bluuebunny/crossref_metadata_2025_split huggingface dataset:
Screening for Elevated Lead Levels in Childhood and Pregnancy: An Updated Summary of Evidence for the US Preventive Services Task Force
Authors: Rischitelli Gary , Nygren Peggy , Bougatsos Christina , Freeman Michele , Helfand Mark 
Published: December 2006

BACKGROUND. In 1996, the US Preventive Services Task Force provided recommendations for routine screening of asymptomatic children and pregnant women for elevated blood lead levels. This review updates the evidence for the benefits and harms of screening and intervention for elevated blood lead in asymptomatic children and pregnant women.METHODS. We searched Medline, reference lists of review articles, and tables of contents of leading pediatric journals for studies published in 1995 or later that contained new information about the prevalence, diagnosis, natural course, or treatment of elevated lead levels in asymptomatic children aged 1 to 5 years and pregnant women.RESULTS. The prevalence of elevated blood lead levels among children and women in the United States, like that in the general population, continues to decline sharply, primarily because of marked reductions in environmental exposure, but still varies substantially among different communities and populations. Similar to the findings in 1996, our searches did not identify direct evidence from controlled studies that screening children for elevated blood lead levels results in improved health outcomes, and there was no direct evidence identified from controlled studies that screening improves pregnancy or perinatal outcomes. No new relevant information regarding the accuracy of screening for lead toxicity was identified during the update, and we did not identify evidence that demonstrates that universal screening for blood lead results in better clinical outcomes than targeted screening. Substantial new relevant information regarding the adverse effects of screening and interventions was not identified.CONCLUSIONS. There is no persuasive evidence that screening for elevated lead levels in asymptomatic children will improve clinical outcomes. For those children who are screened and found to have elevated levels, there is conflicting evidence demonstrating the clinical effectiveness of early detection and intervention.
Funding of North Carolina Tobacco Control Programs Through the Master Settlement Agreement
Authors: Jones Alison Snow , Austin W. David , Beach Robert H. , Altman David G. 
Published: December 2006

Changing political and economic forces in 1 tobacco-dependent state, North Carolina, demonstrate how the interplay between these forces and public health priorities has shaped current allocation of Master Settlement Agreement funds. Allocation patterns demonstrate lawmakers’ changing priorities in response to changes in the economic climate; some of the agreement’s funds targeted to tobacco farmers appear to reflect objectives favored by tobacco manufacturers. Funds earmarked for health have underfunded youth tobacco prevention and tobacco control initiatives, and spending for tobacco farmers in North Carolina has not lived up to the rhetoric that accompanied the original agreement. We discuss the implications of these findings for future partnerships between public health advocates and workers as well as tobacco control strategies.
Going Beyond “ABC” to Include “GEM”: Critical Reflections on Progress in the HIV/AIDS Epidemic
Authors: Dworkin Shari L. , Ehrhardt Anke A. 
Published: December 2006

A considerable number of studies have sought to identify what factors accounted for substantial reductions in HIV seroprevalence after several countries deployed “ABC” (abstinence, be faithful, condom use) strategies. After much public discourse and research on ABC success stories, the Joint United Nations Programme on HIV/AIDS 2004 epidemic report indicated that nearly 50% of infected people worldwide were women, up from 35% in 1985.In light of the feminization of HIV/AIDS, we critically assess the limitations of ABC strategies. We provide 3 additional prevention strategies that focus on gender relations, economics, and migration (GEM) and can speak to the new face of the epidemic. Pressing beyond ABC, GEM strategies provide the basis for a stronger central platform from which national efforts against HIV/AIDS can proceed to reduce transmission risks.
Adolescent Participation in Preventive Health Behaviors, Physical Activity, and Nutrition: Differences Across Immigrant Generations for Asians and Latinos Compared With Whites
Authors: Allen Michele L. , Elliott Marc N. , Morales Leo S. , Diamant Allison L. , Hambarsoomian Katrin , Schuster Mark A. 
Published: December 2006

Objectives. We investigated preventive health behaviors (bicycle helmet, seat belt, and sunscreen use), physical activity, television viewing or video game playing, and nutrition (fruit, vegetable, milk, and soda consumption) among Asian and Latino adolescents living in the United States; assessed trends across generations (first-, second-, and third-generation immigrants or later); and compared each generation with White adolescents. Methods. We used data from 5801 adolescents aged 12 to 17 years in the representative 2001 California Health Interview Survey. Results. In multivariate analysis, first-generation Asians measured worse than Whites for preventive health behaviors (lower participation), physical activity (less activity), and television viewing or video game playing (more hours), but improved across generations. For these same behaviors, Latinos were similar to or worse than Whites, and generally showed no improvement across generations. First-generation Asians and Latinos had healthier diets than Whites (higher fruit and vegetable consumption, lower soda consumption). With succeeding generations, Asians’ fruit, vegetable, and soda consumption remained stable, but Latinos’ fruit and vegetable consumption decreased and their soda consumption increased, so that by the third generation Latinos’ nutrition was poorer than Whites’. Conclusions. For the health behaviors we examined, Asian adolescents’ health behaviors either improved with each generation or remained better than that of Whites. Latino adolescents demonstrated generally worse preventive health behaviors than did Whites and, in the case of nutrition, a worsening across generations. Targeted interventions may be needed to address behavioral disparities.
A Statewide Public Health Approach to Improving Organ Donation: The Massachusetts Organ Donation Initiative
Authors: Koh Howard K. , Jacobson Marsha D. , Lyddy Anne Marie , O’Connor Kevin J. , Fitzpatrick Sean M. , Krakow Milly , Judge Christine M. , Alpert Hillel R. , Luskin Richard S. 
Published: December 2006

Despite the growing disparity between organ supply and demand in the United States, few initiatives have attempted to close the gap through systematic population-based public health endeavors. We examined the evolution, implementation, and outcomes of the Massachusetts Organ Donation Initiative, a statewide effort that included a unique partnership among organ procurement organizations, major teaching hospitals, and the state’s department of public health. Lessons from this initiative have contributed to growing national efforts for increasing organ supply and have provided insights for addressing this continuing public health challenge.
Use of Mental Health Services and Subjective Satisfaction With Treatment Among Black Caribbean Immigrants: Results From the National Survey of American Life
Authors: Jackson James S. , Neighbors Harold W. , Torres Myriam , Martin Lisa A. , Williams David R. , Baser Raymond 
Published: December 2006

Objectives. We examined the use rates and correlates of formal psychiatric services among the US-born and immigrant Caribbean Black population. Methods. We compared overall mental health service use in samples of Caribbean Blacks and African Americans and examined the within-sample ethnic variation among Caribbean Blacks, including for ethnic origin (Spanish Caribbean, Haiti, and English Caribbean), nativity status (those born in or outside the United States), number of years spent living in the United States, age at the time of immigration, and generational status. Results. African Americans and Caribbean Blacks used formal mental health care services at relatively low rates. Among Caribbean Blacks, generational status and nativity showed the greatest effects on rates of reported use, satisfaction, and perceived helpfulness. Of those study participants who met the criteria for disorders as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, about one third used formal mental health care services. The US-born subjects were more likely to receive care than were first-generation immigrants. Conclusions. Our study underscores the importance of ethnicity, immigration, and migration-related factors, within racial categorization, as it pertains to the use of mental health services in the United States. Our findings suggest that timing of migration and generational status of Caribbean Black immigrants and ancestry groups contribute to important differences in rates and sources of use, relative satisfaction, and perception of helpfulness, with regard to formal mental health services.
Searching For Better Prospects: Endogenizing Falling Job Tenure and Private Pension Coverage
Authors: Friedberg Leora , Owyang Michael T , Sinclair Tara M 
Published: December 2006

Abstract
Recent declines in job tenure have coincided with a shift away from traditional defined benefit (DB) pensions, which reward long tenure. New evidence also points to an increase in job-to-job movements by workers, and we document gains in relative wages of job-to-job movers over a similar period. We develop a search model in which firms may offer tenure-based contracts like DB pensions to reduce the incidence of costly on-the-job search by workers. Either reduced search costs or an increase in the probability of job matches can, under fairly general conditions, lower the value of deterring search and the use of DB pensions.
Induction of heme oxygenase-1 and heat shock protein 70 in rat hepatocytes: The role of calcium signaling
Authors: Silomon Malte , Bauer Inge , Bauer Michael , Nolting Julia , Paxian Markus , Rensing Hauke 
Published: December 2006

AbstractStress response genes including heat shock proteins are induced under a variety of conditions to confer cellular protection. This study investigated the role of calcium signaling in the induction of two stress response genes, heme oxygenase-1/hsp32 and hsp70, in isolated rat hepatocytes. Both genes were induced by cellular glutathione depletion. This induction could be inhibited by BAPTA-AM. Culturing in a calcium-free medium prevented the induction of hsp70 gene expression after glutathione depletion without affecting heme oxygenase-1 gene expression. Thapsigargin increased the gene expression of heme oxygenase-1 but not that of hsp70. Thapsigargin-induced heme oxygenase-1 induction was completely inhibited by BAPTA-AM. Incubation with the Ca2+-ionophore A23187 augmented heme oxygenase-1 (two-fold) and hsp70 (5.2-fold) mRNA levels. Our data suggests a significant role of Ca2+-dependent pathways in the induction of the two stress genes. An increase in the cytoplasmic Ca2+ activity seems to play a key role in the cascade of signaling leading to the induction of the two genes. However, the source of Ca2+ that fluxes into the cytoplasm seems to be different. Our data provides evidence for a compartmentalization of calcium fluxes, i.e. the Ca2+ flux from intracellular stores (e.g. the endoplasmic reticulum) plays a major role in the induction of heme oxygenase-1. By contrast, Ca2+ flux from the extracellular medium seems to be a mechanism initiating the cellular signaling cascade leading to hsp70 gene induction.
Lung Cancer Diagnoses and Outcomes During the Syrian War, 2011-2018
Authors: Hanafi Ibrahem , Abo Samra Dana , Alsaqqa Rama , Naeem Ahmad , Shebli Baraa , Ajlyakin Ghassan 
Published: March 2024

ImportanceProtracted wars, which disproportionately affect low-resource countries, exacerbate the challenges faced by cancer care systems, with lung cancer being the most affected as the most fatal oncological condition.ObjectiveTo characterize the presentation and survival of patients with lung cancer during the decade-long Syrian war.Design, Setting, and ParticipantsThis cohort study included patients at a large oncology center in Syria during the first 8 years of the Syrian armed conflict (2011-2018). All patients with a new diagnosis of lung cancer were included. Variables investigated included histological subtypes, TNM classification (tumor, lymph nodes, and metastasis), and staging at diagnosis as well as the yearly follow-ups up to 5 years after presentation.ExposureThe Syrian war divided the country into temporary regions with different political influences and heterogeneously impacted health care accessibility among these regions.Main Outcomes and MeasuresChange in prevalence of advanced lung cancer cases at presentation; change in overall survival odds.ResultsThe study included 5160 patients from all Syrian governorates (mean [SD] age, 59.6 [10.8] years; 4399 men [85.3%]). New diagnoses sharply declined during the first 3 years of the war, with partial recovery afterward. Regardless of their tempo-geographical regions, 60% to 80% of the yearly diagnoses presented with metastases. The 1-year and 5-year survival rates were 13.1% (423 of 3238 patients with follow-up results) and 0.1% (2 of 1853 patients), respectively. Patients who presented from regions more involved in the armed conflicts showed poorer survival rates with odds ranging between 0.51 (95% CI, 0.44-0.59) and 0.61 (95% CI, 0.49-0.74) across follow-ups for up to 2 years in comparison with patients presenting from safer regions. War-related health care inaccessibility explained a greater percentage of the variability in survival (Nagelkerke R2 = 7.5%; P &amp;lt; .001) than both patients’ age and the stage of the disease combined (Nagelkerke R2 = 3.9%; P &amp;lt; .001).Conclusions and RelevanceThe Syrian war has been associated with a marked decline in the management of patients with lung cancer, with limited access to specialized care, delayed diagnoses, and substantial decrease in survival rates correlating with the intensity of armed conflict in the respective regions. The profound repercussions of the prolonged armed conflict on patients with lung cancer in Syria necessitates urgent comprehensive strategies to improve the accessibility and quality of health care services, especially in conflict-ridden zones.
Development and Methodological Validation of a Modified Staging System for de Novo Metastatic Breast Cancer
Authors: Berg Tobias , Jensen Maj-Britt , Rossing Maria , Bechmann Troels , Donskov Frede , Knoop Ann Søegaard , Ejlertsen Bent 
Published: March 2024

ImportanceValidation of a new method for prognostication of de novo metastatic breast cancer (dnMBC) to better reflect the heterogenecity of the disease.ObjectiveTo perform external methodological validation of the Plichta staging system, a novel prognostic system for de novo metastatic breast cancer (dnMBC).Design, Setting, and ParticipantsThis retrospective cohort study used a multicenter, nationwide, population-based Danish Breast Cancer Group database to validate the new method. Participants were patients with dnMBC diagnosed between 2010 and 2019. Data were analyzed from April to June 2023.Main outcomes and measuresA recursive partitioning analysis (RPA) was performed, as demonstrated by Plichta and colleagues, to group patients with similar overall survival (OS) based on clinical factors. The main outcome was to group patients into 4 prognostic groups based on 3-year OS as stage IVa, greater than 70%; stage IVb, 50% to 70%; stage IVc, 25% to less than 50%; or stage IVd, less than 25%. Bootstrapping was applied for 1000 iterations, with final stage assignments based on the most commonly occurring assignment.ResultsA total of 1859 women were included with a median (IQR) age of 69 (57-77) years. With a median potential follow-up of 89.9 (95% CI, 86.4-95.1) months and a median OS of 31.7 (95% CI, 29.5-34.1) months, the RPA stratified patients into 10 groups, with organ sites, estrogen receptor status, and human epidermal growth factor receptor 2 status as the key clinical factors. Three-year survival rates ranged from 62% (95% CI, 56%-69%) to 8% (95% CI, 3%-21%), which were further combined into 3 stage groups: IVb, 59.4% (95% CI, 56.2%-62.8%); IVc, 39.4% (95% CI, 36.2%-43.0%); and IVd, 15.4% (95% CI, 11.2%-21.3%) (P &amp;lt; .001). Following bootstrapping, an IVa group emerged, resulting in 4 stage groups with separate 3-year OS rates identified as IVa, 75.8% (95% CI, 67.8%-84.7%); IVb, 58.8% (95% CI, 55.5%-62.3%); IVc, 39.2% (95% CI, 35.8%-43.0%); and IVd, 14.4% (95% CI, 10.8%-19.4%) (P &amp;lt; .001).Conclusions and relevanceThese findings provide external and independent validation of the methods applied in the novel Plichta staging system for dnMBC. This could guide future revisions of the current American Joint Committee on Cancer staging guidelines and may be incorporated as a stratification factor in clinical trials.
Electronic Patient-Reported Symptoms After Ambulatory Cancer Surgery
Authors: Cracchiolo Jennifer R. , Tin Amy L. , Assel Melissa , McCready Taylor M. , Stabile Cara , Simon Brett , Carlsson Sigrid V. , Vickers Andrew J. , Laudone Vincent 
Published: March 2024

ImportanceComplex cancer procedures are now performed in the ambulatory surgery setting. Remote symptom monitoring (RSM) with electronic patient-reported outcomes (ePROs) can identify patients at risk for acute hospital encounters. Defining normal recovery is needed to set patient expectations and optimize clinical team responses to manage evolving problems in real time.ObjectiveTo describe the patterns of postoperative recovery among patients undergoing ambulatory cancer surgery with RSM using an ePRO platform—the Recovery Tracker.Design, Setting, and ParticipantsIn this retrospective cohort study, patients who underwent 1 of 5 of the most common procedures (prostatectomy, nephrectomy, mastectomy, hysterectomy, or thyroidectomy) at the Josie Robertson Surgery Center at Memorial Sloan Kettering Cancer Center from September 2016 to June 2022. Patients completed the Recovery Tracker, a brief ePRO platform assessing symptoms for 10 days after surgery. Data were analyzed from September 2022 to May 2023.Main Outcomes and MeasuresSymptom severity and interference were estimated by postoperative day and procedure.ResultsA total of 12 433 patients were assigned 110 936 surveys. Of these patients, 7874 (63%) were female, and the median (IQR) age at surgery was 57 (47-65) years. The survey response rate was 87% (10 814 patients responding to at least 1 of 10 daily surveys). Among patients who submitted at least 1 survey, the median (IQR) number of surveys submitted was 7 (4-8), and each assessment took a median (IQR) of 1.7 (1.2-2.5) minutes to complete. Symptom burden was modest in this population, with the highest severity on postoperative days 1 to 3. Pain was moderate initially and steadily improved. Fatigue was reported by 6120 patients (57%) but was rarely severe. Maximum pain and fatigue responses (very severe) were reported by 324 of 10 814 patients (3%) and 106 of 10 814 patients (1%), respectively. The maximum pain severity (severe or very severe) was highest after nephrectomy (92 of 332 [28%]), followed by mastectomy with reconstruction (817 of 3322 [25%]) and prostatectomy (744 of 3543 [21%]). Nausea (occasionally, frequently, or almost constantly) was common and experienced on multiple days by 1485 of 9300 patients (16%), but vomiting was less common (139 of 10 812 [1%]). Temperature higher than 38 °C was reported by 740 of 10 812 (7%). Severe or very severe shortness of breath was reported by 125 of 10 813 (1%).Conclusions and RelevanceDefining detailed postoperative symptom burden through this analysis provides valuable data to inform further implementation and maintenance of RSM programs in surgical oncology patients. These data can enhance patient education, set expectations, and support research to allow iterative improvement of clinical care based on the patient-reported experience after discharge.
Ultra‐High Temperature Operated Ni‐Rich Cathode Stabilized by Thermal Barrier for High‐Energy Lithium‐Ion Batteries
Authors: Dai Zhongsheng , Liu Yun , Lu Xia , Zhao Huiling , Bai Ying 
Published: March 2024

AbstractThe pursuit of high energy density batteries has expedited the fast development of Ni‐rich cathodes. However, the chemo‐mechanical degradation induced by local thermal accumulation and anisotropic lattice strain is posing great obstacles for its wide applications. Herein, a highly‐antioxidative BaZrO3 thermal barrier engineered LiNi0.8Co0.1Mn0.1O2 cathode through an in situ construction strategy is first reported to circumvent the above issues. It is found that the Zr ions are incorporated to Ni‐rich material lattice and influence on the topotactic lithiation as well as enhance the oxygen electronegativity through the rigid Zr─O bonds, which effectively alleviates the lattice strain propagation and decreases the excessive oxidization of lattice oxygen for charge compensation. More importantly, the BaZrO3 thermal barrier with an ultra‐low thermal conductivity validly impedes the fast heat exchange between electrode and electrolyte to mitigate the severe surface side reactions. This helps an ultra‐high mass loading Li‐ion pouch cell deliver a specific energy density of 690 Wh kg−1 at active material level and an excellent capacity retention of 92.5% after 1400 cycles under 1 C at 25 °C. Tested at a high temperature of 55 °C, the pouch type full‐cell also exhibits 88.7% in capacity retention after 1200 cycles.
Origami‐Inspired Reconfigurable Soft Actuators for Soft Robotic Applications
Authors: Feng Yixiong , Yan Weiyu , Song Junjie , Hong Zhaoxi , Qiu Hao , Cui Kaiyue , Song Xiuju , Tan Jianrong 
Published: March 2024

AbstractSoft pneumatic actuators (SPAs) hold great promise for simple and effective actuation of soft robots. Multi‐degree‐of‐freedom SPAs are highly desired as they enable diverse motion forms and improve possibility for soft robots to navigate challenging environments and perform complex tasks. Herein, this study proposes two novel origami‐based SPAs (O‐SPAs), namely the Flasher origami‐inspired SPA (FO‐SPA) and the Kresling origami‐inspired SPA (KO‐SPA), which are fabricated entirely from soft silicone without any rigid supports. A finite element model is developed to predict the deformation behavior of O‐SPAs and the deformability and dynamic response of O‐SPAs are characterized through performance tests. Simulation experiments are carried out to investigate the impact of different structural parameters on their performance. These O‐SPAs are highly sensitive to low negative pressure, exhibiting 80% of maximum deformation at −4 kPa. Based on the Flasher and Kresling origami pattern, the actuators are capable of generating compound motions including contraction, twisting, and radial motions. These motions can be used as “building blocks” for the rapid reconfiguration of various soft robots. The study has successfully enriched the types of existing SPAs by providing important multiple motions through origami, with great potential to facilitate the rapid and low‐cost design of soft robots.