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Biomedical subjects

P Boland

Publications and source records attributed to P Boland.

At least 37 records · Page 2Linked to original sources

The challenge of documenting managed care cost savings and performance.

It is not too late for managed care to turn this situation around because the debate over health care reform and managing change is ongoing. It remains to be seen whether managed care companies will support independent third parties (i.e., researchers) in analyzing proprietary data and making value judgments about their effectiveness. There is a perception among managed care organizations that potentially negative findings could damage them in the marketplace. Nonetheless, smart organizations use negative findings as new opportunity targets for service improvement and product refinement. To what extent will managed care companies voluntarily release accurate data on performance factors in order for researchers to conduct cross-company analyses? Perhaps competitive markets such as managed care are not consistent with voluntary data sharing. On the other hand, mandatory reporting will not ensure data accuracy either. It is up to the managed care industry itself to develop a cooperative approach to data collection, analysis, and dissemination.

Cost Savings↗

The neurotrophins BDNF, NT-3, and NGF display distinct patterns of retrograde axonal transport in peripheral and central neurons.

The pattern of retrograde axonal transport of the target-derived neurotrophic molecule, nerve growth factor (NGF), correlates with its trophic actions in adult neurons. We have determined that the NGF-related neurotrophins, brain-derived neurotrophic factor (BDNF) and neurotrophin-3 (NT-3), are also retrogradely transported by distinct populations of peripheral and central nervous system neurons in the adult. All three 125I-labeled neurotrophins are retrogradely transported to sites previously shown to contain neurotrophin-responsive neurons as assessed in vitro, such as dorsal root ganglion and basal forebrain neurons. The patterns of transport also indicate the existence of neuronal populations that selectively transport NT-3 and/or BDNF, but not NGF, such as spinal cord motor neurons, neurons in the entorhinal cortex, thalamus, and neurons within the hippocampus itself. Our observations suggest that neurotrophins are transported by overlapping as well as distinct populations of neurons when injected into a given target field. Retrograde transport may thus be predictive of neuronal types selectively responsive to either BDNF or NT-3 in the adult, as first demonstrated for NGF.

Animals↗

Joining forces to make managed health care work.

Despite the failure of managed care to infuse cost effectiveness into the nation's healthcare system, structured health plans can be made to work. The rules must be rewritten so that risk-sharing and gain-sharing are more equitably spread among providers, payers, and consumers, according to a recently published book, Making Managed Healthcare Work: A Practical Guide to Strategies and Solutions. This excerpt from the book reflects on basic underpinnings of managed care, its successes and failures, the perspectives of key players, and how trends in managed care will affect the healthcare industry overall.

Contract Services↗

Physiochemical features of monoclonal idiotype-anti-idiotype complexes: importance of inter-chain disulfides for size distribution patterns and molecular geometries.

Cyclic tetramers represent the preferentially formed complexes of a murine monoclonal idiotype-anti-idiotype (Id-anti-Id) system consisting of IgG antibodies or (Fab')2 fragments at micromolar concentrations. The cleavage of inter-chain disulfides of both Id and anti-Id caused the predominant generation of cyclic dimers at the expense of larger aggregates, suggesting with regard to already published data that the hinge located interheavy-chain disulfides are essential for the strain.

Antibodies, Anti-Idiotypic↗

On the nature of IgG dimers. II. Idiotype--anti-idiotype complexes of polyclonal and monoclonal origin: size distribution patterns and molecular geometries.

Electron micrographs of a fraction containing dimers isolated from pooled human polyclonal immunoglobulin G (IgG) suggest essentially a cyclic geometry compatible with bivalently associated monomers. It is obvious that such a structure can be produced by idiotype (Id)--anti-idiotype (anti-Id) interactions where the latter are able to neutralize certain combining site related Id functions. Accordingly, antibody (ab) activities against tetanus toxoid (tt) and rubella antigen (ag) were found to be almost exclusively confined to the monomeric molecules in preparations composed of monomers and dimers only. Moreover, electron micrographs of complexes prepared from a murine monoclonal Id as well as anti-Id reveal the presence of ring complexes, especially of cyclic tetramers. Gel filtration patterns of mixtures containing equimolar concentrations (concns) of such abs (1.6 x 10(-6) M) show, correspondingly for 9 different Id--anti-Id pairs and therefore probably representing a more common feature, mainly the formation of even-numbered complexes, especially tetramers. That is basically in accordance to an equilibrium model developed by Archer and Krakauer but not from a quantitative point of view because non-ideality terms had not been originally included. Despite taking strain energies determined by Schumaker et al. for cyclic complexes of polyclonal rabbit abs and a bivalent hapten into account for computation of size distribution patterns, the predominant formation of dimers was, nevertheless, again predicted by the modified theory in contrast to the experimental results. Fundamental conformity could only be achieved by further decreasing one of the statistical factors, namely the ring closing factor, which theoretically influences the generation of cyclic dimers. Therefore, referring to the experimental results of Schumaker et al., we postulate a strain energy well above 700 cal/mol for cyclic dimers produced by interacting Ids and anti-Ids. In general, the findings confirm predictions based on the interpretation of recent kinetic studies.

Animals↗