bluuebunny/crossref_metadata_2025_split huggingface dataset:
Social Media and Internet‐Based Data in Global Systems for Public Health Surveillance: A Systematic Review
Authors: VELASCO EDWARD , AGHENEZA TUMACHA , DENECKE KERSTIN , KIRCHNER GÖRAN , ECKMANNS TIM 
Published: March 2014

ContextThe exchange of health information on the Internet has been heralded as an opportunity to improve public health surveillance. In a field that has traditionally relied on an established system of mandatory and voluntary reporting of known infectious diseases by doctors and laboratories to governmental agencies, innovations in social media and so‐called user‐generated information could lead to faster recognition of cases of infectious disease. More direct access to such data could enable surveillance epidemiologists to detect potential public health threats such as rare, new diseases or early‐level warnings for epidemics. But how useful are data from social media and the Internet, and what is the potential to enhance surveillance? The challenges of using these emerging surveillance systems for infectious disease epidemiology, including the specific resources needed, technical requirements, and acceptability to public health practitioners and policymakers, have wide‐reaching implications for public health surveillance in the 21st century.MethodsThis article divides public health surveillance into indicator‐based surveillance and event‐based surveillance and provides an overview of each. We did an exhaustive review of published articles indexed in the databases PubMed, Scopus, and Scirus between 1990 and 2011 covering contemporary event‐based systems for infectious disease surveillance.FindingsOur literature review uncovered no event‐based surveillance systems currently used in national surveillance programs. While much has been done to develop event‐based surveillance, the existing systems have limitations. Accordingly, there is a need for further development of automated technologies that monitor health‐related information on the Internet, especially to handle large amounts of data and to prevent information overload. The dissemination to health authorities of new information about health events is not always efficient and could be improved. No comprehensive evaluations show whether event‐based surveillance systems have been integrated into actual epidemiological work during real‐time health events.ConclusionsThe acceptability of data from the Internet and social media as a regular part of public health surveillance programs varies and is related to a circular challenge: the willingness to integrate is rooted in a lack of effectiveness studies, yet such effectiveness can be proved only through a structured evaluation of integrated systems. Issues related to changing technical and social paradigms in both individual perceptions of and interactions with personal health data, as well as social media and other data from the Internet, must be further addressed before such information can be integrated into official surveillance systems.
How Might the Affordable Care Act's Coverage Expansion Provisions Influence Demand for Medical Care?
Authors: ABRAHAM JEAN MARIE 
Published: March 2014

ContextThe Affordable Care Act (ACA) is predicted to expand health insurance to 25 million individuals. Since insurance reduces the price of medical care, the quantity of services demanded by these newly covered individuals is expected to rise. In this article I provide a comprehensive picture of the demographics, health status, and medical care utilization of the population targeted for the ACA's expansion of coverage, contrasted with that of other nonelderly, insured populations. In addition, I synthesize the current evidence regarding the causal impact of insurance on medical care demand, drawing heavily on recent evidence from Massachusetts and Oregon.MethodsUsing the 2008 to 2010 Medical Expenditure Panel Survey, I conducted bivariate and multivariate analyses to examine differences between the ACA target population and other insured groups. I used the results from the descriptive analysis and quasi‐experimental literature to generate “back of the envelope” estimates of the potential impact of the coverage expansion on total medical care utilization by the noninstitutionalized US population.FindingsComparisons of the potential ACA target population with the privately and publicly insured reveal that the former is younger and more likely to be male. The ACA target population, and particularly the uninsured with incomes under 200% of the federal poverty line, reports lower rates of several medical conditions relative to those of the privately and publicly insured. Future changes in rates of inpatient hospitalization and ED use among the newly insured could vary widely, based on descriptive findings and inferences from the quasi‐experimental literature. Results also suggest moderate increases in ambulatory care. Total increases in overall demand for medical care by the newly insured comprise a modest proportion of the aggregate utilization.ConclusionsWith the expected increases in utilization resulting from the coverage expansion, stakeholders will need to monitor local health care delivery system capacity and respond where needed with policy‐ and/or market‐based innovations.
Trends in Health Care Financial Burdens, 2001 to 2009
Authors: BLUMBERG LINDA J. , WAIDMANN TIMOTHY A. , BLAVIN FREDRIC , ROTH JEREMY 
Published: March 2014

ContextOver the past decade, health care spending increased faster than GDP and income, and decreasing affordability is cited as contributing to personal bankruptcies and as a reason that some of the nonelderly population is uninsured. We examined the trends in health care affordability over the past decade, measuring the financial burdens associated with health insurance premiums and out‐of‐pocket costs and highlighting implications of the Affordable Care Act for the future financial burdens of particular populations.MethodsWe used cross sections of the Medical Expenditure Panel Survey Household Component (MEPS‐HC) from 2001 to 2009. We defined financial burden at the health insurance unit (HIU) level and calculated it as the ratio of expenditures on health care—employer‐sponsored insurance coverage (ESI) and private nongroup premiums and out‐of‐pocket payments—to modified adjusted gross income.FindingsThe median health care financial burden grew on average by 2.7% annually and by 21.9% over the period. Using a range of definitions, the fraction of households facing high financial burdens increased significantly. For example, the share of HIUs with health care expenses exceeding 10% of income increased from 35.9% to 44.8%, a 24.8% relative increase. The share of the population in HIUs with health care financial burdens between 2% and 10% fell, and the share with burdens between 10% and 44% rose.ConclusionsWe found a clear trend over the past decade toward an increasing share of household income devoted to health care. The ACA will affect health care spending for subgroups of the population differently. Several groups’ burdens will likely decrease, including those becoming eligible for Medicaid or subsidized private insurance and those with expensive medical conditions. Those newly obtaining coverage might increase their health spending relative to income, but they will gain access to care and the ability to spread their expenditures over time, both of which have demonstrable economic value.
Fast‐track surgery combined with laparoscopy could improve postoperative recovery of low‐risk rectal cancer patients: A randomized controlled clinical trial
Authors: Feng Fan , Li Xiao Hua , Shi Hai , Wu Guo Sheng , Zhang Hong Wei , Liu Xiao Nan , Zhao Qing Chuan 
Published: March 2014

ObjectiveIn this study we aimed to assess the feasibility and safety of fast‐track surgery (FTS) combined with laparoscopy for treating patients with rectal cancer and compare the results with those of the conventional perioperative intervention group.MethodsA total of 120 patients with rectal cancer were prospectively randomly assigned to the FTS combined with laparoscopy group and the conventional perioperative intervention plus laparoscopy group from November 2011 to November 2012. All patients received radical anterior resection with total mesorectal excision. Their baseline characteristics and the perioperative outcomes were recorded for analyses.ResultsCompared with the conventional perioperative intervention group, the fast‐track protocol combined with laparoscopy could shorten the time to the first flatus (53.44 ± 23.64 h vs 67.85 ± 20.12 h, P = 0.001) and first defecation (65.23 ± 22.24 h vs 86.98 ± 24.85 h, P = 0.000) after operation, accelerate the decrease of white blood cell count (P < 0.05), inhibit body temperature augmentation (P < 0.05) and reduce postoperative complication rate (16.9% vs 3.5%, P = 0.030). In addition, the length of postoperative stay was also shortened (5.05 ± 1.38 days vs 6.98 ± 2.26 days, P = 0.000). The medical cost of hospitalization was also reduced in the FTS group.ConclusionFTS in combination with laparoscopy may accelerate the clinical recovery of patients with rectal cancer after surgery.
Adjuvant systemic chemotherapy with or without bevacizumab in patients with resected pulmonary metastases from colorectal cancer
Authors: Turan Nedim , Benekli Mustafa , Dane Faysal , Unal Olcun Umit , Kara Hasan Volkan , Koca Dogan , Balvan Ozlem , Eren Tulay , Tastekin Didem , Helvaci Kaan , Berk Veli , Demirci Umut , Ozturk Selcuk Cemil , Dogan Erkan , Cetin Bulent , Kucukoner Mehmet , Tonyali Onder , Tufan Gulnihal , Oztop Ilhan , Gumus Mahmut , Coskun Ugur , Uner Aytug , Ozet Ahmet , Buyukberber Suleyman ,   for the Anatolian Society of Medical Oncology (ASMO)
Published: March 2014

AbstractIntroductionWe investigated the impact of modern chemotherapy regimens and bevacizumab following pulmonary metastasectomy (PM) from metastatic colorectal cancer (CRC).MethodsA total of 122 consecutive patients who were curatively resected for pulmonary metastases of CRC in twelve oncology centers were retrospectively analysed between January 2000 and April 2012.ResultsOf 122 patients, 14 did not receive any treatment following PM. The remaining 108 patients received fluoropyrimidine‐based (n = 12), irinotecan‐based (n = 56) and oxaliplatin‐based (n = 40) chemotherapy combinations. Among these, 52 patients received bevacizumab (BEV) while 56 did not (NoBEV). Median recurrence‐free survival (RFS) was 17 months and median overall survival (OS) has not been reached at a median follow‐up of 25 months after PM. Three and five‐year OS rates were 66% and 53%, respectively. RFS and OS were similar, irrespective of the chemotherapy regimen or BEV use. Positive pulmonary margin, KRAS mutation status, and previous liver metastasectomy were negative independent prognostic factors for RFS, while pathologically confirmed thoracic lymph node involvement was the only negative independent prognostic for OS in multivariate analysis.ConclusionsNo significant RFS or OS difference was observed in respect to chemotherapy regimens with or without BEV in patients with pulmonary metastases of CRC following curative resection.
Peroneal artery perforator‐based flaps for reconstruction of middle and lower third post‐traumatic defects of the leg
Authors: John Jerry R. , Tripathy Satyaswarup , Sharma Ramesh Kumar , Balan Jyoshid R. , Jadhav Chandan , Bhattacharya Saptarshi 
Published: March 2014

AbstractBackgroundGrade IIIb open tibial fractures require local or free flaps for cover of the fracture site. Perforator flap surgery is an innovative method for wound cover in this setting. The anatomy of perforating vessels of the peroneal artery is well described.MethodsAll patients who underwent peroneal artery perforator‐based flap cover for acute Grade IIIb fracture tibia between December 2011 and March 2013 were prospectively studied. The wounds were located either in middle or in lower third of the tibia. Flaps were performed under loupe magnification after identifying perforators preoperatively with handheld Doppler. All flaps were of a hockey stick or J design, incorporating the peroneal skin territory and completely islanded. Patients were followed up until all wounds were epithelialized.ResultsEleven patients were identified. Eleven flaps were performed, out of which 10 survived entirely and served the purpose of stable wound cover. One patient sustained partial flap necrosis, which was debrided, and another local flap was performed. More than one perforator could be identified and retained in six of these 11 patients.ConclusionThe peroneal artery perforator‐based flap is reliable and reproducible in an acute post‐traumatic setting. It should be considered as a suitable alternative for reconstruction for limited defects with exposed fractured tibia over the middle and lower third of the leg.
UniPR129 is a competitive small molecule Eph‐ephrin antagonist blocking in vitro angiogenesis at low micromolar concentrations
Authors: Hassan‐Mohamed I , Giorgio C , Incerti M , Russo S , Pala D , Pasquale E B , Zanotti I , Vicini P , Barocelli E , Rivara S , Mor M , Lodola A , Tognolini M 
Published: March 2014

Background and PurposeThe Eph receptor tyrosine kinases and their ephrin ligands are key players in tumorigenesis and many reports have correlated changes in their expression with a poor clinical prognosis in many solid tumours. Agents targeting the Eph‐ephrin system might emerge as new tools useful for the inhibition of different components of cancer progression. Even if different classes of small molecules targeting Eph‐ephrin interactions have been reported, their use is hampered by poor chemical stability and low potency. Stable and potent ligands are crucial to achieve robust pharmacological performance.Experimental ApproachUniPR129 (the L‐homo‐Trp conjugate of lithocholic acid) was designed by means of computational methods, synthetized and tested for its ability to inhibit the interaction between the EphA2 receptor and the ephrin‐A1 ligand in an elisa binding study. The ability of UniPR129 to disrupt EphA2‐ephrin‐A1 interaction was functionally evaluated in a prostate adenocarcinoma cell line and its anti‐angiogenic effect was tested in vitro using cultures of HUVECs.Key ResultsUniPR129 disrupted EphA2‐ephrin‐A1 interaction with Ki = 370 nM in an elisa binding assay and with low micromolar potency in cellular functional assays, including inhibition of EphA2 activation, inhibition of PC3 cell rounding and disruption of in vitro angiogenesis, without cytotoxic effects.Conclusions and ImplicationsThe discovery of UniPR129 represents not only a major advance in potency compared with the existing Eph‐ephrin antagonists but also an improvement in terms of cytotoxicity, making this molecule a useful pharmacological tool and a promising lead compound.
Beyond Stimulus Deprivation: Iron Deficiency and Cognitive Deficits in Postinstitutionalized Children
Authors: Doom Jenalee R. , Gunnar Megan R. , Georgieff Michael K. , Kroupina Maria G. , Frenn Kristin , Fuglestad Anita J. , Carlson Stephanie M. 
Published: March 2014

Children adopted from institutions have been studied as models of the impact of stimulus deprivation on cognitive development (Nelson, Bos, Gunnar, & Sonuga‐Barke, 2011), but these children may also suffer from micronutrient deficiencies (Fuglestad et al., 2008). The contributions of iron deficiency (ID) and duration of deprivation on cognitive functioning in children adopted from institutions between 17 and 36 months of age were examined. ID was assessed in 55 children soon after adoption, and cognitive functioning was evaluated 11–14.6 months postadoption when the children averaged 37.4 months old (SD = 4.9). ID at adoption and longer duration of institutional care independently predicted lower IQ scores and executive function (EF) performance. IQ did not mediate the association between ID and EF.
Heterogeneity of molecular sensitization profiles in grass pollen allergy – implications for immunotherapy?
Authors: Darsow U. , Brockow K. , Pfab F. , Jakob T. , Petersson C. J. , Borres M. P. , Ring J. , Behrendt H. , Huss‐Marp J. 
Published: March 2014

SummaryBackgroundData on molecular allergy diagnostics in adults with grass pollen allergy with regard to conjunctival and nasal provocation test outcome and specific immunotherapy are lacking to date.ObjectiveTo assess whether molecular allergy diagnostics for grass pollen allergens could help with predicting provocation test outcomes and serve as a basis for future component‐resolved specific immunotherapy.MethodsSera of 101 adults with grass pollen allergy was analysed for IgE against timothy grass pollen (Phleum pratense), rPhl p 1, rPhl p 2, nPhl p 4, rPhl p 5b, rPhl p 6, rPhl p 7, rPhl p 11 and rPhl p12 and correlated with the individuals' outcome in the nasal and conjunctival provocation tests and investigated in regard to a potential component‐resolved specific immunotherapy.ResultsAn increasing number of sensitizations to timothy grass allergens was correlated to a positive reaction in the conjunctival (4.9 vs. 3.6, P = 0.003) and nasal provocation tests (4.5 vs. 2.2, P = 0.0175). In molecular sensitization profiles, a substantial heterogeneity was detected, with none of the patients exactly matching the allergen composition of a previously published component‐resolved specific immunotherapy containing Phl p 1, Phl p 2, Phl p 5a/b and Phl p 6. The results indicate that in 95% of the patients, a proportion of 50% of timothy‐IgE would be targeted with such a specific immunotherapy, while in 50% and 10% of patients, 80% and 90% of timothy‐IgE would be targeted, respectively.Conclusion and Clinical RelevanceMolecular allergy diagnostics is a prerequisite for future component‐resolved specific immunotherapy due to the high heterogeneity of sensitization profiles. However, of current clinical relevance is the observed correlation between the number of sensitizations and provocation test outcome.
Effects of delayed hypothermia on time‐dependent microglial production of inflammatory and anti‐inflammatory factors
Authors: Matsui Tomohiro , Miyazaki Shun‐ichiro , Motoki Yukari 
Published: March 2014

AbstractObjectiveTherapeutic hypothermia protects neurons after severe brain damage. We have previously shown that immediate hypothermic culture reduces the temporal microglial production of inflammatory and anti‐inflammatory factors. To better understand the therapeutic time window of this therapy for reducing these potential neurotoxic factors, we investigated the effects of delayed hypothermia on the temporal production of tumor necrosis factor (TNF)‐α, interleukin (IL)‐1β, IL‐10 and nitric oxide (NO) by toll‐like receptor (TLR)‐activated microglia.MethodsRat microglia were activated by TLR2 or TLR4 agonists under normothermic (37°C) conditions (time zero). Subsequently, the cells were divided into normothermic or hypothermic (33°C) groups. The hypothermic group was subdivided into two groups with the induction of hypothermia that was started either 1 or 2 h after the activation of microglia. TNF‐α and IL‐1β, and IL‐10 and NO production in the culture supernatant were measured at 3–6 h and 24–48 h, respectively, after time zero.ResultsCompared with normothermia, 1‐h and 2‐h delayed hypothermia decreased TNF‐α and IL‐1β (after TLR2 activation) production at 3–6 h and 6 h, respectively. Both IL‐10 (after TLR2 activation) and NO (after TLR4 activation) production were decreased at 24–48 h by hypothermia that was started within 2 h.ConclusionsDelayed (1–2 h) hypothermic culture decreased the production of early‐phase TNF‐α and IL‐1β, and late‐phase IL‐10 and NO by TLR‐activated microglia, as has been observed with immediate hypothermic culture, suggesting that therapeutic hypothermia that is started within 1–2 h is sufficient to elicit neuroprotective effects by reducing microglial production of these factors.
Knowledge of sports participants about dental emergency procedures and the use of mouthguards
Authors: Sepet Elif , Aren Gamze , Dogan Onur Ozen , Pinar Erdem Arzu , Kuru Sinem , Tolgay Ceren Guney , Unal Sinasi 
Published: March 2014

AbstractAimThe aim of this study was to evaluate the knowledge of sports participants regarding emergency management of dental trauma and the awareness about mouthguards.MethodsA specific questionnaire regarding knowledge, experiences and behaviours after dental trauma and the use of mouthguard was distributed to 359 sports participants up to 18 years of age. The sports involved were basketball, swimming, volleyball, soccer, tennis, badminton, handball, athleticism, golf, gymnastics, water polo and karate. The questions were focused on personal experience, awareness of first aid and dental emergency procedures and knowledge about mouthguards.ResultsThe results showed that 10.9% had experienced a kind of dental trauma, and 12.5% would look for a dentist for treatment in emergency. 34.5% would re‐implant the avulsed tooth, 33.4% would maintain the avulsed tooth in handkerchief and 25.3% would maintain it in saline solution. 41.1% were aware of the possibility of oral injuries during sports practice, and 55.4% knew about mouthguards, but only 11.2% of the participants reported to use them. There was a statistically significant difference between the experienced participants (>5 years) and less‐experienced group (<5 years) in knowledge about dental emergency procedures and mouthguards. Reasons given for not wearing mouthguards include ‘lack of aesthetic’ was significantly high in experienced participants. The less‐experienced participants significantly stated that they had never heard about mouthguards before.ConclusionOur results showed a lack of knowledge of sports participants about management and prevention of traumatic dental injuries. Educational programs should be organized to give information about emergency treatment and promote the use of mouthguards to sport participants.
Collective Obligations: Their Existence, Their Explanatory Power, and Their Supervenience on the Obligations of Individuals
Authors: Wringe Bill 
Published: March 2014

AbstractIn this paper I discuss a number of different relationships between two kinds of (moral) obligation: those which have individuals as their subject, and those which have groups of individuals as their subject. I use the name collective obligations to refer to obligations of the second sort. I argue that there are collective obligations, in this sense; that such obligations can give rise to and explain obligations which fall on individuals; that because of these facts collective obligations are not simply reducible to individual obligations; and that collective obligations supervene on individual obligations, without being reducible to them. The sort of supervenience I have in mind here is what is sometimes called ‘global supervenience’. In other words, there cannot be two worlds which differ in respect of the collective obligations which exist in them without also differing in respect of the individual obligations which exist in them.
Hidden responses to environmental variation: maternal effects reveal species niche dimensions
Authors: Germain Rachel M. , Gilbert Benjamin 
Published: March 2014

AbstractSpecies responses to fluctuating environments structure population and community dynamics in variable ecosystems. Although offspring number is commonly used to measure these responses, maternal effects on offspring quality may be an important but largely unrecognised determinant of long‐term population growth. We selected 29 species across a Mediterranean annual plant phylogeny, and grew populations of each species in wet and dry conditions to determine responses in seed number and maternal effects (seed size, seed dormancy, and seedling growth). Maternal effects were evident in over 40% of species, but only 24% responded through seed number. Despite a strong trade‐off between seed size and seed number among species, there was no consistent trade‐off within species; we observed correlations that ranged from positive to negative. Overall, species in this plant guild show a complex range of responses to environmental variation that may be underestimated when only seed number responses are considered.