bluuebunny/crossref_metadata_2025_split huggingface dataset:
Under Pressure: Financial Effect of the Hospital‐Acquired Conditions Initiative–A Statewide Analysis of Pressure Ulcer Development and Payment
Authors: Meddings Jennifer , Reichert Heidi , Rogers Mary A. M. , Hofer Timothy P. , McMahon Laurence F. , Grazier Kyle L. 
Published: July 2015

ObjectivesTo assess the financial effect of the 2008 Hospital‐Acquired Conditions Initiative (HACI) pressure ulcer payment changes on Medicare, other payers, and hospitals.DesignRetrospective before‐and‐after study of all‐payer statewide administrative data for more than 2.4 million annual adult discharges in 2007 and 2009 using the Healthcare Cost and Utilization Project State Inpatient Datasets for California. How often and by how much the 2008 payment changes for pressure ulcers affected hospital payment was assessed.SettingNonfederal acute care California hospitals (N = 311).ParticipantsAdults discharged from acute‐care hospitals.MeasurementsPressure ulcer rates and hospital payment changes.ResultsHospital‐acquired pressure ulcer rates were low in 2007 (0.28%) and 2009 (0.27%); present‐on‐admission pressure ulcer rates increased from 2.3% in 2007 to 3.0% in 2009. According to clinical stage of pressure ulcer (available in 2009), hospital‐acquired Stage III and IV ulcers occurred in 603 discharges (0.02%); 60,244 discharges (2.42%) contained other pressure ulcer diagnoses. Payment removal for Stage III and IV hospital‐acquired ulcers reduced payment in 75 (0.003%) discharges, for a statewide payment decrease of $310,444 (0.001%) for all payers and $199,238 (0.001%) for Medicare. For all other pressure ulcers, the Hospital‐Acquired Conditions Initiative reduced hospital payment in 20,246 (0.81%) cases (including 18,953 cases with present‐on‐admission ulcers), reducing statewide payment by $62,538,586 (0.21%) for all payers and $47,237,984 (0.32%) for Medicare.ConclusionThe total financial effect of the 2008 payment changes for pressure ulcers was negligible. Most payment decreases occurred by removal of comorbidity payments for present‐on‐admission pressure ulcers other than Stages III and IV. The removal of payment for hospital‐acquired Stage III and IV ulcers by implementation of the HACI policy was 1/200th that of the removal of payment for other types of pressure ulcers that occurred in implementation of the Hospital‐Acquired Conditions Initiative.
Preinjury Physical Function and Frailty in Injured Older Adults: Self‐ Versus Proxy Responses
Authors: Maxwell Cathy A. , Dietrich Mary S. , Minnick Ann F. , Mion Lorraine C. 
Published: July 2015

ObjectivesTo determine the extent to which proxy respondents can provide reliable reports.DesignProspective cohort study.SettingLevel I trauma center.ParticipantsSeventy‐seven older adults (≥65, median 73.0, interquartile range 67–80; 53% female) admitted to three services (trauma, geriatrics, orthopedics) with primary injury diagnoses over a 6‐month period and their proxies (43% spouses, 44% children, 5% siblings, 8% friends or other relatives).MeasurementsThree brief screening instruments (Vulnerable Elders Survey‐13 (VES‐13), modified Barthel Index (mBI), Life Space Assessment (LSA)) for physical function and frailty were administered to older adults and their proxies within 48 hours of admission. Data analysis included frequencies, percentages, intraclass correlations, and Kappa statistics.ResultsApproximately 47% (n = 36) of the proxies lived with the older adults. Perfect agreement and 90% agreement between older adults and proxies: There was perfect agreement for 39 (51%) dyads and a difference of 1 or less (range 1–10) for 66 (86%) on the VES‐13, perfect agreement for 48 (62%) and a difference of two or less (range 0–20) for 69 (89%) on the mBI, and perfect agreement for 27 (35%) and a difference of 12 or less (range 0–120) for 55 (71%) on the LSA.ConclusionProxy reports of older adults’ preinjury physical function and frailty are in an acceptable range of agreement with those of the older adults. Using proxy reports when people cannot provide information on themselves may facilitate care management and goal setting.
Perceived safety and benefit of community water fluoridation: 2009 HealthStyles survey
Authors: Mork Nathan , Griffin Susan 
Published: July 2015

AbstractObjectivesTo describe perceived benefits and safety of community water fluoridation (CWF) and investigate factors associated with those perceptions of CWF among respondents to a proprietary survey in the United States.MethodsWe obtained data from the 2009 HealthStyles survey, a convenience sample of 4,556 respondents. Pearson's chi‐squared and logistic regression were used to determine the associations between certain socio‐demographic factors and perceptions regarding the safety and health benefits of CWF.ResultsThe majority of respondents (55.3 percent) strongly agreed/agreed that CWF was safe, while 31.5 percent were neutral, and 13.2 percent disagreed/strongly disagreed. Twenty‐seven percent of respondents reported CWF had no health benefit, 57.3 percent reported some benefit, and 15.5 percent reported great benefit. Perceived CWF safety and benefit in the bivariate analyses were associated with gender, age, race/ethnicity, education, marital status, income, sealant knowledge, CWF knowledge, past year dental utilization, and perceived vaccine safety. Respondents with knowledge of CWF (47.9 percent) were more likely to agree that it was safe (69.8 percent) than those who reported no knowledge (41.3 percent). Among respondents who said childhood vaccines were not safe (4.0 percent), almost half disagreed that CWF was safe. Logistic regression results indicated that perceived CWF safety and benefits increased with CWF knowledge, perceived vaccine safety, and income.ConclusionsAlthough only a minority of the US population perceived CWF as unsafe or providing no benefit to health, perceptions regarding CWF varied by knowledge of CWF and socio‐demographic factors. Oral health promotion activities should consider these differing perceptions of CWF among groups to tailor oral health messaging appropriately.
Service users' experiences of participation in decision making in mental health services
Authors: Dahlqvist_Jönsson P. , Schön U.‐K. , Rosenberg D. , Sandlund M. , Svedberg P. 
Published: July 2015

Accessible summary
Despite the potential positive impact of shared decision making on service users knowledge and experience of decisional conflict, there is a lack of qualitative research on how participation in decision making is promoted from the perspective of psychiatric service users.
This study highlights the desire of users to participate more actively in decision making and demonstrates that persons with SMI struggle to be seen as competent and equal partners in decision‐making situations. Those interviewed did not feel that their strengths, abilities and needs were being recognized, which resulted in a feeling of being omitted from involvement in decision‐making situations.
The service users describe some essential conditions that could work to promote participation in decision making. These included having personal support, having access to knowledge, being involved in a dialogue and clarity about responsibilities.
Mental health nurses can play an essential role for developing and implementing shared decision making as a tool to promote recovery‐oriented mental health services.
AbstractService user participation in decision making is considered an essential component of recovery‐oriented mental health services. Despite the potential of shared decision making to impact service users knowledge and positively influence their experience of decisional conflict, there is a lack of qualitative research on how participation in decision making is promoted from the perspective of psychiatric service users. In order to develop concrete methods that facilitate shared decision making, there is a need for increased knowledge regarding the users' own perspective. The aim of this study was to explore users' experiences of participation in decisions in mental health services in Sweden, and the kinds of support that may promote participation. Constructivist Grounded Theory (CGT) was utilized to analyse group and individual interviews with 20 users with experience of serious mental illness. The core category that emerged in the analysis described a ‘struggle to be perceived as a competent and equal person’ while three related categories including being the underdog, being controlled and being omitted described the difficulties of participating in decisions. The data analysis resulted in a model that describes internal and external conditions that influence the promotion of participation in decision making. The findings offer new insights from a user perspective and these can be utilized to develop and investigate concrete methods in order to promote user's participation in decisions.
Risk of Damage to the Somatic Innervation of the Penis During the AdVance™ Procedure: An Anatomical Study
Authors: Hogewoning Cornelis R.C. , Elzevier Henk W. , Pelger Rob C.M. , Bekker Milou D. , DeRuiter Marco C. 
Published: July 2015

ABSTRACT

Introduction
One of the methods to treat post radical prostatectomy stress urinary incontinence is the AdVance™ (American Medical Systems®, Minnetonka, MN, USA) male sling procedure. During this procedure, the somatic innervation of the penis may be at risk for injury. Six AdVance™ procedures were performed in six donated bodies at the Anatomy and Embryology Department of the Leiden University Medical Centre. The pelves were dissected and the shortest distance between the sling and the dorsal nerve of the penis (DNP) was documented.

Aim
The aim of this study was to describe the anatomical relation between the AdVance™ male sling and penile nerves based on the dissection of six adult male pelves.

Methods
The AdVance™ male sling procedure was conducted in six donated male bodies. After placement, the pelves were dissected and the shortest distance between sling and the DNP was documented.

Main Outcome Measure
The main outcome measure was the distance between the AdVance™ male sling and the DNP.

Results
The mean distance of the sling to the DNP was 4.1 mm and was found situated directly next to the nerve (distance 0 mm) in 4 out of 12 (33%) hemipelves. The distance of the sling to the obturator neurovascular bundle was 30 mm or more in all six bodies.

Conclusions
Damage to the DNP caused by the AdVance™ male sling procedure appears to be an extremely rare complication, which has not been described in current literature. The proximity of the AdVance™ to the DNP could, however, pose a risk that should be taken into consideration by physicians and patients when opting for surgery.
Sexual Activity and Condom Use among Israeli Adolescents
Authors: Shilo Guy , Mor Zohar 
Published: July 2015

ABSTRACT

Introduction
In Israel, as in other industrialized countries, the age of sexual debut among adolescents has declined, and the rate of sexually transmitted infections (STI) has risen, but the motivations and attitudes of Israeli adolescents toward carrying condoms have yet to be studied.

Aims
The aims of this study were to establish the associations (if any) between demographic characteristics and the knowledge held by Jewish Israeli adolescents about HIV transmission, their attitudes toward condom use and sexual experience, and to explore their recommendations to increase condom use.

Methods
The method used was an analysis of sexual experience and practices, attitudes toward condom carrying and condom use among a national representative sample of Jewish adolescents aged 15–18.

Main Outcome Measures
Two dichotomized measures were assessed: (i) sexual experience (defined as having had previous consensual oral/vaginal/anal sex); and (ii) the practice of carrying a condom on a regular basis.

Results
Of all 410 participants, 14.6% carried condoms, 18.3% had sexual experience, and 70.7% of those used condoms. Those who thought condoms to be protective against HIV, and those who thought they are difficult to wear, were more likely to have sexual experience. The perception of condom use as important, and the perception that condoms are difficult to wear, were predictors of condom carrying. The participants' knowledge of the risk of HIV in vaginal intercourse was deficient. Participants did not consider school sex education to be effective in promoting condom use, and recommended the use of graphic, deterrent personal accounts told by youths to encourage wider use of condoms.

Conclusions
Health educators should consider the barriers cited by adolescents and the deterrent techniques they recommend when planning interventions to encourage condom use.
HCV: the best cure possible or the best possible cure?
Authors: Craxì L. , Cammà C. , Craxì A. 
Published: July 2015

SummaryProgress in medicine goes along with an exponential growth of the cost of drugs and devices. While any person has the right to obtain the best possible benefit from medical care, a state needs to strike a balance between granting the optimal personal benefit to each individual and the needs of the society as a whole. Health systems in all countries therefore are facing a huge problem of distributive justice, as while they should guarantee individual rights, among which the right to health in its broader sense, including physical, psychological and social well‐being (therefore not limited to healing, but extending to compliance and quality of life), they must also grant equal access to the healthcare resources and keep the distribution system sustainable.
Clinical impact of treatment timing for chronic hepatitis C infection: a decision model
Authors: Pho M. T. , Jensen D. M. , Meltzer D. O. , Kim A. Y. , Linas B. P. 
Published: July 2015

SummaryRecent advances in the treatment of hepatitis C virus (HCV) infection have led to the availability of both highly efficacious interferon‐containing and interferon‐sparing regimens. However, the use of such therapies faces restrictions due to high costs. For patients who are medically eligible to receive interferon, the choice between the two will likely be impacted by preferences surrounding interferon, severity of disease, coverage policies and out‐of‐pocket costs. We developed a decision model to quantify the trade‐offs between immediate, interferon‐containing therapy and delayed, interferon‐free therapy for patients with chronic, genotype 1HCVinfection. We projected the quality‐adjusted life expectancy stratified by the presence or absence of cirrhosis for four strategies: (i) no treatment; (ii) immediate, one‐time treatment with an interferon‐containing regimen; (iii) immediate treatment as above with the opportunity for retreatment in patients who fail to achieve sustained virologic response with interferon‐free therapy in 1 year; and (iv) delayed therapy with interferon‐free therapy in 1 year. When compared to one‐time immediate treatment with the interferon‐containing regimen, delayed treatment with the interferon‐free regimen in 1 year resulted in longer life expectancy, with a 0.2 quality‐adjusted life year (QALY) increase in noncirrhotic patients, and a 1.1QALYincrease in patients with cirrhosis. This superiority in health benefits was lost when wait time for interferon‐free therapy was greater than 3–3.2 years. In this modelling analysis, interferon‐free therapy resulted in superior health benefits compared to immediate therapy with interferon until wait time exceeded 3–3.2 years. Such data can inform decision‐making regarding treatment initiation forHCVas healthcare financing evolves.
An ecological classification of rocky shores at a regional scale: a predictive tool for management of conservation values
Authors: Ramos Elvira , Puente Araceli , Juanes José A. 
Published: July 2015

AbstractThe ecological classification of coastal waters has become an important issue in ecosystem water quality assessment. Previous studies have suggested that abiotic variables seem to be a suitable alternative to biological data for classifying coastal areas at different scales. The study presented here proposes a downscaling methodology for the classification of coastal waters at a regional scale within the NE Atlantic based on standardized data and objective decision rules. Physical variables (temperature, wave exposure, tidal range and radiation) were selected because of their ecological role, availability and statistical decision rules. This information was based on satellite data and mathematical modelling of natural coastal processes. The N and NW Spanish coastline was subdivided into 41 20‐km segments that were classified according to physical variables using the self‐organizing map and k‐means algorithms. To validate the classification with biological data, 21 sites representing the entire range of physical typologies in the study area were simultaneously and consistently sampled. Intertidal macroalgae were identified in each of 10 quadrats of 50 × 50 cm for two to three transects per site, according to a stratified sampling procedure. The coverage of macroalgae was obtained by photographic analysis. The physical classification shows four typologies: Lower Rias, Upper Rias, West Cantabric and East Cantabric. Statistical analyses confirmed the ecological significance of these typologies at the tidal levels where seaweeds were the major structural element (lower and middle intertidal). According to the biological data, the greatest differences were found between the Upper Rias and the rest of the N and NW Iberian Peninsula coast. Thus, the classification methodology has potential application as a management tool.
Comparative epigenomics: a powerful tool to understand the evolution of DNA methylation
Authors: Zhong Xuehua 
Published: July 2015

SummaryUnderstanding how developmental and functional complexity of organisms evolves is a longstanding challenge in biology. Genetic mutation has long been thought to be the cause of biological complexity. However, increasing evidence indicates that epigenetic variation provides a parallel path for the evolution of biological complexity. Cytosine DNA methylation, the addition of a chemical mark on DNA, is a conserved and essential gene regulatory mechanism. Recent studies have greatly advanced our understanding of the DNA methylation landscapes and key regulatory components across many species. In this review, I summarize recent advances in understanding DNA methylation from an evolutionary perspective. Using comparative approaches, I highlight the conservation and divergence of DNA methylation patterns and regulatory machinery in plants and other eukaryotic organisms.

Contents

Summary
76

I.
Introduction
76

II.
DNA methylation patterns
77

III.
Eukaryotic DNA methyltransferases
78

IV.
Regulation of DNA methylation
78

V.
Perspectives
79

Acknowledgements
80

References
80
Genome sequence of Valsa canker pathogens uncovers a potential adaptation of colonization of woody bark
Authors: Yin Zhiyuan , Liu Huiquan , Li Zhengpeng , Ke Xiwang , Dou Daolong , Gao Xiaoning , Song Na , Dai Qingqing , Wu Yuxing , Xu Jin‐Rong , Kang Zhensheng , Huang Lili 
Published: July 2015

Summary

Canker caused by ascomycetous Valsa species are among the most destructive diseases of woody plants worldwide. These pathogens are distinct from other pathogens because they only effectively attack tree bark in the field. To unravel the potential adaptation mechanism of bark colonization, we examined the genomes of Valsa mali and Valsa pyri that preferentially infect apple and pear, respectively.

We reported the 44.7 and 35.7 Mb genomes of V. mali and V. pyri, respectively. We also identified the potential genomic determinants of wood colonization by comparing them with related cereal pathogens.

Both genomes encode a plethora of pathogenicity‐related genes involved in plant cell wall degradation and secondary metabolite biosynthesis. In order to adapt to the nutrient limitation and low pH environment in bark, they seem to employ membrane transporters associated with nitrogen uptake and secrete proteases predominantly with acidic pH optima. Remarkably, both Valsa genomes are especially suited for pectin decomposition, but are limited in lignocellulose and cutin degradation. Besides many similarities, the two genomes show distinct variations in many secondary metabolism gene clusters.

Our results show a potential adaptation of Valsa canker pathogens to colonize woody bark. Secondary metabolism gene clusters are probably responsible for this host specificity.
Therapeutic interventions to disrupt the protein synthetic machinery in melanoma
Authors: Kardos Gregory R. , Robertson Gavin P. 
Published: July 2015

SummaryControl of the protein synthetic machinery is deregulated in many cancers, including melanoma, to increase the protein production. Tumor suppressors and oncogenes play key roles in protein synthesis from the transcription of rRNA and ribosome biogenesis to mRNA translation initiation and protein synthesis. Major signaling pathways are altered in melanoma to modulate the protein synthetic machinery, thereby promoting tumor development. However, despite the importance of this process in melanoma development, involvement of the protein synthetic machinery in this cancer type is an underdeveloped area of study. Here, we review the coupling of melanoma development to deregulation of the protein synthetic machinery. We examine existing knowledge regarding RNA polymerase I inhibition and mRNA translation focusing on their inhibition for therapeutic applications in melanoma. Furthermore, the contribution of amino acid biosynthesis and involvement of ribosomal proteins are also reviewed as future therapeutic strategies to target deregulated protein production in melanoma.
Characteristics of Stenotrophomonas maltophilia bacteremia in children
Authors: Furuichi Munehiro , Ito Kenta , Miyairi Isao 
Published: July 2015

AbstractBackgroundEmpiric antimicrobial coverage in compromised hosts commonly includes pseudomonal coverage but often lacks coverage against Stenotrophomonas maltophilia. Identification of risk factors specific for S. maltophilia infection may lead to prompt initiation of appropriate antibiotics and improved outcome.MethodsWe conducted a retrospective analysis of pediatric patients with bacteremia due to S. maltophilia or Pseudomonas aeruginosa from April 2002 to July 2014 at a tertiary children's hospital. Patient demographics, underlying disease, clinical course, and treatment were compared between S. maltophilia and P. aeruginosa cases.ResultsNineteen children with S. maltophilia bacteremia and 49 children with P. aeruginosa bacteremia were identified. On multivariate logistic regression analysis, use of carbapenems within 7 days prior to onset (OR, 5.00; 95%CI: 1.25–20.07; P = 0.02) and previous intensive care unit stay (OR, 3.75; 95%CI: 1.13–12.47; P = 0.03) were significantly associated with S. maltophilia bacteremia compared with P. aeruginosa bacteremia. The majority of the S. maltophilia bacteremia patients had central line‐associated bloodstream infection (79%), compared with the P. aeruginosa bacteremia patients (37%, P = 0.002). There were nine children (47%) who had polymicrobial infection in the S. maltophilia bacteremia group, in contrast to four (8%) in the P. aeruginosa bacteremia group (OR, 10.13; 95%CI: 2.59–39.56; P = 0.001). Consultation with an infectious diseases physician was associated with a lower rate of persistent S. maltophilia bacteremia (P = 0.04).ConclusionsStenotrophomonas maltophilia should be considered in breakthrough bacteremia in pediatric patients who receive carbapenems within 7 days prior to onset.