bluuebunny/crossref_metadata_2025_split huggingface dataset:
Public–Private Partnerships in the health sector: the Danish experience
Authors: VRANGBÆK* KARSTEN 
Published: April 2008

AbstractThis article investigates the current use of Public–Private Partnerships (PPP) in the Danish health sector based on an initial discussion of theoretical approaches that analyze PPP. The empirical analysis concludes that PPP has been used very sparsely in the Danish health sector. There are few examples of large-scale partnership projects with joint investment and risk taking, but a number of smaller partnerships such as jointly owned companies at the regional level. When defining PPP more broadly, we can identify a long tradition for various types of collaboration between public and private actors in health care in Denmark. An analysis of the regulatory environment is offered as an explanation for the limited use of PPPs in Denmark. Major political and institutional actors at the central level differ in their enthusiasm for the PPP concept, and the regulatory framework is somewhat uncertain. A number of general issues and concerns related to PPPs are also discussed. It is suggested that a risk-based framework can be useful for mapping the potential and challenges for both private and public partners. Such a framework can be used to feed into game theoretical models of pros and cons for PPP projects. In general terms, it is concluded that more empirical research is needed for the assessment of the various risk factors involved in using PPPs in health care. Most PPPs are still very young, and the evidence on performance and broader governance issues is only just emerging. Ideally, such assessments should include comparisons with a purely public alternative.
Applying stable isotope probing of phospholipid fatty acids and rRNA in a Chinese rice field to study activity and composition of the methanotrophic bacterial communities in situ
Authors: Qiu Qiongfen , Noll Matthias , Abraham Wolf-Rainer , Lu Yahai , Conrad Ralf 
Published: April 2008

Abstract
Methanotrophs in the rhizosphere play an important role in global climate change since they attenuate methane emission from rice field ecosystems into the atmosphere. Most of the CH4 is emitted via transport through the plant gas vascular system. We used this transport for stable isotope probing (SIP) of the methanotrophs in the rhizosphere under field conditions and pulse-labelled rice plants in a Chinese rice field with CH4 (99% 13C) for 7 days. The rate of 13CH4 loss rate during 13C application was comparable to the CH4 oxidation rate measured by the difluoromethane inhibition technique. The methanotrophic communities on the roots and in the rhizospheric soil were analyzed by terminal-restriction fragment length polymorphism (T-RFLP), cloning and sequencing of the particulate methane monooxygenase (pmoA) gene. Populations of type I methanotrophs were larger than those of type II. Both methane oxidation rates and composition of methanotrophic communities suggested that there was little difference between urea-fertilized and unfertilized fields. SIP of phospholipid fatty acids (PLFA-SIP) and rRNA (RNA-SIP) were used to analyze the metabolically active methanotrophic community in rhizospheric soil. PLFA of type I compared with type II methanotrophs was labelled more strongly with 13C, reaching a maximum of 6.8 atom-%. T-RFLP analysis and cloning/sequencing of 16S rRNA genes showed that methanotrophs, especially of type I, were slightly enriched in the ‘heavy’ fractions. Our results indicate that CH4 oxidation in the rice rhizosphere under in situ conditions is mainly due to type I methanotrophs.
Impact of Social Support Intensity on Walking in the Severely Obese: A Randomized Clinical Trial
Authors: Hemmingsson Erik , Hellénius Mai‐Lis , Ekelund Ulf , Bergström Jakob , Rössner Stephan 
Published: April 2008

Objective: There are few established methods for promoting physical activity (PA) in the severely obese. Because social support is a potential method for promoting PA, we compared mean steps/day during 18 weeks in severely obese outpatients receiving either standard support (SS) or added support (AS).Methods and Procedures: Eighty severely obese outpatients from an obesity clinic were invited; 66 provided written consent, 55 were randomized, and 42 were included in final analyses (9 men, 33 women; age 44.4 ± 13.1 years; BMI 41.9 ± 5.5 kg/m2). All participants received a pedometer and a walking promotion booklet. In addition to SS, the AS group received ten 2‐h group counseling sessions aimed at increasing weekly accumulated steps, every second week during the study. Each participant was asked to complete a 7‐day walking diary every second week (10 observations).Results: Baseline steps/day was 6,912 for the AS group and 5,311 for the SS group (P = 0.023). Data at 18 weeks showed that the AS group recorded 10,136 steps/day and the SS group 6,118 steps/day (P = 0.024). There was no allocation × time interaction (P = 0.46). During the follow‐up period as a whole, the AS group recorded 1,794 more steps/day than the SS group (P = 0.0074).Discussion: The AS group recorded more steps/day than the SS group, reaching a mean level of ∼10,000 steps/day. However, the nonsignificant interaction between allocation × time suggests that this difference was present already at baseline and did not increase during follow‐up.
Trends in Overweight and Obesity in Chinese Adults: Between 1991 and 1999–2000
Authors: Wildman Rachel P. , Gu Dongfeng , Muntner Paul , Wu Xiqui , Reynolds Kristi , Duan Xiufang , Chen Chung‐Shiuan , Huang Guangyong , Bazzano Lydia A. , He Jiang 
Published: April 2008

Objective: The aim of this study was to evaluate trends in BMI and the prevalence of overweight (BMI ≥ 25 kg/m2) and obesity (BMI ≥ 30 kg/m2) between 1991 and 1999–2000 among Chinese adults.Methods and Procedures: In this study, two population‐based samples of Chinese adults aged between 45 and 79 years (n = 7,858 during each period), and comparable in the distributions of age, gender, degree of urbanization, and region (North/South) were used. Height and weight were measured using identical procedures at each period, and BMI was calculated as weight (in kilogram) divided by height (in square meter).Results: From 1991 to 1999–2000, the mean BMI increased from 21.8 to 23.4 kg/m2 among men and from 21.8 to 23.5 kg/m2 among women (each P < 0.001). Among men, the prevalence of overweight and obesity increased from 9.6 and 0.6%, respectively, in 1991 to 20.0 and 3.0%, respectively, in 1999–2000 (each P < 0.001). Among women, the prevalence of overweight and obesity increased from 14.5 and 1.8%, respectively, in 1991 to 26.5 and 5.2%, respectively, in 1999–2000 (each P < 0.001). The prevalence of overweight and obesity increased in all age groups, in rural and urban areas, and in North and South China, with greater relative increases in obesity among older age groups, South China, and rural areas (P interaction < 0.05).Discussion: Overweight and obesity increased tremendously during the 1990s in China. These data underscore the need for national programs in weight maintenance and reduction, to prevent obesity‐related outcomes in China.
Mechanism by Which BMI Influences Leisure‐time Physical Activity Behavior
Authors: Godin Gaston , Bélanger‐Gravel Ariane , Nolin Bertrand 
Published: April 2008

Objective: The objective of this prospective study was to clarify the mechanism by which BMI influences leisure‐time physical activity. This was achieved in accordance with the assumptions underlying the Theory of Planned Behavior (TPB), considered as one of the most useful theories to predict behavior adoption.Methods and Procedures: At baseline, a sample of 1,530 respondents completed a short questionnaire to measure intention and perceived behavioral control (PBC), the two proximal determinants of behavior of TPB. Past behavior, sociodemographic variables, and weight and height were also assessed. The dependent variable, leisure‐time physical activity was assessed 3 months later.Results: Hierarchical multiple regression analyses revealed that BMI is a direct predictor of future leisure‐time physical activity, not mediated by the variables of TPB. Additional hierarchical analyses indicated that BMI was not a moderator of the intention‐behavior and PBC‐behavior relationships.Discussion: The results of this study suggest that high BMI is a significant negative determinant of leisure‐time physical activity. This observation reinforces the importance of preventing weight gain as a health promotion strategy for avoiding a sedentary lifestyle.
Prevalence and Characteristics of Energy Underreporting in African‐American Girls
Authors: Lanctot Jennifer Q. , Klesges Robert C. , Stockton Michelle B. , Klesges Lisa M. 
Published: April 2008

Objective: To determine the frequency and characteristics of energy intake underreporting in African‐American preadolescent girls as part of the Girls health Enrichment Multi‐site Studies (GEMS).Methods and Procedures: Energy intake was summarized using the Nutrition Data System for Research software and computed as a 3‐day average of 24‐h dietary recalls. Physical activity was assessed by an accelerometer, basal metabolic rate (BMR) was estimated using the World Health Organization's prediction equation, and underreporting of caloric intake was based on the Goldberg equation.Results: Using a conservative criterion for determining energy underreporting, we classified 54.8% of the girls as underreporters; 45.2% were classified as plausible reporters. Factors related to underreporting included higher BMI (β = −0.506, P ≤ 0.001), older age (β = −0.159, P = 0.001), greater unhealthy eating behaviors (β = −0.118, P = 0.025), and higher self‐efficacy for diet (β = −0.098, P = 0.033).Discussion: Underreporting of dietary intake, specifically energy, is common in African‐American preadolescent girls and can be partially explained by weight status and psychosocial variables. The extent of dietary underreporting in specific and high‐risk populations is largely unknown and could be evaluated by routinely including a report of such an index in future research studies.
Insulin Increases Tristetraprolin and Decreases VEGF Gene Expression in Mouse 3T3–L1 Adipocytes
Authors: Cao Heping , Urban Joseph F. , Anderson Richard A. 
Published: April 2008

Objectives: Tristetraprolin (TTP) family proteins (TTP/ZFP36; ZFP36L1, ZFP36L2, ZFP36L3) destabilize adenylate uridylate‐rich element‐containing mRNAs encoding cytokines, such as tumor necrosis factor (TNF) and vascular endothelial growth factor (VEGF). Little is known about the expression and insulin regulation of TTP and related genes in adipocytes. We analyzed the relative abundance of TTP family mRNAs in 3T3‐L1 adipocytes compared to RAW264.7 macrophages and investigated insulin effects on the expression of 43 genes in 3T3‐L1 adipocytes.Methods and Procedures: Insulin was added to mouse 3T3‐L1 adipocytes. Relative abundance of mRNA levels was determined by quantitative real‐time PCR. TTP and ZFP36L1 proteins were detected by immunoblotting.Results: Zfp36l1 and Zfp36l2 genes were expressed at eight‐ to tenfold higher than Ttp in adipocytes. Zfp36l3 mRNA was detected at ∼1% of Ttp mRNA levels in adipocytes and its low level expression was confirmed in RAW cells. Insulin at 10 and 100 nmol/l increased Ttp mRNA levels by five‐ to sevenfold, but decreased those of Zfp36l3 by 40% in adipocytes after a 30‐min treatment. Immunoblotting showed that insulin induced TTP but did not affect ZFP36L1 protein levels in adipocytes. Insulin decreased mRNA levels of Vegf and a number of other genes in adipocytes.Discussion: Insulin induced Ttp mRNA and protein expression and decreased Vegf mRNA levels in adipocytes. Zfp36l3 mRNA was detected, for the first time, in cells other than mouse placenta and extraembryonic tissues. This study established a basis for the investigation of TTP and VEGF genes in the regulation of obesity and suggested that Vegf mRNA may be a target of TTP in fat cells.
Pre-Emptive Perception
Authors: Bodis-Wollner Ivan 
Published: April 2008

How can an action to a target be selected without yet knowing what it is? Pre-emptive perception (PEP) is a framework which orders neuronal mechanisms in association with voluntary actions before an action is started and until it is completed. It is assumed that PEP serves the purpose of perception, but a conscious, perceptual identification of the goal is not obligatorily completed during the time period of PEP itself. The concept of PEP is that the brain pre-emptively optimizes an action plan to maximize eventual perception, even before being sure what the goal is. Experimental studies of voluntary saccadic eye movements are considered as prototypic activity within the framework of PEP. The core concept of pre-emption is that a particular saccade is selected while a large number of other possible actions are deselected. Pre-emptive computations include mechanisms associated with internal context and reward. Neurophysiological studies which show anatomically and functionally separate cortical and some subcortical neuronal groups in computing saccades are summarized. There is a potential relationship of PEP as a neurobiological framework and some philosophical concepts. Terms for processes between planning and action, such as intention, anticipation, and attention, are often incongruent in everyday language and in epistemology. It is proposed here that a scrutiny of these terms can be rigorously approached by temporal subdivision of PEP and conversely, clear definitions of these terms can lead to organized experimental designs of cognitive neurobiology. The temporal subdivision of PEP allows a critique of The Will in the definition of Schopenhauer and distinguishes it from the ‘free will’.
Effects of Old Age on Vascular Complexity and Dispersion of the Hepatic Sinusoidal Network
Authors: Warren Alessandra , Chaberek Slawomir , Ostrowski Kazimierz , Cogger Victoria C. , Hilmer Sarah N. , McCuskey Robert S. , Fraser Robin , Le Couteur David G. 
Published: April 2008

ABSTRACTObjectives: In old age, there are marked changes in both the structure of the liver sinusoidal endothelial cell and liver perfusion. The objective of this study was to determine whether there are also aging changes in the microvascular architecture and vascular dispersion of the liver that might influence liver function.Methods: Vascular corrosion casts and light micrographs of young (4 months) and old (24 months) rat livers were compared. Fractal and Fourier analyses and micro‐computed tomography were used. Vascular dispersion was determined from the dispersion number for sucrose and 100‐nm microspheres in impulse response experiments.Results: Age did not affect sinusoidal dimensions, sinusoidal density, or dispersion number. There were changes in the geometry and complexity of the sinusoidal network as determined by fractal dimension and degree of anisotropy.Conclusions: There are small, age‐related changes in the architecture of the liver sinusoidal network, which may influence hepatic function and reflect broader aging changes in the microcirculation. However, sinusoidal dimensions and hepatic vascular dispersion are not markedly influenced by old age.
Real‐Time Contrast Imaging: A New Method to Monitor Capillary Recruitment in Human Forearm Skeletal Muscle
Authors: Mulder Alexandra H. , Van Dijk Arie P.J. , Smits Paul , Tack Cees J. 
Published: April 2008

ABSTRACTObjective: Muscle capillary perfusion can be measured by contrast‐enhanced ultrasound. We examined whether a less time‐consuming ultrasound technique, called “real‐time imaging,” could be used to measure capillary recruitment in human forearm skeletal muscle.Methods: We measured microvascular blood volume and microvascular flow velocity using bolus injections of contrast microbubbles after forearm muscle exercise and a two‐hour infusion of insulin into the brachial artery (both associated with capillary recruitment) and after sodium nitroprusside infusion (no changes in flow distribution).Results: After an intravenous bolus injection of the contrast agent, the steady‐state concentration of contrast agent in forearm muscle lasted long enough (approximately 190 seconds) for the duration of the measurements (which take 70–80 seconds), rendering the continuous infusion of microbubbles unnecessary. Microvascular blood‐volume measurements showed a good short‐time reproducibility and a good reproducibility after repositioning of the forearm. Reproducibility of microvascular flow velocity was too low. Exercise and insulin infusion both increased microvascular blood volume, consistent with capillary recruitment. Sodium nitroprusside had no effect.Conclusion: Real‐time contrast imaging, after bolus injections of an ultrasound contrast agent, provides reliable information about capillary recruitment in human forearm skeletal muscle, and may offer a valuable tool in studying human (patho)physiology.
Monitoring the Capillary‐Alveolar Leakage in an A.R.D.S. Model Using Broncho‐Alveolar Lavage
Authors: Briot Raphael , Bayat Sam , Anglade Daniel , Martiel Jean‐Louis , Grimbert Francis 
Published: April 2008

ABSTRACTObjectives: We developed a modified broncho‐alveolar lavage (BAL) technique in order to perform repeated measurements of capillary‐alveolar leakage of a macromolecule in oleic acid (OA)‐induced lung injury.Methods: BAL was performed in anesthetized dogs in a closed lung sampling site, using a bronchoscope fitted with an inflatable cuff. Fluorescein‐labeled Dextran (FITC‐D70) was continuously infused and its concentration measured in plasma and BAL fluid. A two‐compartment model (blood and alveoli) was used to calculate KAB, the transport‐rate coefficient of FITC‐D70 from blood to alveoli. KAB was estimated every 15 minutes over three hours.Results: KAB, close to zero at base‐line both in control (n = 3) and in OA‐injured lungs (n = 7), reached a peak in permeability 30 minutes after the induction of OA injury (KAB = 1.43 ± 0.31 · 10−3 · minutes−1), followed by a slow recovery.Conclusions: We conclude that this technique allows the monitoring of capillary‐alveolar transport of macromolecules in in vivo experimental models. This monitoring may prove useful to study the mechanisms of the exudative stage of acute lung injury and to test therapies aimed at slowing the alveolar accumulation of plasma proteins and procoagulant factors that contribute to alveolar fibrosis.
Systemic and bronchodilator effects of inhaled rac‐formoterol in subjects with chronic obstructive pulmonary disease: a dose–response study
Authors: Whale Christopher I. , Sovani Milind P. , Mortimer Kevin J. , Harrison Timothy W. , Tattersfield Anne E. 
Published: April 2008

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • The long‐acting inhaled β2‐agonist formoterol has systemic effects when taken in high doses.• It can be used as relief medication in asthma and there is interest in this approach in chronic obstructive pulmonary disease (COPD).• Relief medication can involve high doses, and in subjects with COPD who have limited ability to bronchodilate the adverse effects can outweigh the benefits.• There are concerns with the overall safety of high‐dose β2‐agonists in subjects with COPD, and this study looks at the balance of beneficial and adverse effects of a range of doses of inhaled formoterol. WHAT THIS STUDY ADDS • Among subjects with COPD, high‐dose inhaled formoterol produced a dose‐related increase in forced expiratory volume in 1 s without a corresponding reduction in dyspnoea or increase in walk distance.• Systemic effects were modest, however, and high doses did not appear to reduce patient satisfaction.• Although further safety data are needed, inhaled formoterol may have a role as relief medication in COPD.AIMS Rac‐formoterol is effective as maintenance treatment for both asthma and chronic obstructive pulmonary disease (COPD) and is now used as relief therapy in asthma. Using rac‐formoterol for relief and maintenance treatment could involve inhalation of high doses, and whether this is of benefit in COPD is uncertain. Our aim was to determine whether higher doses of inhaled rac‐formoterol produce systemic adverse effects that outweigh the limited bronchodilator benefit seen in subjects with COPD.METHODS We examined airway and systemic effects of 6, 12, 24 and 48 μg rac‐formoterol and placebo on separate days in 20 subjects with symptomatic COPD [forced expiratory volume in 1 s (FEV1) 47% predicted]. FEV1, oxygen saturation, dyspnoea, 6‐min walk distance, patient satisfaction and systemic effects were measured and treatment was assessed against placebo and for dose–response effects.RESULTS FEV1[area under the time–response curve (AUC)] and satisfaction scores increased with all formoterol doses compared with placebo, as did AUC tremor with the 24‐ and 48‐μg doses and AUC heart rate with the 48‐μg dose. A dose–response relationship was seen with FEV1 and tremor, but not with satisfaction scores. There was no difference between placebo and rac‐formoterol for other variables.CONCLUSIONS Our results show that in patients with COPD rac‐formoterol improves FEV1 and patient satisfaction without a corresponding reduction in dyspnoea. Since the systemic effects from a relatively high dose were minimal, its use as relief medication in COPD merits further evaluation.
Lipid‐lowering therapy does not affect the postprandial drop in high density lipoprotein‐cholesterol (HDL‐c) plasma levels in obese men with metabolic syndrome: a randomized double blind crossover trial
Authors: Hajer Gideon R. , Dallinga‐Thie Geesje M. , Van Vark‐van der Zee Leonie C. , Olijhoek Jobien K. , Visseren Frank L. J. 
Published: April 2008

SummaryIntroduction  The postprandial lipid metabolism in metabolic syndrome patients is disturbed and may add to the increased cardiovascular risk in these patients. It is not known whether postprandial high density lipoprotein‐cholesterol (HDL‐c) metabolism is also affected and whether this can be influenced by statin and/or ezetimibe treatment.Methods  Prospective, randomized, double blind, crossover trial comparing simvastatin 80 mg with simvastatin/ezetimibe 10 mg/10 mg treatment for 6 weeks on postprandial HDL‐c metabolism in 15, nonsmoking, male, obese metabolic syndrome patients (Adult Treatment Panel III, ATPIII). Only study medication was allowed. HDL‐c concentrations, cholesteryl ester transfer (CET), CET protein (CETP) mass and adiponectin were measured before and after oral fat loading. ClinicalTrials.gov NCT00189085.Results  Plasma HDL‐c levels remained stable during continuous fasting following an overnight fast. Pre‐fat load HDL‐c concentrations without treatment, after simvastatin and simvastatin/ezetimibe treatment were 1·15 ± 0·04, 1·16 ± 0·05 and 1·11 ± 0·04 mmol/l. Fat load induced a 11% drop in HDL‐c plasma levels; 1·02 ± 0·05 mmol/l (P < 0·001) which was not affected by either therapy. Triglyceride levels during fat load were similar after both treatments. Total CET increased from 9·73 ± 0·70 to 12·20 ± 0·67 nmol/ml/h (P = 0·004). Four hours after fat loading CETP mass was increased while adiponectin levels were decreased, irrespective of treatment.Discussion  HDL‐c levels decrease as CET increases after fat loading in obese metabolic syndrome patients. This is not influenced by either simvastatin or simvastatin/ezetimibe treatment. After fat loading, CETP mass and CET increased, and adiponectin decreased pointing towards a potential role for intra‐abdominal fat. Decreased postprandial HDL‐c levels may contribute to the increased cardiovascular risk in metabolic syndrome patients on top of already low HDL‐c levels.