bluuebunny/crossref_metadata_2025 huggingface dataset:
An assessment of the strategies and strengths of medium‐sized food processors
Authors: van Duren Erna , Sparling David , Turvey Calum , Lake Linda
Published: January 2003

This article uses the case method of research to analyze the strategies and strengths of independent, domestically owned, successful medium‐sized processing companies in Canada. The assessment of company strengths is based on responses from open‐ended interviews and a questionnaire. All assessment is based on managers' perceptions, and the theoretical concept of a core competence is used. The key conclusions of the research are (1) there was no single internal factor rated as the number one strength across all managers in any one company, or across all companies, and (2) the factors on which managers rated their companies highest were highly interrelated. Reputation, flexibility and customer service and a set of other management variables interact to produce successful strategies. Being responsive to customer needs requires fast product development in industry niches while close relationships with customers allow the in‐depth understanding of customer needs required for this pace of product development. [EconLit citations: Q130, L200, L660.]. © 2003 Wiley Periodicals, Inc. Agribusiness 19: 115–132, 2003.
Household meat demand in Greece: A demand systems approach using microdata
Authors: Lazaridis Panagiotis
Published: January 2003

This article examines meat consumption patterns of households in Greece using data from family budget surveys. For that purpose the linear approximate Almost Ideal Demond System was employed to investigate the economics and demographic effects on the demand for four types of meat. Prices were adjusted for quality, and the demographic translation method was used to incorporate the demographic variables. Finally, the two‐stage generalized Heckman procedure was employed to take into account censoring of the dependent variables. [EconLit citations: Q11, D12.] © 2003 Wiley Periodicals, Inc. Agribusiness 19: 43–59, 2003.
Degree of social contact affects the emission of food calls in the common marmoset (Callithrix jacchus)
Authors: Vitale Augusto , Zanzoni Michela , Queyras Armelle , Chiarotti Flavia
Published: January 2003

The aim of this study was to investigate whether the emission of food calls in common marmosets (Callithrix jacchus) is influenced by different social contexts. Food calls are emitted by this species only in the presence of preferred food. If these calls have any communicative function, it may be that individuals produce food calls in order to call family mates toward the food source. If this is the case, the number of calls produced should vary in accordance with the number of family mates present at the moment of the discovery of the food, i.e., the fewer family mates nearby, the more food calls are emitted. This hypothesis was tested with five pairs of common marmosets, by recording the number of food calls emitted in four experimental conditions: 1) isolation: completely isolated from the family mates; 2) visual isolation: separated by a wooden panel from the family mates; 3) visual contact: separated by a wire‐mesh from the family mates; and 4) physical interaction: together with the family mates. The results show that the proportion of intervals during which food calls were produced by the pairs was significantly different in the four experimental conditions. It decreased from the isolation and visual isolation condition, through the visual contact condition, reaching the lowest value in the physical interaction condition. The variation observed in the proportion of intervals during which food calls were emitted, in relation to different social contexts, is an indication in favor of the communicative function of this vocalization. Am. J. Primatol. 59:21–28, 2003. © 2003 Wiley‐Liss, Inc.
Self‐injurious behavior in rhesus monkeys: New insights into its etiology, physiology, and treatment
Authors: Novak Melinda A.
Published: January 2003

Self‐injurious behavior (SIB) is a significant human health problem frequently associated with profound intellectual disabilities, genetic diseases, and psychiatric conditions. However, it also occurs in subclinical populations and appears to be on the rise in adolescents and young adults. SIB is also seen in a small percentage of nonhuman primates that injure themselves through biting. We have begun to characterize SIB in rhesus monkeys to identify some of the risk factors associated with this disorder, and to determine the parallels with the human condition. In our study population, 14% of individually housed monkeys (the vast majority of which are males) have a veterinary record for self‐inflicted wounding. Wounding is rare, but self‐directed biting is common. SIB can be elicited during aggressive altercations and may be associated with husbandry events. Some monkeys appear to be more vulnerable to acquiring SIB. This increased vulnerability is associated with certain social experiences in the first 2 years of life and with exposure to a larger number of moderately stressful events as compared to controls. Monkeys with SIB also have a dysregulation of the hypothalamic‐pituitary‐adrenal (HPA) axis, indicated by a blunted cortisol response to mild stressors. Our findings suggest that SIB may be a coping strategy to reduce arousal. Biting appears to rapidly lower an escalating heart rate. The potentially reinforcing effects of SIB may account for the failure of some treatment regimens. These findings are compared to studies of SIB in humans, and concordances are identified. Am. J. Primatol. 59:3–19, 2003. © 2003 Wiley‐Liss, Inc.
Long bone articular and diaphyseal structure in Old World monkeys and apes. II: Estimation of body mass
Authors: Ruff Christopher B.
Published: January 2003

Body mass estimation equations are generated from long bone cross‐sectional diaphyseal and articular surface dimensions in 176 individuals and 12 species of hominoids and cercopithecoids. A series of comparisons is carried out to determine the best body mass predictors for each of several taxonomic/locomotor groupings. Articular breadths are better predictors than articular surface areas, while cross‐sectional shaft strengths are better predictors than shaft external breadths. Percent standard errors of estimate (%SEEs) and percent prediction errors for most of the better predictors range between 10–20%. Confidence intervals of equations using sex/species means are fairly representative of those calculated using individual data, except for sex/species means equations with very low %SEEs (under about 10%), where confidence intervals (CIs) based on individuals are likely to be larger. Given individual variability, or biological “error,” this may represent a lower limit of precision in estimating individual body masses. In general, it is much more preferable to determine at least broad locomotor affinities, and thus appropriate modern reference groups, before applying body mass estimation equations. However, some structural dimensions are less sensitive to locomotor distinctions than others; for example, proximal tibial articular M‐L breadth is apparently “locomotor blind” regarding body mass estimation within the present study sample. In other cases where locomotor affiliation is uncertain, mean estimates from different reference groups can be used, while for some dimensions no estimation should be attempted. The techniques are illustrated by estimating the body masses of four fossil anthropoid specimens of Proconsul nyanzae, Proconsul heseloni, Morotopithecus bishopi, and Theropithecus oswaldi. Am J Phys Anthropol 120:16–37, 2003. © 2003 Wiley‐Liss, Inc.
Study of crosslinking acid copolymer/DGEBA systems by FTIR
Authors: Cherdoud‐Chihani A. , Mouzali M. , Abadie M. J. M.
Published: January 2003

A study of crosslinking of diglycidylether of bisphenol A (DGEBA) by four copolymers of poly(acrylic acid‐co‐styrene) having different acid group percentages, in the range 7.6–76.6%, was done by FTIR. The study was done in the isothermal mode for four different temperatures, the reaction being accelerated by triethylamine. We followed each by temperature and the variation of the area of the epoxy infrared band (912–916 cm−1) versus time. The results showed that the mechanism was complex and depended on the acid composition in the copolymer. Three types of reaction were involved: addition esterification, etherification, and condensation esterification. © 2003 Wiley Periodicals, Inc. J Appl Polym Sci 87: 2033–2051, 2003
Study on the photo degradation of pulp mold container
Authors: Ou Yifang , Huang Qiulian
Published: January 2003

The photodegradation of a pulp mold container was investigated with ultraviolet light. The results show that the degree of polymerization of samples decreased about 50%, tensile strength decreased 20–30%, sample weight lost 10–16%, and brightness decreased about 20% after 8 weeks of UV irradiation. © 2003 Wiley Periodicals, Inc. J Appl Polym Sci 87: 2052–2056, 2003
Oxidative stabilization of PAN/VGCF composite
Authors: Zhu Dan , Koganemaru Ai , Xu Chunye , Shen Qundong , Li Suolong , Matsuo Masaru
Published: January 2003

An oxidative stabilization process to prepare carbon films was carried out for a new kind of precursor using the composite of polyacrylonitrile (PAN) and vapor‐grown carbon fiber (VGCF) by a process of gelation/crystallization from dilute solutions. It was found that the new precursor has special features in the stabilization process different from those of the homopolymer in regard to thermal and morphological aspects. In the stabilization process under heat treatment at 180–350°C in an oxidative atmosphere, it was inferred that, although the introduction of VGCF hinders the initiation and propagation step of the cyclization and dehydrogenation reactions, the precursor helps the oxidation and the additional aromatization and intermolecular crosslinking reactions in the stabilization process, thus promoting the formation of the later carbon product in film's shape with good performance. From characteristic works by wide‐angle X‐ray diffraction (WAXD), FTIR, Raman, and DSC, the changes of the precursors in structure, morphology, and mechanical property in terms of different heat‐treat temperatures and tensions were studied. Through a series of experimental results, the effect of the VGCF's introduction on those changes was discussed. © 2003 Wiley Periodicals, Inc. J Appl Polym Sci 87: 2063–2073, 2003
Gel permeation chromatography study of active centers in propylene oxide polymerization catalyzed by C3H5O3K3, C3H5O3K3–CaSO4, C3H5O3K3–crown ether, and C3H5O3K3–CaSO4–crown ether systems
Authors: Huang Mei , Feng Linxian , Hu Gengyuan
Published: January 2003

Gel permeation chromatography (GPC) is widely used to measure the molecular weights of linear polymers. A detailed analysis of high‐quality GPC data is an important source of information about the kinetics of a polymerization reaction. The living polymerization of epoxide demonstrates that the Poisson function is suitable for a molecular weight distribution description of polyether produced with catalysts containing a single type of active center. Therefore, poly(propylene oxide)s obtained by different catalytic systems, including C3H5O3K3, C3H5O3K3–CaSO4, C3H5O3K3–crown ether, and C3H5O3K3–CaSO4–crown ether, were characterized by GPC. The peaks obtained by GPC were resolved with a multi‐Poisson distribution function. This signifies that there might be multiple active sites instead of single site in these catalytic systems. The addition of calcium sulfate to the catalytic systems not only increased the molecular weight of the polyether but also effected the formation of the active sites. Furthermore, the polymerization of propylene oxide was processed in the presence of the aforementioned catalytic systems. Much useful information concerning the kinetic process of the polymerization was obtained from the GPC data with computer analysis. © 2003 Wiley Periodicals, Inc. J Appl Polym Sci 87: 2100–2105, 2003
Preparation and rheological characterization of intercalated polystyrene/organophilic montmorillonite nanocomposite
Authors: Kim Tae H. , Lim Sung T. , Lee Chung H. , Choi Hyoung J. , Jhon Myung S.
Published: January 2003

Polystyrene (PS)/organophilic montmorillonite (OMMT) clay nanocomposites were prepared by a solvent casting method using chloroform as a cosolvent. Intercalation of the OMMT in the PS matrix was achieved as revealed by X‐ray diffraction. The IR spectra of the products indicated that the OMMT is homogeneously dispersed in the PS matrix. A thermogravimetric analysis (TGA) showed that the onset temperature increases linearly with the clay content. The glass‐transition temperature of the PS, examined using differential scanning calorimetry, had a trend similar to that from the TGA. The rheological properties of the PS/OMMT nanocomposites were also investigated via a rotational rheometer with a parallel plate geometry, and they exhibited sharper shear thinning and increased storage and loss modulus with clay content. Furthermore, the shear viscosity obtained from the steady shear experiment was well correlated with the complex viscosity obtained from the oscillatory experiment via the Cox and Merz relation. © 2003 Wiley Periodicals, Inc. J Appl Polym Sci 87: 2106–2112, 2003
Synthesis and characterization of poly(dimethylsiloxane)–polythiophene composites
Authors: Sankır Mehmet , Küçükyavuz Zuhal , Küçükyavuz Savaş
Published: January 2003

The synthesis was performed by the electropolymerization of thiophene on a poly(dimethylsiloxane) (PDMS)‐coated platinum electrode at 2.2 V with tetrabutylammoniumtetrafloroborate (TBAFB) as a supporting electrolyte and with acetonitrile as a solvent. The characterization of the PDMS–polythiophene (Pth) composites was carried out with cyclic voltammetry, Fourier transform infrared (FTIR), scanning electron microscopy (SEM), differential scanning calorimetry (DSC), thermogravimetric analysis, and conductivity measurements. The observed conductivities of the PDMS composites were 2.2–5.2 S/cm. The conductivity of Pth did not change appreciably with the addition of up to 30% insulating PDMS, but its processability improved. FTIR, SEM, and DSC studies showed the existence of a strong interaction, rather than physical adhesion, between PDMS and Pth. Highly flexible and foldable PDMS–Pth composites were obtained. © 2003 Wiley Periodicals, Inc. J Appl Polym Sci 87: 2113–2119, 2003
A comparison of Newtonian and viscoelastic constitutive models for dry spinning of polymer fibers
Authors: Gou Zeming , McHugh Anthony J.
Published: January 2003

A comparison is made of the predictions of one‐dimensional mathematical model simulations of dry spinning based on Newtonian and viscoelastic constitutive equations for the spin dope. The viscoelastic model is based upon a modified Giesekus constitutive equation with a temperature and composition‐dependent relaxation time. The simulation algorithm includes the effects of the glass transition on the expected solution viscosity and relaxation time behavior along the spinline. Predictions of axial velocity, tensile stress, and composition profiles for the two cases suggest the role of viscoelasticity in the locking‐in behavior associated with fiber solidification along the spinline. The effects of model parameters and processing conditions are also discussed. © 2003 Wiley Periodicals, Inc. J Appl Polym Sci 87: 2136–2145, 2003
Determination of green‐bond strength in tacky poly(vinyl alcohol) hydrogels
Authors: Ben‐Zion Omri , Karpasas Mark , Nussinovitch Amos
Published: January 2003

Pressure‐sensitive tack is the adhesive property related to bond formation. It is a key issue when formulating hydrogel poultices for transdermal delivery, dressings, and bioelectrodes. Quantitative tack gives an indication of the potential ease and success of application when gels are brought into contact with skin. The effects of different dwell times and constant pressures on bond formation between tacky poly(vinyl alcohol) (PVA) hydrogels and a skin model were explored in the current study; these were correlated with viscoelastic properties in order to elucidate structure–function relationships. A rolling tack test was performed using a novel apparatus capable of simultaneously controlling the pressure and dwell time in a hydrogel/skin‐model‐probe system. PVA gels were formed via the freeze–thaw technique using Ca2+ ions. Lower calcium availability in PVA gels resulted in longer dwell times required to complete bond formation, decreased creep compliance (at 0.01 s) and a decreased G′(ω = 40)/G′(ω = 0.01) ratio, all three leading to a loss in tack strength. All tested gels were found to have pressure‐sensitive tack. The results of this study support the applicability of a rheological methodology and a novel tack‐testing procedure to quantify green‐bond formation in pressure‐sensitive‐adhesive PVA hydrogels. © 2003 Wiley Periodicals, Inc. J Appl Polym Sci 87: 2130–2135, 2003
Determination of moisture content in nylon 6,6 by near‐infrared spectroscopy and chemometrics
Authors: Camacho Walker , Vallés‐Lluch Ana , Ribes‐Greus Amparo , Karlsson Sigbritt
Published: January 2003

The effects of moisture on the morphology and mechanical properties of polyamides have been extensively studied by a number of researchers. However, the assessment of water content in the resins has been carried out by thermal or thermogravimetric methods, which are destructive. In the present work partial least‐squares (PLS) calibration models based on near‐infrared (NIR) spectroscopy were produced in order to predict the moisture content of nylon 6,6. Differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), and the loss‐on‐drying (LOD) method were used as reference methods. TGA, LOD, DSC, and NIR analysis were performed in parallel, and the obtained data were used for multivariate calibration purposes. Data pretreatment techniques such as derivation and multiplicative scattering correction (MSC) successfully eliminated the baseline offset present in the raw spectra and compensated for differences in thickness and light scattering of the analyzed samples. Calibration models were validated by full cross validation with the help of a test set. A comparison of the prediction ability of PLS models based on pretreated data was also done. NIR spectroscopy is a rapid and nondestructive method for the determination of moisture in recycled nylon. The moisture content can be predicted with a RMSEP = 0.05 wt %. © 2003 Wiley Periodicals, Inc. J Appl Polym Sci 87: 2165–2170, 2003
Investigation of deformation mechanism in polypropylene/glass fiber composite
Authors: Zebarjad S. M. , Bagheri R. , Seyed Reihani S. M. , Forunchi M.
Published: January 2003

A great amount of work has been done over the past few years to understand the structure–properties relationship in polypropylene/glass fiber composites. This is because of the very fast‐growing rate of polypropylene applications in the automotive and other industries. This work focused on the role of glass fibers and fiber–matrix adhesion on deformation mechanism. Composites with different fiber content, with and without adhesion promoter, were fabricated. Tensile tests and microscopy techniques were conducted. Based on the results, a physical model has been proposed that illustrates the initiation and growth of the damage under static loading condition. According to this work, the introduction of glass fibers shifts the deformation mechanism from shear yielding to crazing. Although crazes propagate in a different manner in composites containing standard and treated fibers, no influence of interfacial adhesion was observed on craze thickening phenomenon. © 2003 Wiley Periodicals, Inc. J Appl Polym Sci 87: 2171–2176, 2003
Influence of laboratory ware related changes in conformational and mechanical properties of collagen
Authors: Sripriya R. , Ahmed Md. Rafiuddin , Sehgal P. K. , Jayakumar R.
Published: January 2003

Enzyme‐treated acid‐solubilized bovine collagen (ESBC Type I) prepared in laboratory‐grade glass and polypropylene ware under identical conditions have shown different conformational and mechanical properties. Circular dichroism (CD) studies on ESBC have shown higher triple‐helical contents in polypropylene laboratory‐grade ware compared to laboratory ware of glass. Fourier transform infrared spectroscopy (FTIR) and differential scanning calorimetric (DSC) studies have supported the conformational changes performed on both preparations. Both preparations, in membrane form, were evaluated for their mechanical properties—viz., shrinkage temperature (St), dissolution temperature (Dt), and tensile strength (Ts). The collagen membrane of ESBC prepared in polypropylene showed significantly higher values compared to glass ones. No difference was seen in shrinkage temperature data of the two membranes. Reduced viscosity of ESBC was also measured for both preparations, and it had a significantly higher value in polypropylene ware compared to ESBC prepared in glassware. We postulate that the presence of silicate ions (SiO3−2) in glassware has a role in all these changes. © 2003 Wiley Periodicals, Inc. J Appl Polym Sci 87: 2186–2192, 2003
Stereologic characterization and spatial distribution patterns of Betz cells in the human primary motor cortex
Authors: Rivara Claire‐Bénédicte , Sherwood Chet C. , Bouras Constantin , Hof Patrick R.
Published: January 2003

Betz cells are giant motoneurons located in layer Vb of the primate primary motor cortex. We conducted stereological analyses of Betz cells and neighboring pyramidal cells from the brains of six neurologically normal elderly humans to determine their volume, total number, and spatial distribution, and to relate these data to functional localization. The distribution of cellular volumes exhibits a bimodal pattern, delineating two different subpopulations. Betz cell volumes follow a mediolateral gradient, the largest Betz cells being located on the most medial part of the motor cortex. Additionally, the shape of Betz cells varies between the rostral and caudal parts of the primary motor cortex, supporting the notion that there are anatomically distinct zones in primary motor cortex. The total number of Betz cells per hemisphere accounts for about one‐tenth of the total number of pyramidal cells in layer Vb. Analysis of spatial distribution using Voronoi tessellation revealed maximal clustering of Betz cells in a zone situated two‐thirds from the midline along the mediolateral axis of the primary motor cortex. These data suggest that Betz cells have a discrete subregional distribution that may correspond to certain aspects of the functional parcellation of area 4. These results may offer a histological correlate of functional imaging studies and are relevant in the context of neurodegenerative diseases such as amyotrophic lateral sclerosis, progressive supranuclear palsy, and Guamanian amyotrophic lateral sclerosis/Parkinsonism‐dementia, and in studies of normal brain aging. Anat Rec Part A 270A:137–151, 2003. © 2003 Wiley‐Liss, Inc.
The human vomeronasal organ. V. An interpretation of its discovery by Ruysch, Jacobson, or Kölliker, with an English translation of Kölliker (1877)
Authors: Bhatnagar Kunwar P. , Smith Timothy D.
Published: January 2003

The vomeronasal organs (VNOs) of mammals are highly variable epithelial structures found bilaterally in the mucosa of the nasal septum. Whereas the discovery of the human VNO is traditionally ascribed to Frederick Ruysch (1703, 1724), the organ is named after Ludwig Levin Jacobson (1811, 1813) who described it in nonhuman mammals. We recently have pointed out controversies surrounding the incidence and structure of the enigmatic human VNO, and herein, we provide a historical analysis of its discovery. We present evidence that the honor of discovering the human VNO truly belongs to Kölliker (1877), and not to Ruysch. Ruysch illustrated the lateral view of a 2‐year‐old infant's nasal septum, and it is unclear whether the right nasal passage, the tubular VNO or its opening, or an unrelated duct is being indicated. Jacobson reported the VNO to be missing in humans. Its discovery in the human embryo can be related in part to later authors, such as Dursy (1869). Our reappraisal of the literature confirms that Kölliker was actually the first among these 18th–689th century investigators to provide evidence of the human VNO as a histologically identifiable structure in the fetus and the adult. Anat Rec (Part B: New Anat) 270B:4–15, 2003. © 2003 Wiley‐Liss, Inc.
Integration of advanced technologies to enhance problem‐based learning over distance: Project TOUCH
Authors: Jacobs Joshua , Caudell Thomas , Wilks David , Keep Marcus F. , Mitchell Steven , Buchanan Holly , Saland Linda , Rosenheimer Julie , Lozanoff Beth K. , Lozanoff Scott , Saiki Stanley , Alverson Dale
Published: January 2003

Distance education delivery has increased dramatically in recent years as a result of the rapid advancement of communication technology. The National Computational Science Alliance's Access Grid represents a significant advancement in communication technology with potential for distance medical education. The purpose of this study is to provide an overview of the TOUCH project (Telehealth Outreach for Unified Community Health; http://hsc.unm.edu/touch) with special emphasis on the process of problem‐based learning case development for distribution over the Access Grid. The objective of the TOUCH project is to use emerging Internet‐based technology to overcome geographic barriers for delivery of tutorial sessions to medical students pursuing rotations at remote sites. The TOUCH project also is aimed at developing a patient simulation engine and an immersive virtual reality environment to achieve a realistic health care scenario enhancing the learning experience. A traumatic head injury case is developed and distributed over the Access Grid as a demonstration of the TOUCH system. Project TOUCH serves as an example of a computer‐based learning system for developing and implementing problem‐based learning cases within the medical curriculum, but this system should be easily applied to other educational environments and disciplines involving functional and clinical anatomy. Future phases will explore PC versions of the TOUCH cases for increased distribution. Anat Rec (Part B: New Anat) 270B:16–22, 2003. © 2003 Wiley‐Liss, Inc.
Anatomy and the Access Grid: Exploiting plastinated brain sections for use in distributed medical education
Authors: Lozanoff Scott , Lozanoff Beth K. , Sora Mircea‐Constantin , Rosenheimer Julie , Keep Marcus F. , Tregear Jonathon , Saland Linda , Jacobs Joshua , Saiki Stanley , Alverson Dale
Published: January 2003

Computerized animation is becoming an increasingly popular method to provide dynamic presentation of anatomical concepts. However, most animations use artistic renderings as the base illustrations that are subsequently altered to depict movement. In most cases, the artistic rendering is a schematic that lacks realism. Plastinated sections provide a useful alternative to artistic renderings to serve as a base image for animation. The purpose of this study is to describe a method for developing animations by using plastinated sections. This application is used in Project TOUCH as a supplemental learning tool for a problem‐based learning case distributed over the National Computational Science Alliance's Access Grid. The case involves traumatic head injury that results in an epidural hematoma with transtentorial uncal herniation. In addition, a subdural hematoma is animated permitting the student to contrast the two processes for a better understanding of dural hematomas, in general. The method outlined uses P40 plastinated coronal brain sections that are digitized and to which contiguous anatomical structures are rendered. The base illustration is rendered, interpolated, and viewed while audio narration describes the event. This method demonstrates how realistic anatomical animations can be generated quickly and inexpensively for medical education purposes by using plastinated brain sections. Anat Rec (Part B: New Anat) 270B:30–37, 2003. © 2003 Wiley‐Liss, Inc.
Virtual patient simulator for distributed collaborative medical education
Authors: Caudell Thomas P. , Summers Kenneth L. , Holten Jim , Hakamata Takeshi , Mowafi Moad , Jacobs Joshua , Lozanoff Beth K. , Lozanoff Scott , Wilks David , Keep Marcus F. , Saiki Stanley , Alverson Dale
Published: January 2003

Project TOUCH (Telehealth Outreach for Unified Community Health; http://hsc.unm.edu/touch) investigates the feasibility of using advanced technologies to enhance education in an innovative problem‐based learning format currently being used in medical school curricula, applying specific clinical case models, and deploying to remote sites/workstations. The University of New Mexico's School of Medicine and the John A. Burns School of Medicine at the University of Hawai'i face similar health care challenges in providing and delivering services and training to remote and rural areas. Recognizing that health care needs are local and require local solutions, both states are committed to improving health care delivery to their unique populations by sharing information and experiences through emerging telehealth technologies by using high‐performance computing and communications resources. The purpose of this study is to describe the deployment of a problem‐based learning case distributed over the National Computational Science Alliance's Access Grid. Emphasis is placed on the underlying technical components of the TOUCH project, including the virtual reality development tool Flatland, the artificial intelligence–based simulation engine, the Access Grid, high‐performance computing platforms, and the software that connects them all. In addition, educational and technical challenges for Project TOUCH are identified. Anat Rec (Part B: New Anat) 270B:23–29, 2003. © 2003 Wiley‐Liss, Inc.
Observed increases in positive affect during behavioral treatment
Authors: Toole Lisa M. , Bowman Lynn G. , Thomason Jessica L. , Hagopian Louis P. , Rush Karena S.
Published: January 2003

A 15‐year‐old female diagnosed with mental retardation was admitted to an inpatient facility for the assessment and treatment of a severe behavior disorder. A behavioral treatment to reduce destructive behavior consisting of enriched environment, differential reinforcement, and time‐out was evaluated in a reversal design. Data on affect were collected during baseline and treatment phases. In addition to achieving clinically significant reductions in problem behavior, collateral improvements in positive affect were observed during treatment phases. Copyright © 2003 John Wiley & Sons, Ltd.
Major amputation for soft-tissue sarcoma
Authors: Clark M A , Thomas J M
Published: January 2003

Background

Advances in oncological practice have reduced the number of major amputations performed for soft-tissue sarcoma, but this remains a valuable, if infrequent, option for both curative and palliative indications.

Methods

A review of patients and case-notes was carried out from the prospective sarcoma database at the Royal Marsden Hospital.

Results

Over a 10-year interval, 40 major amputations (18 forequarter, 17 hindquarter and five through hip) were performed, predominantly for disease recurring after previous limb-conserving surgery (31 of 40). A wide variety of soft-tissue sarcoma subtypes was seen; they were often large (more than 10 cm; 18 of 40) or multifocal (six), usually high grade (25), and frequently proximal or involving neurovascular structures such that limb salvage was precluded. Median range age of the patients was 59 (17–87) years. The operative 30-day mortality rate was zero. Hospital stay was a median of 10·5 days for forequarter amputation, and 19 days for hindquarter and through-hip amputation. Local recurrence occurred in ten patients, six of whom had concurrent distant metastases. Twenty-seven patients were alive (20 disease free) at a median follow-up of 12 months, nine of whom were alive without evidence of disease beyond 2 years. Ten patients died after a median of 7·5 months; three survived more than 2 years.

Conclusion

Major amputation is a useful procedure in carefully selected patients with soft-tissue sarcoma.
Mortality, morbidity and functional outcome after ileorectal anastomosis
Authors: Elton C , Makin G , Hitos K , Cohen C R G
Published: January 2003

Background

Total colectomy with an ileorectal anastomosis (IRA) is a commonly performed operation. Postoperative mortality and morbidity are reported to be low and functional outcome is generally rated as good to excellent. The aim of this study was to review postoperative mortality, morbidity and functional results in an effort to identify risk factors predictive of a poor outcome.

Methods

Some 215 patients (118 women and 97 men) with a median age of 33 (interquartile range (i.q.r.) 25–47) years underwent an IRA between November 1990 and December 1999. Median follow-up was 2 years 9 months (i.q.r. 1–5 years). The clinical notes of these patients were reviewed retrospectively to analyse the postoperative course, bowel function and long-term clinical outcome.

Results

The indications for surgery included familial adenomatous polyposis (52·1 per cent), Crohn's disease (14·4 per cent), functional bowel disorder (14·4 per cent), ulcerative colitis (8·4 per cent) and colonic carcinoma (4·7 per cent). The overall 30-day mortality and morbidity rates were 0·9 and 26·0 per cent respectively. This included anastomotic leak (6·5 per cent), small bowel obstruction (14·4 per cent), fistula (2·8 per cent) and anastomotic stricture (1·4 per cent). The incidence of fistula and anastomotic stricture was significantly higher in Crohn's disease (P < 0·001 and P = 0·005 respectively). Only 16 of 31 patients with Crohn's disease had a functioning IRA at long-term follow-up. Median stool frequency was 3 (i.q.r. 3–5) per day one year following surgery and did not change with longer follow-up.

Conclusion

Mortality and morbidity rates following IRA are low. Postoperative fistula and anastomotic stricture are more common in patients with Crohn's disease, approximately half of whom will eventually need a permanent ileostomy. Long-term bowel function for all groups is satisfactory.
Risk of dysplasia in the columnar cuff after stapled restorative proctocolectomy
Authors: Coull D B , Lee F D , Henderson A P , Anderson J H , McKee R F , Finlay I G
Published: January 2003

Background

Stapled restorative proctocolectomy (SRP) for ulcerative colitis retains a ‘cuff’ of columnar epithelium, which carries a risk of undergoing malignant change. The risk of neoplastic transformation was studied in a series of patients who underwent SRP for ulcerative colitis.

Methods

One hundred and thirty-five patients who underwent SRP for ulcerative colitis between 1988 and 1998 were followed up by cuff surveillance biopsy. The median follow-up was 56 (range 12–145) months and the median time since diagnosis of ulcerative colitis was 8·8 (range 2–32) years.

Results

The cuff biopsies showed no dysplasia or carcinoma. The accuracy of obtaining cuff mucosa in the biopsy was 65 per cent. Chronic inflammation was present in 94 per cent of cuff biopsies.

Conclusion

This study shows no evidence of either dysplasia or carcinoma in the columnar cuff mucosa, up to 12 years after pouch formation. This suggests that cuff surveillance in the first decade after SRP, in the absence of dysplasia or carcinoma in the original colectomy specimen, may be unnecessary. Regular cuff surveillance biopsies after SRP should continue for patients with high-grade dysplasia or carcinoma in the original resection specimen.
Effect on diagnostic efficiency of analgesia for undifferentiated abdominal pain
Authors: Thomas S H , Silen W
Published: January 2003

Background

The question of whether it is safe to provide analgesia for patients with undifferentiated acute abdominal pain is marked by longstanding controversy over the possible masking of physical findings. The goal of this review is to assess the pertinent studies.

Method

A Medline search was performed in April 2002, using the terms ‘analgesia’, ‘abdominal pain’, ‘acute abdomen’ and ‘morphine’. Other articles were identified using the bibliographies of papers found through Medline. All articles reporting clinical trials of analgesia and its effects on diagnosis or physical examination were reviewed.

Results

A total of eight trials (one reported only as an abstract) were identified. Because of significant disparity in trial design, no formal analysis such as meta-analysis was performed. However, detailed review of the trials revealed a striking consistency in results. In no study was there an association between analgesia and diagnostic impairment or dangerous masking of the findings of physical examination.

Conclusion

The literature addressing early pain relief for abdominal pain is characterized by weaknesses, but there is a common theme suggesting that analgesia is safe. Pending further research, which should address some of the shortcomings of extant studies, a practice of judicious provision of analgesia appears safe, reasonable and in the best interests of patients in pain.
Impact of surgical procedure for gastric cancer on quality of life
Authors: Díaz de Liaño A , Oteiza Martínez F , Ciga M A , Aizcorbe M , Cobo F , Trujillo R
Published: January 2003

Background

The aim was to assess quality of life in a group of patients who had a curative resection for gastric cancer.

Methods

The European Organization for Research and Treatment of Cancer QLQ-C30 questionnaire with a gastric cancer-specific module was used in patients who had undergone R0 gastrectomy between 1992 and 1999, and who had no disease at the last check-up. A response was obtained from 54 patients, 36 men and 18 women, of mean age 67 years. Of these, 24 patients had total gastrectomy and 26 D2 lymphadenectomy.

Results

Significant differences were found only in the social domain of quality of life in patients aged over 70 years (P = 0·036); there was no impact of operation type on overall quality of life.

Conclusion

The quality of life of patients undergoing curative surgery for gastric cancer, regardless of age, was not significantly influenced by the type of gastrectomy, or whether lymphadenectomy was performed.
Autologous blood storage before hepatectomy for hepatocellular carcinoma with underlying liver disease
Authors: Itamoto T , Katayama K , Nakahara H , Tashiro H , Asahara T
Published: January 2003

Background

Preoperative autologous blood donation has been suggested for patients with liver disease who are to undergo liver resection. The aim of this retrospective study was to clarify the risk factors for increased blood loss and the need for blood transfusion during hepatectomy for hepatocellular carcinoma (HCC).

Methods

From January 1996 to December 2000, 206 consecutive patients, 98·5 per cent of whom had underlying liver disease, underwent elective hepatectomy for HCC.

Results

Major hepatectomy was performed in 34 patients (16·5 per cent) and minor hepatectomy in 172 patients (83·5 per cent). The mean blood loss was 410 (median 260) ml. Eleven (5·3 per cent) of the 206 patients received blood transfusion during or after the operation. Operation time (P = 0·004) and central venous pressure (CVP) (P = 0·041) were independently correlated with blood loss of more than 1000 ml. Only preoperative haemoglobin level (P = 0·001) was independently correlated with the need for blood transfusion.

Conclusion

In patients with underlying liver disease, maintaining CVP at a level below 5 cmH2O during parenchymal transection to reduce blood loss is more important than reserving autologous blood before the operation.
The National Health Service Breast Screening Programme and British Association of Surgical Oncology audit of quality assurance in breast screening 1996–2001
Authors: Sauven P , Bishop H , Patnick J , Walton J , Wheeler E , Lawrence G
Published: January 2003

Background

The National Health Service Breast Screening Programme (NHSBSP) is an example of a nationally coordinated quality assurance programme in which all the professional groups involved participate.

Methods

Surgeons, radiologists and pathologists defined the clinical outcome measures against which they would subsequently be audited. The NHSBSP and the Association of Breast Surgery at BASO are jointly responsible for coordinating an annual audit of all surgical activities undertaken within the NHSBSP.

Results

The trends for key outcome measures between 1996 and 2001 are provided. The preoperative diagnosis rate (minimum standard 70 per cent or more) improved from 63 to 87 per cent. This rise was mirrored by an increase in the use of core biopsy in preference to fine-needle cytology. The proportion of patients in whom lymph node status was recorded improved from 81 to 93 per cent. There was no significant change in the number of women treated by low case-load surgeons and waiting times for surgery increased through the study interval.

Conclusion

The BASO–NHSBSP Breast Audit has recorded major changes in clinical practice over 5 years. A key feature has been the dissemination of good practice through feedback of the results at local and national level.
Organ-preserving pancreatic head resection in chronic pancreatitis
Authors: Farkas G , Leindler L , Daróczi M , Farkas G
Published: January 2003

Background

Twenty to thirty per cent of patients with chronic pancreatitis develop inflammatory enlargement of the head of the pancreas. A safe procedure has been developed for duodenum-preserving pancreatic head resection; this report describes the preliminary results achieved.

Methods

Thirty patients, 27 men and three women of mean age 44 years, underwent surgical resection following the development of an inflammatory mass in the pancreatic head. All patients had weight loss and frequent abdominal pain. Jaundice was present in three and diabetes mellitus in ten patients. The diagnosis of chronic pancreatitis was made by a combination of endoscopic retrograde cholangiopancreatography, sonography and computed tomography. Pancreatic function was assessed by amylum tolerance test (ATT), oral glucose tolerance test and stool elastase measurement. The surgical procedure involved wide local resection of the inflammatory tumour in the pancreatic head, without division of the pancreas over the portal vein. Reconstruction involved drainage via a jejunal Roux-en-Y loop. In three icteric cases, prepapillary bile duct anastomosis was also performed using the same jejunal loop.

Results

There were no hospital deaths or major complications. After a median follow-up of 10 (range 6–14) months, all patients were symptom free. The mean increase in body-weight was 8·9 (range 4–20) kg. The ATT and stool elastase level demonstrated improved exocrine function but there was no change in endocrine function.

Conclusion

This type of pancreatic head resection is a safe procedure that provides good short-term relief of symptoms associated with inflammatory changes in the head of the pancreas in chronic pancreatitis.
Risk factors for perioperative morbidity and mortality after extended hepatectomy for hepatocellular carcinoma
Authors: Wei A C , Tung-Ping Poon R , Fan S-T , Wong J
Published: January 2003

Background

Extended hepatectomy with resection of more than four segments is a high-risk operation, especially in patients with hepatocellular carcinoma (HCC) associated with chronic liver disease. This study evaluated the risk factors for morbidity and mortality following extended hepatectomy for HCC.

Methods

Preoperative and intraoperative variables of 155 patients who underwent extended hepatectomy for HCC were analysed to identify risk factors for postoperative morbidity and mortality.

Results

The overall morbidity rate was 55·5 per cent (n = 86). Most morbidity was due to ascites or pleural effusion. Significant life-threatening complications occurred in 20·0 per cent (n = 31). The perioperative mortality rate was 8·4 per cent (n = 13). Multivariate analysis found that portal clamping (P = 0·023) and perioperative blood transfusion (P < 0·001) were risk factors for morbidity, whereas perioperative blood transfusion (P < 0·001) was the only risk factor for significant morbidity. Co-morbid illness (P = 0·019) and perioperative blood transfusion (P = 0·004) were risk factors for perioperative mortality.

Conclusion

Meticulous operative techniques to minimize blood loss and transfusion, while avoiding a prolonged Pringle manoeuvre, may help reduce postoperative morbidity. Avoidance of perioperative blood transfusion and careful preoperative selection of patients in terms of overall physiological status are important measures to reduce the postoperative mortality rate.
Surgeons and cognitive processes
Authors: Hall J C , Ellis C , Hamdorf J
Published: January 2003

Background

The surgical mind is geared to make important decisions and perform highly skilled tasks. The aim of this review is to explore the cognitive processes that link these actions.

Methods

The core of this review is derived from a literature search of a computer database (Medline).

Results and conclusion

The surgical image is one of action. However, the effective performance of surgery requires more than mere manual dexterity and it is evident that competent surgeons exhibit the cognitive traits that are held by all experts. The changes that are occurring in surgery indicate a need to place greater emphasis on the cognitive processes that underpin the practice of surgery. It is important that surgeons do not become victims of their own cult image.
Radial artery as a conduit for diabetic crural bypass
Authors: Fearn S J , Parkinson E , Nott D M
Published: January 2003

An alternative if saphenous vein is absent
A comparison of video-assisted thoracoscopic oesophagectomy and radical lymph node dissection for squamous cell cancer of the oesophagus with open operation
Authors: Osugi H , Takemura M , Higashino M , Takada N , Lee S , Kinoshita H
Published: January 2003

Background

A direct comparison of open operation and video-assisted thoracoscopic surgery (VATS) for radical oesophagectomy has yet to be published.

Methods

Medical records of 149 patients with oesophageal squamous cell carcinoma who underwent oesophagectomy and three-field lymphadenectomy were reviewed. Seventy-seven patients had the thoracic procedure performed via a 5-cm minithoracotomy and four ports (VATS group); the others were operated on by conventional posterolateral thoracotomy (open group).

Results

The mean number of retrieved mediastinal nodes, blood loss and morbidity were similar in the VATS and open groups (33·9 versus 32·8 nodes, 284 versus 310 g, and 32 versus 38 per cent respectively). The thoracic procedure took longer in patients having VATS than in the control group (227 versus 186 min; P = 0·031). Vital capacity reduction was less with VATS than in the open group (15 versus 22 per cent; P = 0·016). The 3- and 5-year survival rates were similar: 70 and 55 per cent respectively for VATS compared with 60 and 57 per cent for the open procedure.

Conclusion

VATS provides comparable results to open radical oesophagectomy, with less surgical trauma.