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Armstrong DS, Arvieux J, Asaturyan R, Averett T, Bailey SL, Batigne G, Beck DH, Beise EJ, Benesch J, Bimbot L, Birchall J, Biselli A, Bosted P, Boukobza E, Breuer H, Carlini R, Carr R, Chant N, Chao YC, Chattopadhyay S, Clark R, Covrig S, Cowley A, Dale D, Davis C, Falk W, Finn JM, Forest T, Franklin G, Furget C, Gaskell D, Grames J, Griffioen KA, Grimm K, Guillon B, Guler H, Hannelius L, Hasty R, Hawthorne Allen A, Horn T, Johnston K, Jones M, Kammel P, Kazimi R, King PM, Kolarkar A, Korkmaz E, Korsch W, Kox S, Kuhn J, Lachniet J, Lee L, Lenoble J, Liatard E, Liu J, Loupias B, Lung A, MacLachlan GA, Marchand D, Martin JW, McFarlane KW, McKee DW, McKeown RD, Merchez F, Mkrtchyan H, Moffit B, Morlet M, Nakagawa I, Nakahara K, Nakos M, Neveling R, Niccolai S, Ong S, Page S, Papavassiliou V, Pate SF, Phillips SK, Pitt ML, Poelker M, Porcelli TA, Quéméner G, Quinn B, Ramsay WD, Rauf AW, Real JS, Roche J, Roos P, Rutledge GA, Secrest J, Simicevic N, Smith GR, Spayde DT, Stepanyan S, Stutzman M, Sulkosky V, Tadevosyan V, Tieulent R, van de Wiele J, van Oers W, Voutier E, Vulcan W, Warren G, Wells SP, Williamson SE, Wood SA, Yan C, Yun J, Zeps V. Strange-quark contributions to parity-violating asymmetries in the forward g0 electron-proton scattering experiment. PHYSICAL REVIEW LETTERS 2005; 95:092001. [PMID: 16197209 DOI: 10.1103/physrevlett.95.092001] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2005] [Indexed: 05/04/2023]
Abstract
We have measured parity-violating asymmetries in elastic electron-proton scattering over the range of momentum transfers 0.12 < or =Q2 < or =1.0 GeV2. These asymmetries, arising from interference of the electromagnetic and neutral weak interactions, are sensitive to strange-quark contributions to the currents of the proton. The measurements were made at Jefferson Laboratory using a toroidal spectrometer to detect the recoiling protons from a liquid hydrogen target. The results indicate nonzero, Q2 dependent, strange-quark contributions and provide new information beyond that obtained in previous experiments.
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England JD, Gronseth GS, Franklin G, Miller RG, Asbury AK, Carter GT, Cohen JA, Fisher MA, Howard JF, Kinsella LJ, Latov N, Lewis RA, Low PA, Sumner AJ. Distal symmetrical polyneuropathy: Definition for clinical research. Muscle Nerve 2004; 31:113-23. [PMID: 15536624 DOI: 10.1002/mus.20233] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The objective of this report was to develop a case definition of "distal symmetrical polyneuropathy" to standardize and facilitate clinical research and epidemiological studies. A formalized consensus process was employed to reach agreement after a systematic review and classification of evidence from the literature. The literature indicates that symptoms alone have relatively poor diagnostic accuracy in predicting the presence of polyneuropathy; signs are better predictors of polyneuropathy than symptoms; and single abnormalities on examination are less sensitive than multiple abnormalities in predicting the presence of polyneuropathy. The combination of neuropathic symptoms, signs, and electrodiagnostic findings provides the most accurate diagnosis of distal symmetrical polyneuropathy. A set of case definitions was rank ordered by likelihood of disease. The highest likelihood of polyneuropathy (useful for clinical trials) occurs with a combination of multiple symptoms, multiple signs, and abnormal electrodiagnostic studies. A modest likelihood of polyneuropathy (useful for field or epidemiological studies) occurs with a combination of multiple symptoms and multiple signs when the results of electrodiagnostic studies are not available. A lower likelihood of polyneuropathy occurs when electrodiagnostic studies and signs are discordant. For research purposes, the best approach for defining distal symmetrical polyneuropathy is a set of case definitions rank ordered by estimated likelihood of disease. The inclusion of this formalized case definition in clinical and epidemiological research studies will ensure greater consistency of case selection.
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Whelen M, Crawford T, Comi A, Freeman J, Kossoff E, Singer H, Vining E, Yohay K, Shevell M, Ashwal S, Tardo C, Franklin G. Practice parameter: Evaluation of the child with global developmental delay. Neurology 2003. [DOI: 10.1212/wnl.61.9.1315] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Sairam RV, Parani M, Franklin G, Lifeng Z, Smith B, MacDougall J, Wilber C, Sheikhi H, Kashikar N, Meeker K, Al-Abed D, Berry K, Vierling R, Goldman SL. Shoot meristem: an ideal explant for Zea mays L. transformation. Genome 2003; 46:323-9. [PMID: 12723048 DOI: 10.1139/g02-120] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We report on a rapid high-frequency somatic embryogenesis and plant regeneration protocol for Zea mays. Maize plants were regenerated from complete shoot meristem (3-4 mm) explants via organogenesis and somatic embryogenesis. In organogenesis, the shoot meristems were directly cultured on a high-cytokinin medium comprising 5-10 mg x L(-1) 6-benzylaminopurine (BAP). The number of multiple shoots produced per meristem varied from six to eight Plantlet regeneration through organogenesis resulted in just four weeks. Callus was induced in five days of incubation on an auxin-modified Murashige and Skoog (MS) medium. Prolific callus, with numerous somatic embryos, developed within 3-4 weeks when cultured on an auxin medium containing 5 mg 2,4-dichlorophenoxyacetic acid x L(-1). The number of multiple shoots varied from three to six per callus. Using R23 (Pioneer, Hi-Bred, Johnston, Iowa), the frequency of callus induction was consistently in excess of 80% and plant regeneration ranged between 47 and 64%. All regenerated plantlets survived in the greenhouse and produced normal plants. Each transgenic plant produced leaves, glumes, and anthers that uniformly expressed green fluorescent protein (GFP). The GFP gene segregated in the pollen. Based on this data it is concluded that the transgenics arose from single-cell somatic embryos. The rate of transfer DNA (T-DNA) transfer to complete shoot meristems of Zea mays was high on the auxin medium and was independent of using super-virulent strains of Agrobacterium.
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Franklin G, Lakshmi Sita G. Agrobacterium tumefaciens-mediated transformation of eggplant (Solanum melongena L.) using root explants. PLANT CELL REPORTS 2003; 21:549-554. [PMID: 12789429 DOI: 10.1007/s00299-002-0546-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2002] [Revised: 09/19/2002] [Accepted: 09/25/2002] [Indexed: 05/24/2023]
Abstract
An efficient variety-independent method for producing transgenic eggplant (Solanum melongena L.) via Agrobacterium tumefaciens-mediated genetic transformation was developed. Root explants were transformed by co-cultivation with Agrobacterium tumefaciens strain LBA4404 harbouring a binary vector pBAL2 carrying the reporter gene beta-glucuronidase intron (GUS-INT) and the marker gene neomycin phosphotransferase (NPTII). Transgenic calli were induced in media containing 0.1 mg l(-1) thidiazuron (TDZ), 3.0 mg l(-1) N(6)-benzylaminopurine, 100 mg l(-1) kanamycin and 500 mg l(-1) cefotaxime. The putative transgenic shoot buds elongated on basal selection medium and rooted efficiently on Soilrite irrigated with water containing 100 mg l(-1) kanamycin sulphate. Transgenic plants were raised in pots and seeds subsequently collected from mature fruits. Histochemical GUS assay and polymerase chain reaction analysis of field-established transgenic plants and their offsprings confirmed the presence of the GUS and NPTII genes, respectively. Integration of T-DNA into the genome of putative transgenics was further confirmed by Southern blot analysis. Progeny analysis of these plants showed a pattern of classical Mendelian inheritance for both the NPTII and GUS genes.
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Bassalleck B, Berdoz A, Bradtke C, Bröders R, Bunker B, Dennert H, Dutz H, Eilerts S, Eyrich W, Fields D, Fischer H, Franklin G, Franz J, Gehring R, Geyer R, Goertz S, Harmsen J, Hauffe J, Heinsius FH, Hertzog D, Johansson T, Jones T, Khaustov P, Kilian K, Kingsberry P, Kriegler E, Lowe J, Meier A, Metzger A, Meyer CA, Meyer W, Moosburger M, Oelert W, Paschke KD, Plückthun M, Pomp S, Quinn B, Radtke E, Reicherz G, Röhrich K, Sachs K, Schmitt H, Schoch B, Sefzick T, Stinzing F, Stotzer R, Tayloe R, Wirth S. Measurement of spin-transfer observables in p p-->Lambda Lambda at 1.637 GeV/c. PHYSICAL REVIEW LETTERS 2002; 89:212302. [PMID: 12443404 DOI: 10.1103/physrevlett.89.212302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2002] [Indexed: 05/24/2023]
Abstract
Spin-transfer observables for p p-->Lambda Lambda have been measured using a transversely polarized frozen-spin target and a beam momentum of 1.637 GeV/c. Current models of the reaction near threshold are in good agreement with existing measurements performed with unpolarized particles in the initial state but produce conflicting predictions for the spin-transfer observables Dnn and Knn (the normal-to-normal depolarization and polarization transfer), which are measurable only with polarized target or beam. Measurements of Dnn and Knn presented here are found to be in disagreement with predictions from these models.
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Comber SDW, Franklin G, Gardner MJ, Watts CD, Boxall ABA, Howcroft J. Partitioning of marine antifoulants in the marine environment. THE SCIENCE OF THE TOTAL ENVIRONMENT 2002; 286:61-71. [PMID: 11887874 DOI: 10.1016/s0048-9697(01)00963-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The partitioning behaviour of the organic biocides, Irgarol 1051 and diuron and two inorganic biocides (copper and zinc) was investigated using six sediments of differing physico-chemical properties collected from unimpacted sites along the south coast of England. The kinetics of sorption and equilibrium partitioning between the sediments and seawater were investigated over a period of 20 days. Resulting organic carbon/water partition coefficients (log Koc) were related to suspended sediment concentration and ranged from 2.28 to 5.20 for diuron; and from 2.41 to 4.89 for Irgarol 1051. Sediment/water partition coefficients (log Kp) for copper and zinc varied from 2.46 to 5.08 l/kg and from 2.49 to 4.97 l/kg, respectively. Kinetic data indicated that there were significant interactions between the dissolved and particulate phases at the start of the experiments, just after mixing. This is thought to be a result of redistribution of organic carbon between the two phases.
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Keyes KB, Wickizer TM, Franklin G. Two-year health and employment outcomes among injured workers enrolled in the Washington State Managed Care Pilot Project. Am J Ind Med 2001; 40:619-26. [PMID: 11757038 DOI: 10.1002/ajim.10001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Increasing numbers of injured workers are being treated through managed care delivery systems, yet little is known about the long-term effects of care provided through these systems. We analyzed health outcomes, return to work, and employment status at 2 years post-injury among a cohort of workers who were previously enrolled in the Washington State Managed Care Pilot Project. METHODS Data on functional status, satisfaction with quality of life, return to work and employment status were gathered via telephone interviews and mailed questionnaires from a subset of 374 injured workers who had a time loss claim that involved 4 or more days of lost work time. Of these 374 subjects, 106 were treated through managed care and 268 through fee-for-service (FFS) arrangements. Health outcomes were assessed through the SF-36, the Health Assessment Questionnaire (HAQ), and the Satisfaction with Quality of Life (QOL) instruments. Standard univariate and multivariate statistical methods were used to compare the two groups with respect to the health and employment outcomes. RESULTS There were no statistically significant differences between the two groups in functional status, satisfaction with quality of life or employment outcomes, except in regard to perceived recovery. FFS patients were more likely to indicate their recovery at 2 years post injury was going well (62 vs. 45%, P = .01). Almost 90% of the injured workers returned to work at some point following their injury and 72% reported working during the 4 weeks prior to their 2-year follow-up interview. CONCLUSIONS Injured workers treated through managed care, based upon an occupational-medicine model, appear to experience similar long-term health and employment outcomes as workers treated through traditional FFS.
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Brandt NR, Franklin G, Brunschwig JP, Caswell AH. The role of mitsugumin 29 in transverse tubules of rabbit skeletal muscle. Arch Biochem Biophys 2001; 385:406-9. [PMID: 11368024 DOI: 10.1006/abbi.2000.2148] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Ajimura S, Hayakawa H, Kishimoto T, Kohri H, Matsuoka K, Minami S, Mori T, Morikubo K, Saji E, Sakaguchi A, Shimizu Y, Sumihama M, Chrien RE, May M, Pile P, Rusek A, Sutter R, Eugenio P, Franklin G, Khaustov P, Paschke K, Quinn BP, Schumacher RA, Franz J, Fukuda T, Noumi H, Outa H, Gan L, Tang L, Yuan L, Tamura H, Nakano J, Tamagawa T, Tanida K, Sawafta R. Observation of spin-orbit splitting in lambda single-particle states. PHYSICAL REVIEW LETTERS 2001; 86:4255-4258. [PMID: 11328148 DOI: 10.1103/physrevlett.86.4255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2000] [Indexed: 05/23/2023]
Abstract
The spin-orbit splitting of Lambda single-particle states in (13)(Lambda)C was measured. The 13C(K-,pi(-))(13)(Lambda)C reaction was used to excite both the 1/2(-) and 3/2(-) states simultaneously, which have predominantly 12C(0(+)) x p(Lambda) configuration. gamma rays from the states to the ground state were measured in coincidence with the pi(-)'s, by which ls splitting was found to be 152+/-54(stat)+/-36(syst) keV. The value is 20-30 times smaller than exhibited by the ls splitting in the nuclear shell model. This value gives us new insight into the YN interaction.
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McClellan T, DeBord J, Franklin G, Tierney J. Small cell neuroendocrine carcinoma of the urinary bladder: case report of a rare primary tumor. THE WEST VIRGINIA MEDICAL JOURNAL 2001; 97:151-2. [PMID: 11471463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Primary small cell neuroendocrine carcinoma of the bladder is a rare condition, with fewer than 140 cases having been reported. It is an aggressive tumor with an average five-year survival rate of less than 10 percent as cited by multiple case reports. We report a 73-year-old white woman with primary small cell neuroendocrine carcinoma of the bladder who was treated with radical cystectomy and adjuvant cisplatin/etoposide-based chemotherapy.
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Wickizer TM, Franklin G, Plaeger-Brockway R, Mootz RD. Improving the quality of workers' compensation health care delivery: the Washington State Occupational Health Services Project. Milbank Q 2001; 79:5-33. [PMID: 11286095 PMCID: PMC2751183 DOI: 10.1111/1468-0009.00194] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
This article has summarized research and policy activities undertaken in Washington State over the past several years to identify the key problems that result in poor quality and excessive disability among injured workers, and the types of system and delivery changes that could best address these problems in order to improve the quality of occupational health care provided through the workers' compensation system. Our investigations have consistently pointed to the lack of coordination and integration of occupational health services as having major adverse effects on quality and health outcomes for workers' compensation. The Managed Care Pilot Project, a delivery system intervention, focused on making changes in how care is organized and delivered to injured workers. That project demonstrated robust improvements in disability reduction; however, worker satisfaction suffered. Our current quality improvement initiative, developed through the Occupational Health Services Project, synthesizes what was learned from the MCP and other pilot studies to make delivery system improvements. This initiative seeks to develop provider incentives and clinical management processes that will improve outcomes and reduce the burden of disability on injured workers. Fundamental to this approach are simultaneously preserving workers' right to choose their own physician and maintaining flexibility in the provision of individualized care based on clinical need and progress. The OHS project then will be a "real world" test to determine if aligning provider incentives and giving physicians the tools they need to optimize occupational health delivery can demonstrate sustainable reduction in disability and improvements in patient and employer satisfaction. Critical to the success of this initiative will be our ability to: (1) enhance the occupational health care management skills and expertise of physicians who treat injured workers by establishing community-based Centers of Occupational Health and Education; (2) design feasible methods of monitoring patient outcomes and satisfaction with the centers and with the providers working with them in order to assess their effectiveness and value; (3) establish incentives for improved outcomes and worker and employer satisfaction through formal agreements with the centers and providers; and (4) develop quality indicators for the three targeted conditions (low back sprain, carpal tunnel syndrome, and fractures) that serve as the basis for both quality improvement processes and performance-based contracting. What lessons or insights does our experience offer thus far? The primary lesson is the importance of making effective partnerships and collaborations. Our policy and research activities have benefited significantly from the positive relationship the DLI established with the practice community through the Washington State Medical and Chiropractic Associations and from the DLI's close association with the Healthcare Subcommittee of the Workers' Compensation Advisory Committee. This committee is established by state regulation and serves as a forum for dialogue between the committee and the employer and labor communities. Our experience thus underscores the importance of establishing broad-based support for delivery system innovations. Our research activities have also benefited from the close collaboration between DLI program staff and UW health services researchers. The DLI staff brought important program and policy experience, along with an appreciation of the context and environment within which the research, policy, and R&D activities were conducted. The UW research team brought scientific rigor and methodological expertise to the design and implementation of the research and policy activities. In Washington State, the DLI represents a "single payer" for the purposes of workers' compensation. As discussed earlier, Washington State, along with five other states, has a state-fund system that requires all employers that are not self-insured to purchase workers' compensation insurance through the state fund. No matter what one feels about the merits or drawbacks of a single-payer system of health care financing, the fact is that such a system creates important opportunities for policy initiatives and for research and evaluation. Our ability to access population-based data on injured workers and to develop policy initiatives through innovation and pilot testing to assess whether proposed changes are really improvements has been critical. Understanding what works within the constraints and complexities of the system on a small scale is critical in order to bring forth policy and processes that will be of value systemwide. Finally, we note that general medical care faces many of the same quality-related problems and challenges as occupational health care. Medical care for chronic diseases, such as diabetes, is often fragmented and uncoordinated. (ABSTRACT TRUNCATED)
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Hedborg F, Franklin G, Norrman J, Grimelius L, Wassberg E, Hero B, Schilling F, Berthold F, Harms D, Sandstedt B. Evidence of chromaffin oxygen sensing in neuroblastoma. MEDICAL AND PEDIATRIC ONCOLOGY 2001; 36:149-53. [PMID: 11464871 DOI: 10.1002/1096-911x(20010101)36:1<149::aid-mpo1036>3.0.co;2-m] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
With the aid of IGF2 and VEGF in situ hybridization; tyrosine hydroxylase, chromogranin A, and Ki67 immunohistochemistry; and TUNEL staining applied to a large series of clinical neuroblastomas and to an animal model, we show here that stroma-poor neuroblastomas show evidence of chromaffin differentiation similar to that of type 1 small intensely fluorescent (SIF) cells and that this occurs in a vascular-dependent fashion, indicating a role for local tumor hypoxia in the differentiation process.
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Abstract
BACKGROUND Loss of productive life among injured workers potentially could be prevented by clearer knowledge of disability risk factors. Despite the number of studies that have examined predictors of disability, there have been no systematic literature reviews integrating multiple risk factor domains. Such a synthesis could help to define important gaps in knowledge, inform future study designs most likely to successfully address these gaps, and highlight the importance of secondary (disability) prevention to public health policy. A systematic synthesis of the literature on risk factors for chronic or recurrent disability in injured workers was performed to meet this need. METHODS Articles were identified through a MEDLINE search, personal file searches, and requests to experts. Information concerning study methods and results was abstracted from 20 articles that met the inclusion criteria (population-based or prospective cohort studies). RESULTS The most frequently identified predictors of prolonged disability were older age and greater baseline pain and functional disability. Lumbar symptoms, smaller company size, and construction work were significant predictors in several, but not all, studies. Risk factors did not appear to differ for back versus mixed injuries. CONCLUSIONS Several risk factors for prolonged disability were identified. Research is needed to develop and test multivariate models of worker, workplace, health care, and administrative risk factors for prolonged and recurrent disability in order to refine and target interventions.
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Fulton-Kehoe D, Franklin G, Weaver M, Cheadle A. Years of productivity lost among injured workers in Washington state: modeling disability burden in workers' compensation. Am J Ind Med 2000; 37:656-62. [PMID: 10797509 DOI: 10.1002/(sici)1097-0274(200006)37:6<656::aid-ajim10>3.0.co;2-c] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Few studies have examined the impact of disability from nonfatal work-related injuries and illnesses. We developed Years of Productivity Lost (YPL) as a measure of the burden of disability. METHODS YPL was calculated for incident workers' compensation claims with compensable injuries filed in 1986 in Washington State. Final work disability status was determined in June, 1993. We estimated YPL by adding actual accumulated time loss and future lost productivity predicted from permanent partial disability awards and pensions. RESULTS Back and neck sprains were associated with the highest YPL followed by sprains of the lower and upper extremities. Using actual accumulated time loss, we calculated 14,624 years of productivity lost for compensable injuries in 1986. After including predicted lost productivity, YPL ranged from 28,017 to 33,502 years. CONCLUSIONS YPL can be used to quantify the burden of disability due to occupational injuries and illnesses and to prioritize efforts to prevent long-term disability.
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Kanduri C, Holmgren C, Pilartz M, Franklin G, Kanduri M, Liu L, Ginjala V, Ullerås E, Mattsson R, Ohlsson R. The 5' flank of mouse H19 in an unusual chromatin conformation unidirectionally blocks enhancer-promoter communication. Curr Biol 2000; 10:449-57. [PMID: 10801414 DOI: 10.1016/s0960-9822(00)00442-5] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND During mouse prenatal development, the neighbouring insulin-like growth factor II (Igf2) and H19 loci are expressed monoallelically from the paternal and maternal alleles, respectively. Identical spatiotemporal expression patterns and enhancer deletion experiments show that the Igf2 and H19 genes share a common set of enhancers. Deletion of a differentially methylated region in the 5' flank of the H19 gene partially relieves the repression of the maternal Igf2 and paternal H19 alleles in the soma. The mechanisms underlying the function of the 5' flank of the H19 gene are, however, unknown. RESULTS Chromatin analysis showed that the 5' flank of the mouse H19 gene contains maternal-specific, multiple nuclease hypersensitive sites that map to linker regions between positioned nucleosomes. These features could be recapitulated in an episomal-based H19 minigene, which was propagated in human somatic cells. Although the 5' flank of the H19 promoter has no intrinsic silencer activity under these conditions, it unidirectionally extinguished promoter-enhancer communications in a position-dependent manner, without directly affecting the enhancer function. CONCLUSIONS The unmethylated 5' flank of the H19 gene adopts an unusual and maternal-specific chromatin conformation in somatic cells and regulates enhancer-promoter communications, thereby providing an explanation for its role in manifesting the repressed state of the maternally inherited Igf2 allele.
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Kyes KB, Wickizer TM, Franklin G, Cain K, Cheadle A, Madden C, Murphy L, Plaeger-Brockway R, Weaver M. Evaluation of the Washington State Workers' Compensation Managed Care Pilot Project I: medical outcomes and patient satisfaction. Med Care 1999; 37:972-81. [PMID: 10524365 DOI: 10.1097/00005650-199910000-00002] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study examined the effect of managed care on medical outcomes and patient satisfaction as part of an evaluation of the Washington State Workers' Compensation Managed Care Pilot. METHODS One hundred twenty firms (7,041 employees) agreed to have their injured workers treated in managed-care plans. Managed care introduced two changes from the fee-for-service (FFS) delivery system currently used by injured workers in Washington State: (1) experience-rated capitation, and (2) a primary occupational-medicine delivery model. The FFS control group included injured workers employed at 392 firms (12,000 employees). A total of 1,313 workers who experienced occupationally related injuries or illnesses between April 1995 and June 1996 were interviewed by telephone at 6 weeks after injury regarding their medical outcomes and satisfaction with care. Workers whose injuries resulted in four or more lost workdays (n = 372) were also interviewed at 6 months after injury on the same topics. The areas surveyed included functional outcomes and satisfaction with care, providers, and access to providers. RESULTS The measures of functional outcome reflected no consistent differences between the managed care and the FFS conditions. The workers who attended the managed-care system reported lower levels of satisfaction with care, particularly with access to providers. For example, 58% of managed-care patients reported satisfaction with their attending physician as compared with 69% of FFS patients (P<0.01). CONCLUSIONS Workers treated through managed-care arrangements were less satisfied with their care, but their medical outcomes were similar to those of workers who received traditional FFS care. The current workers' compensation system in Washington State affords injured workers great latitude in choosing providers. If provider choice is substantially restricted by managed care, worker satisfaction is likely to diminish.
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Cheadle A, Wickizer TM, Franklin G, Cain K, Joesch J, Kyes K, Madden C, Murphy L, Plaeger-Brockway R, Weaver M. Evaluation of the Washington State Workers' Compensation Managed Care Pilot Project II: medical and disability costs. Med Care 1999; 37:982-93. [PMID: 10524366 DOI: 10.1097/00005650-199910000-00003] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This study examined the effect of managed care on medical and disability costs as part of an evaluation of the Washington State Workers' Compensation Managed Care Pilot (MCP). METHODS One hundred twenty firms (7,041 employees) agreed to have their injured workers treated in managed care plans. Managed care introduced two changes from the fee-for-service (FFS) delivery system currently used by injured workers in Washington State: experience- rated capitation and a primary occupational medicine delivery network. The FFS control group included injured workers employed at 392 firms (12,000 employees). Medical and disability costs were compared for 1,058 injuries in the managed care group and 1,159 injuries in the FFS group occurring between April 1995 and June 1996. Univariate and multivariate statistical methods were used to analyze the effects of managed care on medical and disability costs. RESULTS The mean unadjusted medical cost per injury ($587) for the managed care group was 21.5% lower (P = 0.06) than for the FFS group ($748). Adjustment for differences in worker and firm-level characteristics through multivariate analysis had little effect on the unadjusted results, except that the difference in costs between managed care and FFS groups became statistically significant (P<0.01). The major cost differences were for outpatient surgery (cost per surgery) and ancillary services (pharmacy, x-ray, physical therapy, and all other costs). In addition, disability costs, particularly percent on time loss and time-loss cost per injury, were significantly lower (P<0.01) in the managed care group. CONCLUSIONS The results from the MCP suggest that substantial savings in workers' compensation medical and disability costs may be realized using the type of managed care intervention designed for this study. Delivering occupational health services through managed care arrangements whose design is based on an integrated, occupational health-centered delivery model may offer a viable approach for improving delivery systems, reducing costs and encouraging greater attention to disability prevention.
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Ohlsson R, Falck P, Hellström M, Lindahl P, Boström H, Franklin G, Ahrlund-Richter L, Pollard J, Soriano P, Betsholtz C. PDGFB regulates the development of the labyrinthine layer of the mouse fetal placenta. Dev Biol 1999; 212:124-36. [PMID: 10419690 DOI: 10.1006/dbio.1999.9306] [Citation(s) in RCA: 90] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PDGFB is a growth factor which is vital for the completion of normal prenatal development. In this study, we report the phenotypic analysis of placentas from mouse conceptuses that lack a functional PDGFB or PDGFRbeta gene. Placentas of both types of mutant exhibit changes in the labyrinthine layer, including dilated embryonic blood vessels and reduced numbers of both pericytes and trophoblasts. These changes are seen from embryonic day (E) 13.5, which coincides with the upregulation of PDGFB mRNA levels in normal placentas. By E17, modifications in shape, size, and number of the fetal blood vessels in the mutant placentas cause an abnormal ratio of the surface areas between the fetal and the maternal blood vessels in the labyrinthine layer. Our data suggest that PDGFB acts locally to contribute to the development of the labyrinthine layer of the fetal placenta and the formation of a proper nutrient-waste exchange system during fetal development. We point out that the roles of PDGFB/Rbeta signaling in the placenta may be analogous to those in the developing kidney, by controlling pericytes in the labyrinthine layer and mesangial cells in the kidney.
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Wickizer TM, Lessler D, Franklin G. Controlling workers' compensation medical care use and costs through utilization management. J Occup Environ Med 1999; 41:625-31. [PMID: 10457504 DOI: 10.1097/00043764-199908000-00003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Little is known about the performance of utilization management (UM) programs, which are now widely used within the workers' compensation system to contain medical costs and improve quality. UM programs focus largely on hospital care and rely on preadmission and concurrent reviews to authorize hospital admissions and continued stays. We obtained data from a large UM program representing a national sample of 9319 workers' compensation patients whose medical care was reviewed between 1991 and 1993. We analyzed these data to determine the denial rate for hospital admission and outpatient surgery and the frequency of length-of-stay restrictions among hospitalized patients. The denial rate was approximately 2% to 3% overall, but many of the denials were later reversed. On average, the UM program reduced the length of stay by 1.9 days relative to the number of days of care requested. The estimated gross cost savings resulting from reduced hospitalization time and decreased outpatient care was approximately $5 million. UM programs may offer a viable approach to cost containment within the workers' compensation system. Their value as a tool to improve the quality of care for workers' compensation patients remains to be demonstrated.
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Zabawski EJ, Costner M, Franklin G, Witheiler DD, Eichorn PJ, Cockerell CJ. A potpourri of parasitic infestations. Cutis 1999; 63:81-5. [PMID: 10071735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Ectoparasitic infestations are common cutaneous problems. The vast majority of these are attributable to scabies and pediculosis. While these are usually readily recognizable, infestations caused by other ectoparasites, such as nonscabetic mites, may pose difficulty in diagnosis. In this article, we present a variety of ectoparasitic infestations that initially eluded diagnosis and review the gamut of ectoparasites that can cause eruptions in the skin.
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Li YM, Franklin G, Cui HM, Svensson K, He XB, Adam G, Ohlsson R, Pfeifer S. The H19 transcript is associated with polysomes and may regulate IGF2 expression in trans. J Biol Chem 1998; 273:28247-52. [PMID: 9774446 DOI: 10.1074/jbc.273.43.28247] [Citation(s) in RCA: 93] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The imprinted H19 gene produces a fully processed transcript that does not exhibit any conserved open reading frame between mouse and man. Although transcriptional control elements associated with the mouse H19 locus have been shown to control the neighboring Igf2 gene in cis, the prevailing view is that the cytoplasmic H19 transcript does not display any function. In contrast to earlier reports, we show here that the H19 transcript is associated with polysomes in a variety of cell types, in both mouse and man. A possible trans-function of the H19 gene is suggested by a reciprocal correlation in trans between cytoplasmic H19 and IGF2 mRNA levels, as well as IGF2 mRNA translatability. We discuss these results in terms of their challenge to the prevailing dogma on the function of the enigmatic H19 gene, as well as with respect to the ontogeny of the Beckwith-Wiedemann syndrome, and propose that the human H19 gene is an antagonist of IGF2 expressivity in trans.
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Rempel D, Evanoff B, Amadio PC, de Krom M, Franklin G, Franzblau A, Gray R, Gerr F, Hagberg M, Hales T, Katz JN, Pransky G. Consensus criteria for the classification of carpal tunnel syndrome in epidemiologic studies. Am J Public Health 1998; 88:1447-51. [PMID: 9772842 PMCID: PMC1508472 DOI: 10.2105/ajph.88.10.1447] [Citation(s) in RCA: 384] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Criteria for the classification of carpal tunnel syndrome for use in epidemiologic studies were developed by means of a consensus process. Twelve medical researchers with experience in conducting epidemiologic studies of carpal tunnel syndrome participated in the process. The group reached agreement on several conceptual issues. First, there is no perfect gold standard for carpal tunnel syndrome. The combination of electrodiagnostic study findings and symptom characteristics will provide the most accurate information for classification of carpal tunnel syndrome. Second, use of only electrodiagnostic study findings is not recommended. Finally, in the absence of electrodiagnostic studies, specific combinations of symptom characteristics and physical examination findings may be useful in some settings but are likely to result in greater misclassification of disease status.
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Ramsey SD, Luce BR, Deyo R, Franklin G. The limited state of technology assessment for medical devices: facing the issues. THE AMERICAN JOURNAL OF MANAGED CARE 1998; 4 Spec No:SP188-99. [PMID: 10185994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Medical devices are an integral part of clinical practice and account for a substantial proportion of the national health budget. Clinical testing and regulation of medical devices, however, is vastly different from and inferior to the testing and regulation of drugs. As managed care organizations begin to exert controls on device use, providers are being caught between the policies of their organizations and the demands of device manufacturers and patients, who want wider access to devices. We outline several reasons for the poor state of medical device evaluations and the dangers of using devices without adequate information, and include the recently developed device assessment and reporting guidelines created by the Task Force on Technology Assessment of Medical Devices.
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Teschke K, Morgan MS, Checkoway H, Franklin G, Spinelli JJ, van Belle G, Weiss NS. Mesothelioma surveillance to locate sources of exposure to asbestos. Canadian Journal of Public Health 1997. [PMID: 9260356 DOI: 10.1007/bf03403881] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
To determine whether there were previously unrecognized sources of asbestos exposure in British Columbia, incident mesothelioma cases (n = 51) and population-based controls (n = 154) were interviewed about their occupational histories and asbestos exposures. The following occupations were at elevated risk: sheet metal workers (OR = 9.6, 95% CI: 1.5-106), plumbers and pipefitters (OR = 8.3, 95% CI: 1.5-86), shipbuilding workers (OR = 5.0, 95% CI: 1.2-23), painters (OR = 4.5, 95% CI: 1.0-24), welders (OR = 3.9, 95% CI: 0.8-22), gardeners (OR = 3.9, 95% CI: 0.8-22), bricklayers (OR = 3.5, 95% CI: 0.9-14), miners (OR = 3.4, 95% CI: 0.9-13), machinists (OR = 3.2, 95% CI: 1.0-11), construction foremen (OR = 3.1, 95% CI: 0.9-11), and electricians (OR = 3.0, 95% CI: 0.8-12). In a reanalysis excluding subjects who worked in occupations or processes considered strongly a priori at risk, three groups remained of interest: non-asbestos miners (OR = 9.6, 95% CI: 1.8-53), bricklayers (OR = 5.4, 95% CI: 1.0-28), and construction labourers (OR = 2.8, 95% CI: 0.7-10.6).
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