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Selected AbstractsCharacteristics of skin aging in Korean men and womenINTERNATIONAL JOURNAL OF COSMETIC SCIENCE, Issue 1 2005J. H. Chung Introduction Korea is located between Japan and Mainland China. The people of these three countries have similar appearances and it is difficult to differentiate between them. Although the population of Asia is more than half of the total population of the Earth, the inherent characteristics of Asian skin have not been well investigated. Commercial markets for cosmetics and drugs for photoaged skin are rapidly expanding in many Asian countries. Therefore, many investigators in the field of dermatology and cosmetology have become interested in brown Asian skin. Clinical characteristics of skin aging and photoaging in Asians Skin aging can be divided into two basic processes: intrinsic aging and photoaging [1]. Intrinsic aging is characterized by smooth, dry, pale, and finely wrinkled skin, whereas photoaging, which indicates premature skin aging in chronically photodamaged skin, is characterized by severe wrinkling and irregular pigmentation. The pattern of wrinkling in Asians seems to differ from that in Caucasians. Asians have coarser, thicker and deep wrinkles, particularly in the forehead, perioral and Crow's foot areas. In contrast, Caucasians usually have relatively fine cheek and Crow's foot wrinkles. The reasons for these differences are not known and need further investigation. There are racial, ethnic and genetic differences, and differences of skin structure and function, between the brown skin of Asians and the white skin of Caucasians. As Asian skin is more pigmented, acute and chronic cutaneous responses to UV irradiation differ from those in white skin. Many people believe, based on clinical impressions, that the main process of photoaging in Asians involves pigmentary changes, rather than wrinkling. However, no study has been performed to confirm this belief. Risk factors for skin wrinkles and their relative risks in Korean skin [2] Various factors such as age, sun-exposure, and smoking are known to be important risk factors for wrinkles. However, the relative risks of each factor on wrinkles in the brown skin of Asians have not been investigated, and they could differ from those in Caucasians. An evaluation system for skin wrinkling is necessary for Asian skin [3]. Thus, we developed an eight-point photographic scale for assessing wrinkles in both Korean genders [2]. This scale can probably be applied to the populations of other Asian countries, at least to the Japanese and Chinese. The pattern of wrinkles in both genders appears to be similar. Age Age is an important risk factor for wrinkling in Asians, as in Caucasians. Korean subjects in their 60s showed a 12-fold increased risk of wrinkling, while subjects in their 70s have a 56-fold increased risk compared with young age group. UV light It is well known that the UV component in sunlight can cause and accelerate photoaging. The pigmented skin of Asian may better protect skin from acute and chronic UV damage. However, we found a strong association between sun-exposure and the development of wrinkling in Koreans. It was found that sun exposure of more than 5 h per day was associated with a 4.8-fold increased risk in wrinkling versus less than 2 h of sun-exposure in Koreans. Estrogen deficiency Korean females have more wrinkles than men, after controlling for age, sun exposure, and smoking, it was found that they have a 3.6-fold increased risk of developing wrinkles than their male counterparts [2]. It has also been reported, that the relative risk for wrinkling in women is higher than in men as for in white Caucasians [4]. The reason why women show more wrinkles remains to be determined. It is possible that a reduction in skin collagen because of estrogen deficiency in postmenopausal woman may aggravate wrinkling severity. Korean women with more than 10 years since menopause showed a 3.9-fold higher risk of wrinkling than the women 5 years of beyond menopause [5]. We demonstrated that women with a history of HRT have a significantly lower risk, more specifically, one fifth of the risk of facial wrinkling relative to those who had no history of HRT. Interestingly, we found that wrinkle severity significantly increased with an increasing number of full term pregnancies. The relative risk for severe wrinkling is increased by approximately 1.8-fold per full term pregnancy. Smoking It is known that smoking causes skin wrinkling in Caucasians, and that it plays no role in Blacks [6, 7]. Koreans with have a smoking history of more than 30 pack years showed a more than 2.8-fold increased risk of wrinkles [2]. The relative risks of wrinkles associated with a 30,50 pack-years history of smoking were 2.8- and 5.5-fold, respectively. Dyspigmentation in Asian skin To follow pigmentary changes, six photographic standards for both genders were developed for Korean skin, to produce a 6-point scale [2, 8]. Hyperpigmented spots, mostly lentigines, were prominent among women, while seborrheic keratosis tended to be more prominent in men. Seborrheic keratosis in Korean men Seborrheic keratoses (SKs) are benign cutaneous tumors. They have diverse clinical and histopathological appearances and are very common in the elderly (over 50 years old). The etiology of SKs is not well understood, although patients with a great number of lesionsshow a familial trait with an autosomal dominant pattern, and human papilloma virus has been suggested as possible cause because of verrucous appearance of the lesions. Exposure to sunlight has been suggested to be a risk factor for SKs. However, there is still some debate in terms of the role of sunlight. Recently, we have investigated the clinical characteristics of SKs and relationship between SKs and sunlight exposure in Korean males [9]. The prevalence of SKs in Koreans increases with age; it rose from 78.9% at 40 years, to 93.9% at 50 years and 98.7% in those over 60 years. Exposed areas, i.e. the face, neck and dorsum of the hands, demonstrate a significant increase in the prevalence of SKs by decade, whereas partly exposed areas, although SKs tended to increase in prevalence with age, this trend was not significant. When the estimated body surface area (BSA) is taken into account, the number of SKs on both the face and dorsum of the hands (0.51 ± 0.08 per 1% BSA) was over-represented compared with the trunk. SKs were also concentrated on the neck (0.38 ± 0.07 per 1% BSA) and in the V-area (0.47 ± 0.09 per 1% BSA). Outer forearms also showed 3-fold more SKs per unit area than neighboring arms and inner forearms, which are classified as partly exposed area (0.09 ± 0.02, 0.03 ± 0.01, respectively). The total area covered by SKs on exposed area also became significantly larger with aging than on intermittently exposed areas. These results indicate that exposure to sunlight might be related to SK growth. Our results indicated that excessive sun exposure is an independent risk factor of SKs. After controlling for age, smoking, and skin type, subjects with a sun exposure history of more than 6 hours per day showed a 2.28-fold increased risk of having severe SKs (n , 6) compared with those exposed for less that 3 h per day. These findings indicated that sun-exposure may play an important role in SK development. In summary, SKs are very common in Korean males and represent one of the major pigmentary problems. SKs concentrate on exposed skin, especially on the face and dorsum of the hands. Both age and lifetime cumulative sunlight exposure are important contributing factors and may work in a synergistic manner. Conclusion Many people tend to believe that wrinkles are not a prominent feature of Asian photoaged skin, and that dyspigmentation is a major manifestation in Asian skin. Contrary to this impression, wrinkling is also a major problem in the photoaged skin of Asians, and Korean people showing severe pigmentary changes usually tend to have severe wrinkles. In conclusion, the wrinkling patterns and pigmentary changes of photoaged skin in East Asians differ from those of Caucasians, and the relative risks of aggravating factors may be different from those of Caucasian skin. References 1.,Gilchrest, B.A. Skin aging and photoaging: an overview. J. Am. Acad. Dermatol. 21, 610,613 (1989). 2.,Chung, J.H. et al. Cutaneous photodamage in Koreans: influence of sex, sun exposure, smoking, and skin color. Arch. Dermatol. 137, 1043,1051 (2001). 3.,Griffiths, C.E. et al. A photonumeric scale for the assessment of cutaneous photodamage. Arch. Dermatol. 128, 347,351 (1992). 4.,Ernster, V.L. et al. Facial wrinkling in men and women, by smoking status. Am. J. Public Health. 85, 78,82 (1995). 5.,Youn, C.S. et al. Effect of pregnancy and menopause on facial wrinkling in women. Acta Derm. Venereol. 83, 419,424 (2003). 6.,Kadunce, D.P. et al. Cigarette smoking: risk factor for premature facial wrinkling. Ann. Intern. Med. 114, 840,844 (1991). 7.,Allen, H.B., Johnson, B.L. and Diamond, S.M. Smoker's wrinkles? JAMA. 225, 1067,1069 (1973). 8.,Chung, J.H. Photoaging in Asians. Photodermatol. Photoimmunol. Photomed. 19, 109,121 (2003). 9.,Kwon, O.S. et al. Seborrheic keratosis in the Korean males: causative role of sunlight. Photodermatol. Photoimmunol. Photomed. 19, 73,80 (2003). [source] Predicting risk selection following major changes in medicareHEALTH ECONOMICS, Issue 4 2008Steven D. Pizer Abstract The Medicare Modernization Act of 2003 created several new types of private insurance plans within Medicare, starting in 2006. Some of these plan types previously did not exist in the commercial market and there was great uncertainty about their prospects. In this paper, we show that statistical models and historical data from the Medicare Current Beneficiary Survey can be used to predict the experience of new plan types with reasonable accuracy. This lays the foundation for the analysis of program modifications currently under consideration. We predict market share, risk selection, and stability for the most prominent new plan type, the stand-alone Medicare prescription drug plan (PDP). First, we estimate a model of consumer choice across Medicare insurance plans available in the data. Next, we modify the data to include PDPs and use the model to predict the probability of enrollment for each beneficiary in each plan type. Finally, we calculate mean-adjusted actual spending by plan type. We predict that adverse selection into PDPs will be substantial, but that enrollment and premiums will be stable. Our predictions correspond well to actual experience in 2006. Copyright © 2007 John Wiley & Sons, Ltd. [source] The Impact of a Microfinance Program on Client Perceptions of the Quality of Care Provided by Private Sector Midwives in UgandaHEALTH SERVICES RESEARCH, Issue 6p2 2004Sohail Agha Objective. To assess the impact of a microfinance program that provided business skills training and revolving loans to private sector midwives on perceived quality of services and client loyalty. Study Design. A quasi-experimental study with a pretest, posttest design was used to evaluate the impact of the intervention. Exit interviews were conducted at 15 clinics that received the intervention and 7 clinics that did not. Baseline exit interviews were conducted between November and December 2000. Five days of business skills training were provided to midwives, and loans (averaging $454) were given during January and February 2001. A follow-up clinic visit was made to assess whether midwives were implementing what was emphasized during the training. The loans were to be repaid with interest within 6 to 12 months, at an interest rate that is standard within the local commercial market. For those who repaid the first set of loans (11 clinics), a second set of loans (averaging $742) was provided after June 2001. Follow-up exit interviews were conducted at the same clinics between February and March 2002. We assessed the effect of the intervention at both clinic and client levels. T-tests, the analysis of variance, and multivariate logistic regression analysis were conducted. Principal Findings. These findings should be interpreted cautiously since secular trends were observed during the study period. The intervention was associated with improvement in clients' perceptions of the quality of care received at intervention clinics. The intervention was also associated with a higher level of client loyalty. Conclusions. The enthusiastic response of midwives and the high loan repayment rate indicate that midwives were very receptive to the microfinance program. Overall, these findings suggest that microfinance may have an important role in strengthening private sector health services by increasing private providers' business skills and clients' satisfaction with services. [source] EVALUATION OF LIGHT DETECTION AND RANGING (LIDAR) FOR MEASURING RIVER CORRIDOR TOPOGRAPHY,JOURNAL OF THE AMERICAN WATER RESOURCES ASSOCIATION, Issue 1 2002Zachary H. Bowen ABSTRACT: LIDAR is relatively new in the commercial market for remote sensing of topography and it is difficult to find objective reporting on the accuracy of LIDAR measurements in an applied context. Accuracy specifications for LIDAR data in published evaluations range from 1 to 2 m root mean square error (RMSEx,y) and 15 to 20 cm RMSEz. Most of these estimates are based on measurements over relatively flat, homogeneous terrain. This study evaluated the accuracy of one LIDAR data set over a range of terrain types in a western river corridor. Elevation errors based on measurements over all terrain types were larger (RMSEz equals 43 cm) than values typically reported. This result is largely attributable to horizontal positioning limitations (1 to 2 m RMSEx,y) in areas with variable terrain and large topographic relief. Cross-sectional profiles indicated algorithms that were effective for removing vegetation in relatively flat terrain were less effective near the active channel where dense vegetation was found in a narrow band along a low terrace. LIDAR provides relatively accurate data at densities (50,000 to 100,000 points per km2) not feasible with other survey technologies. Other options for projects requiring higher accuracy include low-altitude aerial photography and intensive ground surveying. [source] The Impact of Blue Cross Conversions on Accessibility, Affordability, and the Public InterestTHE MILBANK QUARTERLY, Issue 4 2003MARK A. HALL For-profit organization in health care delivery has been a major public policy issue least since at least the 1980s, driven by the growth of for-profit hospital chains and a wave of conversions by nonprofit hospitals. As significant as these events have been, however, they pale in comparison with the potential impact of conversions by Blue Cross and/or Blue Shield plans (which we refer to generically as Blue Cross, abbreviated BC). Because Blue Cross plans are the largest health insurer in almost every state (or substate region where they operate), these conversions could remake the corporate landscape of health care finance. Although BC plans no longer hold the overwhelming market share they enjoyed 50 years ago (when they commanded more than two-thirds of the commercial market; see Blackstone and Fuhr 1998), their share still is considerable. Blue Cross controls at least half the individual market in 33 states and more than a third of the group market in 29 states (Chollet, Kirk, and Chow 2000; McCann 2003). [source] Genetic Identification of Pelagic Shark Body Parts for Conservation and Trade MonitoringCONSERVATION BIOLOGY, Issue 4 2002Mahmood Shivji Difficulties with the identification of many commonly fished sharks and their body parts has resulted in a global dearth of catch and trade information, making reliable assessment of exploitation effects and conservation needs for individual species nearly impossible. We developed and tested a highly streamlined molecular genetic approach based on species-specific, polymerase-chain-reaction primers in an eight-primer multiplex format to discriminate simultaneously between body parts from six shark species common in worldwide pelagic fisheries. The species-specific primers are based on DNA sequence differences among species in the nuclear ribosomal internal transcribed spacer 2 locus. The primers and multiplex format accurately and sensitively distinguished samples from each of three lamnid ( Isurus oxyrinchus, Isurus paucus, and Lamna nasus) and three carcharhinid ( Prionace glauca, Carcharhinus obscurus, and Carcharhinus falciformis) species from all but one other shark species encountered in the North Atlantic fishery. Furthermore, the three lamnid primers were robust enough in their discriminatory power to be useful for species diagnosis on a global scale. Preliminary testing of dried fins from Asian and Mediterranean commercial markets suggests that our genetic approach will be useful for determining the species of origin of detached fins, thus allowing the monitoring of trade in shark fins for conservation assessment. Our approach will also facilitate detection of products from protected and other at-risk shark species and may prove useful as a model for development of the high-throughput, genetic, species-diagnosis methods typically required in conservation and management contexts. Resumen: La conservación y manejo de tiburones fundamentado a nivel de especie es una necesidad imperativa debido a la creciente demanda de aletas de tiburón y el reconocimiento de que las especies individuales de tiburones responden de manera distinta a la explotación. Las dificultades para la identificación de muchos tiburones capturados comúnmente, así como de partes de su cuerpo, han resultado en una escasez global de información sobre capturas y comercialización, haciendo casi imposible el poder realizar evaluaciones de los efectos de la explotación y de las necesidades de conservación. Desarrollamos y evaluamos un método altamente estilizado de genética molecular basado en detonadores de la reacción en cadena de la polimerasa, especie-específicos, en un formato múltiple de ocho detonadores para discriminar simultáneamente entre las partes del cuerpo de seis especies de tiburones provenientes de pesquerías pelágicas mundiales comunes. Los detonadores especie-específicos están basados en diferencias en las secuencias de ADN entre especies del locus espaciador 2 nuclear, ribosomal, transcrito. Los detonadores y el formato múltiple distinguen muestras con precisión y sensitividad de cada uno de los tres lámnidos ( Isurus oxyrinchus, Isurus paucus y Lamna nasus) y tres especies de carcarínidos ( Prionace glauca, Carcharhinus obscurus y Carcharhinus falciformis) especies todas encontradas en las pesquerías de Norteamérica, excepto una. Mas aún, los detonadores de los tres lamnidos fueron lo suficientemente robustos en su poder discriminante como para ser usados para el diagnóstico de especies a escala mundial. Las pruebas preliminares de aletas secas de los mercados comerciales de Asia y el Mediterráneo sugieren que nuestro método genético puede ser útil para determinar la especie de origen de las aletas separadas, permitiendo así usar el monitoreo de las aletas de tiburón para evaluaciones de conservación. Nuestro método también podría facilitar la detección de productos provenientes de especies protegidas o en riesgo y podría resultar útil como un modelo para el desarrollo de métodos genéticos de alto rendimiento para el diagnóstico de especies, métodos típicamente requeridos en los contextos de conservación y manejo. [source] Watershed protection: Capturing the benefits of nature's water supply servicesNATURAL RESOURCES FORUM, Issue 2 2005Sandra L. Postel Abstract Healthy watersheds provide valuable services to society, including the supply and purification of fresh water. Because these natural ecosystem services lie outside the traditional domain of commercial markets, they are undervalued and underprotected. With population and development pressures leading to the rapid modification of watershed lands, valuable hydrological services are being lost, which poses risks to the quality and cost of drinking water and the reliability of water supplies. Increasing the scale and scope of programmes to protect hydrological services requires policies that harmonize land uses in watersheds with the provision of these important natural services. This article summarizes key attributes of hydrological services and their economic benefits; presents a spectrum of institutional mechanisms for safeguarding those services; discusses programmes in Quito (Ecuador), Costa Rica and New York City; and offers some lessons learned and recommendations for achieving higher levels of watershed protection. [source] Extrusion conditions and properties of vapor grown carbon fiber reinforced polypropylenePOLYMER COMPOSITES, Issue 5 2001Rex J. Kuriger Vapor grown carbon fiber (VGCF) is a new and inexpensive carbon fiber produced by vapor deposition of hydrocarbons on metal catalysts. The ability to fabricate VGCF reinforced thermoplastic composites by extrusion provides the potential to exploit VGCF into new commercial markets. This study investigates the extrusion conditions and properties of VGCF reinforced polypropylene. Extrusion was carried out using a Leistritz twin-screw extruder. Polypropylene reinforced with 0% to 12.5% volume fraction VGCF was extruded successfully at temperatures ranging from 215°C to 250°C. The extrusion pressure increased and the flow rate decreased as the percentage of fiber was increased. Increases in tensile strength and modulus were observed by the addition of VGCF. However, the void content of the composite samples increased with fiber content. [source] Illiquidity and Pricing Biases in the Real Estate MarketREAL ESTATE ECONOMICS, Issue 3 2007Zhenguo Lin This article addresses the micro-analytic foundations of illiquidity and price dynamics in the real estate market by integrating modern portfolio theory with models describing the real estate transaction process. Based on the notion that real estate is a heterogeneous good that is traded in decentralized markets and that transactions in these markets are often characterized by costly searches, we argue that the most important aspects defining real estate illiquidity in both residential and commercial markets are the time required for sale and the uncertainty of the marketing period. These aspects provide two sources of bias in the commonly adopted methods of real estate valuation, which are based solely on the prices of sold properties and implicitly assume immediate execution. We demonstrate that estimated returns must be biased upward and risks downward. These biases can be significant, especially when the marketing period is highly uncertain relative to the holding period. We also find that real estate risk is closely related to investors' time horizons, specifically that real estate risk decreases when the holding period increases. These results are consistent with the conventional wisdom that real estate is more favorable to long-term investors than to short-term investors. They also provide a theoretical foundation for the recent econometric literature, which finds evidence of smoothing of real estate returns. Our findings help explain the apparent risk-premium puzzle in real estate,that is, that ex post returns appear too high, given their apparent low volatility,and can lead to the formal derivation of adjustments that can define real estate's proper role in the mixed-asset portfolio. [source] | ||||||||||