bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Axiomatic Approach to Systemic Risk
Authors: Chen Chen , Iyengar Garud , Moallemi Ciamac C. 
Published: January 2013

Systemic risk refers to the risk of collapse of an entire complex system as a result of the actions taken by the individual component entities or agents that comprise the system. Systemic risk is an issue of great concern in modern financial markets as well as, more broadly, in the management of complex business and engineering systems. We propose an axiomatic framework for the measurement and management of systemic risk based on the simultaneous analysis of outcomes across agents in the system and over scenarios of nature. Our framework defines a broad class of systemic risk measures that accomodate a rich set of regulatory preferences. This general class of systemic risk measures captures many specific measures of systemic risk that have recently been proposed as special cases and highlights their implicit assumptions. Moreover, the systemic risk measures that satisfy our conditions yield decentralized decompositions; i.e., the systemic risk can be decomposed into risk due to individual agents. Furthermore, one can associate a shadow price for systemic risk to each agent that correctly accounts for the externalities of the agent's individual decision making on the entire system. This paper was accepted by Gérard P. Cachon, stochastic models and simulation.
Product Market Competition, Managerial Compensation, and Firm Size in Market Equilibrium
Authors: Subramanian Ajay 
Published: January 2013

We develop a tractable equilibrium model of competing firms in an industry to show how the distribution of firm qualities, moral hazard, and product market characteristics interact to affect firm size, managerial compensation, and market structure. Different determinants of product market competition have contrasting effects on firm size and managerial compensation. Although both firm size and managerial compensation increase with the entry cost, they increase with the elasticity of substitution if and only if firm size exceeds a high threshold but decrease if it is below a low threshold. Aggregate shocks to the firm productivity distribution affect incentives in our equilibrium framework. We show statistically and economically significant empirical support for several hypotheses derived from the theory that relates product market characteristics to managerial compensation, firm size, and the number of firms in the industry. Different determinants of competition indeed have contrasting effects, as predicted by the theory. This paper was accepted by Brad Barber, finance.
Home and Community Based Services (HCBS) Waivers: A Nationwide Study of the States
Authors: Rizzolo Mary C. , Friedman Carli , Lulinski-Norris Amie , Braddock David 
Published: January 2013

Abstract
In fiscal year (FY) 2009, the Medicaid program funded over 75% of all publicly funded long-term supports and services (LTSS) for individuals with intellectual and developmental disabilities (IDD) in the United States (Braddock et al., 2011). The majority of spending was attributed to the Home and Community Based Services (HCBS) Waiver program. In FY 2009, federal–state spending for the HCBS Waiver program reached over $25.1 billion and constituted almost half of total funding across the nation that year (Braddock et al., 2011). Considerable effort has been spent investigating Medicaid program expenditures, however, due in part to the unique and state-specific nature of HCBS programs, national-level analysis on the types of services offered to individuals with IDD has not been available. A full understanding of the supports available through the Medicaid program is critical as the United States considers strategies for economic recovery among competing state and federal budget priorities. This article presents the results of an analysis of 88 Medicaid HCBS Section 1915(c) waiver applications for individuals with intellectual and developmental disabilities in 41 states and the District of Columbia. It analyzes IDD data and trends close to the real time intent of states and empowers advocates in presenting timely solutions to real-time issues.
Incidence of second neoplasm in childhood cancer survivors treated with GH: an analysis of GeNeSIS and HypoCCS
Authors: Woodmansee Whitney W , Zimmermann Alan G , Child Christopher J , Rong Qi , Erfurth Eva Marie , Beck-Peccoz Paolo , Blum Werner F , Robison Leslie L 
Published: January 2013

ObjectiveChildhood cancer survivors are commonly treated with GH for GH deficiency that develops either as a result of primary malignancy or its treatment. One study – the Childhood Cancer Survivor Study (CCSS) – demonstrated increased risk of second neoplasm (SN) in GH-treated childhood cancer survivors compared with non-GH treated, after adjusting for key risk factors. We assessed the incidence of SN in GH-treated childhood cancer survivors in outpatient observational studies of GH replacement.DesignRetrospective analysis of two prospective cohort studies that collected data on safety of GH replacement as prescribed in clinical practice.MethodsChildhood cancer survivors enrolled in Eli Lilly and Company's pediatric (Genetics and Neuroendocrinology of Short Stature International Study (GeNeSIS)) and adult (Hypopituitary Control and Complications Study (HypoCCS)) observational studies of GH treatment were assessed for incidence of SN.ResultsThe percentage of childhood cancer survivors treated with GH who developed a SN was 3.8% in pediatric GeNeSIS participants and 6.0% in adult HypoCCS participants. The estimated cumulative incidence of SN at 5 years of follow-up in these studies was 6.2 and 4.8% respectively.ConclusionsThe incidence of SN in GeNeSIS and HypoCCS GH-treated participants is similar to the published literature and is thus consistent with increased risk of SN in childhood cancer survivors treated with GH. As follow-up times were relatively short (<3 years), longer observation is recommended. Nevertheless, clinicians should be alerted to the possibility of increased risk of SN in childhood cancer survivors treated with GH and continue chronic surveillance.
Validation of Rapid Neurodevelopmental Assessment for 2- to 5-Year-Old Children in Bangladesh
Authors: Khan Naila Z. , Muslima Humaira , Shilpi Asma Begum , Begum Dilara , Parveen Monowara , Akter Nasima , Ferdous Shamim , Nahar Kamrun , McConachie Helen , Darmstadt Gary L. 
Published: January 2013

OBJECTIVE:
Validate a tool to determine neurodevelopmental impairments (NDIs) in &gt;2- to 5-year-old children in a country with limited child development expertise.

METHODS:
Rapid Neurodevelopmental Assessment (RNDA) is a tool designed to detect functional status and NDIs across multiple neurodevelopmental domains. Validity was determined in 77 children enrolled by door-to-door sampling in Dhaka and who were administered the RNDA by 1 of 6 testers (4 developmental therapists, 2 special education teachers) and simultaneously administered a test of adaptive behavior (AB; Independent Behavior Assessment Scale) and intelligence quotient (IQ) tests (Bayley Scales of Infant Development II, Stanford Binet Intelligence Scale, Wechsler Preschool and Primary Scales of Intelligence) by psychologists.

RESULTS:
Interrater reliability ranged from good to excellent. There were significant differences in AB in mean percentile scores on the Independent Behavior Assessment Scale for motor (P = .0001), socialization (P = .001), communication (P = .001), and full-scale (P = .001) scores in children with ≥1 NDI (“any NDI”) versus no NDI. Significant differences in those with versus those without “any NDI” were found on IQ scores. Sensitivity and specificity for “significant difficulties” (defined as AB z-scores &lt; −2 SDs and/or IQ &lt;70) and “mild difficulties included” (AB z-scores &lt; −1SD and/or IQ &lt;85) were 90% and 60% and 80% and 76%, respectively.

CONCLUSIONS:
The RNDA validity results are promising for use by child care professionals in field and clinical settings, but the tool needs further replication and refinement for assessment of specific impairments of vision, hearing, and seizures.
Symptoms and Otoscopic Signs in Bilateral and Unilateral Acute Otitis Media
Authors: Uitti Johanna M. , Laine Miia K. , Tähtinen Paula A. , Ruuskanen Olli , Ruohola Aino 
Published: January 2013

OBJECTIVE:Bilateral acute otitis media (AOM) is considered more severe than unilateral AOM, and several guidelines recommend more active treatment and/or follow-up of bilateral AOM. We studied whether bilateral AOM is a clinically more severe illness than unilateral AOM by comparing symptoms and otoscopic signs between bilateral and unilateral AOM.METHODS:Two hundred thirty-two children aged 6 to 35 months diagnosed with AOM were eligible. We surveyed the symptoms with a structured questionnaire and recorded the otoscopic signs systematically.RESULTS:Ninety-eight children had bilateral and 134 children unilateral AOM. Children with bilateral AOM were more often &lt;24 months than children with unilateral AOM (87% vs 75%; P = .032). Fever (≥38°C) occurred in 54% and 36% (P = .006) and severe conjunctivitis in 16% and 44% (P = .047) of children with bilateral and unilateral AOM, respectively. In 15 other symptoms, we found no overall differences even when adjusted with age. We observed the following severe otoscopic signs in the bilateral and unilateral AOM group, respectively: moderate/marked bulging of tympanic membrane (63% and 40%; P = .001), purulent effusion (89% and 71%; P = .001), bulla formation (11% and 10%; P = .707), and hemorrhagic redness of tympanic membrane (7% and 10%; P = .386).CONCLUSIONS:Bilateral AOM seems to be a clinically only slightly more severe illness than unilateral AOM. Therefore, when assessing AOM severity, bilaterality should not be used as a determining criterion; instead, the child’s symptomatic condition together with otoscopic signs should also be taken into consideration.
Prehypertension and Hypertension in Community-Based Pediatric Practice
Authors: Lo Joan C. , Sinaiko Alan , Chandra Malini , Daley Matthew F. , Greenspan Louise C. , Parker Emily D. , Kharbanda Elyse O. , Margolis Karen L. , Adams Kenneth , Prineas Ronald , Magid David , O’Connor Patrick J. 
Published: January 2013

OBJECTIVE:
To examine the prevalence of prehypertension and hypertension among children receiving well-child care in community-based practices.

METHODS:
Children aged 3 to 17 years with measurements of height, weight, and blood pressure (BP) obtained at an initial (index) well-child visit between July 2007 and December 2009 were included in this retrospective cohort study across 3 large, integrated health care delivery systems. Index BP classification was based on the Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents: normal BP, &lt;90th percentile; prehypertension, 90th to 94th percentile; hypertension, 3 BP measurements ≥95th percentile (index and 2 subsequent consecutive visits).

RESULTS:
The cohort included 199 513 children (24.3% aged 3–5 years, 34.5% aged 6–11 years, and 41.2% aged 12–17 years) with substantial racial/ethnic diversity (35.9% white, 7.8% black, 17.6% Hispanic, 11.7% Asian/Pacific Islander, and 27.0% other/unknown race). At the index visit, 81.9% of participants were normotensive, 12.7% had prehypertension, and 5.4% had a BP in the hypertension range (≥95th percentile). Of the 10 848 children with an index hypertensive BP level, 3.8% of those with a follow-up BP measurement had confirmed hypertension (estimated 0.3% prevalence). Increasing age and BMI were significantly associated with prehypertension and confirmed hypertension (P &lt; .001 for trend). Among racial/ethnic groups, blacks and Asians had the highest prevalence of hypertension.

CONCLUSIONS:
The prevalence of hypertension in this community-based study is lower than previously reported from school-based studies. With the size and diversity of this cohort, these results suggest the prevalence of hypertension in children may actually be lower than previously reported.
Apply Awaji-shima Consensus Conference Criteria Before Diagnosing Amyotrophic Lateral Sclerosis
Authors: Finsterer Josef , Stöllberger Claudia 
Published: January 2013

Objectives:
ALS may be diagnosed although affection of other organs suggests another pathogenetic back-ground.

Case report:
In a 72yo non-smoking male progressive gait disturbance with recurrent falls since 2y was initially attributed to axonal polyneuropathy. Additionally, he had arterial hypertension, diabetes, hyperlipidemia, hyperuricemia, hyper-CK-emia, hepatopathy, atrial fibrillation, recurrent heart-failure, pulmonary hypertension, mitral insufficiency, and restrictive cardiomyopathy. Possible causes of polyneuropathy were diabetes, long-standing alcoholism, folate-deficiency, or hereditary disease. Later the patient was re-diagnosed as ALS despite absence of upper motor-neuron or bulbar signs, the presence of multiple risk factors for polyneuropathy, of stocking-type sensory disturbances, and of cardiac abnormalities, which could explain dyspnea. Misdiagnosing polyneuropathy as ALS stigmatized the patient and prevented him from further diagnostic work-up for cardiac disease and adequate treatment for heart-failure. Though the diagnosis of ALS was withdrawn, he was put on comfort care and opiates were given when dyspnea acutely deteriorated to death without further cardiac or pulmonary investigations or specific cardiac treatment.

Conclusions:
ALS should be diagnosed only if the Awaji-shima criteria are fulfilled and if all differential diagnoses were profoundly excluded. Respiratory insufficiency should not be attributed to bulbar involvement in ALS as long as cardiac, pulmonary, or myopathic causes were excluded.
Effects of a d-Xylose Preload With or Without Sitagliptin on Gastric Emptying, Glucagon-Like Peptide-1, and Postprandial Glycemia in Type 2 Diabetes
Authors: Wu Tongzhi , Bound Michelle J. , Zhao Beiyi R. , Standfield Scott D. , Bellon Max , Jones Karen L. , Horowitz Michael , Rayner Christopher K. 
Published: January 2013

OBJECTIVE
Macronutrient “preloads” can reduce postprandial glycemia by slowing gastric emptying and stimulating glucagon-like peptide-1 (GLP-1) secretion. An ideal preload would entail minimal additional energy intake and might be optimized by concurrent inhibition of dipeptidyl peptidase-4 (DPP-4). We evaluated the effects of a low-energy d-xylose preload, with or without sitagliptin, on gastric emptying, plasma intact GLP-1 concentrations, and postprandial glycemia in type 2 diabetes.

RESEARCH DESIGN AND METHODS
Twelve type 2 diabetic patients were studied on four occasions each. After 100 mg sitagliptin (S) or placebo (P) and an overnight fast, patients consumed a preload drink containing either 50 g d-xylose (X) or 80 mg sucralose (control [C]), followed after 40 min by a mashed potato meal labeled with 13C-octanoate. Blood was sampled at intervals. Gastric emptying was determined.

RESULTS
Both peak blood glucose and the amplitude of glycemic excursion were lower after PX and SC than PC (P &lt; 0.01 for each) and were lowest after SX (P &lt; 0.05 for each), while overall blood glucose was lower after SX than PC (P &lt; 0.05). The postprandial insulin-to-glucose ratio was attenuated (P &lt; 0.05) and gastric emptying was slower (P &lt; 0.01) after d-xylose, without any effect of sitagliptin. Plasma GLP-1 concentrations were higher after d-xylose than control only before the meal (P &lt; 0.05) but were sustained postprandially when combined with sitagliptin (P &lt; 0.05).

CONCLUSIONS
In type 2 diabetes, acute administration of a d-xylose preload reduces postprandial glycemia and enhances the effect of a DPP-4 inhibitor.
Numerical transient state analysis of partly obstructed haemodynamics using FSI approach
Authors: Lorenzini Giulio , Conti Alessandra 
Published: January 2013

Abstract
Blood interacts in compliance with the vessels it flows in, determining effects of fluid-structure interaction (FSI). Using this approach, the present paper analyses the blood flow and its pathological conditions before diagnostic (Doppler catheters) or pathological (stenoses) obstacles. Catheters are concentric cylinders with defined vessels, whereas stenoses are shaped as triangles, trapeziums or hemi-ellipses. Rather than a basic/rigid case, three models were adopted to describe the artery wall dynamics: elastic (Hooke), hyper-elastic Mooney-Rivley 1 (MR1) and hyper-elastic Mooney-Rivley 2 (MR2). Blood has non-Newtonian rheological properties (Casson fluid. The numerical study used the CFD code Comsol Multiphysics, version 3.4. The FSI effect was studied through 3 physical parameters with reference to the blood flow: minimum velocity (re-circulation), maximum velocity (the mechanical stress on the obstacle) and the disturbance length. Results show a strong dependence of the FSI effect on the characteristics of the obstacle considered and on the kind of elastic/hyper-elastic model chosen. In a few cases, however, the results of the old rigid-vessel approach were reasonably accurate.
How Much Exposure to English Do International Graduate Students Really Get? Measuring Language Use in a Naturalistic Setting
Authors: Ranta Leila , Meckelborg Amy 
Published: January 2013

Abstract:Many believe that the best way to learn a language is to study it in a country where that language is widely spoken. Underlying this belief is the assumption that study in a naturalistic setting will provide learners with ample opportunities for exposure to the target language and interaction with native-speakers of that language. This article reports the findings from a longitudinal study of the quantity and quality of exposure experienced by 17 Chinese graduate students at a Canadian university. Exposure was measured using a computerized log that participants completed once a month for one week, over a six-month period. Our findings show a general trend toward receptive rather than interactive use of English, and considerable variation among individuals in terms of the amount and type of language use. The discussion explores possible reasons for participants’ relatively low amount of oral interaction in English in this naturalistic setting.
Negative Pressure Wound Therapy (NPWT) in open wound management: A study of 16 Cases in Orthopaedic Department of Faridpur Medical College Hospital
Authors: Shaheed Nusrat , Chowdhury A S M Jahangir , Mondal Anadi Ranjan , Paul Amal Chandra , Akhter Md Shahin , Rahman A S M Tanjilur , Islam Md Touhidul Touhidul , Chowdhury Mohiuddin Majed 
Published: January 2013

Wound management is a major concern in open fracture cases. Negative Pressure Wound Therapy (NPWT) is an advanced method for managing open wounds. It is a topical treatment using sub-atmospheric pressure to increase blood flow, remove bacteria and increase growth of granulation tissue in the wound. The study was performed to evaluate the results of NPWT in patients with open fracture in lower extremity. Using Aquarium pump as an NPWT device, 16 patients were prospectly treated for open fractures in their inferior extremity. Mean patients' age range was 21 to 60 yrs. The patients under study either had suffered from trauma, fall or had post operative wound infection. Many of them had wounds with underlying tendon or bone exposure. Necrotic tissues were debrided before applying NPWT. Dressings were changed every 3rd or 4th day and treatments were continued for 07 to 28 days. Exposed tendons and bones were successfully covered with healthy granulation tissue in all cases, depth of the wounds reduced as well as surface areas. In 12 cases coverage of granulation tissue were achieved and further managed by skin grafting, 4 cases with wound infections were closed with secondary suture. No significant complications were noted regarding the treatment. NPWT was found to facilitate the rapid formation of healthy granulation tissue on open wounds in lower extremity and thus to shorten healing time and minimize secondary soft tissue defect coverage procedures. DOI: http://dx.doi.org/10.3329/fmcj.v7i2.13500 Faridpur Med. Coll. J. 2012;7(2):63-66
Pattern of Child and Adolescent Patients Attending Psychiatric Outpatient Department of the Mental Hospital in Bangladesh
Authors: Giasuddin Noor Ahmed , Diba Shazadi Farha 
Published: January 2013

Bangladesh has only one mental hospital which is situated in Pabna district of the country. People from the nearby locality as well as from distant regions of the country come here for psychiatric service. Clinical records of all the children who attended the outpatient department of 'Mental Hospital, Pabna' (MHP) during January, 2009 to June, 2009 were analyzed. Of the 143 children, 125 (88%) were of school going age (i.e., ?6 years of age). The majority (63%) of the patients were male. International Classification of Diseases (ICD) classification revealed that the patients came with mental retardation (F70-F79) (38%), Episodic and paroxysmal disorder (G43-G44) (26%) and Schizophrenia, schizotypal & delusional disorders (F20-F29) (22%). The main comorbid condition was behavioural problem with mental retardation (43% of mentally retarded). Of the 103 patient we had information about the pathway to care, 20 patients (19%) came directly to MHP and the rest 83 (81%) consulted other service provider before reaching here. Among the previous service providers, there were medical graduates (60%), Kobiraj (36%) and indigenous & religious healer (34%). Considering the variety of presentation of child and adolescent patients, we propose to establish a multidisciplinary approach in MHP. DOI: http://dx.doi.org/10.3329/fmcj.v7i2.13501 Faridpur Med. Coll. J. 2012;7(2):67-70
Quality of Care: View of Patient Satisfaction with Physiotherapy in Government and Private Settings in Dhaka, Bangladesh
Authors: Hossain Sheikh Jamal , Ferdousi Jannatul , Biswas Manaj Kumar , Mahfuz Nageeb , Biswas Gonopati 
Published: January 2013

Patients' satisfaction plays an important role to attract patients for health services. It has not been closely monitored in physiotherapy; limited studies exist in this area of allied health services. The objective of the study was to determine the level of satisfaction of patients at the government and private hospitals in Dhaka and to compare between two facilities. This descriptive type of cross-sectional study was carried out with patients who sought physiotherapy care at the outdoor of Physical Medicine Department of the Dhaka Medical College Hospital (DMCH) and the Centre for Rehabilitation of Paralyzed (CRP), Mirpur, Dhaka. In total, 150 patients - 75 from each setting were interviewed. Appropriate research instruments comprising a structured and semi-structured questionnaire developed by the American Physical Therapy Association (APTA) were administered by interviewers to collect data. To find out any association among the socio-demographic characteristics, chi-squire test was applied, and the level of satisfaction was measured in percentages to compare between the two settings (government and private). Patients attendance differ because different socio-demographic characteristics and location of physical health problem in two hospital. Location of the hospital, privacy of patients, behaviour of staff members, physical qualities of hospitals (cleanliness, light, ventilation, etc.) had more than 10% variation in the level of satisfaction between the two settings. So, patient satisfaction with physiotherapy is higher in private setting than that in government setting in Dhaka. DOI: http://dx.doi.org/10.3329/fmcj.v7i2.13502 Faridpur Med. Coll. J. 2012;7(2):71-74