bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sind die Probleme der Bevölkerungsalterung durch eine höhere Geburtenrate lösbar?
Authors: Berkel Barbara , Börsch-Supan Axel , Ludwig Alexander , Winter Joachim 
Published: November 2004

AbstractCan the aging problem be solved by a higher birth rate? While the popular notion - ‘‘if we have too many elderly we need more children in order to compensate for this” - seems plausible, the results of economic theory are ambiguous at best. This paper employs a quantitative macroeconomic simulation model for Germany and leads to a more subtle view, stressing the importance of human capital formation for long-term economic growth in this context. Moreover, it takes a very long transitional period until a higher fertility rate results in a larger and bettereducated labour force that contributes to social security. Therefore, reforms of the social security system still have the highest priority because this is the only way to solve the problems of an aging baby-boomer generation in the short and medium term - meaning the time until the baby boomers will retire.
Stress incontinence and pelvic floor neurophysiology 15 years after the first delivery
Authors: Dolan Lucia M. , Hosker Gordon L. , Mallett Veronica T. , Allen Ruth E. , Smith Anthony R.B. 
Published: November 2004

Headline
This is a longitudinal study of a cohort of primigravidae recruited between 1985 and 1987 and followed up 7 and 15 years later. Pelvic floor neurophysiology was performed and questionnaires were administered to determine the natural history of stress incontinence and to establish whether pelvic floor denervation after the first delivery is associated with symptoms of stress urinary incontinence in the future.Objectives
To study the natural history of stress urinary incontinence arising during the first pregnancy, to determine whether postnatal pelvic floor denervation progresses with time and whether it predisposes to stress urinary incontinence in the future.Design
Prospective longitudinal cohort study.Setting
Tertiary referral urogynaecology unit.Sample
Cohort of 96 primigravidae studied prospectively between 1985 and 1987 and followed up 7 years (n= 76) and 15 years (n= 55) later.Methods
Urinary incontinence symptoms were recorded and pelvic floor neurophysiology was performed antenatally and postnatally between 1985 and 1987. Repeat neurophysiological tests and questionnaires were completed by those relocated 7 and 15 years later.Main outcome measure
Symptoms of stress urinary incontinence.Secondary outcomes
Symptoms of urge urinary incontinence and anal incontinence; motor unit potential duration and pudendal nerve terminal latency; vaginal squeeze pressure measured by perineometry.Results
Prevalence of stress incontinence was highest during pregnancy and had increased seven years after the first postnatal period (P= 0.0129). Two‐thirds of women with antenatal stress incontinence had stress incontinence 15 years later. One‐third of women with stress incontinence at any time appear to undergo resolution of symptoms. Motor unit potential duration increased at seven years (P= 0.036). Vaginal squeeze pressure improved during the same period (P= 0.0007).Conclusions
When stress urinary incontinence arises during the first pregnancy, the risk of stress incontinence occurring 15 years later is doubled. Although pelvic floor reinnervation progressed after the postnatal period, the absence of an adequate marker for pelvic floor denervation makes it of uncertain clinical significance.
Isolation and characterization of polymorphic microsatellite loci in white truffle (Tuber magnatum)
Authors: Rubini A. , Topini F. , Riccioni C. , Paolocci F. , Arcioni S. 
Published: November 2004

Abstract Tuber spp. are fungi that establish symbiosis with several trees and shrubs. Some of these fungal species produce edible ascomata, also known as truffles, which are highly appreciated for their taste and odour. We isolated and characterized eight polymorphic microsatellite loci from Tuber magnatum, the finest white truffle species, and assessed their variability in 370 individuals collected from all over the species range of distribution. Although two to 18 alleles per locus were found, no heterozygous individuals were observed. The availability of simple sequence repeat loci provides valuable tools for assessment of the genetic structure and population dynamics in this species.
Name that microbe: rapid identification of taxa responsible for individual fragments in fingerprints of microbial community structure
Authors: Grant Alastair , Ogilvie Lesley Ann 
Published: November 2004

AbstractPolymerase chain reaction (PCR)‐based ‘fingerprinting’ methods, such as Terminal restriction fragment length polymorphism, Length Heterogeneity‐Polymerase Chain Reaction (LH‐PCR) and Automated Ribosomal Intergenic Spacer Analysis (ARISA) make possible quantitative studies of microbial community structure and dynamics. Here we outline a strategy for the rapid and cost‐effective isolation of 16S clones corresponding to particular fragment sizes in a fingerprint, based on applying the fingerprinting method to pools of colonies from a clone library. This allows the definitive identification of taxa responsible for the most important bands in the community fingerprint from a full 16S sequence. It offers significant advantages over random selection of clones and removes a significant barrier to the use of these methods.
Synergism of atenolol and amlodipine on lowering and stabilizing blood pressure in spontaneously hypertensive rats
Authors: Xu Li‐Ping , Shen Fu‐Ming , Shu He , Miao Chao‐Yu , Jiang Yúan‐Ying , Su Ding‐Feng 
Published: November 2004

AbstractThis study was designed to investigate the possible synergism of atenolol and amlodipine on lowering and stabilizing blood pressure (BP) in spontaneously hypertensive rats. Sixty‐four spontaneously hypertensive rats were randomly divided into eight groups. They were given 0.8% carboxymethylcellulose sodium (control), atenolol (10 mg/kg), amlodipine (0.5, 1 and 2 mg/kg) and the combinations of atenolol and amlodipine (10 + 0.5, 10 + 1 and 10 + 2 mg/kg), respectively. The drugs were given via a catheter of gastric fistula. BP was recorded for 25 h from 1 h before drug administration to 24 h after administration, in conscious, freely moving rats. It was found that combination of atenolol and amlodipine significantly decreased BP and systolic BP variability. From probability sum analysis it was found that the combination of atenolol and amlodipine, in a proportion as 10 : 1, was the best one (q = 1.54). In conclusion, the present work clearly demonstrated that there is a synergistic effect between atenolol and amlodipine in lowering and stabilizing the BP. The synergistic effect is highest when the dose proportion of the two drugs is 10 : 1.
Trends in peptic ulcer pharmacotherapy
Authors: Sivri Bülent 
Published: November 2004

AbstractConsidering the diseases of the stomach and duodenum, peptic ulcer has been the one with a significant clinical impact. The pathophysiology of peptic ulcer has centred on an imbalance between aggressive and protective factors. The discovery of Helicobacter pylori as a cause of peptic ulcer has changed our approach greatly towards this disease. Despite the decreasing frequency of H. pylori‐induced peptic ulcers, peptic ulcer remains a major clinical problem partly because nonsteroidal anti‐inflammatory drug (NSAID)‐related ulcers and hospital admissions for ulcer complications associated with NSAIDs have increased in frequency. The interaction between H. pylori and NSAIDs is one of the most controversial issues in peptic ulcer. In this article, current concepts of peptic ulcer etiopathogenesis and the management of peptic ulcer according to the etiology were reviewed.
Differential effects of FK506 and cyclosporin A on catecholamine release from bovine adrenal chromaffin cells
Authors: Matsumura C. , Kuwashima H. , Kimura T. 
Published: November 2004

Summary 1 The effects of the immunosuppressants, tacrolimus (FK506) and cyclosporin A (CsA), on catecholamine (CA) release were examined in cultured bovine adrenal chromaffin cells. 2 In intact cells, FK506 (1–30 μm) inhibited CA release stimulated by acetylcholine (ACh; 100 μm), 1,1‐dimethyl‐4‐phenyl‐piperazinium (DMPP, 10 μm) or high K+ (40 mm). CsA (1–30 μm) had a little inhibitory effect on the ACh‐ or DMPP‐stimulated CA release, whereas it enhanced the high K+‐stimulated CA release. 3 In β‐escin‐permeabilized cells, FK506 inhibited CA release stimulated by Ca2+ (1 and 10 μm) in the presence and absence of MgATP (2 mm). CsA induced CA release under Ca2+‐free condition and enhanced the Ca2+‐stimulated CA release in the presence and absence of MgATP. 4 It is known that the Ca2+‐dependent exocytosis involves at least two distinct steps, ATP‐requiring priming stage and ATP‐independent fusion step in adrenal chromaffin cells. Therefore, it is suggested that FK506 inhibits the Ca2+‐dependent exocytosis probably at the fusion step whereas CsA induces CA release from bovine adrenal chromaffin cells.
Identification of Lanius species and subspecies using tandem repeats in the mitochondrial DNA control region
Authors: Hernández M. Angeles , Campos Francisco , Gutiérrez‐Corchero Francisco , Amezcua Ana 
Published: November 2004

The number of tandem repeats in the mitochondrial control region were used to differentiate the Red‐backed Shrike Lanius collurio, Woodchat Shrike Lanius senator, Great Grey Shrike (subspecies Lanius excubitor excubitor) and the Southern Grey Shrike (subspecies L. meridionalis meridionalis, L. m. koenigi, L. m. pallidirostris and L. m. aucheri). The Red‐backed and Woodchat Shrikes lacked repeats whereas the Great Grey and Southern Grey had two, three and 2 + 3 repeats. A subspecies of Southern Grey (L. m. koenigi) had 2 + 3 + 4 repeats. These findings are discussed in terms of the taxonomy of the Lanius genus, especially with respect to the Great Grey and Southern Grey Shrikes.
The Impact of Diabetes on Workforce Participation: Results from a National Household Sample
Authors: Vijan Sandeep , Hayward Rodney A. , Langa Kenneth M. 
Published: November 2004

Objective. Diabetes is a highly prevalent condition that results in substantial morbidity and premature mortality. We investigated how diabetes‐associated mortality, disability, early retirement, and work absenteeism impacts workforce participation.Data Source. We used the Health and Retirement Study (HRS), a national household sample of adults aged 51–61 in 1992, as a data source.Study Design. We conducted cross‐sectional analyses on the baseline HRS data, and longitudinal analyses using data from eight years of follow‐up. We used two‐part regression models to estimate the adjusted impact of diabetes on workforce participation, and then estimated the economic impact of diabetes‐related losses in productivity.Principal Findings. Diabetes is a significant predictor of lost productivity. The incremental lost income due to diabetes by 1992 was $60.0 billion over an average diabetes duration of 9.7 years. From 1992 to 2000, diabetes was responsible for $4.4 billion in lost income due to early retirement, $0.5 billion due to increased sick days, $31.7 billion due to disability, and $22.0 billion in lost income due to premature mortality, for a total of $58.6 billion dollars in lost productivity, or $7.3 billion per year.Conclusions. In the U.S. population of adults born between 1931 and 1941, diabetes is associated with a profound negative impact on economic productivity. By 1992, an estimated $60 billion in lost productivity was associated with diabetes; additional annual losses averaged $7.3 billion over the next eight years, totaling about $120 billion by the year 2000. Given the rising prevalence of diabetes, these costs are likely to increase substantially unless countered by better public health or medical interventions.
An Algorithm for the Use of Medicare Claims Data to Identify Women with Incident Breast Cancer
Authors: Nattinger Ann B. , Laud Purushottam W. , Bajorunaite Ruta , Sparapani Rodney A. , Freeman Jean L. 
Published: November 2004

Objective. To develop and validate a clinically informed algorithm that uses solely Medicare claims to identify, with a high positive predictive value, incident breast cancer cases.Data Source. Population‐based Surveillance, Epidemiology, and End Results (SEER) Tumor Registry data linked to Medicare claims, and Medicare claims from a 5 percent random sample of beneficiaries in SEER areas.Study Design. An algorithm was developed using claims from 1995 breast cancer patients from the SEER‐Medicare database, as well as 1995 claims from Medicare control subjects. The algorithm was validated on claims from breast cancer subjects and controls from 1994. The algorithm development process used both clinical insight and logistic regression methods.Data Extraction. Training set: Claims from 7,700 SEER‐Medicare breast cancer subjects diagnosed in 1995, and 124,884 controls. Validation set: Claims from 7,607 SEER‐Medicare breast cancer subjects diagnosed in 1994, and 120,317 controls.Principal Findings. A four‐step prediction algorithm was developed and validated. It has a positive predictive value of 89 to 93 percent, and a sensitivity of 80 percent for identifying incident breast cancer. The sensitivity is 82–87 percent for stage I or II, and lower for other stages. The sensitivity is 82–83 percent for women who underwent either breast‐conserving surgery or mastectomy, and is similar across geographic sites. A cohort identified with this algorithm will have 89–93 percent incident breast cancer cases, 1.5–6 percent cancer‐free cases, and 4–5 percent prevalent breast cancer cases.Conclusions. This algorithm has better performance characteristics than previously proposed algorithms. The ability to examine national patterns of breast cancer care using Medicare claims data would open new avenues for the assessment of quality of care.
Care following Acute Myocardial Infarction in the Veterans Administration Medical Centers: A Comparison with Medicare
Authors: Landrum Mary Beth , Guadagnoli Edward , Zummo Rose , Chin David , McNeil Barbara J. 
Published: November 2004

Objective. To compare patients treated for acute myocardial infarction (AMI) in a Veterans Health Administration (VHA) facility to similar patients treated under Medicare.Data Sources. Administrative data on 13,129 elderly male veterans hospitalized for AMI in a VHA facility between October 1, 1996, and September 30, 1999, and a matched set of male Medicare beneficiaries with AMI treated in a non‐VHA facility during the same time period.Study Design. We conducted a retrospective cohort study using propensity score methods to identify a matched set of male elderly AMI patients treated either in a VHA facility or in a non‐VHA facility under Medicare. We compared the two groups of patients according to characteristics of the admitting hospital, distances traveled for care, the use of invasive procedures, and mortality. We assessed the robustness of our conclusions to biases arising from unmeasured confounders using sensitivity analyses.Principal Findings. VHA patients were significantly less likely than Medicare beneficiaries to be admitted to high‐volume facilities (for example, 25 percent versus 46 percent in 1999, p<0.001) or facilities with the capability to perform invasive cardiac procedures. Compared to Medicare patients, VHA patients traveled almost twice as far to their admitting hospital. The VHA patients were significantly less likely to undergo coronary angiography or revascularization in the 30 days following their AMI (p<0.001 for all comparisons). Veterans treated in the VHA had significantly higher mortality at one‐year in all years studied (for example, 35.2 percent versus 30.6 percent in 1999). The proportion of elderly VHA patients admitted to high‐volume facilities increased and 30‐day mortality rates decreased between 1997 and 1999. Using sensitivity analyses to assess possible effects of unmeasured confounders, we could explain some but not all of the observed mortality differences.Conclusions. We observed differences in the way care for AMI patients was structured, in the use of invasive therapies, and in long term mortality between patients treated in VHA hospitals and those treated in non‐VHA facilities under Medicare. Future research should focus on explanations for the differences between the two systems and for the reduction in short‐term mortality among VHA patients. Further study of these differences both between and within the systems of care may help identify cost‐effective strategies to improve care in both sectors.
The Magnitude and Nature of Risk Selection in Employer‐Sponsored Health Plans
Authors: Nicholson Sean , Bundorf Kate , Stein Rebecca M. , Polsky Daniel 
Published: November 2004

Objective. To determine whether health maintenance organizations (HMOs) attract enrollees who use relatively few medical resources and whether a simple risk‐adjustment system could mitigate or eliminate the inefficiency associated with risk selection.Data Sources. The first and second rounds of the Community Tracking Study Household Survey (CTSHS), a national panel data set of households in 60 different markets in the United States.Study Design. We use regression analysis to examine medical expenditures in the first round of the survey between enrollees who switched plan types (i.e., from a non‐HMO plan to an HMO plan, or vice versa) between the first and second rounds of the survey versus enrollees who remained in their original plan. The dependent variable is an enrollee's medical resource use, measured in dollars, and the independent variables include gender, age, self‐reported health status, and other demographic variables.Data Collection Methods. We restrict our analysis to the 6,235 non‐elderly persons who were surveyed in both rounds of the CTSHS, received health insurance from their employer or the employer of a household member in both years of the survey, and were offered a choice of an HMO and a non‐HMO plan in both years.Principal Findings. We find that people who switched from a non‐HMO to an HMO plan used 11 percent fewer medical services in the period prior to switching than people who remained in a non‐HMO plan, and that this relatively low use persisted once they enrolled in an HMO. Furthermore, people who switched from an HMO to a non‐HMO plan used 18 percent more medical services in the period prior to switching than those who remained in an HMO plan.Conclusions. HMOs are experiencing favorable risk selection and would most likely continue to do so even if employers adjusted health plan payments based on enrollees' gender and age because the selection is based on enrollee characteristics that are difficult to observe, such as preferences for medical care and health status.
America's Health Centers: Reducing Racial and Ethnic Disparities in Perinatal Care and Birth Outcomes
Authors: Shi Leiyu , Stevens Gregory D. , Wulu John T. , Politzer Robert M. , Xu Jiahong 
Published: November 2004

Objective. To examine whether community health centers (CHCs) reduce racial/ethnic disparities in perinatal care and birth outcomes, and to identify CHC characteristics associated with better outcomes.Background. Despite great national wealth, the U.S. continues to rank poorly relative to other industrialized nations on infant mortality and other birth outcomes, and with wide inequities by race/ethnicity. Disparities in primary care (including perinatal care) may contribute to disparities in birth outcomes, which may be addressed by CHCs that provide safety‐net medical services to vulnerable populations.Methods. Data are from annual Uniform Data System reports submitted to the Bureau of Primary Health Care over six years (1996–2001) by about 700 CHCs each year.Results. Across all years, about 60% of CHC mothers received first‐trimester prenatal care and more than 70% received postpartum and newborn care. In 2001, Asian mothers were the most likely to receive both postpartum and newborn care (81.7% and 80.3%), followed by Hispanics (75.0% and 76.3%), blacks (70.8% and 69.9%), and whites (70.7% and 66.7%). In 2001, blacks had higher rates of low birth weight (LBW) babies (10.4%), but the disparity in rates for blacks and whites was smaller in CHCs (3.3 percentage points) compared to national disparities for low‐socioeconomic status mothers (5.8 percentage points) and the total population (6.2 percentage points). In CHCs, greater perinatal care capacity was associated with higher rates of first‐trimester prenatal care, which was associated with a lower LBW rate.Conclusion. Racial/ethnic disparities in certain prenatal services and birth outcomes may be lower in CHCs compared to the general population, despite serving higher‐risk groups. Within CHCs, increasing first‐trimester prenatal care use through perinatal care capacity may lead to further improvement in birth outcomes for the underserved.
Hospital Choice of Rural Medicare Beneficiaries: Patient, Hospital Attributes, and the Patient–Physician Relationship
Authors: Tai Wan‐Tzu Connie , Porell Frank W. , Adams E. Kathleen 
Published: November 2004

Objective. To examine how patient and hospital attributes and the patient–physician relationship influence hospital choice of rural Medicare beneficiaries.Data Sources. Medicare Current Beneficiary Survey (MCBS), Health Care Financing Administration (HCFA) Provider of Services (POS) file, American Hospital Association (AHA) Annual Survey, and Medicare Hospital Service Area (HSA) files for 1994 and 1995.Study Design. The study sample consisted of 1,702 hospitalizations of rural Medicare beneficiaries. McFadden's conditional logit model was used to analyze hospital choices of rural Medicare beneficiaries. The model included independent variables to control for patients' and hospitals' attributes and the distance to hospital alternatives.Principal Findings. The empirical results show strong preferences of aged patients for closer hospitals and those of greater scale and service capacity. Patients with complex acute medical conditions and those with more resources were more likely to bypass their closest rural hospitals. Beneficiaries were more likely to bypass their closest rural hospital if they had no regular physician, had a shorter patient–physician tie, were dissatisfied with the availability of health care, and had a longer travel time to their physician's office.Conclusions. The significant influences of patients' socioeconomic, health, and functional status, their satisfaction with and access to primary care, and their strong preferences for certain hospital attributes should inform federal program initiatives about the likely impacts of policy changes on hospital bypassing behavior.