bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Costs of Non-Insurance in Maryland
Authors: Waters Hugh , Steinhardt Laura , Oliver Thomas R , Burton Alice , Milner Susan 
Published: March 2007

This study calculates expenditures and costs related to a lack of health insurance coverage in the State of Maryland. Research methods. The study is based on detailed primary and secondary data collection on the following sources of payment and care related to non-insurance: (1) uncompensated hospital care; (2) other public subsidies; (3) ambulatory services; (4) philanthropic spending; and (5) uninsured individuals' costs. Results. Expenditures by and for the uninsured in Maryland total $1.47 billion dollars. On a per-capita basis, this is equivalent to $2,371 per full-year uninsured person in the state. Twenty-seven percent of this total, or $633 per uninsured person, is paid directly by the uninsured themselves in out-of-pocket medical expenditures. The state and local governments spent $497 per uninsured person (21% of the total), and the federal government spent an additional $401 (17%). Private payers (including insurance, physicians, and philanthropy) accounted for $460 (19%). Conclusions. The sources and flows of spending on the uninsured are complex, and these expenditure levels should not be interpreted as savings that would directly result from an expansion of insurance coverage. Our results are consistent with earlier studies completed at the national level, and add considerable detail.
Circle Hooks for Pacific Longliners: Not a Panacea for Marlin and Shark Bycatch, but Part of the Solution
Authors: Kaplan Isaac C. , Cox Sean P. , Kitchell James F. 
Published: March 2007

AbstractBlue marlin Makaira nigricans, striped marlin Tetrapturus audax, and pelagic sharks (e.g., blue shark Prionace glauca) are commonly caught as bycatch by longline fisheries in the central North Pacific Ocean. Recently, concern has increased about depletion of these species. Modifications in longline gear may offer one solution. Here, we test the use of circle hooks, rather than the conventional tuna‐style hooks, on longlines using an ecosystem model of the central North Pacific Ocean. The simulations considered span a range of reasonable circle hook catchability and survival rates for released fish. The results suggest that if circle hooks have higher catchability than the currently used tuna‐style hooks, switching to circle hooks depletes marlin biomass by 25–40% and shark biomass by 15–35% over 30 years. However, these depletions do not occur if circle hook catchability is equal to or lower than that of tuna‐style hooks. When the effects of catch‐and‐release requirements for marlins and sharks were also considered, we found that regardless of assumptions about circle hook catchability and survival rates, a combined policy of using circle hooks and releasing sharks and marlins leads to net increases in marlin and shark abundance. The simulations show a trade‐off between the abundance of marlins and sharks and their prey items, yellowfin tuna Thunnus albacares and small blue sharks. There is also evidence of trophic trade‐offs between yellowfin tuna and small blue sharks and their prey, small scombrids (Auxis spp.) and mahi mahi Coryphaena hippurus. The results illustrate the importance of understanding catchability and survival rates for circle hooks compared with those for tuna‐style hooks and encourage further research in this area.
Effectiveness of Two Forms of Feedback on Training of a Joint Mobilization Skill by Using a Joint Translation Simulator
Authors: Chang Ju-Ying , Chang Guan-Liang , Chien Chia-Jen Chang , Chung Kao-Chi , Hsu Ar-Tyan 
Published: March 2007

Background and Purpose
Joint mobilization is a complicated task to learn and to teach and is characterized by great intersubject variability. This study's purpose was to investigate whether quantitatively augmented feedback could enhance the learning of joint mobilization and, more specifically, to compare the effects of training with concurrent or terminal feedback by using a joint translation simulator (JTS).

Subjects
Thirty-six undergraduate physical therapist students were randomly assigned to control (no feedback), concurrent feedback, and terminal feedback groups.

Methods
The JTS was designed to simulate tissue resistance based on load-displacement relationships of glenohumeral joint specimens. Subjects applied specific mobilization grades of force on the JTS while quantitative feedback was given to the feedback groups either during a trial (ie, concurrent feedback) or after a trial (ie, terminal feedback). The skill acquisition phase lasted a total of 40 minutes, and a total of 75 repetitions were performed for each grade of each joint model. Pretest and no-feedback retention tests were conducted.

Results
During acquisition and retention, both feedback groups performed more accurately than did the control group. No obviously superior performance was shown by the terminal feedback group compared with concurrent feedback group during retention testing.

Discussion and Conclusion
Subjects who trained with augmented feedback had less variability, and thus more consistency, than the control group subjects who received no feedback. Augmented feedback provides the student with a reference force and the status of his or her performance. The effectiveness of the JTS feedback compared with no feedback was clearly demonstrated. Skill acquisition in mobilization can be enhanced by either concurrent or terminal feedback.
Relationship between esophageal varices and azygos vein evaluated by cineportography
Authors: Kimura Tohru , Moriyasu Fuminori , Kawasaki Toshihiko , Someda Hitoshi , Tamada Takashi , Yamashita Yukitaka , Ono Shigeki , Kajimura Kouzou , Nishida Osamu , Okuma Minoru 
Published: March 2007

The relationship between esophageal varices and the azygos vein, which is generally considered to drain the major part of the variceal blood flow, was evaluated by percutaneous transhepatic cineportography in 35 patients with portal hypertension. We classified the patients into three groups. Those patients in whom most of the variceal blood drained into the azygos vein were designated the azygos-type group (n = 18). Those in whom most of the blood flowed into the brachiocephalic venous system were defined as the cervical-type group (n = 5), and those in whom the varices were drained by both the azygos vein and the brachiocephalic venous system were called the combined-type group (n = 12).
Highly developed esophageal varices were recognized endoscopically in all patients in the combined-type and cervical-type groups, whereas some of the patients in the azygos-type group had less well-developed varices. In the azygos-type group, a tendency for the varices to be more severe as their drainage into the azygos vein became more cephalad was noted. Evaluation of the drainage of esophageal varices was considered useful not only for obtaining full comprehension of the significance of the azygos vein but also for assessing the suitability for sclerotherapy. Percutaneous transhepatic cineportography was useful for this purpose because it enables visualization of even the most minute amounts of blood flow. (Hepatology 1991; 13:858-864.)
Sex hormones in postmenopausal women with primary biliary cirrhosis
Authors: Becker Ulrik , Almdal Thomas , Christensen Erik , Gluud Christian , Farholt Stense , Bennett Paul , Svenstrup Birgit , Hardt Finn 
Published: March 2007

To evaluate serum sex hormone profiles in nonalcoholic postmenopausal women with liver disease, 25 women with primary biliary cirrhosis (11 in cirrhotic stage) and 46 healthy controls were studied.
The patients had significantly (p <0.05) elevated serum concentrations of estrone and androstenedione and significantly (p <0.05) lower concentrations of estrone sulfate, dehydroepiandrosterone sulfate and 5α-dihydrotestosterone compared with the 46 controls. Serum concentrations of sex hormone binding globulin, testosterone, non-sex hormone binding globulin-bound testosterone and non-protein-bound testosterone did not differ significantly (p> 0.05) between primary biliary cirrhosis patients and controls. Patients in the cirrhotic stage had significantly (p < 0.05) higher concentrations of sex hormone binding globulin than did controls.
Patients in the cirrhotic stage had significantly (p < 0.05) higher sex hormone binding globulin and estrone sulfate levels compared with noncirrhotic patients with primary biliary cirrhosis. Otherwise, no significant differences were observed between cirrhotic and noncirrhotic patients.
The observed changes in steroid concentrations may be a consequence of hepatic dysfunction. (Hepatology 1991;13:865-869.)
Double-blind investigation of the effects of propranolol and placebo on the pressure of esophageal varices in patients with portal hypertension
Authors: Feu Faust , Bordas Josep M. , Garcia-Pagán Joan C. , Bosch Jaime , Rodés Joan 
Published: March 2007

This study was aimed at investigating the effects of propranolol on esophageal variceal pressure in patients with portal hypertension.
Variceal pressure was measured at endoscopy using a miniature pressure-sensitive gauge in 20 patients with portal hypertension. Measurements were obtained under baseline conditions and 20 min after double-blind administration of propranolol (0.15 mg/kg; n = 10) or an identical amount of placebo (normal saline, 0.3 ml/kg; n = 10).
Under baseline conditions, variceal pressure was similar in propranolol and placebo groups (14.1 ± 5 mm Hg vs. 14.9 ± 6.6 mm Hg, respectively; not significant). Placebo had no significant effect on variceal pressure (baseline = 14.9 ± 6.6 mm Hg; placebo = 15.5 ± 6.6 mm Hg; not significant), and values after placebo administration were closely correlated with baseline values (r = 0.98; y = 1.1 + 0.97 x; p < 0.0001). In contrast, propranolol caused a significant decrease in the pressure of esophageal varices (from 14.1 ± 5 mm Hg to 11.3 ± 4.4 mm Hg; p < 0.002). No significant changes in the size of esophageal varices were observed after propranolol or placebo administration.
This study shows (a) the endoscopic pressure-gauge technique has a low variability and may be used to assess acute drug-induced changes in variceal pressure; and (b) propranolol causes significant decreases in variceal pressure in patients with portal hypertension and esophageal varices. (Hepatology 1991;13:917-922.)
Expression of insulin-like growth factor II and receptors for insulin-like growth factor II, insulin-like growth factor I and insulin in isolated and cultured rat hepatocytes
Authors: Lamas Eugenia , Zindy Frédérique , Seurin Danielle , Guguen-Guillouzo Christiane , Brechot Christian 
Published: March 2007

Insulin-like growth factor II is believed to play an important role in fetal growth and development. The insulin-like growth factor II gene expression is tissue specific and developmentally regulated. We have previously shown an enhanced level of insulin-like growth factor II messenger RNA and protein in human hepatocellular carcinomas. This led to the suggestion that hepatocytes might be involved in insulin-like growth factor II expression. However, previous studies based on in situ hybridization only showed insulin-like growth factor II messenger RNA in liver sinusoidal cells. This paper reports on the analysis of the expression of insulin-like growth factor II and insulin-like growth factor II, insulin-like growth factor I and insulin receptor messenger RNAs in vivo in isolated rat hepatocytes at various stages of development and in vitro in adult rat hepatocytes primary culture.
Our study indicates that isolated rat hepatocytes synthesize insulin-like growth factor II messenger RNA with a switch between fetal and adult messenger RNA profiles occurring 21 days after birth. In addition, adult rat hepatocytes in culture expressed insulin-like growth factor II messenger RNA and protein. Insulin-like growth factor II, insulin-like growth factor I and insulin receptor messenger RNAs were also detected.
Therefore these results are consistent with the hypothesis that insulin-like growth factor II acts as an autocrine growth factor for hepatocytes in addition to having a paracrine effect. They also indicate that primary culture of hepatocytes is a good model for further studies on insulin-like growth factor II gene regulation. (Hepatology 1991;13:936-940.)
Failure of ursodeoxycholic acid to prevent a cholestatic episode in a patient with benign recurrent intrahepatic cholestasis: A study of bile acid metabolism
Authors: Crosigani Andrea , Podda Mauro , Bertolini Emanuela , Battezzati Pier Maria , Zuin Massimo , Setchell Kenneth D. R. 
Published: March 2007

Ursodeoxycholic acid was administered to a patient with benign recurrent intrahepatic cholestasis to prevent cholestatic episodes. A detailed study of bile acid metabolism in this patient was carried out in the anicteric and icteric phases before and after ursodeoxycholic acid (750 mg/day) administration. Urinary, biliary and serum bile acids were measured by gas chromatography-mass spectrometry and by highperformance liquid chromatography techniques.
During the anicteric phase the daily urinary excretion and serum concentrations of bile acids were within normal ranges, indicating normal hepatic uptake and secretion of bile acids during the cholestasis-free period. Only slight qualitative differences from normal individuals were observed; the relative proportions of deoxycholic acid in the bile and serum were higher, and 12-oxo-lithocholic acid was the predominant urinary bile acid.
During the icteric phase a marked increase in the urinary excretion of primary bile acids and C-1, C-2, C-4 and C-6 hydroxylated metabolites was found. Serum bile acid concentrations increased before the rise in bilirubin, suggesting an acute disturbance in bile acid transport at the onset of the cholestatic attack.
After ursodeoxycholic acid administration in the anicteric phase, bile became enriched with the exogenous bile acid, but little qualitative change was found in the other metabolites present in the urine, serum or bile during the anicteric or icteric phases. Prolonged administration of ursodeoxycholic acid failed to prevent recurrence of a cholestatic episode, suggesting that in benign recurrent intrahepatic cholestasis, oral ursodeoxycholic acid may be of little benefit in the treatment or prevention of cholestasis despite marked enrichment of the bile acid pool with this hydrophilic bile acid. (Hepatology 1991;13:1076-1083.)
Blood and liver-infiltrating lymphocytes in primary biliary cirrhosis: Increase in activated T and natural killer cells and recruitment of primed memory T cells
Authors: Björkland Anna , Festin Roger , Mendel-Hartvig Ib , Nyberg Anders , Lööf Lars , Tötterman Thomas H. 
Published: March 2007

We used two-color and three-color flow cytometric analysis to study phenotypical activation and functional subsets of T and natural killer cells in the blood and liver tissue of patients with primary biliary cirrhosis, other chronic liver diseases and the blood of healthy subjects. The changes in blood lymphocyte phenotype in patients with primary biliary cirrhosis and other chronic liver diseases were similar and comprised elevated relative or absolute numbers of activated human leukocyte antigen-DR+ T subset (CD4+ and CD8+) cells and DR+ natural killer-like (CD16+) cells. B cell (CD19+) numbers were normal. In primary biliary cirrhosis a selective reduction in T cells of suppressor-inducer (CD45RA+ CD4+) type was registered. The human leukocyte antigen-DR expression among CD4 + T cell subsets was investigated further in primary biliary cirrhosis and healthy controls using triple antibody flow cytometric analysis. Phenotypical cell activation was confined to helper T cells of the primed, memory (CD45RO + CD4+) type. The decrease in suppressor-inducer T cells in primary biliary cirrhosis was paralleled by a reciprocal increase in primed memory T cells.
Several significant differences were observed when blood and liver-infiltrating cells from primary biliary cirrhosis patients were compared. In the liver tissue, the CD4/CD8 ratio was decreased, the relative activation of T-subset cells and NK cells was further increased, the suppressor-inducer T subset was further depressed and the primed memory T subset was increased. The cytotoxic T-cell subset (CD11b−) dominated within the CD8+ population. In liver tissue from other chronic liver disease subjects, a lower CD4/CD8 ratio was found compared with primary biliary cirrhosis. However, the infiltrate was relatively similar to primary biliary cirrhosis, indicating a common inflammatory pattern. (Hepatology 1991;13:1106-1111.)
Hepatocellular expression of lymphocyte function—associated antigen 3 in chronic hepatitis
Authors: Autschbach Frank , Meuer Stefan C. , Moebius Ulrich , Manns Michael , Hess Georg , Büschenfelde Karl-Hermann Meyer Zum , Thoenes Wolfgang , Dienes Hans-Peter 
Published: March 2007

T lymphocyte—mediated cytolytic immune reactions are considered a major cause of hepatocyte injury in chronic viral and autoimmune hepatitis. To further investigate local immune responses, we studied the expression of lymphocyte antigens and cell-cell interaction molecules known to be involved in effector-target cell interactions by light and electron microscopy in liver biopsy specimens from patients with chronic viral and autoimmune hepatitis.
CD8+ lymphocytes were found to be the predominant population of cells in the inflammatory infiltrate in chronic hepatitis B and non-A, non-B hepatitis. In contrast, CD4+ cells constituted a comparably higher proportion of cells and were more numerous than CD8+ cells in chronic autoimmune hepatitis. In both viral and autoimmune hepatitis, a substantial portion of lymphocytes expressed activation antigens such as T11/3 (CD2R) and IL-2-R (CD25). Lymphocyte function—associated antigen-3 (CD58), which mediates lymphocyte adhesion and activation and is the natural ligand of the CD2/T11 lymphocyte surface receptor, could be demonstrated on endothelial cells and hepatocytes. Hepatocellular lymphocyte function—associated antigen-3 expression in chronic hepatitis showed membranous and cytoplasmic staining of hepatocytes and had a positive correlation with the degree of inflammatory activity.
These results suggest that effector-target interactions between hepatocytes and lymphocytes mediated by the lymphocyte function—associated antigen-3/CD2 pathway play a role in chronic inflammatory liver disease. Possible functional consequences of this interaction include enhancement of antigen-specific immune reactions and antigen-independent mechanisms of T cell activation, which may contribute considerably to the degree of inflammatory activity and tissue damage in chronic hepatitis. (HEPATOLOGY 1991;14:223-230.)
Binding and internalization of transforming growth factor-β1 by human hepatoma cells: Evidence for receptor recycling
Authors: Sathre Kim A. , Tsang Monica L.-S. , Weatherbee James A. , Steer Clifford J. 
Published: March 2007

Cellular processing of 125I-labeled transforming growth factor-β1 was investigated in the human hepatoma cell lines Hep G2 and Hep 3B. Binding of 125I-transforming growth factor-β1 to cell surface receptors was specific, saturable and calciumindependent. Both cell lines exhibited a single class of high-affinity (Kd = 2.2 × 10−10 mol/L) binding sites (4.5 × 103 for the Hep G2 cell; 1.5 × 103 for the Hep 3B cell) for both human and porcine transforming growth factor-β1. Binding was temperature dependent, time dependent and pH dependent. Cell-bound 125I-transforming growth factor-β1 was removed by brief exposure to acidic medium (pH <4) but was converted into an acid-resistant state rapidly after shifting the cells to 37°C. Spontaneous dissociation of bound ligand over a 6 hr period at 4° C was less than 10%. Disuccinimidyl suberate was used to covalently label 125I-transforming growth factor-β1 to cell-surface binding sites. Labeling of the ligand/receptor complexes was inhibited by unlabeled transforming growth factor-β1 but was unaffected by other growth factors. The radiolabeled complexes showed approximate molecular weights of 280,000, 85,000 and 65,000 when run on reducing sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Cell-bound 125I-transforming growth factor-β1 was internalized and degraded at 37° C, and the products were released into the medium as trichloroacetic acid-nonprecipitable radioactivity. The lysosomotropic base chloroquine and the carboxylic ionophore monensin inhibited degradation and release of 125I-labeled products from the cells.
In the presence of cycloheximide and under conditions of sustained binding and uptake of saturating amounts of 125I-transforming growth factor-β1 for 3 hr, a 20% decrease in the binding capacity of Hep G2 cells occurred. The result indicates that during active processing of the 125I-transforming growth factor-β1 receptor complex by Hep G2 cells, surface receptors for transforming growth factor-β1 are replenished either from a cryptic intracellular pool or by receptor recycling. (HEPATOLOGY 1991;14:287-295.)
In vitro fragmentation of gallstones: Comparison of electrohydraulic, electromagnetic and piezoelectric shockwave lithotripters
Authors: Schneider Thomas H. , Fromm Martin , Ott Roland , Janowitz Paul , Swobodnik Werner , Neuhaus Horst , Ell Christian 
Published: March 2007

To compare the fragmentation efficiency of three different shockwave systems, 63 human gallstone triplets were disintegrated in vitro using an electrohydraulic (MPL 9000, Dornier), an electromagnetic (Lithostar Plus, Siemens) and a piezoelectric (Piezolith 2300, R. Wolf) lithotripter. Since each stone triplet was obtained from the same gallbladder, the concrements of one such set were identical in physicochemical parameters. According to the maximal diameter, the calculi were divided into group A (6 to 15 mm) and group B (16 to 30 mm). Shockwave application was terminated when residual fragments measured 4 mm or less. Forty-five triplets were fragmented at energy settings mainly used in clinical treatment of patients with gallbladder stones (MPL 9000: 20 kV; Lithostar Plus: setting 9 (maximal); Piezolith 2300: setting 3). The fragmentation endpoint was achieved in group A (n = 3 × 36) with the Piezolith 2300 after median 150 (range = 50 to 500) pulses and with the Lithostar Plus after 150 (50 to 750) pulses compared with 500 (50 to 1,500) pulses using the MPL 9000 (p < 0.01). In group B (n = 3 × 9) the Lithostar Plus (median = 750, range = 250 to 1,250 pulses) required fewer discharges than the Piezolith 2300 (1,250,250 to 2,500 pulses; p < 0.05) and the MPL (1,500,500 to 1,600 [upper limit] pulses; p < 0.01). At maximal intensities (MPL 9000: 26 kV; Lithostar Plus: setting 9; Piezolith 2300: setting 4), no statistically significant differences between the three tested shockwave systems were observed (Piezolith 2300: 100, 50 to 250 pulses; MPL 9000: 100, 50 to 500 pulses; Lithostar Plus: 100, 50 to 1000 pulses) for group A stones (n = 3 × 12) and group B stones (n = 3 × 6; Piezolith 2300 [500, 250 to 750 pulses], MPL 9000 [625,250 to 750 pulses] and Lithostar Plus [750, 250 to 1,000 pulses]).
An adequate degree of fragmentation independent of the physical shockwave system can be achieved in vitro at maximal intensities for each tested stone size. At submaximal energy settings, better results were obtamed in stones up to 15 mm in diameter with the piezoelectric generator than with the electrohydraulic device, whereas in larger stones disintegration efficiency did not differ significantly between these two lithotripters. (HEPATOLOGY 1991;14:301-305.)