bluuebunny/crossref_metadata_2025_split huggingface dataset:
Military Health Care Utilization by Teens and Young Adults
Authors: Blankson Major Kwabena L. , Roberts Commander Timothy A. 
Published: March 2014

OBJECTIVES:
Adolescents and young adults are frequently uninsured (9.0% and 26.4%). Under the Affordable Care Act, the impact of insuring this population on health care utilization is unclear. We examined insurance records from &gt;3.5 million non-pregnancy-related primary care visits in the Military Health System to describe health care utilization patterns among 467 099 non–active duty patients, aged 12 to 22, with access to free health care.

METHODS:
We described association of age and gender with primary care utilization rates, clinic type, and primary and secondary diagnoses.

RESULTS:
Adolescents and young adults were seen for 2.63 primary care visits per year. Use of Pediatric Clinics declined with age (51.6% to 1.8%) and increased for Family Medicine (45.5% to 91.1%). The top 3 diagnostic groups in our study were health maintenance (18.3%), health evaluation (17.3%), and respiratory/ear, nose, and throat (15.1%). Age-by-gender interactions had a significant association with health care utilization rates and diagnoses at primary care appointments. For example, the percent of all appointments accounted for by musculoskeletal injuries increased significantly (P &lt; .001) with age for males (10.6%, 12–14 years; 12.8%, 15–18 years; 15.2%, 19–22 years) and decreased for females (10.3%, 9.2%, 7.5%).

CONCLUSIONS:
Unlike previous studies of adolescents and young adults, we show that this population, especially female young adults, does use health care when it is available and largely free. Extrapolating from our Military Health System data, we expect implementation of the Affordable Care Act will result in an increased demand for health care, particularly in the areas of reproductive health care, respiratory/ear, nose, and throat issues, and routine health maintenance.
Association Between Riding With an Impaired Driver and Driving While Impaired
Authors: Li Kaigang , Simons-Morton Bruce G. , Vaca Federico E. , Hingson Ralph 
Published: March 2014

OBJECTIVE:
To examine the association between driving while alcohol/drug impaired (DWI) and the timing and amount of exposure to others’ alcohol/drug-impaired driving (riding while impaired [RWI]) and driving licensure timing among teenage drivers.

METHODS:
The data were from waves 1, 2, and 3 (W1, W2, and W3, respectively) of the NEXT Generation Study, with longitudinal assessment of a nationally representative sample of 10th graders starting in 2009–2010. Multivariate logistic regression was used for the analyses.

RESULTS:
Teenagers exposed to RWI at W1 (adjusted odds ratio [AOR] = 21.12, P &lt; .001), W2 (AOR = 19.97, P &lt; .001), and W3 (AOR = 30.52, P &lt; .001) were substantially more likely to DWI compared with those reporting never RWI. Those who reported RWI at 1 wave (AOR = 10.89, P &lt; .001), 2 waves (AOR = 34.34, P &lt; .001), and all 3 waves (AOR = 127.43, P &lt; .001) were more likely to DWI compared with those who never RWI. Teenagers who reported driving licensure at W1 were more likely to DWI compared with those who were licensed at W3 (AOR = 1.83, P &lt; .05).

CONCLUSIONS:
The experience of riding in a vehicle with an impaired driver increased the likelihood of future DWI among teenagers after licensure. There was a strong, positive dose-response association between RWI and DWI. Early licensure was an independent risk factor for DWI. The findings suggest that RWI and early licensure could be important prevention targets.
Uterotonic Use at Childbirth in Ghana: A Qualitative Study of Practices, Perceptions, and Knowledge Among Facility-Based Health Care Providers and Community Members
Authors: Koski Alissa D. , Mirzabagi Ellie , Cofie Patience , Tripathi Vandana 
Published: March 2014

PURPOSE: Uterotonic drugs, administered immediately after delivery, can prevent postpartum hemorrhage (PPH). As programs expand uterotonic access in settings of high maternal mortality, it is important to understand why and how these drugs are currently used. This qualitative study aimed to describe Ghanaian health care providers’ and community members’ knowledge, perceptions, and practices of uterotonic usage at or near labor and delivery.METHODS: In-depth interviews were conducted in 3 districts with 185 physicians, medical assistants, midwives, nurses, new mothers, mothers aged 50 years and older, traditional birth attendants, and chemists.FINDINGS: Providers described using misoprostol most commonly for labor induction, oxytocin for labor augmentation and PPH prevention, and ergometrine for PPH treatment. Unsafe practices and knowledge gaps were identified regarding labor augmentation and uterotonic storage. Community members reported experience with uterotonics in facility deliveries. Community-based use of pharmaceutical uterotonics was rarely reported, except misoprostol for pregnancy termination; however, community members described use of herbal medicines for intended uterotonic effect. Across respondent categories, uterotonics were more commonly associated with accelerating delivery than PPH prevention.CONCLUSION: Programs promoting facility childbirth and/or uterotonic coverage at home births should consider these underlying patterns of use and encourage safe practices through provider and community engagement.
A Schizophrenia-Like Psychotic Disorder Secondary to an Arachnoid Cyst
Remitted with Neurosurgical Treatment of the Cyst
Authors: Baquero G.A. , Molero P. , Pla J. , Ortuño F. 
Published: March 2014

We describe a case of delusional psychosis that was terminated by neurosurgical removal of a large arachnoid
cyst. The patient was suffering his first psychotic episode and had symptoms typical of schizophrenia.
The case underscores the importance of considering that an arachnoid cyst can induce psychopathological symptoms,
even those of schizophrenia. Indeed, such symptoms may be the cyst's only clinical manifestation.
In addition, the case highlights the importance of doing a structural imaging test when confronted with a first episode of
psychosis, especially if the episode is relatively late in appearance. Such imaging may lead to a diagnosis that in turn can
enable a definitive neurosurgical resolution of the psychosis.
A Self-Guided Relaxation Module for Telepsychiatric Services: Development, Usefulness, and Feasibility
Authors: Malhotra Savita , Chakrabarti Subho , Gupta Aarzoo , Mehta Anurati , Shah Ruchita , Kumar Vineet , Sharma Minali 
Published: March 2014

Objective: A modified form of the standard autogenic relaxation exercise was developed as part of a telepsychiatry project, which aims to deliver mental healthcare to remote areas through the net, and through the agency of non-specialists. This study describes the development and evaluation of a brief and simpler form of a relaxation technique, the Self-Guided Relaxation (SGR). Method: SGR is a systematic technique to focus on muscle groups and feel the heaviness and relaxation through suggestions to induce relaxation in the body. The SGR was taught to 37 patients with different psychiatric disorders over two sessions a week apart. Measures of change used were scores on the Hamilton Anxiety Rating Scale (HAM-A) and a visual analog scale. Its usefulness and feasibility was examined over a follow-up period of one month. Additionally a group of non-specialists was trained in SGR supplemented by audiovisual aids and printed instructions. These therapists rated the ease in learning and administering SGR in patients. Results: There was a consistent reduction in the HAM-A scores over the follow-up period among patients. Improvements were also noted in positive experiences, adherence, depth of relaxation achieved, perceived benefit, and patient satisfaction. Majority of the patients, relatives, and therapists reported that they could administer or practice SGR after having learned the technique in a single session lasting about 30 minutes. The use of audio-video aids and manual was helpful in making the process of learning easy. Conclusions: Preliminary findings of usefulness, feasibility, and acceptance of the SGR were encouraging. These findings pave way for larger, randomized controlled study and for testing applicability of the SGR as a net-based psychological intervention.
Does Dividend Policy Drive Earnings Smoothing?
Authors: Liu Nan , Espahbodi Reza 
Published: March 2014

SYNOPSIS
This paper examines the earnings-smoothing behavior of dividend-paying firms. We show that dividend-paying firms engage in more earnings smoothing than non-payers through both real activities and accrual choices. More specifically, dividend-paying firms with positive (negative) pre-managed earnings changes engage in more downward (upward) earnings management than non-payers. Additional tests suggest that the results are driven by dividend-related incentives and not the differences in the economic characteristics of dividend-paying firms, are robust to alternative measures of earnings management, and are not due to spurious correlation. We also show that earnings smoothing, in part, explains the higher earnings persistence of dividend-paying firms. These findings are consistent with a firm's dividend policy having an incremental impact on earnings-smoothing behavior.
JEL Classifications: M41; G35
Avoid Losing a Daubert Challenge: Some Best Practices for Expert Witnesses
Authors: Crumbley D. Larry , Cheng Christine C. 
Published: March 2014

ABSTRACT
Accounting experts, like other experts hired for litigation cases, are subject to Daubert challenges. While the use of Daubert challenges was primarily in jury trials, a recent U.S. Tax Court case, Boltar LLC v. Commissioner, used the Daubert standards to discredit an “absurd” appraisal. To avoid the potential detrimental reputational and potential financial consequences and adverse effects on the clients, accounting experts must be aware of Daubert challenges and the standards by which their testimony will be judged. In this article, we discuss the Daubert challenge and the standards by which a judge will evaluate an expert's testimony in considering the admissibility of, or weight placed on, the expert's testimony. We also discuss some best practices and discuss the potential growing application of Daubert challenges in bench trials, as well as the potential that similar challenges may exist outside of the U.S. jurisdictions.
Cultivating conditions optimization of the anaerobic digestion of corn ethanol distillery residuals using response surface methodology
Authors: Gyenge László , Ráduly Botond , Crognale Silvia , Lányi Szabolcs , Ábrahám Beáta 
Published: March 2014

Abstract
This study investigated the individual and interactive effects of three factors — temperature, inoculum/substrate ratio (ISR) and inoculum typology — on the anaerobic digestion of corn ethanol distillery wastewater. Biochemical methane potential assays planned with factorial design with two independent quantitative variables on three levels (ISR: 1:1, 2:1 and 3:1; temperature: 30°C, 33.5°C, 37°C) and one independent qualitative variable (inoculum type: suspended, granular, mixed) have been performed. Response Surface Methodology has been used to study the effect of the factors with the aim of maximizing the specific methane yields (YCH4) obtainable with this substrate. The results show that all three investigated factors influence in a significant matter the YCH4, the ISR having the strongest effect on it. The temperature has significant influence on the YCH4 only in combination with high ISR values. The optimal conditions for the maximum YCH4 (551 mL CH4 g−1 VSadded) have been found at 37°C operating temperature, ISR=3:1 and using granular inoculum. These conditions gave rise to a 4-fold increase of YCH4 with respect to the worst combination of factors (YCH4=129 mL g−1 VSadded for the suspended inoculum type, at 30°C and ISR=1:1). The results improve the knowledge on the digestion of this substrate, providing information for successful process up-scaling.
Microwave plasma assisted pyrolysis of refuse derived fuels
Authors: Khongkrapan Parin , Thanompongchart Patipat , Tippayawong Nakorn , Kiatsiriroat Tanongkiat 
Published: March 2014

Abstract
This work combined plasma reactivity and pyrolysis for conversion of solid wastes. Decomposition of refuse derived fuel (RDF) and its combustible components (paper, biomass, and plastic) in an 800 W microwave plasma reactor was investigated at varying argon flow rates of 0.50 to 1.25 lpm for 3 minutes. The characteristic bright light emission of plasma was observed with calculated maximum power density of about 35 W/cm3. The RDF and its components were successfully converted into char and combustible gas. The average char yield was found to be 12–21% of the original mass, with a gross calorific value of around 39 MJ/kg. The yield of the product gas was in the range 1.0–1.7 m3/kg. The combustible gas generated from the pyrolysis of the RDF contained about 14% H2, 66% CO, and 4% CH4 of the detected gas mass, with a heating value of 11 MJ/m3. These products are potentially marketable forms of clean energy.
Optimization of gas injection conditions during deposition of AlN layers by novel reactive GIMS method
Authors: Zdunek Krzysztof , Nowakowska-Langier Katarzyna , Chodun Rafal , Dora Jerzy , Okrasa Sebastian , Talik Ewa 
Published: March 2014

Abstract
In 2011, we proposed a novel magnetron sputtering method. It involved the use of pulsed injection of working gas for the initiation and control of gas discharge during reactive sputtering of an AlN layer (Gas Injection Magnetron Sputtering — GIMS). Unfortunately, the presence of Al-Al bonds was found in XPS spectra of the AlN layers deposited by GIMS onto Si substrate. Our studies reported in this paper proved that the synchronization of time duration of the pulses of both gas injection and applied voltage, resulted in the elimination of Al-Al bonds in the AlN layer material, which was confirmed by the XPS studies. In our opinion the most probable reason of Al-Al bonds in the AlN layers deposited by the GIMS was the self-sputtering of the Al target in the final stage of the pulsed discharge.
Efficacy and Safety of Sublingual Immunotherapy in Children Aged 3–13 Years with Allergic Rhinitis
Authors: Shao Jie , Cui Yu-xia , Zheng Yu-fei , Peng Han-fen , Zheng Zhu-li , Chen Jing-ya , Li Qin , Cao Lan-fang 
Published: March 2014

Background Sublingual immunotherapy (SLIT) is recommended for allergic diseases. However, clinical studies containing evidence-based data of this treatment in young children, which is rarely reported in the literature, are needed. This study was designed to assess the efficacy and safety of SLIT in children, including very young children. Methods Two hundred sixty-four children aged 3–13 years old (133 children, 3–5 years old) with Dermatophagoides farinae–induced allergic rhinitis with or without asthma treated by standard pharmacotherapy had randomly received either SLIT (SLIT group) or no SLIT (control group) for 12 months. Symptoms, medications, visual analog scale (VAS) and presence of adverse events (AEs) were assessed at monthly visits. Skin-prick test and Dermatophagoides farinae–specific IgE and IgG4 were measured before and after treatment. Results Both treatments were effective in the global clinical scores during the first seven visits when compared with baseline (all, p < 0.01), and SLIT showed lower symptoms scores and VAS scores throughout this period (all, p < 0.01). These improvements continued until the later visits only in the SLIT group. Also, the asthma medication consumption was decreased by SLIT treatment only at the end of study (p < 0.01). The specific IgG4 was significantly increased after SLIT treatment when compared with the control group, but no significant change of specific IgE was observed in either groups. In the SLIT group, there was no significant difference between children less than or more than 5 year old in terms clinical efficacy, onset of action, immunologic parameters, and safety. No severe systemic AEs were reported. Conclusion SLIT is effective and well-tolerated in children with allergic rhinitis 3–13 years old.
Osteitis is Associated with P-Glycoprotein Overexpression in Patients with Chronic Sinusitis without Nasal Polyps
Authors: Günel Ceren , Feldman Rachel E. , Bleier Benjamin S. 
Published: March 2014

Background P-glycoprotein (P-gp) is a membrane-bound efflux pump that is up-regulated in eosinophilic chronic rhinosinusitis and participates in epithelial cytokine secretion. Osteitis is associated with eosinophilic inflammation and may represent a method to predict patients with P-gp overexpression. The purpose of this article was to determine whether P-gp overexpression and increased osteitis scores are associated in patients with chronic rhinosinusitis (CRS). Methods An Institutional Review Board-approved study was performed using sinus tissue in 38 patients with CRS. P-gp expression was calculated using quantitative fluorescent immunohistochemistry to generate an epithelial-to-background staining ratio. Patients were stratified into low and high P-gp expression groups. Osteitis was scored radiologically using the Kennedy Osteitis Score (KOS) and Global Osteitis Score (GOS). Serum eosinophilia was assessed. KOS and GOS were compared using a Pearson's correlation coefficient. Osteitis scores and serum eosinophil concentrations between P-gp expression groups were compared using a nonparametric Mann-Whitney U test (two tailed). Results Among the 38 patients, 7(18.42%) had high P-gp expression (mean ± SD, 4.86 ± 1.33) whereas 31(81.57%) had low expression ratios (1.93 ± 0.45). No patients in the high P-gp expression group had undergone prior surgery. Median serum eosinophil values were significantly greater in the high versus low P-gp expression group (6.98 ± 2.17 versus 2.36 ± 1.38, p < 0.001). GOS and KOS values were significantly greater in the high versus low P-gp expression group (15.86 ± 4.91 versus 6.29 ± 1.25 and 4.55 ± 4.33 verus 2.23 ± 1.71; p < 0.001). KOS and GOS values were significantly correlated (r = 0.835; p < 0.001). Conclusion Increased osteitis burden as measured by either the KOS or the GOS is associated with creased P-gp membranous expression in CRS. Radiographic quantification of osteitis may therefore be used to identify patients with P-gp overexpression thereby providing a novel potential therapeutic target.
The Effect of an Absorbable Gelatin Dressing Impregnated with Triamcinolone within the Olfactory Cleft on Polypoid Rhinosinusitis Smell Disorders
Authors: Bardaranfar Mohammad Hossein , Ranjbar Zahra , Dadgarnia Mohammad Hossein , Atighechi Saeid , Mirvakili Abbas , Behniafard Nasim , Sadeghi Masoumeh , Abbaslu Fatemeh , Baradaranfar Amin 
Published: March 2014

Background Chronic rhinosinusitis (CRS) is an inflammatory process that causes different clinical symptoms: nasal blockage and congestion, posterior and anterior nasal drip, and smell disorder ranging from reduced olfaction (hyposmia) to complete loss of smell (anosmia). It has been suggested that mechanical blockage of olfactory clef after polypectomy is responsible for the persistent impairment of olfaction in some cases. The aim of this study was to evaluate the efficacy of application of steroids at the olfactory cleft in improving olfactory function in patients who underwent sinus surgery. Methods A double-blind, randomized controlled trial was conducted in Yazd, Iran, between March and December 2012. Eligible patients who had CRS with polyposis and underwent functional endoscopic sinus surgery were recruited. An absorbable gelatin dressing combined with triamcinolone (case) or normal saline (control) was applied at the site of surgery. Olfaction was assessed by butanol threshold tests before and 8 weeks after surgery. Results A total of 60 patients were enrolled into the study and were equally divided into triamcinolone and control groups. Subjects in both arms of trial experienced augmentation of smell function throughout the study; however, patients who received triamcinolone had better improvement after 8 weeks (p = 0.007). Complete remission rate was 100% in the triamcinolone group and the corresponding figure was 76% in the control group. Conclusion We suggest that application of triamcinolone at the olfactory cleft can boost the effect of surgery in restoring olfactory function.
Systematic Review of Immunotherapy for Chronic Rhinosinusitis
Authors: DeYoung Kristen , Wentzel Jennifer L. , Schlosser Rodney J. , Nguyen Shaun A. , Soler Zachary M. 
Published: March 2014

Background Immunotherapy (IT) has been well established as an effective treatment for allergic rhinitis (AR), but little is known about the benefits of IT on clinical outcomes of comorbid chronic rhinosinusitis (CRS). The goal of this publication is to systematically review the literature regarding outcomes of IT in patients with atopic CRS. Methods A systematic review of the literature was conducted including studies that assessed the efficacy of IT on clinical outcome measures in CRS including without polyp, with polyp, and allergic fungal rhinosinusitis subgroups. Excluded articles were those only reporting outcomes specific to asthma or AR. Results Seven studies met the inclusion and exclusion criteria for this review, none of which were randomized controlled trials. Generally, symptom scores improved in patients treated with IT when compared with baseline data and control patients. Objective endoscopic exam measures improved with IT treatment in short-term studies. Significant improvements were observed in radiographic assessments, and there was a decreased necessity for revision surgery, interventional office visits, and intranasal and oral steroid use. Conclusion Conclusions are limited by the paucity of available data on the efficacy of IT for treating CRS-specific outcome measures. There is weak evidence to support the use of IT as an adjunctive treatment in CRS patients, particularly in the postoperative period.
Prevalence of White Spot Lesion in Nepalese Patients with Fixed Orthodontic Appliance
Authors: Shrestha Sandhya , Shrestha Rabindra Man 
Published: March 2014

Introduction: Enamel decalcification in the form of white spot lesion is a common complication seen in patients with fixed orthodontic appliances.
Objective: To determine the prevalence of white spot lesion among Nepalese fixed orthodontic patients, to compare the occurrence of WSL among the patients with lesser and greater duration of treatment, and to compare between the gender groups.
Materials & Method: A cross-sectional study was done to compare the prevalence of WSL between 300 orthodontic patients and 100 non-orthodontic subjects. Further comparison was done between the mean treatment duration between orthodontic subjects of 6-18 months and >18 months, and between male and female samples. Subjects were visually examined on second premolar to second premolar in both maxillary and mandibular arches using Gorelick’s WSL index. Descriptive statistics were calculated and independent t-test was used to compare the difference between the groups. The p-value <0.05 was considered significant.
Result: The prevalence of WSL in Nepalese orthodontic patients was 54.3%; among them prevalence was 40% in lesser treatment duration group and 68.7% in greater treatment duration group. The study found significant difference between untreated nonorthodontic group and orthodontically treated group with respect to the number of teeth affected with WSL. Also, there was significant difference between the categories of orthodontic treatment duration. There was no significant difference between male and female samples.
Conclusion: Fixed orthodontic treatment increase the risk of white spot lesion. Duration of orthodontic treatment also showed significant increase in the occurrence of WSL.