bluuebunny/crossref_metadata_2025_split huggingface dataset:
Microsimulation of Private Health Insurance and Medicaid Take‐Up Following the U.S. Supreme Court Decision Upholding the Affordable Care Act
Authors: Parente Stephen T. , Feldman Roger 
Published: February 2013

ObjectiveTo predict take‐up of private health insurance and Medicaid following the U.S. Supreme Court decision upholding the Affordable Care Act (ACA).Data SourcesData came from three large employers and a sampling of premiums from ehealthinsurance.com. We supplemented the employer data with information on state Medicaid eligibility and costs from the Kaiser Family Foundation. National predictions were based on the MEPS Household Component.Study DesignWe estimated a conditional logit model of health plan choice in the large group market. Using the coefficients from the choice model, we predicted take‐up in the group and individual health insurance markets. Following ACA implementation, we added choices to the individual market corresponding to plans that will be available in state and federal exchanges. Depending on eligibility for premium subsidies, we reduced the out‐of‐pocket premiums for those choices. We simulated several possible patterns for states opting out of the Medicaid expansion, as allowed by the Supreme Court.Principal FindingsThe ACA will increase coverage substantially in the private insurance market and Medicaid. HSAs will remain desirable in both the individual and employer markets.ConclusionsIf states opt out of the Medicaid expansion, this could increase the federal cost of health reform, while reducing the number of newly covered lives.
Tax Subsidies for Employer‐Sponsored Health Insurance: Updated Microsimulation Estimates and Sensitivity to Alternative Incidence Assumptions
Authors: Miller G. Edward , Selden Thomas M. 
Published: February 2013

ObjectiveTo estimate 2012 tax expenditures for employer‐sponsored insurance (ESI) in the United States and to explore the sensitivity of estimates to assumptions regarding the incidence of employer premium contributions.Data SourcesNationally representative Medical Expenditure Panel Survey data from the 2005–2007 Household Component (MEPS‐HC) and the 2009–2010 Insurance Component (MEPS IC).Study DesignWe use MEPS HC workers to construct synthetic workforces for MEPS IC establishments, applying the workers' marginal tax rates to the establishments' insurance premiums to compute the tax subsidy, in aggregate and by establishment characteristics. Simulation enables us to examine the sensitivity of ESI tax subsidy estimates to a range of scenarios for the within‐firm incidence of employer premium contributions when workers have heterogeneous health risks and make heterogeneous plan choices.Principal FindingsWe simulate the total ESI tax subsidy for all active, civilian U.S. workers to be $257.4 billion in 2012. In the private sector, the subsidy disproportionately flows to workers in large establishments and establishments with predominantly high wage or full‐time workforces. The estimates are remarkably robust to alternative incidence assumptions.ConclusionsThe aggregate value of the ESI tax subsidy and its distribution across firms can be reliably estimated using simplified incidence assumptions.
Different paths to sexual size dimorphism in two praying mantids, Pseudomantis albofimbriata and Hierodula majuscula
Authors: Allen Louise E. , Barry Katherine L. , Holwell Gregory I. 
Published: February 2013

AbstractSexual size dimorphism (SSD) is widespread among diverse animal taxa and has attracted the attention of evolutionary biologists for over a century. SSD is likely to be adaptive and the result of divergent selection on different size optima for males and females, given their different roles in reproduction. The developmental trajectory leading to SSD may help us to understand how selection acts on male and female size. Here, we describe the growth and development of two Australian praying mantids, Pseudomantis albofimbriata and Hierodula majuscula including the number of moults, time to adulthood, size at each moult, and the degree of SSD. While both species exhibit the common pattern of female‐biased SSD, the number of moults required for individuals to reach adulthood differed between males and females and between species. Despite their larger adult size, P. albofimbriata females require fewer moults and less time than males to reach adulthood, but are significantly larger than males from the second instar onwards. In contrast, H. majuscula males reached adulthood in fewer moults, and less time than females, however males and females did not differ in size until females went through their final moult into adulthood. H. majuscula also required more time and more moults to reach adulthood than P. albofimbriata. We discuss these different developmental pathways in light of the existing knowledge of reproductive biology for each species. We also suggest that these differences may relate to the different phenologies that occur in strongly seasonal temperate environments compared with those in the tropics. This study provides evidence that SSD can result from two different patterns of growth and development in closely related species.
Development of SNP markers identifying European wildcats, domestic cats, and their admixed progeny
Authors: Nussberger B. , Greminger M. P. , Grossen C. , Keller L. F. , Wandeler P. 
Published: February 2013

AbstractIntrogression can be an important evolutionary force but it can also lead to species extinction and as such is a crucial issue for species conservation. However, introgression is difficult to detect, morphologically as well as genetically. Hybridization with domestic cats (Felis silvestris catus) is a major concern for the conservation of European wildcats (Felis s. silvestris). The available morphologic and genetic markers for the two Felis subspecies are not sufficient to reliably detect hybrids beyond first generation. Here we present a single nucleotide polymorphism (SNP) based approach that allows the identification of introgressed individuals. Using high‐throughput sequencing of reduced representation libraries we developed a diagnostic marker set containing 48 SNPs (Fst > 0.8) which allows the identification of wildcats, domestic cats, their hybrids and backcrosses. This allows assessing introgression rate in natural wildcat populations and is key for a better understanding of hybridization processes.
Defective immunoglobulin A (IgA) glycosylation and IgA deposits in patients with IgA nephropathy
Authors: Kolka Ragnhildur , Valdimarsson Helgi , Bodvarsson Magnus , Hardarson Sverrir , Jonsson Thorbjorn 
Published: February 2013

Defective glycosylation and immune complex (IC) formation may be of primary importance in immunoglobulin A nephropathy (IgAN) pathogenesis. The aim of this study was to determine whether defective IgA1 glycosylation might support renal deposition of IgA and disease activity. IgA was isolated from the serum of 44 IgAN patients and 46 controls and glycosylation analysed by ELISA using glycan‐specific lectins. IgA was measured by immunodiffusion and immune complexes by ELISA. IgA subclasses in IC deposits in kidney glomeruli were identified by immunohistochemical methods. A significant increase in N‐acetylgalactosamine (GalNAc) in terminal position (p = 0.02) observed in some of the IgAN patients, became more pronounced when sialic acid was removed from IgA1, indicating enhanced expression of α‐2,6‐sialyltransferase in patients compared with controls (p < 0.0001). Patients with defective galactosylation had lower serum IgA than other IgAN patients (p = 0.003). IgAN patients with both IgA1 and IgA2 glomerular deposits (21.7%) had increased GalNAc in terminal position (p = 0.003). Taken together, our results show that increased IgA glycosylation in IgAN associates with low levels of IgA, concomitant IgA1 and IgA2 glomerular deposits and poor clinical outcome.
Happiness, subjective and objective oral health status, and oral health behaviors among Korean elders
Authors: Yoon Hyun‐Seo , Kim Hae‐Young , Patton Lauren L. , Chun Jin‐Ho , Bae Kwang‐Hak , Lee Mi‐Ok 
Published: February 2013

AbstractObjectivesThis study aims to comprehensively assess the association of subjective and objective oral health status and oral health behaviors with happiness, under consideration of demographic, socioeconomic, and general health‐related factors. This study also aims to test whether subjective oral health outcomes are better predictors of happiness compared with objective oral health outcomes.MethodsThe data were collected from 479 community‐dwelling elders aged 65 years or over selected by a cluster sampling method. A questionnaire and an oral examination were implemented. A multiple regression method was conducted to assess associations with happiness index (HI).ResultsThe mean age of the elders was 74.6 years. Mean (standard deviation, SD) HI, EuroQol‐visual analog scale (EQ‐VAS) and 14‐item oral health impact profile (OHIP‐14) index were 5.7 (SD 2.3), 59.8 (SD 21.1), and 16.3 (SD 13.1). In the final model, a significant association with HI of the OHIP‐14 index (P = 0.091) among all the participants and significant associations of oral symptoms (P = 0.038), wearing a removable denture (P = 0.039), and of the oral health behavior of daily toothbrushing (P = 0.007) among poorer oral health QoL group were confirmed under consideration of other related factors. While correlations of HI to subjective measures of health, EQ‐VAS and OHIP‐14 score were moderate to weak, those to objective measures of health were only weak or insignificant.ConclusionsOral impacts which might persistently affect one's daily life need to be considered in designing and delivering public services aimed to promote people's happiness. With oral health impacts and behaviors accounting for 10% of happiness among elders, public and community services for the elderly that support oral health and daily toothbrushing for the dentate are critical for the well‐being of our elders.
Atopy phenotypes in the Childhood Asthma Prevention Study (CAPS) cohort and the relationship with allergic disease
Authors: Garden F. L. , Simpson J. M. , Marks G. B. ,   for the CAPS Investigators
Published: February 2013

SummaryBackgroundAtopy in early life is heterogeneous in timing of onset, remission and persistence and in the nature of specific sensitization to allergens. However, this heterogeneity is not well characterized.ObjectiveOur aim was to define longitudinal phenotypes of atopy between ages 1.5 and 8 years, and to assess the relationship of the atopy phenotypes to the risk of asthma, eczema and rhinitis at 8 years of age.MethodsWe used latent class analysis (LCA) to define atopy phenotypes using data from skin prick tests that were performed at 1.5, 3, 5 and 8 years in participants in the Childhood Asthma Prevention Study (CAPS).ResultsFour phenotypes were defined: late mixed inhalant sensitization; mixed food and inhalant sensitization; house dust mite (HDM) monosensitized; and no atopy. All three atopic phenotypes were associated with asthma, eczema and rhinitis, but the strongest association, particularly for asthma, was with the mixed food and inhalant sensitization phenotype.Conclusion & clinical relevanceWe have used a LCA model to define atopy phenotypes empirically. The finding of a strong association between the mixed food and inhalant sensitization class and the presence of asthma and poor asthma control at age 8 years implies that food sensitization in early life may be of greater significance for subsequent risk of asthma than previously thought.
Anal mucosectomy for haemorrhoids: should we start to speak Chinese?
Authors: Dindo D. , Hahnloser D. 
Published: February 2013

AbstractAimCircular stapled mucosectomy is the standard therapy for the treatment of symptomatic third‐degree haemorrhoids and mucosal prolapse. Recently, new staplers made in China have entered the market offering an alternative to the PPH stapling devices. The aim of this prospective randomized study was to compare the safety and efficacy of these new devices.MethodsFifty patients with symptomatic third‐degree haemorrhoids were randomized to mucosectomy either by using stapler A (CPH32; Frankenman International Ltd, Hong Kong, China; n = 25) or stapler B (PPH03; Ethicon Endo‐Surgery, Spreitenbach, Switzerland; n = 25). All procedures were performed by two experienced surgeons. After the stapler was fired by one surgeon, the other surgeon, who was blinded for stapler type, evaluated the stapler line. Postoperative outcome including pain, complications and patient satisfaction were analysed.ResultsDemographic and clinical features were no different between the groups. There was no significant difference regarding venous bleeding (P = 0.55), but arterial bleeding was significantly more frequent when stapler B was used (P < 0.001). This led to significantly more suture ligations (P = 0.002). However, no differences regarding operation time (P = 0.99), weight of the resected mucosa (P = 0.81) and height of the stapler line (anterior, P = 0.18; posterior, P = 0.65) were detected. Postoperative pain scores (visual analogue scale) and patient satisfaction were no different either (P = 0.91 and P = 0.78, respectively). No recurrence or incontinence occurred during follow‐up.ConclusionsCPH32 required significantly fewer sutures for bleeding control along the stapler line after circular mucosectomy. However, operation time, rate of postoperative complications and patient satisfaction were similar in both groups.
Prevalence and predictive factors of the need for surgery for advanced colorectal adenoma
Authors: Desgrippes R. , Beauchamp C. , Henno S. , Bouguen G. , Siproudhis L. , Bretagne J.‐F. 
Published: February 2013

AbstractAimEndoscopic resection is the primary treatment for colorectal adenoma, but in some cases surgery is necessary. The aim of this retrospective study was to define the prevalence and predictive factors for surgery in patients with advanced colorectal adenoma managed in a referral endoscopy centre.MethodConsecutive patients diagnosed with advanced adenoma (Class 4 in the Vienna classification) during a colonoscopy from 2007 to 2009 in the endoscopy centre of the University Hospital of Rennes were included. Predictive factors of surgery were determined by univariate and multivariate analysis.ResultsTwo‐hundred and twelve (135 male) patients with a mean age of 65.8 years were included. The reason for colonoscopy was for diagnosis in 63.2%, surveillance in 25.5% and screening in 11.3%. These referred patients amounted to 20.8% of all patients having colonoscopy. Surgery was performed in 13.7% of the 212 patients and in 16 (8.3%) of the 192 patients in whom endoscopic removal was attempted. In the subgroup of 192 patients, univariate analysis revealed that body mass index (P = 0.04), histology (P = 0.002), size (P = 0.03) and macroscopic appearance (P < 0.001) of the polyp were associated with surgery. Multivariate analysis revealed that the macroscopic appearance and histology only were significantly associated with surgery.ConclusionSurgery was needed in 13.7% of patients with an advanced adenoma, but in only 8.3% of the subgroup of 192 patients in whom endoscopic removal was attempted. Factors associated with surgery included macroscopic appearance and histology.
Disseminated tumour cells in bone marrow in experimental colon cancer: metastatic or resident?
Authors: Barone M. , Altomare D. F. , Rotelli M. T. , Scavo M. P. , Piscitelli D. , De Tullio N. , Bocale D. , Di Leo A. 
Published: February 2013

AbstractAimThere are conflicting data on the biological and prognostic significance of disseminated tumour cells (DTCs) in the bone marrow of colorectal cancer patients since bone metastasis is rare in this disease. The study aimed to determine the origin of bone marrow DTCs using human colorectal cancer cells in in vivo and in vitro experimental settings.MethodCD1 nude female mice were xenotransplanted with SW620 cells (a colorectal cancer cell line isolated from a male patient) injected in the colon wall. At autopsy, the presence of SW620 in the bone marrow (BM), colon and other organs/tissues was recognized by detection of the epithelial marker cytokeratin‐19 (CK19) and Y chromosome. In addition SW620 cells or their conditioned medium were cultured with human BM cells.ResultsMacroscopically evident CK19+/Y‐chromosome‐positive tumours developed only in five mice receiving SW620 cells while putative DTCs (CK19+) were found in the bone marrow of all treated mice. Most of these CK19+ cells were Y chromosome negative, only few being Y chromosome positive. In vitro SW620 cells or their conditioned medium induced CK19 expression in cultured human bone marrow cells.ConclusionExperimental colorectal cancer can induce the appearance of two distinct CK19+ cell populations in the bone marrow, one of metastatic origin and the other of murine origin. These findings suggest that bone marrow cells may undergo phenotypic modifications induced by cancer cells.
Laparoscopic treatment of advanced colonic cancer: a case‐matched control with open surgery
Authors: Vignali A. , Ghirardelli L. , Di Palo S. , Orsenigo E. , Staudacher C. 
Published: February 2013

AbstractAimThe safety, feasibility and oncological results of laparoscopic resection for advanced colon cancer were evaluated.MethodSeventy consecutive patients with a histologically proven T4 colon cancer who underwent laparoscopic (LPS) right or left colectomy were matched for comorbidity on admission (American Society of Anesthesiologists score), tumour stage and grading with 70 patients who underwent open colectomy over a 10‐year period. Short‐ and long‐term outcome measures were evaluated.ResultsThe overall conversion rate was 7.1%. Less intra‐operative blood loss (P = 0.01), a trend toward a longer operation time (P = 0.09) and a lower peri‐operative blood transfusion rate (P = 0.06) were observed in the LPS group. A similar number of lymph nodes were retrieved (P = 0.37) and the R1 resection rate (P = 0.51) was no different in the two groups. The overall mortality rate was 1.4%. The overall morbidity rate was 21.4% (15/70 patients) in the LPS group and 27.5% (19/70 patients) in the open group (P = 0.42), with anastomotic leakage rates of 7.1% and 4.2% (P = 0.32). Length of stay was shorter after LPS (P = 0.009). Five‐year overall survival rate (P = 0.18) and disease‐free survival rate (P = 0.20) did not differ significantly between the two groups.ConclusionLaparoscopic treatment of T4 colon cancer is safe and feasible and provides a similar surgical and oncological outcome compared with the open technique.
Assessing the Need for a Research Ethics Remediation Program
Authors: DuBois James M. , Anderson Emily E. , Chibnall John 
Published: February 2013

AbstractWith supplement funding to the Washington University CTSA, the Restoring Professionalism and Integrity in Research (RePAIR) program was developed at Saint Louis University to meet the remediation needs of institutions nationwide regarding investigators who violate research regulations. With the aim of determining the frequency and kinds of wrongdoing at leading research institutions in the United States, as well as institutional responses and levels of interest in a formal remediation program, an online questionnaire was distributed by email to a research integrity officer (RIO) and institutional review board (IRB) chair at all medical schools and comprehensive doctoral institutions in the United States (N = 194). One hundred sixty‐one individuals responded (44%) representing 66% of institutions. For those institutions that had both RIOs and IRB chairs responding, 96% had investigated at least one case over the past 2 years; the modal individual response was 3–5 cases, with a range from 0 to more than 16 cases. The most common forms of wrongdoing were violations of procedure, informed consent, research integrity (fabrication, falsification, plagiarism), privacy, and conflict of interest policies. Most RIOs and IRB chairs expressed interest in the RePAIR program, despite concerns about costs and faculty resistance.
Mechanisms of acute exacerbation of respiratory symptoms in chronic obstructive pulmonary disease
Authors: Roca Mihai , Verduri Alessia , Corbetta Lorenzo , Clini Enrico , Fabbri Leonardo M. , Beghé Bianca 
Published: February 2013

AbstractExacerbations of chronic obstructive respiratory disease (ECOPD) are acute events characterized by worsening of the patient's respiratory symptoms, particularly dyspnoea, leading to change in medical treatment and/or hospitalisation. AECOP are considered respiratory diseases, with reference to the respiratory nature of symptoms and to the involvement of airways and lung. Indeed respiratory infections and/or air pollution are the main causes of ECOPD. They cause an acute inflammation of the airways and the lung on top of the chronic inflammation that is associated with COPD. This acute inflammation is responsible of the development of acute respiratory symptoms (in these cases the term ECOPD is appropriate). However, the acute inflammation caused by infections/pollutants is almost associated with systemic inflammation, that may cause acute respiratory symptoms through decompensation of concomitant chronic diseases (eg acute heart failure, thromboembolism, etc) almost invariably associated with COPD. Most concomitant chronic diseases share with COPD not only the underlying chronic inflammation of the target organs (i.e. lungs, myocardium, vessels, adipose tissue), but also clinical manifestations like fatigue and dyspnoea. For this reason, in patients with multi‐morbidity (eg COPD with chronic heart failure and hypertension, etc), the exacerbation of respiratory symptoms may be particularly difficult to investigate, as it may be caused by exacerbation of COPD and/or ≥ comorbidity, (e.g. decompensated heart failure, arrhythmias, thromboembolisms) without necessarily involving the airways and lung. In these cases the term ECOPD is inappropriate and misleading.
Myasthenia gravis – treatment of acute severe exacerbations in the intensive care unit results in a favourable long‐term prognosis
Authors: Spillane J. , Hirsch N. P. , Kullmann D. M. , Taylor C. , Howard R. S. 
Published: February 2013

Background and purposeAcute severe exacerbations of myasthenia gravis (MG) are common in both early and late onset MG. We wished to examine the current management in the intensive care unit (ICU) of severe exacerbations of MG and to study the long‐term prognosis of MG following discharge from the ICU.MethodsWe retrospectively reviewed the medical records of all patients admitted to a specialist neuro‐ICU with acute exacerbations of MG over a 12‐year period.ResultsWe identified 38 patients. Over 60% were over the age of 50 years, and MG was newly diagnosed in over 40%. Intubation was required in 63%, and over 90% of patients were treated with prednisolone and/or intravenous immunoglobulin. Four patients died in hospital. The remainder of patients were followed up for a mean of 4 years, and the majority were either asymptomatic or had mild symptoms of MG at clinical review.ConclusionsDespite the significant morbidity and mortality associated with severe exacerbations of MG, specialized neurointensive care can result in a good long‐term prognosis in both early‐ and late‐onset MG.