bluuebunny/crossref_metadata_2025_split huggingface dataset:
Offspring sex ratio variation in relation to brood size and mortality in a promiscuous species: the Aquatic Warbler Acrocephalus paludicola
Authors: Dyrcz Andrzej , Sauer‐Gürth Hedi , Tkadlec Emil , Wink Michael 
Published: December 2004

We analyse nestling sex ratio variation in the Aquatic Warbler Acrocephalus paludicola to test for predictions from sex allocation theory that the brood sex ratio is close to parity. We also tested Fiala's (1980) prediction that there is no difference in sex ratio between broods affected and not affected by mortality, and whether a shift in primary sex ratios or simple differential mortality by sex underlies that difference. Furthermore, we explore additional analytical possibilities for inferring proximate mechanisms through simulation modelling. In the Aquatic Warbler, which is promiscuous, the overall sex ratio determined by molecular sexing of nestlings at 8–11 days of age did not deviate significantly from parity (proportion of females 0.509), nor did we find any predictive effect of brood size, maternal body mass, fat condition, wing and bill length, laying date, mean daily temperature, and multiple‐male mating. However, extensive simulation suggested that the whole pattern of sex ratio variation is unlikely to arise purely by chance: (1) there is a diverging sex ratio between complete and partial broods, (2) large broods tended to be female‐biased and small broods male‐biased, and (3) low ambient temperature prior to the laying period seemed to increase the proportion of female offspring in complete broods. We conclude that most variation in nestling sex ratio is non‐adaptive in nature, and results from variation in female nestlings mortality dependent on brood size and sex ratio.
Effects of Medicaid Managed Care Programs on Health Services Access and Use
Authors: Garrett Bowen , Davidoff Amy J. , Yemane Alshadye 
Published: December 2004

Objective. To estimate the effects of Medicaid managed care (MMC) programs on Medicaid enrollees’ access to and use of health care services at the national level.Data Sources/Study Setting 1991–1995 National Health Interview Surveys (NHIS) and a 1998 Urban Institute survey on state Medicaid managed care programs.Study Design. Using multivariate regression models, we estimated the effect of living in a county with an MMC program on several access and use measures for nonelderly women who receive Medicaid through AFDC and child Medicaid recipients. We focus on mandatory programs and estimate separate effects for primary care case management (PCCM) programs, health maintenance organization (HMO) programs, and mixed PCCM/HMO programs, relative to fee‐for‐service (FFS) Medicaid. We control for individual and county characteristics, and state and year effects.Data Collection/Extraction Method. This study uses pooled individual‐level data from up to five years of the NHIS (1991–1995), linked to information on Medicaid managed care characteristics at the county level from the 1998 MMC survey.Principal Findings We find virtually no effects of mandatory PCCM programs. For women, mandatory HMO programs reduce some types of non–emergency room (ER) use, and increase reported unmet need for medical care. The PCCM/HMO programs increase access, but had no effects on use. For children, mandatory HMO programs reduce ER visits, and increase the use of specialists. The PCCM/HMO programs reduce ER visits, while increasing other types of use and access.Conclusions Mandatory PCCM/HMO programs improved access and utilization relative to traditional FFS Medicaid, primarily for children. Mandatory HMO programs caused some access problems for women.
Improving Care for Minorities: Can Quality Improvement Interventions Improve Care and Outcomes For Depressed Minorities? Results of a Randomized, Controlled Trial
Authors: Miranda Jeanne , Duan Naihua , Sherbourne Cathy , Schoenbaum Michael , Lagomasino Isabel , Jackson‐Triche Maga , Wells Kenneth B. 
Published: December 2004

Objective. Ethnic minority patients often receive poorer quality care and have worse outcomes than white patients, yet practice‐based approaches to reduce such disparities have not been identified. We determined whether practice‐initiated quality improvement (QI) interventions for depressed primary care patients improve care across ethnic groups and reduce outcome disparities.Study Setting. The sample consists of 46 primary care practices in 6 U.S. managed care organizations; 181 clinicians; 398 Latinos, 93 African Americans, and 778 white patients with probable depressive disorder.Study Design. Matched practices were randomized to usual care or one of two QI programs that trained local experts to educate clinicians; nurses to educate, assess, and follow‐up with patients; and psychotherapists to conduct Cognitive Behavioral Therapy. Patients and physicians selected treatments. Interventions featured modest accommodations for minority patients (e.g., translations, cultural training for clinicians).Data Extraction Methods. Multilevel logistic regression analyses assessed intervention effects within and among ethnic groups.Principal Findings. At baseline, all ethnic groups (Latino, African American, white) had low to moderate rates of appropriate care and the interventions significantly improved appropriate care at six months (by 8–20 percentage points) within each ethnic group, with no significant difference in response by ethnic group. The interventions significantly decreased the likelihood that Latinos and African Americans would report probable depression at months 6 and 12; the white intervention sample did not differ from controls in reported probable depression at either follow‐up. While the intervention significantly improved the rate of employment for whites and not for minorities, precision was low for comparing intervention response on this outcome. It is important to note that minorities remained less likely to have appropriate care and more likely to be depressed than white patients.Conclusions. Implementation of quality improvement interventions that have modest accommodations for minority patients can improve quality of care for whites and underserved minorities alike, while minorities may be especially likely to benefit clinically. Further research needs to clarify whether employment benefits are limited to whites and if so, whether this represents a difference in opportunities. Quality improvement programs appear to improve quality of care without increasing disparities, and may offer an approach to reduce health disparities.
Does Satisfaction Reflect the Technical Quality of Mental Health Care?
Authors: Edlund Mark J. , Young Alexander S. , Kung Fuan Yue , Sherbourne Cathy D. , Wells Kenneth B. 
Published: December 2004

Objective. To analyze the relationship between satisfaction and technical quality of care for common mental disorders.Data Source. A nationally representative telephone survey of 9,585 individuals conducted in 1997–1998.Study Design. Using multinomial logistic regression techniques we investigated the association between a five‐level measure of satisfaction with the mental health care available for personal or emotional problems and two quality indicators. The first measure, appropriate technical quality, was defined as use of either appropriate counseling or psychotropic medications during the prior year for a probable depressive or anxiety disorder. The second, active treatment, indicated whether the respondent had received treatment for a psychiatric disorder in the past year. Covariates included measures of physical and mental health and sociodemographic indicators.Principal Findings. Appropriate technical quality of care was significantly associated with higher levels of satisfaction. The strength of the association was moderate.Conclusions. Satisfaction is associated with technical quality of care. However, profiling quality of care with satisfaction will likely require large samples and case‐mix adjustment, which may be more difficult for plans or provider groups to implement than measuring technical indicators. More importantly, satisfaction is not the same as technical quality, and our results suggest that at this time they cannot be made to approach each other closely enough to eliminate either.
Callers' Ability to Understand Advice Received from a Telephone Health‐Line Service: Comparison of Self‐Reported and Registered Data
Authors: Leclerc Bernard‐Simon , Dunnigan Lise , Côté Harold , Zunzunegui Maria‐Victoria , Hagan Louise , Morin Diane 
Published: December 2004

Objective. To validate users' perception of nurses' recommendations to look for another health resource among clients seeking teleadvice. To analyze the effects of different users' and call characteristics on the incorrectness of the self‐report.Data Sources/Study Setting. This study is a secondary analysis of data obtained from 4,696 randomly selected participants in a survey conducted in 1997 among users of Info‐Santé CLSC, a no‐charge telenursing health‐line service (THLS) available all over the province of Québec.Study Design/Data Collection. Self‐reported advice from follow‐up survey phone interviews, conducted within 48 to 120 hours after the participant's call, were compared to the data consigned by the nurse in the computerized call record. Covariables concerned characteristics of callers, context of the calls, and satisfaction about the nurses' intervention. Association between these variables and inaccurate reports was identified using multinomial logistic regression analyses.Principal Findings. Advice to consult were recorded by the nurse in 42 percent of cases, whereas 39 percent of callers stated they had received one. Overall disagreement between the two sources is 27 percent (12 percent by false positive and 15 percent by false negative) and kappa is 0.45. Characteristics such as living alone (adjusted OR=2.5), calls relating to psychological problems (OR=2.8), perceived seriousness (OR=∼2.6), as well as others, were associated with inaccurate reports.Conclusions. Telephone health‐line providers should be aware that many callers appear to interpret advice to seek additional health care differently than intended. Our findings suggest the need for continuing quality control interventions to reduce miscommunication, insure better understanding of advice by callers, and contribute to more effective service.
Health Care Costs among Smokers, Former Smokers, and Never Smokers in an HMO
Authors: Fishman Paul A. , Khan Zeba M. , Thompson Ella E. , Curry Susan J. 
Published: December 2004

Objective. We estimate long‐term health care costs of former smokers compared with continuing and never smokers using a retrospective cohort study of HMO enrollees. Previous research on health care costs associated with former smokers has suggested that quitters may incur greater health care costs than continuing smokers, therefore, getting people to quit creates more expensive health care consumers. We studied the trend in cost for former smokers over seven years after they quit to assess how the cessation experience impacts total health care cost.Data Sources/Study Setting. Group Health Cooperative (GHC), a nonprofit mixed model health maintenance organization in western Washington state.Study Design. Retrospective cohort study using automated and primary data collected through telephone interviews.Principal Findings. We find that former smokers' costs are significantly greater (p<.05) in the year immediately following cessation relative to continuing smokers, but former smokers' costs fall in year two. This decrease maintains throughout the six‐year follow‐up period. Although former smokers cost more than continuing smokers in the year after cessation, this increase appears to be transient. Long‐term costs for former smokers are not statistically different from those of continuing smokers and cumulative health care expenses are lower by the seventh year postquit. Our evidence suggests that smoking cessation does not increase long‐term heath care costs.Conclusions. Health care costs among former smokers increase relative to continuing smokers in the year after cessation but fall to a level that is statistically indistinguishable in the second year postquit. Any net increase in costs among former smokers relative to continuing smokers appears compensated for within two years post‐quit and is maintained for at least six years after cessation.
Recent Publications
Authors: HUWE TERENCE K. , KIMBALL JANICE 
Published: December 2004

Books reviewed:David Bacon, The Children of NAFTA.Laurence J. Kotlikoff and Scott Burns, The Coming Generational Storm: What You Need to Know About America's Economic Future.Pablo J. Boczkowski, Digitizing the News: Innovation in Online Newspapers.Frank Levy and Richard J. Murnane, The Division of Labor: How Computers Are Creating the Next Job Market.Dominque Foray, The Economics of Knowledge.Martin Campbell‐Kelly, From Airline Reservations to Sonic the Hedgehog: A History of the Software Industry.Rick Fantasia and Kim Voss, Hard Work: Remaking the American Labor Movement.Brian K. Obach, Labor and the Environmental Movement: The Quest for Common Ground.Chris Rhomberg, No There There: Race, Class and Political Community in Oakland.Daniel Cohen, Our Modern Times: The Nature of Capitalism in the Information Age.Steven Henry Lopez, Reorganizing the Rust Belt: An Inside Study of the American Labor Movement.Bruce Sinclair ed., Technology and the African‐American Experience: Needs and Opportunities for Study.
Early prostate cancer detected using expression of non‐functional cytolytic P2X7 receptors
Authors: Slater M , Danieletto S , Gidley‐Baird A , Teh L C , Barden J A 
Published: December 2004

Aims:  To detect early prostate cancer reliably by monitoring the expression of non‐functional P2X7 cytolytic purinergic receptors.Methods and results:  P2X7 receptors were absent from normal prostate epithelium obtained from post mortem tissue and tissue from cases of transurethral resection collected from young men (n = 23) who were confirmed to be free of cancer at later procedures 5–10 years after collection of the original samples. However, P2X7 was present in every case of 116 confirmed prostate cancers regardless of Gleason grade or patient age. P2X7 was present in apparently normal epithelial cells in acini well outside the tumour margins, but appeared in a distinct stage‐specific manner commencing with the nucleus, progressing to the cytoplasm and collecting finally on the apical membrane of the epithelial cells in morphologically distinct cancer. The pattern of P2X7 receptor localization in the epithelial cells was recorded in earlier biopsies obtained from the same patient cohort. One hundred and fourteen of 116 prostates stained positively for P2X7 at the earliest biopsy, though generally with a less advanced pattern of distribution.Conclusions:  The appearance of P2X7 receptors in normal prostate tissue adjacent to prostate tumours makes direct tumour biopsy less critical for positive cancer diagnosis and enables cancer progression to be monitored.
Atypical pleomorphic epithelioid angiomyolipoma localized to the pelvis: a case report and review of the literature
Authors: Gronchi A , Diment J , Colecchia M , Fiore M , Santinami M 
Published: December 2004

Aims:  Angiomyolipoma is the most common mesenchymal tumour of the kidney. It has been reported in several other sites outside the kidney, mainly in the liver. We report the first case of atypical pleomorphic angiomyolipoma in a man, arising from the pouch of Douglas and extending to the entire abdominal cavity.Methods:  A 17‐year‐old man underwent a complete resection of a giant abdominopelvic mass. The tissue was formalin fixed and paraffin embedded and 4 µm thick histological sections were stained with haematoxylin–eosin. Immunohistochemical stains for HMB‐45, smooth muscle actin, vimentin, calponin, S100 and desmin were performed. Sections for electron microscopy were also prepared.Results:  Microscopic examination revealed a neoplasm composed of pleomorphic epithelioid cells with atypical features, immunoreactive for HMB‐45, MART‐1, actin, vimentin and calponin, while S100 protein and desmin stains were negative. Ultrastructurally, the tumour cells showed prominent nucleoli, vacuolated cytoplasm, and some premelanosomes. A diagnosis of atypical pleomorphic epithelioid angiomyolipoma was then made.Conclusions:  To date five patients with abdominal epithelioid angiomyolipoma have been described in the literature. All were women. Three of the five patients reported developed metastasis, while our patient is still free of disease at 16 months of follow‐up. Clear prognostic pathological features have not been identified.
Morphologically distinct patterns of apoptosis correlate with size and high‐grade dysplasia in colonic adenomas
Authors: Brodie C M , Crotty P L , Gaffney E F 
Published: December 2004

Aims:  To examine the relationship of morphological patterns of apoptosis in colonic adenomas to standard pathological variables.Methods and results:  Apoptosis patterns were evaluated in 184 consecutive colonic adenomas and 14 adenocarcinomas, using haematoxylin and eosin sections. Apoptosis identification was selectively validated by electron microscopy. There were three patterns of apoptosis: (i) confluent basal apoptosis; (ii) crypt lumen apoptosis, both assessed semiquantitatively; and (iii) scattered apoptosis (not quantified). Adenoma site, size, type, mitoses, and grade of dysplasia were also assessed. MIB‐1 immunostaining was performed in 20 cases. In 142 adenomas (77%) confluent basal apoptosis (n = 124) and/or crypt lumen apoptosis (n = 69) were identified; 42 (23%) had scattered apoptosis only. Significant correlations were: (i) extensive confluent basal apoptosis with small adenomas ≤5 mm (P < 0.0001); (ii) crypt lumen apoptosis with large adenomas >5 mm (P < 0.0001) and (iii) with high‐grade dysplasia (P < 0.0003); and (iv) coexistence of both patterns (n = 51) with large adenomas >5 mm (P < 0.0001). Neither apoptosis pattern correlated with other variables. Adenocarcinomas had minimal confluent basal apoptosis (5/14), conspicuous crypt lumen apoptosis (14/14), intraglandular coagulative necrosis, and scattered apoptotic tumour cells.Conclusions:  Confluent basal apoptosis is maximal early in colonic tumorigenesis. The ‘switch’ to a predominant crypt lumen apoptosis pattern suggests that a different apoptosis induction mechanism might be associated with the transition to adenocarcinoma.
Expression of matrix metalloproteinases MMP‐2, MMP‐9 and their tissue inhibitors TIMP‐1, ‐2, and ‐3 in benign and malignant tumours of the salivary gland
Authors: Nagel H , Laskawi R , Wahlers A , Hemmerlein B 
Published: December 2004

Aims:  The balance between matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) is involved in the morphogenesis of the normal salivary gland as well as in mechanisms of tumour invasion and metastasis. Our aim was to analyse protein and mRNA expression of MMPs and TIMPs in normal salivary gland tissue and in various salivary gland neoplasms.Methods and results:  Immunohistochemistry for MMP‐2, MMP‐9, TIMP‐1, ‐2 and ‐3 was performed in 20 malignant and six benign salivary gland tumours. The immunoscores of MMP‐2 were significantly higher in carcinomas compared with adenomas (P = 0.0028). The MMP/TIMP ratio was significantly higher in carcinomas than in adenomas (P = 0.0097). In mucoepidermoid carcinomas MMP‐2 expression was preferentially observed in the intermediate cell type. Neoplastic acinar cells of acinic cell carcinoma demonstrated de novo expression of MMP‐2, MMP‐9, TIMP‐1, and TIMP‐2. Immunoscores of TIMP‐3 were not decreased in malignant tumours compared with adenomas. In accordance with the immunostaining of MMP‐2 and ‐9, gelatinolytic activity could be demonstrated by in‐situ zymography. The mRNA expression of MMPs and TIMPs analysed by real‐time reverse transcriptase‐polymerase chain reaction in three malignant and two benign tumours and their corresponding normal tissue did not generally correlate with their protein expression.Conclusions:  Our findings suggest a disturbed balance between MMP and TIMP in malignant salivary gland tumours. MMP‐2 expression in particular seems to be related to the invasive properties and the malignant potential of these tumours.
Expression of Bcl‐2 family members and presence of Epstein–Barr virus in the regulation of cell growth and death in classical Hodgkin's lymphoma
Authors: Kim L‐H , Nadarajah V S , Peh S‐C , Poppema S 
Published: December 2004

Aims:  To examine the expression of the Bcl‐2 family of proteins (Bcl‐2, Bcl‐x, Bcl‐xL and Bax) in classical Hodgkin's lymphoma (cHL) and to correlate the expression of these proteins with proliferation, apoptosis and the presence of Epstein–Barr virus (EBV).Methods and results:  Expression of the Bcl‐2 family of proteins was detected by immunohistochemistry, proliferation was determined by Ki67 labelling and apoptosis by TUNEL in‐situ hybridization. EBV was detected by Epstein–Barr virus early RNA (EBER) in‐situ hybridization. Expression of Bcl‐2, Bcl‐x, Bcl‐xL and Bax was detected in the Hodgkin/Reed–Sternberg (H/RS) cells in 43.7% (27/62), 87.5% (56/64), 67.2% (41/61) and 74.6% (47/63) of the cHL cases, respectively. EBER was detected in 53% (35/66) of the cases, whereas Ki67 was observed in 86.7% (52/60) of the cases. Apoptotic H/RS cells were observed infrequently, and only 43.2% (11/26) of the cases showed an apoptotic index of ≥ 10% in the H/RS cells. A statistically significant inverse relationship was observed between the expression of Bcl‐2 and the presence of EBV (P = 0.003). Bcl‐xL showed an inverse correlation with apoptosis in the H/RS cells (P = 0.004).Conclusions:  The higher Bcl‐xL expression (67.2%) compared with Bcl‐2 expression (43.5%) observed in cHL as well as the statistically significant inverse relationship between Bcl‐xL and apoptosis suggests that Bcl‐xL plays an important role in the survival of H/RS cells. Expression of Bax may be neutralized by other anti‐apoptotic members of the family such as Bcl‐2 and/or Bcl‐xL.
Mast cell chymase expression in Helicobacter pylori‐associated gastritis
Authors: Matsuo T , Ikura Y , Ohsawa M , Ogami M , Kayo S , Yoshimi N , Hai E , Naruko T , Ohishi M , Higuchi K , Arakawa T , Ueda M 
Published: December 2004

Aims:  To study the role of mast cell chymase in the inflammatory processes of human chronic gastritis. Experimental studies have shown that mast cell chymase stimulates inflammatory cell accumulation, and contributes to angiotensin II formation.Methods and results:  Tissue sections from human stomachs with Helicobacter pylori‐associated gastritis (surgery/autopsy n = 20; biopsy n = 16) and normal stomachs (n = 10) were studied using immunohistochemical single and double labelling techniques. Monoclonal antibodies used were directed against mast cell chymase, tryptase, neutrophils (CD66b, elastase, and myeloperoxidase), macrophages, T‐lymphocytes, and interleukin (IL)‐4. The expression of angiotensin‐converting enzyme and angiotensin II type 1 receptor was investigated using immunohistochemical analysis and the reverse transcription‐polymerase chain reaction. The number of chymase‐positive mast cells was significantly higher (P < 0.0001) in H. pylori‐associated gastritis than in normal stomachs. Increased expression of chymase in inflamed mucosa was closely related to an increase in the accumulation of neutrophils, macrophages, T‐lymphocytes, and IL‐4‐positive cells. The expression of angiotensin‐converting enzyme and angiotensin II type 1 receptor was not altered in gastritis specimens.Conclusions:  These observations suggest that mast cell chymase may be an important mediator in the inflammatory processes of human H. pylori‐associated gastritis.