bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient Experiences with Involuntary Out‐of‐Network Charges
Authors: Kyanko Kelly A. , Pong Denise D. , Bahan Kathleen , Curry Leslie A. 
Published: June 2013

BackgroundApproximately 40 percent of individuals using out‐of‐network physicians experience involuntary out‐of‐network care, leading to unexpected and sometimes burdensome financial charges. Despite its prevalence, research on patient experiences with involuntary out‐of‐network care is limited. Greater understanding of patient experiences may inform policy solutions to address this issue.ObjectiveTo characterize the experiences of patients who encountered involuntary out‐of‐network physician charges.MethodsQualitative study using 26 in‐depth telephone interviews with a semi‐structured interview guide. Participants were a purposeful sample of privately insured adults from across the United States who experienced involuntary out‐of‐network care. They were diverse with regard to income level, education, and health status. Recurrent themes were generated using the constant comparison method of data analysis by a multidisciplinary team.ResultsFour themes characterize the perspective of individuals who experienced involuntary out‐of‐network physician charges: (1) responsibilities and mechanisms for determining network participation are not transparent; (2) physician procedures for billing and disclosure of physician out‐of‐network status are inconsistent; (3) serious illness requiring emergency care or hospitalization precludes ability to choose a physician or confirm network participation; and (4) resources for mediation of involuntary charges once they occur are not available.ConclusionsOur data reveal that patient education may not be sufficient to reduce the prevalence and financial burden of involuntary out‐of‐network care. Participants described experiencing involuntary out‐of‐network health care charges due to system‐level failures. As policy makers seek solutions, our findings suggest several potential areas of further consideration such as standardization of processes to disclose that a physician is out‐of‐network, holding patients harmless not only for out‐of‐network emergency room care but also for non‐elective hospitalization, and designation of a mediator for involuntary charges.
Malpractice Litigation and Nursing Home Quality of Care
Authors: Konetzka R. Tamara , Park Jeongyoung , Ellis Robert , Abbo Elmer 
Published: June 2013

ObjectiveTo assess the potential deterrent effect of nursing home litigation threat on nursing home quality.Data Sources/Study SettingWe use a panel dataset of litigation claims and Nursing Home Online Survey Certification and Reporting (OSCAR) data from 1995 to 2005 in six states: Florida, Illinois, Wisconsin, New Jersey, Missouri, and Delaware, for a total of 2,245 facilities. Claims data are from Westlaw's Adverse Filings database, a proprietary legal database, on all malpractice, negligence, and personal injury/wrongful death claims filed against nursing facilities.Study DesignA lagged 2‐year moving average of the county‐level number of malpractice claims is used to represent the threat of litigation. We use facility fixed‐effects models to examine the relationship between the threat of litigation and nursing home quality.Principal FindingsWe find significant increases in registered nurse‐to‐total staffing ratios in response to rising malpractice threat, and a reduction in pressure sores among highly staffed facilities. However, the magnitude of the deterrence effect is small.ConclusionsDeterrence in response to the threat of malpractice litigation is unlikely to lead to widespread improvements in nursing home quality. This should be weighed against other benefits and costs of litigation to assess the net benefit of tort reform.
Musculoskeletal lymphoma: MRI of bone or soft tissue presentations
Authors: Carroll Gemma , Breidahl William , Robbins Peter 
Published: June 2013

AbstractAimTo assess the MRI findings of musculoskeletal lymphoma primarily presenting clinically as a bone lesion or soft tissue mass.MethodsMagnetic resonance imaging of 23 cases of musculoskeletal lymphoma were retrospectively reviewed. Features assessed included tumour location, morphology, signal intensity (SI) characteristics, cortical destruction, involvement of multiple anatomic compartments, encasement of adjacent neurovascular structures/tendons and subcutaneous oedema.ResultsOsseous lesions were typically poorly defined and hypointense on T1‐weighted imaging. T2‐weighted SI was usually heterogeneous, with 54% of cases having a ‘mosaic’ pattern of marrow replacement. Ninety‐two per cent of osseous tumours had cortical abnormalities, most commonly a permeative pattern. A periosseous soft tissue cuff was present in 46% of cases while 38% had a more significant extraosseous component. All cases of soft tissue lymphoma were iso‐/slightly hyperintense to muscle on T1‐weighted images and hyperintense on T2‐weighted images. Multicompartment involvement by extraosseous tumour was present in 75% of cases, and 67% had subcutaneous oedema. Eighty‐three per cent of soft tissue tumours showed encasement of adjacent structures. Multifocal lymphoma had similar morphology and SI characteristics to single‐site lesions. Histopathologically, there were 21 cases of non‐Hodgkin's lymphoma and two of Hodgkin's lymphoma.ConclusionMagnetic resonance imaging features of primary osseous lymphoma include T2 heterogeneity, a periosseous soft tissue cuff or a more substantial mass, and cortical disruption often disproportionate to the extent of extraosseous tumour. Features characteristic of soft tissue lymphoma include relative homogeneity on T1‐ and T2‐weighted imaging, multicompartment involvement and encasement of neurovascular structures.
StAMPP: an R package for calculation of genetic differentiation and structure of mixed‐ploidy level populations
Authors: Pembleton Luke W. , Cogan Noel O. I. , Forster John W. 
Published: June 2013

AbstractStatistical Analysis of Mixed‐Ploidy Populations (StAMPP) is a freely available R package for calculation of population structure and differentiation based on single nucleotide polymorphism (SNP) genotype data from populations of any ploidy level, and/or mixed‐ploidy levels. StAMPP provides an advance on previous similar software packages, due to an ability to calculate pairwise FST values along with confidence intervals, Nei's genetic distance and genomic relationship matrixes from data sets of mixed‐ploidy level. The software code is designed to efficiently handle analysis of large genotypic data sets that are typically generated by high‐throughput genotyping platforms. Population differentiation studies using StAMPP are broadly applicable to studies of molecular ecology and conservation genetics, as well as animal and plant breeding.
A Corn Oil–Based Diet Protects Against Combined Ethanol and Iron‐Induced Liver Injury in a Mouse Model of Hemochromatosis
Authors: Tan Terrence C. H. , Crawford Darrell H. G. , Jaskowski Lesley A. , Murphy Therese L. , Santrampurwala Nishreen , Crane Denis , Clouston Andrew D. , Subramaniam V. Nathan , Anderson Gregory J. , Fletcher Linda M. 
Published: June 2013

BackgroundCombined iron overload and alcohol may promote synergistic chronic liver injury and toxicity. The role of specific dietary fats in influencing the development of co‐toxic alcoholic liver disease needs further evaluation and is investigated in this study.MethodsWild‐type (WT) and the iron‐loaded Hfe‐null (Hfe−/−) mice were fed chow (CC), a AIN‐93G standard control (SC), or a corn oil–modified, AIN‐93G‐based (CO) diet with or without the addition of 20% ethanol (EtOH) in the drinking water for 8 weeks and assessed for liver injury.ResultsWT mice on CC, SC, and CO diets had no liver injury, although mild steatosis developed in the SC and CO groups. The addition of EtOH resulted in mild steatohepatitis in WT mice fed SC but not those on a CO diet. EtOH administration in Hfe−/− animals on the CC and SC diets caused marked oxidative stress, inflammatory activity, and subsinusoidal and portal–portal tract linkage fibrosis with significant up‐regulation of genes involved in cellular stress signaling and fibrogenic pathways. These effects were abrogated in the CO‐fed mice, despite elevated serum EtOH levels and hepatic iron concentrations, reduced hepatic glutathione and mitochondrial superoxide dismutase activities. Feeding with the CO diet led to increased hepatic glutathione peroxidase and catalase activities and attenuated alcohol‐induced hepatic steatosis in the Hfe−/− animals. Iron and EtOH feeding markedly reduced p‐STAT3 and p‐AMPK protein levels, but this effect was significantly attenuated when a CO diet was consumed.ConclusionsA CO‐based diet is protective against combined EtOH‐ and iron‐induced liver toxicity, likely via attenuation of hepatic steatosis and oxidative stress and may have a role in the prevention of fibrosis development in chronic liver disease.
Nationwide time trends in dispensed prescriptions of psychotropic medication for children and adolescents in Denmark
Authors: Steinhausen H.‐C. , Bisgaard C. 
Published: June 2013

ObjectiveThe analysis of time trends in dispensed prescriptions of psychotropic medications for children and adolescents in Denmark.MethodThe entire data set of the Danish prescription register covering stimulants, antidepressants, antipsychotics, and anxiolytics used in children and adolescents over a 15‐year time span from 1996 to 2010 was analyzed. Both non‐adjusted age‐standardized prevalence rates and adjusted age‐standardized prevalence rates considering the increase in patient numbers over time were calculated, and time trends were assessed based on 105 908 patient‐years.ResultsFor stimulants, antidepressants, and antipsychotics, the non‐adjusted prevalence rates increased significantly. These trends were strongest for the stimulants. However, all adjusted prevalence rates were much lower with the anxiolytics even declining significantly. The prevalence rates of stimulants and antipsychotics were significantly higher among males than females, whereas females received significantly more antidepressants. The increase in prescription rates for both antidepressants and antipsychotics was mainly due to increased use among the 14‐ to 17‐year‐olds. Stratification by diagnoses revealed significantly increasing prevalence rates of dispensed antidepressants and antipsychotics in six major diagnostic indications.ConclusionAlthough increasing, the unadjusted Danish prevalence rates of dispensed prescriptions of psychotropics for children and adolescents are still lower than in many other Western countries.
Alcohol consumption and tobacco smoking among community‐dwelling older Australian men: The Concord Health and Ageing in Men Project
Authors: Ilomäki Jenni , Gnjidic Danijela , Le Couteur David G , Bell J Simon , Blyth Fiona M , Handelsman David J , Cumming Robert G , Seibel Markus J , Waite Louise M , Naganathan Vasi , Hilmer Sarah N 
Published: June 2013

AimTo describe the prevalence and correlates of alcohol consumption and tobacco smoking among older Australian men.MethodSelf‐reported alcohol and tobacco use was assessed among a random sample of community‐dwelling men aged ≥70 years living in Sydney (n = 1705) from 2005 to 2007. Logistic regression was used to compute odds ratios (ORs) and 95% confidence intervals (CIs) for factors associated with alcohol and tobacco use.ResultsThe prevalence of heavy/excessive drinking was 19.2%, daily drinking 33.7%, and binge drinking 14.1%. Daily drinking was associated with chronic pain (OR = 1.38, 95% CI: 1.07–1.78). Binge drinking was associated with anxiety (OR = 1.93, 95% CI: 1.05–3.54) and being widowed (OR = 1.74, 95% CI: 1.11–2.73). Six per cent of men were current smokers and 56.7% were former smokers. Former smoking was associated with polypharmacy (OR = 1.47, 95% CI: 1.14–1.91) and each additional comorbid condition (OR = 1.11, 95% CI: 1.03–1.19).ConclusionsNearly one‐fifth of older men drank heavily or excessively. This highlights the need for public health initiatives to reduce alcohol consumption in older people.
Up‐dosing with bilastine results in improved effectiveness in cold contact urticaria
Authors: Krause K. , Spohr A. , Zuberbier T. , Church M. K. , Maurer M. 
Published: June 2013

AbstractBackgroundCold contact urticaria (CCU) is characterized by itchy wheal and flare responses due to the release of histamine and other pro‐inflammatory mediators after exposure to cold. The treatment of choice is nonsedating antihistamines, dosages of which may be increased up to fourfold if standard doses are ineffective. Here, we assess the effects of a standard 20 mg dose and up‐dosing to 40 and 80 mg of bilastine in reducing the symptoms of CCU and inflammatory mediator release following cold challenge.MethodsTwenty patients with CCU were included in this randomized, crossover, double‐blind, placebo‐controlled 12‐week study. They received placebo, 20, 40 or 80 mg of bilastine daily each for 7 days with 14‐day washout periods. The primary readout was change in critical temperature thresholds (CTT). Secondary readouts were changes in pruritus, levels of histamine IL‐6, IL‐8 and TNF‐α collected by skin microdialysis and safety and tolerability of bilastine.ResultsBilastine 20 mg was highly effective (P < 0.0001) in reducing CTT. Up‐dosing to 80 mg significantly (P < 0.04) increased its effectiveness. At this dose, 19 of 20 (95%) patients responded to treatment, with 12 of 20 (60%) becoming symptom free. Only one patient was refractory to treatment. Microdialysis levels of histamine, IL‐6 and IL‐8 assessed 1–3 h after cold challenge were significantly (P < 0.05) decreased following up‐dosing with 80 mg bilastine. Bilastine treat‐ment was well tolerated without evidence of increased sedation with dose escala‐tion.ConclusionsBilastine was effective in reducing the symptoms of patients with CCU. Increased efficacy of bilastine with fourfold up‐dosing was without sedation and supports urticaria treatment guidelines.
Generation and functional analysis of human TNF‐α/iNOS‐producing dendritic cells (Tip‐DC)
Authors: Wilsmann‐Theis D. , Koch S. , Mindnich C. , Bonness S. , Schnautz S. , von Bubnoff D. , Bieber T. 
Published: June 2013

AbstractBackgroundA unique type of CD11cpos dendritic cells (DC) is abundant in inflamed tissue, for example, in chronic inflammatory skin diseases. Due to their remarkable production of tumor necrosis factor (TNF)‐α and inducible NO synthase (iNOS), these cells have been referred to as TNF and iNOS‐producing DC (Tip‐DC). While Tip‐DC have been mainly characterized in murine models of infection, functional data about their human counterpart are lacking.ObjectivesWe sought to generate human Tip‐DC in vitro und thus provide a new model for the investigation of their phenotype and function.MethodsWe generated human Tip‐DC from monocytic precursor cells of healthy individuals, atopic and psoriatic patients using human serum. Resting and stimulated cells were analyzed by flow cytometry, real‐time PCR, and by ELISA. INOS activity was measured by fluorometric detection of NO.ResultsTip‐DC closely resembled their in vivo counterparts by expressing CD11c, CD86, and CD40 while lacking CD1a, CD1c, or CD207/Langerin. Bacterial stimulation of Tip‐DC from healthy donors, atopic dermatitis, or psoriasis patients resulted in a similar increase in iNOS activity and TNF‐α production. In kinetic experiments, TNF‐α, a putative activator of Tip‐DC, could not induce NOS2. Upon bacterial stimulation, TNFA, IL6, IL12B, and IL23A mRNA appeared in a first wave, while IL12A and NOS2 mRNA were up‐regulated later on but not blocked by anti‐TNF‐α agents, implying a biphasic pro‐inflammatory response.ConclusionsWe developed a new model for the study of human Tip‐DC and provide the first evidence of their pro‐inflammatory capacity.
Retinoic acids up‐regulate functional eosinophil‐driving receptor CCR3
Authors: Ueki S. , Nishikawa J. , Yamauchi Y. , Konno Y. , Tamaki M. , Itoga M. , Kobayashi Y. , Takeda M. , Moritoki Y. , Ito W. , Chihara J. 
Published: June 2013

AbstractEotaxins and their receptor CCR3 have a definitive role for tissue accumulation of eosinophils both under homeostatic and pathologic conditions. However, physiological stimuli that can up‐regulate CCR3 in blood‐derived human eosinophils have not been recognized. As a prior gene microarray study revealed up‐regulation of CCR3 in eosinophils stimulated with retinoic acids (RAs), the expression of functional CCR3 was examined. We found that 9‐cis RA and all‐trans RA (ATRA) significantly induced surface CCR3 expression regardless of the presence of IL‐3 or IL‐5. Pharmacological manipulations with receptor‐specific agonists and antagonists indicated that retinoic acid receptor‐α activation is critical for CCR3 up‐regulation. RA‐induced CCR3 was associated with its functional capacity, in terms of the calcium mobilization and chemotactic response to eotaxin‐1 (CCL11). Our study suggests an important role of vitamin A derivatives in the tissue accumulation of eosinophils.
Population pharmacokinetic and pharmacogenetic analysis of tacrolimus in paediatric liver transplant patients
Authors: Abdel Jalil Mariam H. , Hawwa Ahmed F. , McKiernan Patrick J. , Shields Michael D. , McElnay James C. 
Published: June 2013

AimsTo build a population pharmacokinetic model that describes the apparent clearance of tacrolimus and the potential demographic, clinical and genetically controlled factors that could lead to inter‐patient pharmacokinetic variability within children following liver transplantation.MethodsThe present study retrospectively examined tacrolimus whole blood pre‐dose concentrations (n = 628) of 43 children during their first year post‐liver transplantation. Population pharmacokinetic analysis was performed using the non‐linear mixed effects modelling program (nonmem) to determine the population mean parameter estimate of clearance and influential covariates.ResultsThe final model identified time post‐transplantation and CYP3A5*1 allele as influential covariates on tacrolimus apparent clearance according to the following equation:
urn:x-wiley:03065251:media:bcp12174:bcp12174-math-5001
where TVCL is the typical value for apparent clearance, TPT is time post‐transplantation in days and the CYP3A5 is 1 where *1 allele is present and 0 otherwise. The population estimate and inter‐individual variability (%CV) of tacrolimus apparent clearance were found to be 0.977 l h−1 kg−1 (95% CI 0.958, 0.996) and 40.0%, respectively, while the residual variability between the observed and predicted concentrations was 35.4%.ConclusionTacrolimus apparent clearance was influenced by time post‐transplantation and CYP3A5 genotypes. The results of this study, once confirmed by a large scale prospective study, can be used in conjunction with therapeutic drug monitoring to recommend tacrolimus dose adjustments that take into account not only body weight but also genetic and time‐related changes in tacrolimus clearance.
Protocatechuic Acid Induces Angiogenesis through PI3K‐Akt‐eNOS‐VEGF Signalling Pathway
Authors: Kang Zechun , Zhu Haibo , Jiang Wanglin , Zhang Shuping 
Published: June 2013

AbstractIn this study, we sought to elucidate whether protocatechuic acid contributes to induce angiogenesis as well as its mechanisms. To this end, we examined the role of protocatechuic acid on human brain microvascular endothelial cell line (HBMEC) proliferation, invasion and tube formation in in vitro. For the study of mechanisms involved, the phosphoinositide 3 kinase (PI3K)‐Akt inhibitor LY294002, the endothelial nitric oxide synthase (eNOS) inhibitor L‐NAME, vascular endothelial growth factor (VEGF), antagonist sFlt‐1 and VEGF receptor blocker SU‐1498 were used. Proliferation of HBMEC was tested by MTT. Scratch adhesion test was used to assess the ability of invasion. A Matrigel tube formation assay was performed to test capillary tube formation ability. PI3K‐Akt‐eNOS‐VEGF pathway activation in HBMEC was tested by Western blot. Our data suggested that protocatechuic acid induces angiogenesis in vitro by increasing proliferation, invasion and tube formation. VEGF expression was increasing by protocatechuic acid and counteracted by VEGF antagonist sFlt‐1, LY294002 and L‐NAME in HBMEC. Tube formation was increased by protocatechuic acid and counteracted by VEGF receptor blocker‐SU1498, LY294002 and L‐NAME. These data suggest that protocatechuic acid may be a candidate therapy for stroke recovery by promoting angiogenesis via a programmed PI3K/Akt/eNOS/VEGF signalling axis.
Exploring the use of Web 2.0 technology to promote moral and psychosocial development: Can YouTube work?
Authors: Koh Caroline 
Published: June 2013

AbstractThis paper explores the use of the video sharing site, YouTube, as a platform for enhancing moral and psychosocial development through increased awareness of moral values and models of moral behavior. The research involved a qualitative design whereby video snippets illustrating moral issues were identified from YouTube. These video snippets were analyzed in terms of their viewership, the moral dilemma and the levels of moral judgment that they presented. The comments made by viewers in response to the video contents were then captured and their contents analyzed for evidence of moral reasoning and ego (psychosocial) development. The findings showed that the video sharing websites such as YouTube offered opportunities for moral issues to be featured, shared and discussed at a global level, as well as moral judgments and ego development to be made evident through viewers' comments. From an educational viewpoint, it also paves the way for the use of appropriate video footage for promoting moral values and moral development.
Impact of gait analysis on correction of excessive hip internal rotation in ambulatory children with cerebral palsy: a randomized controlled trial
Authors: Wren Tishya A L , Lening Christopher , Rethlefsen Susan A , Kay Robert M 
Published: June 2013

AimThe aim of this study was to determine if gait analysis improves correction of excessive hip internal rotation in ambulatory children with spastic cerebral palsy (CP).MethodChildren undergoing orthopedic surgery were randomized to receive or not receive a preoperative gait analysis report. This secondary analysis included all participants whose gait report recommended external femoral derotation osteotomy (FDRO). One‐year postoperative, and pre‐ to postoperative change in femoral anteversion, mean hip rotation in stance, and mean foot progression in stance were compared between groups and in subgroups based on whether the recommendation for FDRO was followed.ResultsOutcomes did not differ between the group which received a gait report (n=39; 19 males, 20 females; mean age 10y 4mo [SD 3y]; hemiplegia, 3; di/triplegia, 28; quadriplegia, 8; Gross Motor Function Classification System [GMFCS]: level I, 5; level II, 12; level III 19; level IV, 3) and the control group (n=26; 14 males, 12 females; mean age 9y 5mo [SD 2y 10mo]; hemiplegia, 1; di/triplegia, 21; quadriplegia, 4; GMFCS: level I, 4; level II, 1; level III, 9; level IV, 2; all p values >0.29), but improved more in the gait report subgroup in which the FDRO recommendation was followed (seven limbs; change in anteversion −32.9°, hip rotation −25.5°, foot progression −36.2°) than in the control group (anteversion −12.2°, hip rotation −7.6°, foot progression −12.4°; all p values ≤0.02) and the gait report subgroup in which FDRO was not performed (32 limbs; anteversion −1.0°, hip rotation 0.5°, foot progression −8.0°; all p values ≤0.003). Postoperative measures became normal only in the gait report subgroup in which the recommended FDRO was performed.InterpretationGait analysis can improve outcomes when its recommendations are incorporated in the treatment plan.