bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of Chain Acquisition among Independent Dialysis Facilities
Authors: Pozniak Alyssa S. , Hirth Richard A. , Banaszak‐Holl Jane , Wheeler John R. C. 
Published: February 2010

Objective. To determine the predictors of chain acquisition among independent dialysis providers.Data Sources. Retrospective facility‐level data combined from CMS Cost Reports, Medical Evidence Forms, Annual Facility Surveys, and claims for 1996–2003.Study Design. Independent dialysis facilities' probability of acquisition by a dialysis chain (overall and by chain size) was estimated using a discrete time hazard rate model, controlling for financial and clinical performance, practice patterns, market factors, and other facility characteristics.Data Collection. The sample includes all U.S. freestanding dialysis facilities that report not being chain affiliated for at least 1 year between 1997 and 2003.Principal Findings. Above‐average costs and better quality outcomes are significant determinants of dialysis chain acquisition. Facilities in larger markets were more likely to be acquired by a chain. Furthermore, small dialysis chains have different acquisition strategies than large chains.Conclusions. Dialysis chains appear to employ a mix of turn‐around and cream‐skimming strategies. Poor financial health is a predictor of chain acquisition as in other health care sectors, but the increased likelihood of chain acquisition among higher quality facilities is unique to the dialysis industry. Significant differences among predictors of acquisition by small and large chains reinforce the importance of using a richer classification for chain status.
Long‐Term Trends in Medicare Payments in the Last Year of Life
Authors: Riley Gerald F. , Lubitz James D. 
Published: February 2010

Objective. To update research on Medicare payments in the last year of life.Data Sources. Continuous Medicare History Sample, containing annual summaries of claims data on a 5 percent sample from 1978 to 2006.Study Design. Analyses were based on elderly beneficiaries in fee for service. For each year, Medicare payments were assigned either to decedents (persons in their last year) or to survivors (all others).Results. The share of Medicare payments going to persons in their last year of life declined slightly from 28.3 percent in 1978 to 25.1 percent in 2006. After adjustment for age, sex, and death rates, there was no significant trend.Conclusions. Despite changes in the delivery of medical care over the last generation, the share of Medicare expenditures going to beneficiaries in their last year has not changed substantially.
Petrogenetic modelling of strongly residual metapelitic xenoliths within the southern Platreef, Bushveld Complex, South Africa
Authors: JOHNSON T. E. , BROWN M. , WHITE R. W. 
Published: February 2010

AbstractXenoliths of quartz‐absent Fe‐rich aluminous metapelite are common within the platinum group element‐rich mafic/ultramafic magmatic rocks of the Platreef. Relative to well‐characterized protoliths, the xenoliths are strongly depleted in K2O and H2O, and have lost a substantial amount of melt (>50 vol.%). Mineral equilibria calculations in the NCKFMASHTO system yield results that are consistent with observations in natural samples. Lower‐grade rocks that lack staurolite constrain peak pressures to ∼2.5 kbar in the southern Platreef. Smaller xenoliths and the margins of larger xenoliths comprise micro‐diatexite rich in coarse acicular corundum and spinel, which record evidence for the metastable persistence of lower‐grade hydrous phases and rapid melting consequent on a temperature overstep of several hundred degrees following their incorporation in the mafic/ultramafic magmas. In the cores of larger xenoliths, temperatures increased more slowly enabling progressive metamorphism by continuous prograde equilibration and the loss of H2O by subsolidus dehydration; the H2O migrated to xenolith margins where it may have promoted increased melting. According to variations in the original compositional layering, layers became aluminosilicate‐ and/or cordierite‐rich, commonly with spinel but only rarely with corundum. The differing mineralogical and microstructural evolution of the xenoliths depends on heating rates (governed by their size and, therefore, proximity to the Platreef magmas) and the pre‐intrusive metamorphic grade of the protoliths. The presence or absence of certain phases, particularly corundum, is strongly influenced by the degree of metastable retention of lower‐grade hydrates in otherwise identical protolith bulk compositions. The preservation of fine‐scale compositional layering that is inferred to be relict bedding in xenolith cores implies that melt loss by compaction was extremely efficient.
Migraine Education Improves Quality of Life in a Primary Care Setting
Authors: Smith Timothy R. , Nicholson Robert A. , Banks James W. 
Published: February 2010

(Headache 2010;50:600‐612)Objective.— The objective of this study was to evaluate the effectiveness of the Mercy Migraine Management Program (MMMP), an educational program for physicians and patients. The primary outcome was change in headache days from baseline at 3, 6, and 12 months. Secondary outcomes were changes in migraine‐related disability and quality of life, worry about headaches, self‐efficacy for managing migraines, emergency room (ER) visits for headache, and satisfaction with headache care.Background.— Despite progress in the understanding of the pathophysiology of migraine and development of effective therapeutic agents, many practitioners and patients continue to lack the knowledge and skills to effectively manage migraine. Educational efforts have been helpful in improving the quality of care and quality of life for migraine sufferers. However, little work has been performed to evaluate these changes over a longer period of time. Also, there is a paucity of published research evaluating the influence of education about migraine management on cognitive and emotional factors (for example, self‐efficacy for managing headaches, worry about headaches).Methods.— In this open‐label, prospective study, 284 individuals with migraine (92% female, mean age = 41.6) participated in the MMMP, an educational and skills‐based program. Of the 284 who participated in the program, 228 (80%) provided data about their headache frequency, headache‐related disability (as measured by the Headache Impact Test‐6 (HIT‐6), migraine‐specific quality of life (MSQ), worry about headaches, self‐efficacy for managing headaches, ER visits for headaches, and satisfaction with care at 4 time points over 12 months (baseline, 3 months, 6 months, 12 months).Results.— Overall, 46% (106) of subjects reported a 50% or greater reduction in headache frequency. Over 12 months, patients reported fewer headaches and improvement on the HIT‐6 and MSQ (all P < .001). The improvement in headache impact and quality of life was greater among those who had more worry about their headaches at baseline. There were also significant improvements in “worry about headaches,”“self‐efficacy for managing headaches,” and “satisfaction with headache care.”Conclusion.— The findings demonstrate that patients participating in the MMMP reported improvements in their headache frequency as well as the cognitive and emotional aspects of headache management. This program was especially helpful among those with high amounts of worry about their headaches at the beginning of the program. The findings from this study are impetus for further research that will more clearly evaluate the effects of education and skill development on headache characteristics and the emotional and cognitive factors that influence headache.
Primary gastric diffuse large B‐cell Lymphoma (DLBCL): analyses of prognostic factors and value of pretreatment FDG‐PET scan
Authors: Chihara Dai , Oki Yasuhiro , Ine Shouji , Kato Harumi , Onoda Hiroshi , Taji Hirofumi , Kagami Yoshitoyo , Yamamoto Kazuhito , Morishima Yasuo 
Published: February 2010

Abstract Objectives: We report a single institution experience with gastric diffuse large B‐cell lymphoma (DLBCL) in an attempt to evaluate the roles of different treatment modalities, to assess the value of pretreatment positron emission tomography (PET) scan, and to identify potential prognostic factors. Methods: Among 384 patients diagnosed with DLBCL between 1995 and 2008, 75 patients had primary gastric DLBCL and were reviewed and analyzed. Results: The median age was 66. International prognostic index (IPI) risk was low in 52%, low‐intermediate in 23%, high‐intermediate in 9%, and high in 16%. Pretreatment PET scan was highly sensitive in detecting gastric lesions except stage I gastric DLBCL without detectable mass by CT or gastroscopy. As a general rule, patients with limited‐stage disease were treated with three times of CHOP (with or without rituximab) and radiotherapy, and those with advanced‐stage disease were treated with eight cycles of CHOP (with or without rituximab), and radiotherapy was given to residual diseases after chemotherapy. Three‐year overall survival (OS) rate was 78%. Multivariate analysis revealed that low albumin, hemoglobin <12.0 g/dL, and treatment without rituximab were independently associated with shorter OS. Low albumin, hemoglobin <12.0 g/dL,and advanced stage were independently associated with shorter progression‐free survival. Conclusion: We showed the survival benefit of rituximab and potential prognostic value of pretreatment hemoglobin and serum albumin levels in gastric DLBCL.
Organising pneumonia mimicking invasive fungal disease in patients with leukaemia
Authors: Forghieri Fabio , Potenza Leonardo , Morselli Monica , Maccaferri Monica , Pedrazzi Letizia , Barozzi Patrizia , Vallerini Daniela , Riva Giovanni , Zanetti Eleonora , Quadrelli Chiara , Rossi Giulio , Rivasi Francesco , Messino’ Massimino , Rumpianesi Fabio , Grottola Antonella , Venturelli Claudia , Pecorari Monica , Codeluppi Mauro , Torelli Giuseppe , Luppi Mario 
Published: February 2010

AbstractClinical charts from 63 consecutive highly immunocompromised haematologic patients presenting with pulmonary nodular lesions on CT scan, classified as either probable or possible invasive fungal disease (IFD) according to the revised EORTC/MSG classification, were retrospectively studied. Histopathological analysis of lung tissues, available for 23 patients, demonstrated proven IFD in 17 cases (14 invasive aspergillosis and 3 invasive zygomycosis), diffuse alveolar damage in one and organising pneumonia (OP) in five cases. In the OP cases, three of which have been defined as probable IFD according to EORTC/MSG classification, extensive immunohistochemical, molecular and immunological analyses for fungi were negative. Our case descriptions extend the notion that OP may be encountered as a distinct histopathological entity in pulmonary nodular lesions in patients with leukaemia with probable/possible IFD.
Borderline intellectual functioning in children and adolescents – insufficiently recognized difficulties
Authors: Fernell Elisabeth , Ek Ulla 
Published: February 2010

AbstractAim:  To draw attention to groups of children and adolescents with borderline intellectual functioning, especially with respect to their school‐situation.Methods:  In one study, population‐based, children with borderline intellectual functioning at age 10 years were followed until they finished compulsory school when their final certificates could be analysed. In a second study parents of 20 individuals in the upper secondary school for pupils with mild mental retardation were interviewed according to the Vineland adaptive scales and school health records were reviewed. In a third study pupils attending an individual programme in upper secondary school were assessed and we report one representative case.Results:  (1) Pupils with borderline intellectual functioning, assessed in grade 4, received significantly lower grades when finishing the compulsory school. (2) In the group of pupils in the upper secondary school for the mildly mentally retarded, compiled data indicated that a considerable number did not fulfil the combined IQ and adaptive criteria for mild mental retardation. (3) The subtle nature of borderline intellectual functioning may delay appropriate measures at school, which our case illustrates.Conclusion:  Borderline intellectual functioning seldom attracts attention. Our studies indicate that school and also society at large must be prepared to adapt educational and working conditions for the large minority of individuals with borderline intellectual functioning.
Peripheral neuropathy following nitrous oxide abuse
Authors: Richardson Philip G 
Published: February 2010

AbstractUndifferentiated neurological presentations are not uncommon to the ED. Vitamin B (12) deficiency can lead to progressive demyelination and axonal lesions on the peripheral nerves and cervicothoracic spinal cord causing a peripheral neuropathy. Nitrous oxide is a common adjuvant to anaesthesia in the ED but it not often thought of as a drug of abuse. A case is reported of prolonged and intensive nitrous oxide abuse that resulted in the development of a peripheral neuropathy.
Does the standard intravenous solution of fentanyl (50 µg/mL) administered intranasally have analgesic efficacy?
Authors: Crellin Dianne , Ling Rong Xiu , Babl Franz E 
Published: February 2010

AbstractBackground:  Intranasal (IN) fentanyl provides rapid and powerful non‐parenteral analgesia in the ED. A concentrated solution of fentanyl (300 µg/mL) has been used in prior trials, yet many ED use the standard solution at a concentration of 50 µg/mL, which is widely available and of low cost. We set out to determine if this lower concentration of fentanyl is also efficacious.Methods:  Prospective audit in children aged 5–18 years presenting with upper limb injuries. Patients received IN fentanyl (50 µg/mL) at 1.5 µg/kg. Patient assessed pain scores were collected 5, 10, 20, 30 and 60 min following IN fentanyl administration using a visual analogue scale or Bieri Faces – Revised scale. Parental scores were used if patients were unable to provide a score.Results:  Of the 59 eligible patients, 36 were enrolled; median age was 6.8 years (range 5–15 years), and 89% (32/36) ultimately required fracture reduction. Median first dose of IN fentanyl was 1.4 µg/kg. Median pain scores dropped from 7 (interquartile range 5–10) pre‐fentanyl to 5 (interquartile range 4–8) at 5 min and 2 (interquartile range 1–4) at 30 and 60 min. A total of 21 (58%) children did not require further analgesia in the ED. There were no adverse events.Conclusions:  Standard i.v. concentration IN fentanyl (50 µg/mL) appears to have analgesic efficacy in children with upper limb injuries.
Market Impacts of Technological Change in Canadian Agriculture
Authors: Prasada Pahan , Bredahl Maury E. , Wigle Randall 
Published: February 2010

Market impacts of technological change in Canadian agriculture are measured within a computable general equilibrium framework using 2001 input‐output data with agriculture disaggregated to six sectors and 13 commodities. Technological change is modeled as productivity rises in the use of intermediate inputs and of primary factors. Impacts on output, intermediate use of output, foreign trade, final consumption, returns to primary factors, and relative prices are calculated for primary agricultural commodities and processed food products. Impacts are summarized as three general outcomes. First, supply managed sectors adjust to technological change differently than other agricultural sectors. In the former, quota rents increase while in the latter, outputs, exports, and final consumption increase along with declines of relative supply prices. Second, large relative price declines for other commodities lead to consumer gains. Third, producer gains increase when the international competitiveness of agriculture increases. Finally, we compare the differential impact of technological change with and without supply management. L'impact que le changement technologique au sein de l’agriculture canadienne a sur le marché est évaluéà l’aide d’un modèle d’équilibre général calculable (EGC) qui utilise des données entrées‐sorties de 2001 pour six secteurs agricoles et treize produits de base. Le changement technologique est modélisé en termes de hausses de productivité dans l’utilisation d’intrants intermédiaires et primaires. L'impact sur les extrants, l’utilisation intermédiaire d’extrants, le commerce extérieur, la consommation finale, les rendements des intrants primaires et les prix relatifs sont calculés pour les principaux produits de base agricoles et produits alimentaires transformés. L'impact est classé en trois catégories de résultats. Premièrement, les secteurs soumis à la gestion de l’offre s’adaptent différemment des autres secteurs au changement technologique. Dans le premier cas, les rentes de contingentement augmentent tandis que dans le second, les extrants, les exportations et la consommation finale augmentent et les prix relatifs de l’offre diminuent. Deuxièmement, les chutes importantes du prix relatif d’autres produits de base entraînent des avantages pour le consommateur. Troisièmement, les gains du producteur augmentent lorsque la compétitivité de l’agriculture sur la scène internationale augmente. Finalement, nous avons comparé l’impact différentiel du changement technologique dans les secteurs soumis et non soumis à la gestion de l’offre.
AgriStability with Catastrophic Price Risk for Cow‐Calf Producers
Authors: Schaufele Brandon , Unterschultz James R. , Nilsson Tomas 
Published: February 2010

AgriStability is the primary Canadian agricultural risk management program. Recent experience with bovine spongiform encephalopathy (BSE) in the cattle sector demonstrated that output prices are susceptible to both “normal” risk and sudden, “catastrophic” declines. This paper evaluates the AgriStability program for cow‐calf producers when there is potential for catastrophic price risk. A simulation model is developed. Under a base case scenario, when there is no catastrophic price risk, AgriStability behaves more like an income support program than a risk management tool. Risk‐neutral producers see a 12.1% increase in certainty equivalent wealth compared to 12.5% for moderately risk‐averse producers. Introducing catastrophic price risk increases risk‐averse producers’ expected benefits to 21.8%. Actuarially fair program premiums and implied subsidies are also estimated. These results demonstrate that AgriStability is highly subsidized. Finally, benefits from supplementary catastrophic revenue insurance are calculated and discussed, along with several additional structural features of the program. Agri‐stabilité constitue le principal programme canadien de gestion des risques en agriculture. L'encéphalopathie spongiforme bovine qui a frappé le secteur de l’élevage bovin a démontré que les prix des extrants sont exposés à des risques « normaux » et à des chutes soudaines et « catastrophiques ». Le présent article évalue le programme Agri‐stabilité dans le cas des producteurs vache‐veau (veaux d’embouche) lorsqu’un potentiel de risque de prix catastrophique existe. Nous avons élaboré un modèle de simulation. Dans le cadre d’un scénario de référence, lorsqu’il n’existe pas de risque de prix catastrophique, le programme Agri‐stabilité ressemble davantage à un programme de soutien du revenu qu’à un outil de gestion des risques. Dans le cas des producteurs indifférents aux risques, l’équivalent certain de la richesse aléatoire est supérieur de 12,1 % comparativement à 12,5 % dans le cas des producteurs modérément risquophobes. L'introduction de risque de prix catastrophique augmente les bénéfices espérés des producteurs risquophobes de 21,8 %. Nous avons également estimé ce que représentent les indemnités actuariellement justes ainsi que les subventions implicites. Les résultats ont montré que le programme Agri‐stabilité est très subventionné. Finalement, nous avons examiné et calculé les indemnités tirées d’une assurance‐revenu supplémentaire en cas de risque catastrophique et nous avons aussi analysé plusieurs autres caractéristiques structurelles du programme.
Consumer Choice and Health: The Importance of Health Attributes for Retail Meat Demand in Canada
Authors: Anders Sven , Mőser Anke 
Published: February 2010

Fat content is an attribute of major concern to health conscious consumers and of growing importance in the discussion of nutrition‐related diseases in Canada. This paper combines multinomial logit and Almost Ideal Demand System (AIDS) analysis to investigate Canadian consumers’ preferences and retail demand for ground meat products differentiated by fat content. We apply Nielsen household and retail‐level scanner data. Evidence from multinomial logit supports the hypothesis of strong habits in household's point‐of‐sale product choices, driven by sociodemographic characteristics and regional cultural customs. Estimates of own and cross price elasticities from the AIDS model reveal that preferences for health triumph over taste. We find that perceived healthier “extra lean” ground meats have evolved into a staple in the Canadian diet. Our results are a starting point for a more in‐depth understanding of consumer behavior toward healthy food choices. This information is essential for more targeted health and nutrition policy aimed at the promotion of healthful meat choices in Canadian grocery retailing. La teneur en matière grasse est un attribut qui préoccupe les consommateurs soucieux de leur santé et un sujet qui est de plus en plus présent dans le débat sur les maladies liées à la nutrition au Canada. Le présent article combine une analyse logit multinomiale et l’analyse d’un système de demande AIDS pour étudier les préférences des consommateurs canadiens et la demande du marché de détail en produits de viande hachée différenciés par la teneur en matière grasse. Nous avons utilisé les données de Nielsen portant sur les habitudes de consommation des ménages et scannées dans les commerces de détail. Les résultats de l’analyse logit multinomiale appuient l’hypothèse selon laquelle les habitudes des ménages quant au choix de produits dans les points de vente sont bien ancrées et sont motivées par des caractéristiques sociodémographiques et des pratiques culturelles régionales. Les estimations des élasticités‐prix et des élasticités‐prix croisées effectuées à partir du modèle AIDS ont révélé que l’aspect « santé» des aliments l’emportait sur l’aspect « goût ». Nous avons observé que les viandes hachées très maigres perçues comme étant meilleures pour la santé sont devenues une denrée de consommation courante du régime alimentaire de la population canadienne. Nos résultats constituent un point de départ pour une étude plus approfondie sur le comportement des consommateurs concernant des choix alimentaires sains. Cette information est essentielle à l’élaboration d’une politique sur la nutrition et la santé plus ciblée visant à promouvoir des choix de viande sains dans le commerce de détail canadien.