bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Self‐Report Measure of Clinicians' Orientation toward Integrative Medicine
Authors: Hsiao An‐Fu , Hays Ron D. , Ryan Gery W. , Coulter Ian D. , Andersen Ronald M. , Hardy Mary L. , Diehl David L. , Hui Ka‐Kit , Wenger Neil S. 
Published: September 2005

Objective. Patients in the U.S. often turn to complementary and alternative medicine (CAM) and may use it concurrently with conventional medicine to treat illness and promote wellness. However, clinicians vary in their openness to the merging of treatment paradigms. Because integration of CAM with conventional medicine can have important implications for health care, we developed a survey instrument to assess clinicians' orientation toward integrative medicine.Study Setting. A convenience sample of 294 acupuncturists, chiropractors, primary care physicians, and physician acupuncturists in academic and community settings in California.Data Collection Methods. We used a qualitative analysis of structured interviews to develop a conceptual model of integrative medicine at the provider level. Based on this conceptual model, we developed a 30‐item survey (IM‐30) to assess five domains of clinicians' orientation toward integrative medicine: openness, readiness to refer, learning from alternate paradigms, patient‐centered care, and safety of integration.Principal Findings. Two hundred and two clinicians (69 percent response rate) returned the survey. The internal consistency reliability for the 30‐item total scale and the five subscales ranged from 0.71 to 0.90. Item‐scale correlations for the five subscales were higher for the hypothesized subscale than other subscales 75 percent or more of the time. Construct validity was supported by the association of the IM‐30 total scale score (0–100 possible range, with a higher score indicative of greater orientation toward integrative medicine) with hypothesized constructs: physician acupuncturists scored higher than physicians (71 versus 50, p<.001), dual‐trained practitioners scored higher than single‐trained practitioners (71 versus 62, p<.001), and practitioners' self‐perceived “integrativeness” was significantly correlated (r=0.60, p<.001) with the IM‐30 total score.Conclusion. This study provides support for the reliability and validity of the IM‐30 as a measure of clinicians' orientation toward integrative medicine. The IM‐30 survey, which we estimate as requiring 5 minutes to complete, can be administered to both conventional and CAM clinicians.
Factors Associated with Interorganizational Relationships among Outpatient Drug Treatment Organizations 1990–2000
Authors: Wells Rebecca , Lemak Christy Harris , D'Aunno Thomas A. 
Published: September 2005

Objective.To identify the factors associated with drug abuse treatment center participation in interorganizational relationships (IORs).Data Sources.Three nationally representative samples of outpatient drug abuse treatment units surveyed in 1990, 1995, and 1999/2000 as part of the National Drug Abuse Treatment System Survey (NDATSS), stratified by public/private status, treatment modality (methadone or nonmethadone), and organizational affiliation.Study Design.Probit analyses on 647 lagged treatment center‐year observations from the years 1990 to 1995 with outcomes in 1995 and 2000, respectively. Standard errors were adjusted for clustering of center‐year observations within centers.Principal Findings.Centers with greater motivation to form IORs (e.g., as a result of client diversity or government revenue) were more likely to do so, as were centers with greater opportunities to form IORs (e.g., centers whose directors participated in policy making).Conclusions.Both motivating and enabling factors promoted the formation of IORs by drug abuse treatment centers. Managed care also played a distinct role, in this case appearing to undermine interorganizational cooperation. Because IORs can improve access to care and quality, policy makers should consider using both incentives and support such as management training to promote IOR formation.
Medicaid Managed Care and Health Care for Children
Authors: Baker Laurence C. , Afendulis Christopher 
Published: September 2005

Objective. Many states expanded their Medicaid managed care programs during the 1990s, causing concern about impacts on health care for affected populations. We investigate the relationship between Medicaid managed care enrollment and health care for children.Data Sources and Measures. Repeated cross‐sections of Medicaid‐covered children under 18 years of age from the 1996/1997 and 1998/1999 Community Tracking Study Household Surveys (n=2,602) matched to state‐year CMS Medicaid managed care enrollment data. For each individual, we constructed measures of health care utilization (provider and emergency department visits, hospitalizations, surgeries); health care access (usual source of care, unmet medical needs, put‐off needed care); and satisfaction (satisfaction overall, with doctor choice, and with last visit).Study Design. Regression analysis of the relationship between within‐state changes in Medicaid managed care enrollment rates and changes in mean utilization, access, and satisfaction measures for children covered by Medicaid, controlling for a range of potentially confounding factors.Principal Findings. Increases in Medicaid health maintenance organization (HMO) enrollment are associated with less emergency room use, more outpatient visits, fewer hospitalizations, higher rates of reporting having put off care, and lower satisfaction with the most recent visit. Medicaid primary care case management (PCCM) plans are associated with increases in outpatient visits, but also with higher rates of reporting unmet medical needs, putting off care, and having no usual source of care.Conclusions. Both Medicaid HMO and PCCM plans can have important impacts on health care utilization, access, and satisfaction. Some impacts may be positive (e.g., less ED use and more outpatient provider use), although concern about increasing challenges in access to care and satisfaction is also warranted.
Carrot or Stick? Contract Frame and Use of Decision‐Influencing Information in a Principal‐Agent Setting
Authors: FREDERICKSON JAMES R. , WALLER WILLIAM 
Published: September 2005

ABSTRACTA fundamental management accounting issue is how to incorporate decision‐influencing information (e.g., an ex post state signal) into employment contracts. Our experiment examines the effects of contract framing on such information use in a principal‐agent setting. In each of 40 rounds, participants (as employer and worker) negotiate a contract that specifies pay depending on an ex post state signal. State‐signal pay is framed as either a bonus or a penalty over two groups. The results show that the bonus frame facilitates information use, because of worker loss aversion. Although both groups initially underweigh the state signal, the bonus group quickly converges toward the optimal weight, whereas the penalty group persistently underweighs the state signal.
Increase in liver antioxidant enzyme activities in non‐alcoholic fatty liver disease
Authors: Perlemuter Gabriel , Davit‐Spraul Anne , Cosson Claudine , Conti Marc , Bigorgne Amélie , Paradis Valérie , Corre Marie‐Pierre , Prat Lydie , Kuoch Viceth , Basdevant Arnaud , Pelletier Gilles , Oppert Jean‐Michel , Buffet Catherine 
Published: September 2005

Abstract: Aims: Steatosis may increase oxidative stress, which is counteracted by cellular enzymatic (cytosolic and mitochondrial superoxide dismutases (Cu/Zn‐SOD and Mn‐SOD), glutathione peroxidase (GPx), catalase) and non‐enzymatic antioxidant systems. We aimed to determine, in patients with non‐alcoholic fatty liver disease (NAFLD), the level of antioxidant defenses (1) in liver biopsies, to demonstrate the existence of oxidative stress; (2) in erythrocytes and plasma, to determine whether their antioxidant defenses reflect liver oxidative stress.Methods: Erythrocyte and plasma antioxidant defenses were prospectively studied in two groups of 16 patients: patients with NAFLD and controls. Liver biopsies were performed in eight NAFLD patients; liver antioxidant enzyme activities were measured and compared with those in 12 control livers used for transplantation.Results: Cu/Zn‐SOD, GPx and catalase activities were significantly higher in NAFLD livers than in controls whereas no significant differences were observed in Mn‐SOD activity, and thiobarbituric acid‐reactive substance (TBARS) concentration. No differences were observed in erythrocyte antioxidant enzyme activities (GPx, catalase, Cu/Zn‐SOD), erythrocyte TBARS concentration, and plasma α‐tocopherol concentration.Conclusions: Liver antioxidant enzyme activities were high in patients with NAFLD, reflecting an oxidative stress possibly involved in inflammation and fibrogenesis. However, erythrocyte and plasma antioxidant defenses did not reflect intrahepatic peroxidation.
Overexpression of granulocyte‐macrophage colony‐stimulating factor in mouse liver enhances the susceptibility of lipopolysaccharide leading to massive apoptosis of hepatocytes
Authors: Hirano Katsuharu , Shimizu Yukihiro , Nakayama Yasuhiro , Minemura Masami , Yasumura Satoshi , Sugiyama Toshiro 
Published: September 2005

Abstract: Background/Aims: We examined whether antigen‐nonspecific accumulation of dendritic cells (DCs) and macrophages in the liver by the overexpression of granulocyte macrophage‐colony stimulating factor (GM‐CSF) could prime severe liver injury after LPS injection.Methods: We injected a recombinant adenovirus encoding GM‐CSF intravenously (AdGM), and LPS was administered 7 days later. Liver histology, serum alanine aminotransferase (ALT) levels and apoptosis of hepatocytes were examined.Results: Liver histology of the AdGM‐primed mice showed marked infiltrates of mononuclear cells (DCs and macrophages) without granuloma formation on day 7. Expression of toll‐like receptor‐4 on intrahepatic mononuclear cells isolated from AdGM‐primed mice was up‐regulated. After LPS injection, serum ALT levels in AdGM‐primed mice reached about 6000 IU/l at 12 h, and all those mice died within 24 h. Hemorrhagic liver injury with massive apoptosis of hepatocytes was histologically recognized. When AdGM and LPS were injected in FasL‐deficient C57BL/6J‐gld/gld mice, serum ALT levels were not elevated by the pretreatment with a neutralizing anti‐TNF‐α antibody.Conclusions: Our present study provides a new model of severe liver injury, in which antigen‐nonspecific accumulation of DCs and macrophages in the liver by overexpressing GM‐CSF enhances the susceptibility to LPS, leading to hemorrhagic liver injury with massive hepatocyte apoptosis after LPS injection.
Beraprost sodium, a prostacyclin (PGI2) analogue, ameliorates concanavalin A‐induced liver injury in mice
Authors: Ohta Satoshi , Nakamuta Makoto , Fukushima Marie , Kohjima Motoyuki , Kotoh Kazuhiro , Enjoji Munechika , Nawata Hajime 
Published: September 2005

Abstract: Background/Aims: Prostacyclin (PGI2) is a potent mediator in the inflammatory and coagulation processes. The aim of this study was to test whether beraprost sodium, a PGI2 analogue, could prevent experimental hepatic injury induced by concanavalin A (Con A), which is a model of fulminant hepatic failure.Methods: Beraprost (100 μg/kg) was administered intraperitoneally simultaneously with Con A (40 mg/kg) in C57B6J mice. Blood circulation in the liver was determined by laser‐Doppler flowmetry. Plasma levels of alanine aminotransferase (ALT), tumor necrosis factor (TNF)‐α, interferon (IFN)‐γ, and interleukin (IL)‐6 were determined. Levels of TNF‐α and IFN‐γ in culture supernatant of splenocytes were also determined.Results: Beraprost administration reduced the incidence of death following hepatic failure (76.5% vs. 29.4%, P<0.05). Plasma levels of ALT were significantly lower in the beraprost‐treated group than in the control group, and in the former, there was concomitant suppression of the histological features of injury. Beraprost significantly increased hepatic blood flow volume in Con A‐treated mice. Plasma levels of TNF‐α and IFN‐γ were significantly reduced at 6 and 12 h after Con A injection, respectively, but the levels of IL‐6 were increased at 6 h. In vitro, beraprost also suppressed Con A‐induced TNF‐α production in splenocytes, while it stimulated IFN‐γ production.Conclusion: These findings imply that beraprost suppresses Con A‐induced liver injury. These data also suggest that beraparost, which is clinically effective in treating pulmonary hypertension, may have therapeutic potential for preventing hepatic injury.
Polymorphisms in the transforming growth factor‐β1 gene (TGF‐β1) and the risk of advanced alcoholic liver disease
Authors: Oliver Javier , Agúndez José A. G. , Morales Sonia , Fernández‐Arquero Miguel , Fernández‐Gutierrez Benjamín , De La Concha Emilio G. , Díaz‐Rubio Manuel , Martín Javier , Ladero José M. 
Published: September 2005

Abstract: Background/aims: There are wide interindividual differences in the risk of developing alcoholic cirrhosis. Transforming growth factor β1 (TGF‐β1) is the main cytokine involved in liver fibrogenesis. The TGF‐β1 gene is polymorphic at several sites and these polymorphisms are probably related to differences in the rate of TGF‐β1 synthesis. Our aim has been to analyse the influence of the TGF‐β1 gene polymorphisms in the predisposition to advanced alcoholic liver disease (ALD) in ethanol abusers.Methods: TGF‐β1 single nucleotide polymorphisms at positions –509 (C or T), +869 (C or T, codon 10), and +915 (C or G, codon 25) were examined in 165 alcoholics with advanced ALD and in 185 healthy controls.Results: Among the 94 male patients with oesophageal varices, those carrying the GG genotype at position +915 were diagnosed at an older age than the remaining patients (age 52.1 years, standard deviation (SD) 9.9 vs. 45 SD 13.4, P=0.012). No other statistically significant differences were found in the distribution of the three TGF‐β1 polymorphisms analysed individually or as combined haplotypes.Conclusions: The polymorphisms at the TGF‐β1 gene analysed in this study are probably not related to the risk of advanced ALD.
Does Preservation of Perisomatic Inhibition in Epileptic Hippocampus Contribute to Seizures?
Authors: Mazarati Andrey M. 
Published: September 2005

Surviving CA1 Pyramidal Cells Receive Intact Perisomatic Inhibitory Input in the Human Epileptic Hippocampus Wittner L, Eross L, Czirjak S, Halasz P, Freund TF, Magloczky Z Brain 2005;128:138–152 Temporal lobe epilepsy (TLE) is known to be linked to an impaired balance of excitation and inhibition. Whether inhibition is decreased or preserved in the human epileptic hippocampus, beside the excess excitation, is still a debated question. In the present study, quantitative light and electron microscopy has been performed to analyze the distribution, morphology, and input–output connections of parvalbumin (PV)-immunopositive interneurons, together with the entire perisomatic input of pyramidal cells, in the human control and epileptic CA1 region. Based on the degree of cell loss, the patients with therapy-resistant TLE formed four pathologic groups. In the nonsclerotic CA1 region of TLE patients, where large numbers of pyramidal cells are preserved, the number of PV-immunopositive cell bodies decreased, whereas axon terminal staining and the distribution of their postsynaptic targets was not altered. The synaptic coverage of CA1 pyramidal cell axon initial segments (AISs) remained unchanged in the epileptic tissue. The somatic inhibitory input also is preserved; it has been decreased only in the cases with patchy pyramidal cell loss in the CA1 region (control, 0.637; epileptic with mild cell loss, 0.642; epileptic with patchy cell loss, 0.424- μm synaptic length/100- μm soma perimeter). The strongly sclerotic epileptic CA1 region, where pyramidal cells can hardly be seen, contains a very small number of PV-immunopositive elements. Our results suggest that perisomatic inhibitory input is preserved in the epileptic CA1 region as long as pyramidal cells are present. Basket and axoaxonic cells survive in epilepsy if their original targets are present, although many of them lose their PV content or PV immunoreactivity. An efficient perisomatic inhibition is likely to take part in the generation of abnormal synchrony in the nonsclerotic epileptic CA1 region, and thus participate in the maintenance of epileptic seizures driven, for example, by hyperactive afferent input.
Prophylactic Antiepileptic Drugs in Patients with Brain Tumors
Authors: Bergen Donna C. 
Published: September 2005

Seizure Prophylaxis in Patients with Brain Tumors: A Meta-analysis Sirven JI, Wingerchuk DM, Drazkowski JF, Lyons MK, Zimmerman RS Mayo Clin Proc 2004;79:1489–1494 Purpose To assess whether antiepileptic drugs (AEDs) should be prescribed to patients with brain tumors who have no history of seizures. Methods We performed a meta-analysis of randomized controlled trials (1966 to 2004) that evaluated the efficacy of AED prophylaxis versus no treatment or placebo to prevent seizures in patients with brain tumors who had no history of epilepsy. Summary odds ratios were calculated by using a random-effects model. Three subanalyses were performed to assess pooled odds ratios (ORs) of seizures in patients with primary glial tumors, cerebral metastases, and meningiomas. Results Of 474 articles found in the initial search, 17 were identified as primary studies. Five trials met inclusion criteria: patients with a neoplasm (primary glial tumors, cerebral metastases, and meningiomas) but no history of epilepsy who were randomized to either an AED or placebo. The three AEDs studied were phenobarbital, phenytoin, and valproic acid. Of the five trials, four showed no statistical benefit of seizure prophylaxis with an AED. Meta-analysis confirmed the lack of AED benefit at 1 week (OR, 0.91; 95% confidence interval [CI], 0.45–1.83) and at 6 months (OR, 1.01; 95% CI, 0.51–1.98) of follow-up. The AEDs had no effect on seizure prevention for specific tumor pathology, including primary glial tumors (OR, 3.46; 95% CI, 0.32–37.47), cerebral metastases (OR, 2.50; 95% CI, 0.25–24.72), and meningiomas (OR, 0.62; 95% CI, 0.10–3.85). Conclusions No evidence supports AED prophylaxis with phenobarbital, phenytoin, or valproic acid in patients with brain tumors and no history of seizures, regardless of neoplastic type. Subspecialists who treat patients with brain tumors need more education on this issue. Future randomized controlled trials should address whether any of the newer AEDs are useful for seizure prophylaxis.
Lamotrigine-induced Rash: Can We Stop Worrying?
Authors: Kanner Andres M. 
Published: September 2005

Lamotrigine-induced Rash: Worth a Rechallenge P-Codrea Tigaran S, Sidenius P, Dam M Acta Neurol Scand 2005;111:191–194 Purpose The only serious adverse event associated with lamotrigine (LTG) treatment is a hypersensitivity reaction primarily occurring as a rash. Despite this concern, LTG is an antiepileptic drug (AED) with one of the most favorable efficacy/tolerability ratios compared with the new as well as the old AEDs. Thus, this study aimed to evaluate the results of rechallenge with LTG after the initial rash. Methods In total, 688 patients (350 as monotherapy, and 338 as add-on therapy) with either idiopathic generalized epilepsy or focal epilepsy were treated with LTG. The patients with LTG-induced rash were rechallenged with LTG. The dosage schedule was 5 mg every day or every second day for 14 days, increased by 5 mg every 14th day to 25 mg/day. After achieving the daily dosage of 25 mg/day, the uptitration was completed by following the current guidelines. Results In 52 patients, a rash developed. The LTG-induced rash occurred in 6%, whereas 12 (1.8%) developed a rash shown to be coincidentally associated with the initiation of LTG therapy. In their cases, LTG was continued with success without intermission. Nineteen (38%) of the initial cohort were rechallenged with LTG, with a success rate of 84%. Conclusions This study is the first to provide a successful recipe verified in time for the rechallenge with LTG after the initial drug-induced rash. The concurrent use of valproate was not found in this study to represent an additional risk factor for the occurrence of the rash during rechallenge with LTG. Our results agree with previous findings that women are more likely to develop the rash ( P < 0.009).
Inhibition of skin pigmentation by an extract of Lepidium apetalum and its possible implication in IL‐6 mediated signaling
Authors: Choi Hyunjung , Ahn Soomi , Lee Byeong G. , Chang Ihseop , Hwang Jae S. 
Published: September 2005

SummaryThe development of effective skin‐lightening agents is an increasingly important area of research aimed at the treatment of hyperpigmentation induced by UV irradiation or by medical conditions such as melasma, postinflammatory melanoderma and solar lentigo. Although some inhibit tyrosinase, identifying and understanding the mechanisms of action of other agents is an important goal if more effective pigmentation inhibitors are to be developed. We present here that an extract of Lepidium apetalum (ELA) decreased UV‐induced skin pigmentation in brown guinea pigs and melanogenesis of HM3KO human melanoma cells. Interestingly, ELA did not reduce melanogenesis in HM3KO cells unless they were co‐cultivated in keratinocyte‐conditioned medium prepared by culturing keratinocytes with ELA. Under these conditions, ELA decreased tyrosinase mRNA and protein expression as well as melanin content via an ELA‐mediated increase in keratinocyte IL‐6 production which in turn was shown to decrease in the expression Mitf, a transcription factor implicated in tyrosinase gene expression and melanocyte differentiation. The results reveal that ELA may be an effective inhibitor of hyperpigmentation caused by UV irradiation or by pigmented skin disorders through a mechanism involving IL‐6‐mediated downregulation of Mitf rather than a direct inhibition of tyrosinase activity.
Melanin in human irides of different color and age of donors
Authors: Wielgus Albert R. , Sarna Tadeusz 
Published: September 2005

SummaryMelanin is the main chromophore of the human iris. This pigment is considered to be the most important factor that determines the color of the irides. Previous studies based mainly on chemical degradation methods showed that brown irides contain more melanin than blue ones. In our study, we used electron spin resonance (ESR) spectroscopy to detect and characterize melanin free radical centers and associated iron in human irides. Based on this method, we determined the amount of melanin in the irides and the relative content of iron in iridial melanin as a function of their color, shade, and the age of their donors. Chemical degradation of iridial homogenates enabled us to characterize the structure of eumelanin and determine the content of pheomelanin present in human and bovine irides. The ESR amplitude, the normalized intensity obtained by double integration of the ESR signal of melanin, and the content of the pigment in the irides depended on color and shade of the eyes being 40% higher in the brown group of the irides compared with all other groups. On the other hand, the relative iron content normalized to the melanin content in light blue irides showed a small decrease with age of donors. Melanin in human and bovine irides was mostly composed of eumelanin, and pheomelanin content was of the order of a few percent. Although some differences in the structure of eumelanin present in the human and bovine irides are possible, the results obtained in this study suggest that human irides contain eumelanin with very similar chemical properties.