bluuebunny/crossref_metadata_2025_split huggingface dataset:
Commodification of Human Tissue: Implications for Feminist and Development Ethics
Authors: Dickenson Donna 
Published: March 2003

One effect of late capitalism – the commodification of practically everything – is to knock down the Chinese walls between the natural and productive realms, to use a Marxist framework. Women's labour in egg extraction and ‘surrogate’ motherhood might then be seen as what it is, labour which produces something of value. But this does not necessarily mean that women will benefit from the commodification of practically everything, in either North or South. In the newly developing biotechnologies involving stem cells, the reverse is more likely, particular given the shortage in the North of the egg donors who will be increasingly necessary to therapeutic cloning.Although most of the ethical debate has focused on the status of the embryo, this is to define ethics with no reference to global or gender justice. There has been little or no debate about possible exploitation of women, particularly of ovum donors from the South. Countries of the South without national ethics committees or guidelines may be particularly vulnerable: although there is increasing awareness of the susceptibility of poorer countries to abuses in research ethics, very little has been written about how they might be affected by the enormously profitable new technologies exploiting human tissue. Even in the UK, although the new Medical Research Council guidelines make a good deal of the ‘gift relationship’, what they are actually about is commodification. If donors believe they are demonstrating altruism, but biotechnology firms and researchers use the discourse of commodity and profit, we have not ‘incomplete commodification’ but complete commodification with a plausibly human face.
Consent Issues in Medico‐Legal Procedures: How Competent Are Children to Make Their Own Decisions?
Authors: Fundudis Trian 
Published: March 2003

Background: The rights and competence of children in relation to medico‐legal matters (for example, medical and/or psychological treatment, custody dispute) have become matters with which professionals have been expected to become more familiar.Method: These issues are reviewed in terms of addressing the criteria of age and psychological maturity and their significance for determining a child's competence for making decisions when consent is involved.Conclusions: Evidence indicates that assessment of a child's competence to make informed decisions requires systematic examination of a number of important considerations and factors over and above the child's age and wishes.
School Based Early Identification and Intervention Service for Adolescents: A Psychology and School Nurse Partnership Model
Authors: Clarke Marie , Coombs Cathy , Walton Lisa 
Published: March 2003

Background: Adolescents are increasingly experiencing multiple stresses and emotional problems. Child and Adolescent Mental Health Services have a role in working creatively to provide easily accessible and non‐stigmatising services.Method: A training and consultation model was developed to respond to the needs of Tier 1 staff encountering vulnerable adolescents in a deprived inner city area. This paper describes the development of a partnership between the clinical psychology service and the school health system and the application of the practice model.Conclusion: The evaluation, clinical implications and future developments are discussed.
A National Study of Efficiency for Dialysis Centers: An Examination of Market Competition and Facility Characteristics for Production of Multiple Dialysis Outputs
Authors: Ozgen Hacer , A. Ozcan Yasar 
Published: March 2003

Objective. To examine market competition and facility characteristics that can be related to technical efficiency in the production of multiple dialysis outputs from the perspective of the industrial organization model.Study Setting. Freestanding dialysis facilities that operated in 1997 submitted cost report forms to the Health Care Financing Administration (HCFA), and offered all three outputs—outpatient dialysis, dialysis training, and home program dialysis.Data Sources. The Independent Renal Facility Cost Report Data file (IRFCRD) from HCFA was utilized to obtain information on output and input variables and market and facility features for 791 multiple‐output facilities. Information regarding population characteristics was obtained from the Area Resources File.Study Design. Cross‐sectional data for the year 1997 were utilized to obtain facility‐specific technical efficiency scores estimated through Data Envelopment Analysis (DEA). A binary variable of efficiency status was then regressed against its market and facility characteristics and control factors in a multivariate logistic regression analysis.Principal Findings. The majority of the facilities in the sample are functioning technically inefficiently. Neither the intensity of market competition nor a policy of dialyzer reuse has a significant effect on the facilities' efficiency. Technical efficiency is significantly associated, however, with type of ownership, with the interaction between the market concentration of for‐profits and ownership type, and with affiliations with chains of different sizes. Nonprofit and government‐owned facilities are more likely than their for‐profit counterparts to become inefficient producers of renal dialysis outputs. On the other hand, that relationship between ownership form and efficiency is reversed as the market concentration of for‐profits in a given market increases. Facilities that are members of large chains are more likely to be technically inefficient.Conclusions. Facilities do not appear to benefit from joint production of a variety of dialysis outputs, which may explain the ongoing tendency toward single‐output production. Ownership form does make a positive difference in production efficiency, but only in local markets where competition exists between nonprofit and for‐profit facilities. The increasing inefficiency associated with membership in large chains suggests that the growing consolidation in the dialysis industry may not, in fact, be the strategy for attaining more technical efficiency in the production of multiple dialysis outputs.
The End of an Era: What Became of the “Managed Care Revolution” in 2001?
Authors: Lesser Cara S. , Ginsburg Paul B. , Devers Kelly J. 
Published: March 2003

Objective. To describe how the organization and dynamics of health systems changed between 1999 and 2001, in the context of expectations from the mid‐1990s when managed care was in ascendance, and assess the implications for consumers and policymakers.Data Sources/Study Setting. Data are from the Community Tracking Study site visits to 12 communities that were randomly selected to be nationally representative of metropolitan areas with 200,000 people or more. The Community Tracking Study is an ongoing effort that began in 1996 and is fielded every two years.Study Design. Semistructured interviews were conducted with 50–90 stakeholders and observers of the local health care market in each of the 12 communities every two years. Respondents include leaders of local hospitals, health plans, and physician organizations and representatives of major employers, state and local governments, and consumer groups. First round interviews were conducted in 1996–1997 and subsequent rounds of interviews were conducted in 1998–1999 and 2000–2001. A total of 1,690 interviews were conducted between 1996 and 2001.Data Analysis Methods. Interview information was stored and coded in qualitative data analysis software. Data were analyzed to identify patterns and themes within and across study sites and conclusions were verified by triangulating responses from different respondent types, examining outliers, searching for disconfirming evidence, and testing rival explanations.Principal Findings. Since the mid‐1990s, managed care has developed differently than expected in local health care markets nationally. Three key developments shaped health care markets between 1999 and 2001: (1) unprecedented, sustained economic growth that resulted in extremely tight labor markets and made employers highly responsive to employee demands for even fewer restrictions on access to care; (2) health plans increasingly moved away from core strategies in the “managed care toolbox”; and (3) providers gained leverage relative to managed care plans and reverted to more traditional strategies of competing for patients based on services and amenities.Conclusions. Changes in local health care markets have contributed to rising costs and created new access problems for consumers. Moreover, the trajectory of change promises to make the goals of cost‐control and quality improvement more difficult to achieve in the future.
Benefit‐Cost Analysis of Addiction Treatment: Methodological Guidelines and Empirical Application Using the DATCAP and ASI
Authors: French Michael T. , Salomé Helena J. , Sindelar Jody L. , Thomas McLellan A. 
Published: March 2003

Objective.To provide detailed methodological guidelines for using the Drug Abuse Treatment Cost Analysis Program (DATCAP) and Addiction Severity Index (ASI) in a benefit‐cost analysis of addiction treatment.Data Sources/Study Setting.A representative benefit‐cost analysis of three outpatient programs was conducted to demonstrate the feasibility and value of the methodological guidelines.Study Design.Procedures are outlined for using resource use and cost data collected with the DATCAP. Techniques are described for converting outcome measures from the ASI to economic (dollar) benefits of treatment. Finally, principles are advanced for conducting a benefit‐cost analysis and a sensitivity analysis of the estimates.Data Collection/Extraction Methods.The DATCAP was administered at three outpatient drug‐free programs in Philadelphia, PA, for 2 consecutive fiscal years (1996 and 1997). The ASI was administered to a sample of 178 treatment clients at treatment entry and at 7‐months postadmission.Principal Findings.The DATCAP and ASI appear to have significant potential for contributing to an economic evaluation of addiction treatment. The benefit‐cost analysis and subsequent sensitivity analysis all showed that total economic benefit was greater than total economic cost at the three outpatient programs, but this representative application is meant to stimulate future economic research rather than justifying treatment per se.Conclusions.This study used previously validated, research‐proven instruments and methods to perform a practical benefit‐cost analysis of real‐world treatment programs. The study demonstrates one way to combine economic and clinical data and offers a methodological foundation for future economic evaluations of addiction treatment.
The Cost of Doing Business: Cost Structure of Electronic Immunization Registries
Authors: Fontanesi John M , Flesher Don S , De Guire Michelle , Lieberthal Allan , Holcomb Kathy 
Published: March 2003

Objective. To predict the true cost of developing and maintaining an electronic immunization registry, and to set the framework for developing future cost‐effective and cost‐benefit analysis.Data Sources/Study Setting. Primary data collected at three immunization registries located in California, accounting for 90 percent of all immunization records in registries in the state during the study period.Study Design. A parametric cost analysis compared registry development and maintenance expenditures to registry performance requirements.Data Collection/Extraction Methods. Data were collected at each registry through interviews, reviews of expenditure records, technical accomplishments development schedules, and immunization coverage rates.Principal Findings. The cost of building immunization registries is predictable and independent of the hardware/software combination employed. The effort requires four man‐years of technical effort or approximately $250,000 in 1998 dollars. Costs for maintaining a registry were approximately $5,100 per end user per three‐year period.Conclusions. There is a predictable cost structure for both developing and maintaining immunization registries. The cost structure can be used as a framework for examining the cost‐effectiveness and cost‐benefits of registries. The greatest factor effecting improvement in coverage rates was ongoing, user‐based administrative investment.
The Social Ontology of Virtual Environments
Authors: Brey Philip 
Published: March 2003

ABSTRACT .This paper analyzes the ontological structure of institutional and other social entities in virtual environments. The emphasis is on institutional reality, which consists of entities (objects, events, etc.) like money, contracts, and chess pieces, which are constituted in part through collective agreements. It is studied how institutional entities are constructed in virtual environments, how they relate to institutional entities in the real world, and how they are recognized by users.
Differential STAT3, STAT5, and NF-κB activation in human hematopoietic progenitors by endogenous interleukin-15: implications in the expression of functional molecules
Authors: Giron-Michel Julien , Caignard Anne , Fogli Manuela , Brouty-Boyé Danièle , Briard Diane , van Dijk Marc , Meazza Raffaella , Ferrini Silvano , Lebousse-Kerdilès Caroline , Clay Denis , Bompais Heidi , Chouaib Salem , Péault Bruno , Azzarone Bruno 
Published: March 2003

AbstractDifferent forms of interleukin-15 (IL-15) have been identified and shown to elicit different transduction pathways whose impact on hematopoiesis is poorly understood. We demonstrated herein that hematopoietic CD34+ cells constitutively produced endogenous secreted IL-15 (ES-IL-15) that activated different transcription factors and controlled the expression of several functional proteins, depending on the progenitor source. Thus, nuclear factor-κ B (NF-κ B) was activated in bone marrow (BM) and cord blood (CB) progenitors, whereas signal transducer and activator of transcription 3 (STAT3) and STAT5 activation was restricted to peripheral granulocyte—colony-stimulating factor (G-CSF)—mobilized and BM progenitors, respectively. ES-IL-15 acts through autocrine/paracrine loops controlled by high-affinity receptors involving IL-15 receptor α (IL-15R α). Furthermore, ES-IL-15 was found to differentially control the expression of several functional molecules important for hematopoietic differentiation. Indeed, in BM precursors, neutralizing anti—IL-15 monoclonal antibody (mAb) inhibits the expression of the γ c chain and of the chemokine stromal derived factor-1 (SDF-1) but had no effect on vascular cell adhesion molecule 1 (VCAM-1) and β 1 integrin adhesion molecule expression. Conversely, in CB progenitors, anti—IL-15 mAb inhibited VCAM-1 and β 1 integrin expression without affecting γ c chain expression and, most important, up-regulated SDF-1 expression. In conclusion, unprimed human hematopoietic CD34+ cells secrete cell-unbound IL-15, which activates through autocrine/paracrine loop distinct signaling pathways, depending on the progenitor source, thereby influencing the expression of several molecules important in the control of hematopoiesis. (Blood. 2003;102:109-117)
Rapid recruitment of inflammatory monocytes is independent of neutrophil migration
Authors: Henderson Robert B. , Hobbs Josie A. R. , Mathies Meg , Hogg Nancy 
Published: March 2003

AbstractEarly neutrophil entry into an inflammatory site is thought to mediate a chemokine switch, inducing subsequent monocyte recruitment through the regulation of monocyte chemoattractant protein-1 (MCP-1) release. As the murine monocyte is poorly characterized and difficult to identify, there has been little examination of either its early recruitment in inflammatory models or of the factors that influence its early migration. The phenotyping of rapidly recruited inflammatory leukocytes with 7/4 and Gr-1 monoclonal antibodies (mAbs) identifies 2 distinct populations, which we characterize as murine monocytes and neutrophils. Monocytes migrate in the first 2 hours of inflammation making use of α4β1 but not of Mac-1 or lymphocyte function-associated antigen-1 (LFA-1) integrins. Early migration is dependent on MCP-1, but neither MCP-1 release nor monocyte recruitment is affected by the reduced neutrophil migration seen in LFA-1-/- mice. Endogenous peritoneal macrophages and mesothelial cells lining the peritoneum contain MCP-1, which is released following thioglycollate stimulation. The murine monocyte therefore responds rapidly to chemokines produced in situ by tissue cells at the site of inflammation with no requirement for prior influx of neutrophils. (Blood. 2003;102:328-335)
Regulation of 17-AAG—induced apoptosis: role of Bcl-2, Bcl-xL, and Bax downstream of 17-AAG—mediated down-regulation of Akt, Raf-1, and Src kinases
Authors: Nimmanapalli Ramadevi , O'Bryan Erica , Kuhn Deborah , Yamaguchi Hirohito , Wang Hong-Gang , Bhalla Kapil N. 
Published: March 2003

Abstract
17-allylamino-demethoxy geldanamycin (17-AAG) inhibits the chaperone function of heat shock protein—90 (Hsp-90) and promotes the proteasomal degradation of its misfolded client proteins. Here, we demonstrate that treatment of the human acute myeloid leukemia HL-60 cells with 17-AAG attenuates the intracellular levels of a number of Hsp-90 client proteins, including Akt, c-Raf-1, and c-Src. Also, 17-AAG induced the mitochondrial release and cytosolic accumulation of cytochrome c (cyt c) and second mitochondria-derived activator of caspases (Smac)/DIABLO, resulting in the activation of caspase-9 and caspase-3 and apoptosis. Treatment with 17-AAG triggered the B-cell lymphoma—2 (Bcl-2)—associated X protein (Bax) conformational change associated with apoptosis, while Bax-deficient cells were resistant to 17-AAG—induced apoptosis. In addition, in HL-60/Bcl-2 and HL-60/Bcl-xL cells, which ectopically express Bcl-2 and Bcl-xL respectively, 17-AAG—induced Bax conformational change, cytosolic accumulation of cyt c and Smac/DIABLO, and apoptosis were markedly inhibited. Although the rate of 17-AAG—mediated decline in Akt, c-Raf-1, and c-Src levels was blunted, the total decline was not compromised in HL-60/Bcl-2 and HL-60/Bcl-xL cells. Cotreatment with HA14-1, a nonpeptidic ligand that can bind and inhibit the antiapoptotic activity of Bcl-2, significantly overcame the resistance to 17-AAG—induced apoptosis in HL-60/Bcl-2 cells. Together, these findings indicate that although 17-AAG treatment causes the levels of a number of survival-signaling protein kinases to decline, the downstream engagement of the mitochondrial pathway of apoptosis is regulated by the activity of the Bcl-2 family of proteins. Also, neutralizing the antiapoptotic effect of Bcl-2 would further enhance the antileukemia activity of 17-AAG. (Blood. 2003;102:269-275)
In vitro effects of l‐arginine and guanidino compounds on NTPDase1 and 5′‐nucleotidase activities from rat brain synaptosomes
Authors: Balz Daniela , de Souza Wyse Angela Terezinha , Morsch Vera Maria , da Silva Adriane Cismoski , Vieira Vânia Lúcia , Morsch André Luı́s Bittencourt , Schetinger Maria Rosa Chitolina 
Published: March 2003

AbstractTissue accumulation of arginine (Arg), N‐acetylarginine (NA), argininic acid (AA) and homoarginine (HA) occurs in hyperargininemia, an inborn error of the urea cycle. In the present study, we investigated the in vitro effects of Arg, NA, AA and HA on NTPDase1 and 5′‐nucleotidase activities from synaptosomal cerebral cortex of rats. The results showed that Arg enhances NTPDase1 activity at the high concentrations tested (1.5 and 3.0 mM) for both the ATP and ADP nucleotides. Activation was also observed with other guanidino compounds tested: NA, AA and HA activated ATP and ADP hydrolysis in all experiments at the concentration of 25 μM. Besides this, NA and AA activated ATP hydrolysis at a lower concentration (1 μM). In another set of experiments, we verified the effect of Arg on purified apyrase at pH 8.0 and 6.5 and observed an increase in the enzyme activity at all Arg concentrations tested (0.01–3.0 mM). In contrast, Arg and the other guanidino compounds tested did not alter 5′‐nucleotidase activity. These results suggest that changes in nucleotide hydrolysis may be involved in the brain dysfunction caused by hyperargininemia amongst other potential pathophysiological mechanisms involved in this condition.
The effect of air filtration on airborne dog allergen
Authors: Green R , Simpson A , Custovic A , Faragher B , Chapman M , Woodcock A 
Published: March 2003

Background: Effective methods of reducing dog allergen are required to help alleviate symptoms in asthmatic patients sensitized to dog who refuse to part with their pet. The aim of this study was to investigate the use of the high efficiency particulate air (HEPA) filter air cleaner to reduce airborne Can f 1 in homes with a dog. Methods: The effect of a HEPA air cleaner was investigated in nine homes with a dog. Samples were collected from two rooms of each house concurrently, one of which contained the dog, on two separate days (active day – HEPA air cleaner on – and control day). Eight consecutive 1‐h samples were collected from each room with a high‐volume air sampler (airflow rate 60 l/min). Can f 1 was determined by monoclonal‐polyclonal antibody‐based ELISA. Results: Baseline airborne Can f 1 levels were 3.8‐fold greater when sampling was performed with a dog in the room (GM 27.1 ng Can f 1/m3, range 2.63–329) than when the dog was elsewhere in the house (GM 7.1 ng Can f 1/m3, range 0.69–27.2). When the dog was elsewhere in the house, airborne Can f 1 levels fell on both active and control days, but the magnitude of the reduction was significantly greater on the active days (P<0.05), and was approximately 90% from baseline. With the dog in the room, a significant fall in airborne Can f 1 was observed only on active days (75% from baseline), but not on control days (active vs control P<0.001). Conclusions: HEPA air cleaners reduce airborne Can f 1 in homes with dogs. Furthermore, preventing the access of the dog to the bedroom and possibly the living room may reduce the total allergen load inhaled.
Specific IgE determinations to crude and boiled lentil (Lens culinaris) extracts in lentil‐sensitive children and controls
Authors: Ibáñez Sandín D. , Martínez San Ireneo M. , Alonso Lebrero E. , Laso Borrego T. , Marañón Lizana F. , Fernández‐Caldas E. 
Published: March 2003

Background: The aims of this study were to evaluate the allergenicity of boiled and crude lentil extracts and to compare specific IgE binding in tolerant and nontolerant lentil‐allergic children. Methods: Thirty‐eight children were studied and divided into three groups. Group I comprised 24 children with a positive open oral challenge, or a convincing history of anaphylaxis after the ingestion of lentils; group II comprised nine children with a history of allergic reactions in the past, but currently tolerant of lentils; and group III comprised five children allergic to other legumes, but always tolerant of the ingestion of lentils. Specific IgE determinations and ELISA inhibitions were performed with the crude and boiled lentil extracts. The allergenic profile of both extracts was evaluated by SDS–PAGE and immunoblot. Results: Mean specific IgE levels in group I were significantly higher than in groups II and III. The heating process caused a significant decrease in specific IgE binding. However, IgE‐inhibition studies showed that the boiled lentil extract had a greater inhibitory capacity than the crude extract. Immunoblots revealed no important differences in IgE‐binding patterns between the two extracts. Multiple allergens were detected in a wide range of molecular masses. Conclusions: Boiled lentil extracts maintain strong allergenicity. Patients who have developed tolerance of lentil ingestion have lower specific IgE levels than symptomatic patients.