Miracle-dz/UniFAR-FTUs huggingface dataset:
Medigap premiums and Medicare HMO enrollment.

OBJECTIVE Markets for Medicare HMOs (health maintenance organizations) and supplemental Medicare coverage are often treated separately in existing literature. Yet because managed care plans and Medigap plans both cover services not covered by basic Medicare, these markets are clearly interrelated. We examine the extent to which Medigap premiums affect the likelihood of the elderly joining managed care plans. DATA SOURCES The analysis is based on a sample of Medicare beneficiaries drawn from the 1996-1997 Community Tracking Study (CTS) Household Survey by the Center for Studying Health System Change. Respondents span 56 different CTS sites from 30 different states. Measures of premiums for privately-purchased Medigap policies were collected from a survey of large insurers serving this market. Data for individual, market, and HMO characteristics were collected from the CTS, InterStudy, and HCFA (Health Care Financing Administration). STUDY DESIGN Our analysis uses a reduced-form logit model to estimate the probability of Medicare HMO participation as a function of Medigap premiums controlling for other market- and individual-level characteristics. The logit coefficients were then used to simulate changes in Medicare participation in response to changes in Medigap premiums. PRINCIPAL FINDINGS We found that Medigap premiums vary considerably among the geographic markets included in our sample. Measures of premiums from different insurers and for different types of Medigap policies were generally highly correlated across markets. Our models consistently indicate a strong positive relationship between Medigap premiums and HMO participation. This result is robust across several specifications. Simulations suggest that a one standard deviation increase in Medigap premiums would increase HMO participation by more than 8 percentage points. CONCLUSIONS This research provides strong evidence that Medigap premiums have a significant effect on seniors' participation in Medicare HMOs. Policy initiatives aimed at lowering Medigap premiums will likely discourage enrollment in Medicare HMOs, holding other factors constant. Although the Medigap premiums are just one factor affecting the future penetration rate of Medicare HMOs, they are an important driver of HMO enrollment and should be considered carefully when creating policy related to seniors' supplemental coverage. Similarly, our results imply that reforms to the Medicare HMO market would influence the demand for Medigap policies.
Comparison of a Radiant Patient Warming Device with Forced Air Warming during Laparoscopic Cholecystectomy

The importance of maintaining a patient's core body temperature during anaesthesia to reduce the incidence of postoperative complications has been well documented. The standard practice of this institution is the use of a forced air device for intraoperative warming. The purpose of this study was to compare this standard with an alternative warming device using a radiant heat source which only heated the face. This prospective, randomized controlled trial compared the efficacy of two methods of intraoperative warming: the BairHugger ™ (Augustine Medical, U.S.A.) forced air device and the SunTouch ™ (Fisher & Paykel Healthcare, N.Z.) radiant warmer during laparoscopic cholecystectomy in 42 female patients. Oesophageal core temperatures were recorded automatically on to computer during operations using standardised anaesthesia, intravenous infusions and draping. The study failed to show any statistical or clinical difference between the two patient groups in terms of mean core temperature both intraoperatively (P=0.42) and in the recovery period (P=0.54). Mean start to end core temperature differences were marginly lower in the radiant group (0.08°C) but not statistically or clinically significantly different. Given some of the drawbacks with forced air systems, such as the expense of the single use blanket, this new radiant warming device offers an alternative method of active warming with advantages in terms of cost and possible application to a wide variety of surgical procedures.
Lipopolysaccharide modulation of a CD14‐like molecule on porcine alveolar macrophages

Cluster of differentiation antigen 14 (GD14) functions as a receptor for lipopolysaccharide (LPS) LPS‐binding protein (LBP) complexes. Because LPS has varying effects on CD14 expression in vitro, we evaluated GDI 4 expression in response to LPS with a fully differen tiated macrophage phenotype, the alveolar macrophage. By using flow microfluorometric analysis and a radioim munoassay with an anti‐human CD14 monoclonal anti body (My4) that cross‐reacts with porcine GD14, we found that macrophages stimulated with LPS for 24 h ex hibited a two‐ to fivefold increase in CD14‐like antigen compared with unstimulated cells. At low concentrations of LPS, up‐regulation of the CD14‐like antigen was de pendent on scrum; at higher concentrations of LPS, se rum was not required. In the absence of serum a 10‐fold higher dose of LPS (10 ng/ml) was required to increase CD14‐like expression. In addition, LPS‐induced CD14‐like up‐regulation correlated with secretion of tumor necrosis factor‐α, regardless of serum concentration. Blockade with My4 antibody significantly inhibited LPS‐induced tumor necrosis factor‐α secretion at 1 ng/ml of LPS. However, inhibition decreased as we increased the LPS concentration, suggesting the existence of GDI4‐independent pathways of macrophage activation in response to LPS. Alternatively, My4 may have a lower affinity for the porcine CD14 antigen than LPS, which may have only partially blocked the LPS‐LBP binding site at high concentrations of LPS. Therefore, these data suggest that LPS activation of porcine alveolar macro phages for 24 h increased CD14‐like receptor expression. The degree of CD14‐like up‐regulation was related to LPS concentration, however, activation did not require the presence of serum at high concentrations of LPS. J. Leukoc. Biol. 57: 581–586; 1995.
Glucosamine-induced endoplasmic reticulum stress attenuates apolipoprotein B100 synthesis via PERK signaling

Glucosamine impairs hepatic apolipoprotein B100 (apoB100) production by inducing endoplasmic reticulum (ER) stress and enhancing cotranslational and posttranslational apoB100 degradation (Qiu, W., R. K. Avramoglu, A. C. Rutledge, J. Tsai, and K. Adeli. Mechanisms of glucosamine-induced suppression of the hepatic assembly and secretion of apolipoprotein B-100-containing lipoproteins. J. Lipid Res. 2006. 47: 1749–1761). Here, we report that glucosamine also regulates apoB100 protein synthesis via ER-stress-induced PERK activation. Short-term (4 h) glucosamine treatment of HepG2 cells reduced both cellular (by 62%) and secreted apoB100 (by 43%) without altering apoB100 mRNA. Treatment with proteasomal inhibitors only partially prevented the suppressive effects of glucosamine, suggesting that mechanisms other than proteasomal degradation may also be involved. Glucosamine-induced ER stress was associated with a significantly reduced apoB100 synthesis with no significant change in posttranslational decay rates, suggesting that glucosamine exerted its effect early during apoB biosynthesis. The role of PERK and its substrate, &agr;-subunit of eukaryotic initiation factor 2 (eIF2&agr;), in the suppressive effects of glucosamine on apoB synthesis was then investigated. Coexpression of apoB15 (normally resistant to intracellular degradation) with wild-type double stranded (ds) RNA activated protein kinase (PKR)-like endoplasmic reticulum kinase (PERK) in COS-7 cells resulted in a dramatic reduction in the levels of newly synthesized apoB15. Interestingly, cotransfection with apoB15 and a kinase inactive PERK mutant (K618A) increased apoB15 expression. In addition, short-term glucosamine treatment stimulated an increase in phosphorylation of PERK and eIF2&agr;. Taken together, these data suggest that in addition to the induction of ER-associated degradation and other degradative pathways, ER stress is associated with suppression of apoB synthesis via a PERK-dependent mechanism.
MODELING X-RAY BINARY EVOLUTION IN NORMAL GALAXIES: INSIGHTS FROM SINGS

We present the largest-scale comparison to date between observed extragalactic X-ray binary (XRB) populations and theoretical models of their production. We construct observational X-ray luminosity functions (oXLFs) using Chandra observations of 12 late-type galaxies from the Spitzer Infrared Nearby Galaxy Survey. For each galaxy, we obtain theoretical XLFs (tXLFs) by combining XRB synthetic models, constructed with the population synthesis code StarTrack, with observational star formation histories (SFHs). We identify highest-likelihood models both for individual galaxies and globally, averaged over the full galaxy sample. Individual tXLFs successfully reproduce about half of the oXLFs, but for some galaxies we are unable to find underlying source populations, indicating that galaxy SFHs and metallicities are not well matched and/or that XRB modeling requires calibration on larger observational samples. Given these limitations, we find that the best models are consistent with a product of common envelope ejection efficiency and central donor concentration ≃ 0.1, and a 50% uniform–50% “twins” initial mass-ratio distribution. We present and discuss constituent subpopulations of tXLFs according to donor, accretor, and stellar population characteristics. The galaxy-wide X-ray luminosity due to low-mass and high-mass XRBs, estimated via our best global model tXLF, follows the general trend expected from the LX–star formation rate and LX–stellar mass relations of Lehmer et al. Our best models are also in agreement with modeling of the evolution of both XRBs over cosmic time and of the galaxy X-ray luminosity with redshift.
[Investigation of voiding dysfunction in a population-based sample of children aged 3 to 9 years].

OBJECTIVE To describe voiding patterns and related dysfunctions in a population-based sample of children aged 3 to 9 years. METHODS A cross-sectional population-based survey including 580 children. A probabilistic sample of households in the urban area of Pelotas in southern Brazil was selected following a multiple-stage protocol. Voiding and fecal patterns were investigated using the dysfunction score created by Farhat et al. and modified by the addition of high urinary frequency (more than eight times a day). Boys with scores above eight and girls above five were clinically investigated, as well as a sub-sample of the remaining children. RESULTS Nocturia (60.4%), urinary urgency (49.7%) and holding maneuvers (42.1%) were the most frequently reported symptoms. The prevalence of enuresis was 20.1% in boys and 15.1% in girls. The prevalence of urinary dysfunction was 22.8%. Most symptoms were more frequently reported by girls and younger children. Among girls, low socioeconomic level was related to an increased prevalence of enuresis and straining to urinate, while among boys urgency was more common among the poor. Only 10.5% of the parents of the children with voiding dysfunction consulted a doctor because of their problems. CONCLUSIONS The voiding symptoms studied presented high prevalence rates, and therefore should be investigated in clinical practice, with direct questions about each symptom, aiming to diagnose voiding dysfunction.
The Meaning and Meaningfulness of Corporate Social Initiatives

In response to pressures to be more socially responsible, corporations are becoming more active in global communities through direct involvement in social initiatives. Critics, however, question the sincerity of these activities and argue that firms are simply attempting to stave off stakeholder pressures without providing a corresponding benefit to society. By drawing on institutional theory and resource dependence theory, we consider what factors influence the adoption of a meaningful social initiative - an initiative that is sustainable and has the potential for a significant positive impact on society - as opposed to a symbolic initiative. In addition, we raise the question of how social initiatives - both meaningful and symbolic - participate in the institutional war over the meaning of corporate social responsibility.
A simulation of current focusing and steering with penetrating optic nerve electrodes

Objective. Current focusing and steering are both widely used to shape the electric field and increase the number of distinct perceptual channels in neural stimulation, yet neither technique has been used for an optic nerve (ON)-based visual prosthesis. In order to evaluate the effects of current focusing and steering in penetrative stimulation, we built an integrated computational model to simulate and investigate the influence of stimulating parameters on ON fibre recruitment. Approach. Finite element models with extremely fine meshes were first established to compute the 3D electric potential distribution under different stimulating parameters. Then the external electric potential was fed to randomized multi-compartment cable models to predict the distribution of fibres generating an action potential. Finally a statistical process was conducted to quantify the recruitment region. Main results. The simulation results show that a two-electrode mode is superior to a three-electrode mode in current steering. The three-electrode mode performs poorly in current focusing, albeit the localized recruitment from both configurations implies that current focusing might be unnecessary in penetrative ON stimulation. Significance. This study provides useful information for the optimized design of penetrating ON electrodes and stimulating strategies. The Monte Carlo style computation paradigm is designed to simulate neural responses of an ensemble of ON fibres, which can be immediately transferred to other similar problems.
Human plasma concentrations of cytochrome P450 probe cocktails extrapolated from pharmacokinetics in mice transplanted with human hepatocytes and from pharmacokinetics in common marmosets using physiologically based pharmacokinetic modeling

Abstract 1. The pharmacokinetic data of cytochrome P450 probes in humans can be extrapolated from corresponding data in cynomolgus monkeys, dogs and minipigs using simplified physiologically based pharmacokinetic (PBPK) modeling. In this study, the modeling methodology was further adapted to estimate human plasma concentrations of P450 probes based on data from mice transplanted with human hepatocytes or based on data from marmosets. 2. Using known species allometric scaling factors, the observed plasma concentrations of caffeine, warfarin, omeprazole, metoprolol, and midazolam in chimeric TK-NOG mice with humanized liver were scaled to human oral monitoring equivalents. Using the same approach, the previously reported pharmacokinetics of the five P450 probes in marmosets were also scaled to reported equivalents in humans using in vitro metabolic clearance data. 3. Human plasma concentration profiles of the five P450 probes estimated by simplified human PBPK models based on the observed pharmacokinetics in mice with humanized liver and on the reported pharmacokinetics in marmosets were consistent with previously published pharmacokinetic data in Caucasians. 4. These results suggest that mice with humanized liver and/or marmosets could be suitable pharmacokinetic models for humans during research into new drugs, especially when used in combination with simple PBPK models.
Sex-related differences in baseline characteristics, management and outcome in patients with acute coronary syndrome without ST-segment elevation

Aim: To detect sex-related differences in baseline characteristics, management and outcome in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS). Methods: Data from 812 consecutive patients admitted to our cardiology department for NSTE-ACS between 2001 and 2004 were obtained. Early invasive therapy was defined as revascularization during first hospital stay. A seven-year follow-up for the clinical endpoint of all-cause mortality could be obtained in 342 women and 440 men, respectively. Results: Compared with men, women were significantly older and more likely to suffer from renal insufficiency. The proportion treated with clopidogrel at admission was 43.6% for women and 52.7% for men, respectively (p=0.011). Significantly fewer women underwent an early invasive therapy compared with men (27.5% vs. 35.2%; p=0.021). Age and renal insufficiency were the strongest predictors for a conservative approach in both female and male patients. After adjustment for baseline characteristics there was no significant difference in treatment between women and men (odds ratio 0.89; 95% confidence interval 0.59–1.35; p=0.588). While in-hospital mortality was similar between the sexes, long-term mortality was significantly higher in women compared with men (8.2% vs. 7.0%; p=0.549 for in-hospital mortality and 54.8% vs. 39.3%; p<0.001 for seven-year mortality). However, after adjustment for baseline characteristics and treatment there was no significant difference in long-term mortality between women and men (hazard ratio 1.14; 95% confidence interval 0.89–1.47; p=0.307). Conclusion: In these patients with NSTE-ACS women were less likely to undergo an early invasive therapy compared with men due to their higher age and the higher rate of renal insufficiency. After adjustment for age, comorbidities and treatment female sex was not associated with worse long-term outcome.
Immunohistochemical evidence for the myeloperoxidase/H2O2/halide system in human atherosclerotic lesions: colocalization of myeloperoxidase and hypochlorite-modified proteins.

The 'oxidation theory' of atherosclerosis proposes that oxidation of low density lipoprotein (LDL) contributes to atherogenesis. Although the precise mechanisms of in vivo oxidation are widely unknown, increasing evidence suggests that myeloperoxidase (MPO, EC 1.11.1.7), a protein secreted by activated phagocytes, generates modified/oxidized (lipo)proteins via intermediate formation of hypochlorous acid (HOCl). In vitro generation of HOCl transforms lipoproteins into high uptake forms for macrophages giving rise to cholesterol-engorged foam cells. To identify HOCl-modified-epitopes in human plaque tissues we have raised monoclonal antibodies (directed against human HOCl-modified LDL) that do not cross-react with other LDL modifications, i.e. peroxynitrite-LDL, hemin-LDL, Cu2+-oxidized LDL, 4-hydroxynonenal-LDL, malondialdehyde-LDL, glycated-LDL, and acetylated-LDL. The antibodies recognized a specific epitope present on various proteins after treatment with OCl- added as reagent or generated by the MPO/H2O2/halide system. Immunohistochemical studies revealed pronounced staining for HOCl-modified-epitopes in fibroatheroma (type V) and complicated (type VI) lesions, while no staining was observed in aortae of lesion-prone location (type I). HOCl-oxidation-specific epitopes are detected in cells in the majority of atherosclerotic plaques but not in control segments. Staining was shown to be inside and outside monocytes/macrophages, endothelial cells, as well as in the extracellular matrix. A similar staining pattern using immunohistochemistry could be obtained for MPO. The colocalization of immunoreactive MPO and HOCl-modified-epitopes in serial sections of human atheroma (type IV), fibroatheroma (type V) and complicated (type VI) lesions provides further convincing evidence for MPO/H2O2/halide system-mediated oxidation of (lipo)proteins under in vivo conditions. We propose that MPO could act as an important link between the development of atherosclerotic plaque in the artery wall and chronic inflammatory events.
Structural energetics of peptide recognition: Angiotensin II/antibody binding

The ability to predict the strength of the association of peptide hormones or other ligands with their protein receptors is of fundamental importance in the fields of protein engineering and rational drug design. To form a tight complex between a flexible peptide hormone and its receptor, the large loss of configurational entropy must be overcome. Recently, the crystallographic structure of the complex between angiotensin II and the Fab fragment of a high affinity monoclonal antibody has been determined (Garcia, K. C., Ronco, P. M., Verroust, P. J., Brünger, A. T., Amzel, L. M. Three‐dimensional structure of an angiotensin II–Fab complex at 3 Å: Hormone recognition by an anti‐idiotypic antibody. Science 257:502–507, 1992). In this paper we present a study of the thermodynamics of the association by high sensitivity isothermal titration calorimetry. The results of the experiments indicate that at 30°C the binding is characterized by (1) a ΔH of −8.9 ± 0.7 kcal mol−1, (2) a ΔCp of −240 ± 20 cal K−1 mol−1, and (3) the release of 1.1 ± 0.1 protons per binding site in the pH range 6.0–7.3. Using these values and the previously determined binding constant in phosphate buffer, ΔG at 30°C is estimated as −11 kcal mol−1 and ΔS as 6.9 cal K−1 mol−1. The calorimetric data indicate that binding is favored both enthalpically and entropically. These results have been complemented by structural thermodynamic calculations. The calculated and experimentally determined thermodynamic quantities are in good agreement. Entropically, the loss of configurational entropy is more than compensated by the entropy gain from solvent release associated with the hydrophobic effect. Enthalpically, binding is favored by polar interactions (hydrogen bonding). Consequently, the problem of binding flexible hormones is solved in much the same way as the folding of an unstructured polypeptide chain into a globular protein. © 1993 Wiley‐Liss, Inc.
p53 protein expression and proliferative activity in imprints of superficial transitional cell carcinoma of the bladder.

OBJECTIVE To investigate p53 protein expression and proliferative activity in imprints of tumor biopsies from superficial transitional cell carcinoma of the bladder in relation to the histologic grade of malignancy and recurrence status. STUDY DESIGN The study group consisted of 70 cases of superficial transitional cell carcinoma of the bladder. In order to investigate p53 protein expression and Ki-67 expression, an immunocytochemical avidin-extravidin complex technique was performed using monoclonal antibodies p53 D0-7 and proliferating cells correspondingly. RESULTS Thirty-seven percent of superficial transitional cell carcinoma cases showed positive expression of p53 protein. No correlation was found between p53 protein expression and grade of malignancy (P = .45). p53 Protein expression was statistically correlated with a high Ki-67 labeling index (LI) (P < .001) and recurrence status (P < .001). Forty-seven percent of cases showed a Ki-67 LI > 25%. No correlation was found between a high Ki-67 LI and grade of malignancy (P = .703). A significant difference in high Ki-67 LI between recurrent and nonrecurrent tumors of the same grade (P < .001) and between recurrent and nonrecurrent tumors was found independently of grade (P < .001). CONCLUSION These results on cytologic material could provide useful information on the biologic behavior of superficial transitional cell carcinoma of the bladder at the time of diagnosis.