were actions performed in time that had concrete manifestations, while Ashʿarīs argued that divine speech in general, and commands in particular, were eternal divine attributes. After exposing certain weaknesses in the Euthyphro‐inspired objections to theistic ethics, I argue that the Ashʿarī idea of commands as divine attributes is a promising move for scholars interested in defending a divine command view of moral obligation.
The Paradox of Inwardness in Kant and Kierkegaard
Authors: Palmquist Stephen R. 
Published: November 2016

AbstractAside from bioethics, the main theme of Ronald Green's lifework has been an exploration of the relation between religion and morality, with special emphasis on the philosophies of Immanuel Kant and Søren Kierkegaard. This essay summarizes and assesses his work on this theme by examining, in turn, four of his relevant books. Religious Reason (1978) introduced a new method of comparative religion based on Kant's model of a rational religion. Religion and Moral Reason (1988) expanded on this project, clarifying that religious traditions cannot be reduced to their moral grounding. Kierkegaard and Kant: The Hidden Debt (1992) offered bold new evidence that Kant, not Hegel, was the philosopher whose ideas primarily shaped Kierkegaard's overtly religious philosophy; both philosophers focused on the problem of how to understand the relation between moral reasoning and historical religion. And Kant and Kierkegaard on Time and Eternity (2011) republished ten essays that explore various aspects of this theme in greater depth. I argue that throughout these works Green defends a “paradox of inwardness”: principles or ideals that are by their nature essentially inward end up requiring outward manifestation in order to be confirmed or fully justified as real.
Retracing Augustine's Ethics
Authors: Puffer Matthew 
Published: November 2016

AbstractAugustine's exposition of the image of God in Book 15 of On The Trinity (De Trinitate) sheds light on multiple issues that arise in scholarly interpretations of Augustine's account of lying. This essay argues against interpretations that posit a uniform account of lying in Augustine—with the same constitutive features, and insisting both that it is never necessary to tell a lie and that lying is absolutely prohibited. Such interpretations regularly employ intertextual reading strategies that elide distinctions and developments in Augustine's ethics of lying. Instead, I show how looking at texts written prior and subsequent to the texts usually consulted suggests a trajectory in Augustine's thought, beginning with an understanding of lies as morally culpable but potentially necessary, and culminating in a vision of lying as the fundamental evil and the origin of every sin.
Italian American literature
Authors: De Marco Alessandra 
Published: November 2016

AbstractUnlike its African‐American, Jewish‐American, or Irish‐American counterparts, Italian American literature still remains in the margins of mainstream American Studies. Many contemporary Italian American writers are virtually unknown to the general public and field scholars alike, while household names such as Don DeLillo deny the influence of Italianità on their works. Yet, as a number of Italian American scholars have been engaged in demonstrating, the narrative arising from the experiences of three generations of Americans of Italian descent can offer significant insights into American culture and socio‐economic history. The present article aims to offer an overview of Italian American literature and of the existing Italian American literary scholarship. The article wishes to raise awareness around “the emerging canon of Italian American literature”(Bonomo and Russo) and to underscore the potential for new research perspectives and topics within the broader field of American Studies offered by Italian Americana. Ultimately, the article will posit that the narrative produced by Italian American writers can effectively offer a fresh perspective from which to investigate not only American literature but also a new viewpoint from which to reflect upon some of the distinctive traits that have shaped, and continue to shape, American history and culture.
A Cutaneous Lupus Erythematosus‐Like Eruption Induced by Hydroxyurea
Authors: Yanes Daniel A. , Mosser‐Goldfarb Joy L. 
Published: November 2016

AbstractHydroxyurea is a medication with many well‐described cutaneous side effects, notably the dermatomyositis‐like eruption known as hydroxyurea dermopathy. Although systemic lupus erythematosus has been reported with hydroxyurea use, cutaneous lupus has not. We report a novel case of chronic cutaneous lupus induced by hydroxyurea and propose that this is a side effect that is distinct from hydroxyurea dermopathy.
Reconstructing a Pregnancy Cohort to Examine Potential Selection Bias in Studies on Racial Disparities in Preterm Delivery
Authors: Sapra Katherine J. , Chaurasia Ashok K. , Hutcheon Jennifer A. , Ahrens Katherine A. 
Published: October 2016

AbstractBackgroundEpidemiologic studies examining preconception risk factors on perinatal outcomes are typically restricted to livebirths. By including only non‐terminated pregnancies, estimates for the underlying pregnancy cohort may be subject to selection bias. We examined if potential selection bias due to induced termination by maternal race may result in different estimates of the non‐Hispanic black – non‐Hispanic white risk ratio (RR) for preterm delivery (PTD) among a reconstructed pregnancy cohort (‘pseudo‐pregnancy cohort’).MethodsUsing New York City registries of 1.6 million livebirths, spontaneous terminations, and induced terminations among non‐Hispanic black and non‐Hispanic white women (2000–12), we multiply imputed PTD (<37 weeks) and early PTD (<32 weeks) outcomes for induced terminations based on maternal race, age, parity, marital status, nativity, and medical care payer to construct the pseudo‐pregnancy cohort.ResultsAmong non‐Hispanic black and non‐Hispanic white women, 55% and 19% of pregnancies ended in induced termination and 13% and 8% resulted in PTD, respectively. Although several factors were associated with both PTD and induced termination, PTD RRs in the birth (RR 1.64, 95% confidence interval (CI) 1.62, 1.66) and pseudo‐pregnancy (RR 1.63, 95% CI 1.56, 1.71) cohorts were similar. However, early PTD RR was somewhat larger in the birth (RR 2.80, 95% CI 2.71, 2.89) than pseudo‐pregnancy (RR 2.47, 95% CI 2.23, 2.73) cohort.ConclusionsUsing birth certificate data – thereby excluding induced terminations – to estimate the PTD racial disparity did not produce biased estimates. Our data suggest observed PTD disparities likely are not artefacts of selection bias due to induced termination.
Ancient Heavy Metal Contamination in Soils as a Driver of Tolerant Anthyllis vulneraria Rhizobial Communities
Authors: Mohamad Roba , Maynaud Geraldine , Le Quéré Antoine , Vidal Céline , Klonowska Agnieszka , Yashiro Erika , Cleyet-Marel Jean-Claude , Brunel Brigitte 
Published: October 2016

ABSTRACT

Anthyllis vulneraria
is a legume associated with nitrogen-fixing rhizobia that together offer an adapted biological material for mine-soil phytostabilization by limiting metal pollution. To find rhizobia associated with
Anthyllis
at a given site, we evaluated the genetic and phenotypic properties of a collection of 137 rhizobia recovered from soils presenting contrasting metal levels. Zn-Pb mine soils largely contained metal-tolerant rhizobia belonging to
Mesorhizobium metallidurans
or to another sister metal-tolerant species. All of the metal-tolerant isolates harbored the
cadA
marker gene (encoding a metal-efflux P
IB
-type ATPase transporter). In contrast, metal-sensitive strains were taxonomically distinct from metal-tolerant populations and consisted of new
Mesorhizobium
genospecies. Based on the symbiotic
nodA
marker, the populations comprise two symbiovar assemblages (potentially related to
Anthyllis
or
Lotus
host preferences) according to soil geographic locations but independently of metal content. Multivariate analysis showed that soil Pb and Cd concentrations differentially impacted the rhizobial communities and that a rhizobial community found in one geographically distant site was highly divergent from the others. In conclusion, heavy metal levels in soils drive the taxonomic composition of
Anthyllis-
associated rhizobial populations according to their metal-tolerance phenotype but not their symbiotic
nodA
diversity. In addition to heavy metals, local soil physicochemical and topoclimatic conditions also impact the rhizobial beta diversity.
Mesorhizobium
communities were locally adapted and site specific, and their use is recommended for the success of phytostabilization strategies based on
Mesorhizobium
-legume vegetation.

IMPORTANCE
Phytostabilization of toxic mine spoils limits heavy metal dispersion and environmental pollution by establishing a sustainable plant cover. This eco-friendly method is facilitated by the use of selected and adapted cover crop legumes living in symbiosis with rhizobia that can stimulate plant growth naturally through biological nitrogen fixation. We studied microsymbiont partners of a metal-tolerant legume,
Anthyllis vulneraria
, which is tolerant to very highly metal-polluted soils in mining and nonmining sites. Site-specific rhizobial communities were linked to taxonomic composition and metal tolerance capacity. The rhizobial species
Mesorhizobium metallidurans
was dominant in all Zn-Pb mines but one. It was not detected in unpolluted sites where other distinct
Mesorhizobium
species occur. Given the different soil conditions at the respective mining sites, including their heavy-metal contamination, revegetation strategies based on rhizobia adapting to local conditions are more likely to succeed over the long term compared to strategies based on introducing less-well-adapted strains.
Salmonella enterica Serovar Kentucky Flagella Are Required for Broiler Skin Adhesion and Caco-2 Cell Invasion
Authors: Salehi Sanaz , Howe Kevin , Lawrence Mark L. , Brooks John P. , Bailey R. Hartford , Karsi Attila 
Published: October 2016

ABSTRACT

Nontyphoidal
Salmonella
strains are the main source of pathogenic bacterial contamination in the poultry industry. Recently,
Salmonella enterica
serovar Kentucky has been recognized as the most prominent serovar on carcasses in poultry-processing plants. Previous studies showed that flagella are one of the main factors that contribute to bacterial attachment to broiler skin. However, the precise role of flagella and the mechanism of attachment are unknown. There are two different flagellar subunits (
fliC
and
fljB
) expressed alternatively in
Salmonella enterica
serovars using phase variation. Here, by making deletions in genes encoding flagellar structural subunits (
flgK
,
fliC
, and
fljB
), and flagellar motor (
motA
), we were able to differentiate the role of flagella and their rotary motion in the colonization of broiler skin and cellular attachment. Utilizing a broiler skin assay, we demonstrated that the presence of FliC is necessary for attachment to broiler skin. Expression of the alternative flagellar subunit FljB enables
Salmonella
motility, but this subunit is unable to mediate tight attachment. Deletion of the
flgK
gene prevents proper flagellar assembly, making
Salmonella
significantly less adherent to broiler skin than the wild type.
S
. Kentucky with deletions in all three structural genes,
fliC
,
fljB
, and
flgK
, as well as a flagellar motor mutant (
motA
), exhibited less adhesion and invasion of Caco-2 cells, while an
fljB
mutant was as adherent and invasive as the wild-type strain.

IMPORTANCE
In this work, we answered clearly the role of flagella in
S
. Kentucky attachment to the chicken skin and Caco-2 cells. We demonstrated that the presence of FliC is necessary for attachment to broiler skin. Expression of the alternative flagellar subunit FljB enables
Salmonella
motility, but this subunit is unable to mediate strong attachment. Deletion of the
flgK
gene prevents proper flagellar assembly, making
Salmonella
significantly less adherent to broiler skin than the wild type.
S
. Kentucky with deletions in all three structural genes,
fliC
,
fljB
, and
flgK
, as well as a flagellar motor mutant (
motA
), exhibited less adhesion and invasion of Caco-2 cells, while an
fljB
mutant was as adherent and invasive as the wild-type strain. We expect these results will contribute to the understanding of the mechanisms of
Salmonella
attachment to food products.
Differences in Abundances of Total Vibrio spp., V. vulnificus, and V. parahaemolyticus in Clams and Oysters in North Carolina
Authors: Froelich B. A. , Phippen B. , Fowler P. , Noble R. T. , Oliver J. D. 
Published: October 2016

ABSTRACT

Filter feeding shellfish can concentrate pathogenic bacteria, including
Vibrio vulnificus
and
Vibrio parahaemolyticus
, as much as 100-fold from the overlying water. These shellfish, especially clams and oysters, are often consumed raw, providing a route of entry for concentrated doses of pathogenic bacteria into the human body. The numbers of foodborne infections with these microbes are increasing, and a better understanding of the conditions that might trigger elevated concentrations of these bacteria in seafood is needed. In addition, if bacterial concentrations in water are correlated with those in shellfish, then sampling regimens could be simplified, as water samples can be more rapidly and easily obtained. After sampling of oysters and clams, either simultaneously or separately, for over 2 years, it was concluded that while
Vibrio
concentrations in oysters and water were related, this was not the case for levels in clams and water. When clams and oysters were collected simultaneously from the same site, the clams were found to have lower
Vibrio
levels than the oysters. Furthermore, the environmental parameters that were correlated with levels of
Vibrio
spp. in oysters and water were found to be quite different from those that were correlated with levels of
Vibrio
spp. in clams.

IMPORTANCE
This study shows that clams are a potential source of infection in North Carolina, especially for
V. parahaemolyticus
. These findings also highlight the need for clam-specific environmental research to develop accurate
Vibrio
abundance models and to broaden the ecological understanding of clam-
Vibrio
interactions. This is especially relevant as foodborne
Vibrio
infections from clams are being reported.