bluuebunny/crossref_metadata_2025 huggingface dataset:
NEW STRATEGY TO PREVENT ASCENDING CHOLANGITIS IN LARGER CHOLEDOCHODUODENAL FISTULA
Authors: Li Zhi‐Hua , Ding Jun , Ye Yongqian , Cai Lei , Liu Xiangde , Liu Jikui , Chen Ming , Li Xiaowu , Dong Jiahong
Published: August 2006

Background:  Choledochoduodenal fistula (CDF) is a complication of common bile duct stones or cholangitis in Asia. It is unclear as to which type of the fistula needs surgical treatment.

Methods:  To determine whether the sizes of CDF imply different clinical presentations and treatments, we reviewed 50 patients with CDF and their treatments during a recent 14‐year period. For treatments of CDF, we applied the conventional methods, including removal of stone and complete decompression of biliary obstruction to treat the original bile lesions. In addition, according to the sizes of fistula and the frequencies of ascending cholangitis, we proposed the following strategies for fistula treatments: (i) for fistula orifices larger than 1 cm, a transection of common bile duct was applied to prevent the reflux of duodenal juice; (ii) for fistula orifices between 0.5 and 1.0 cm, an effective biliary drainage was applied; and (iii) for fistula orifices less than 0.5 cm, non‐surgical treatments were applied.

Results:  We found that hepatic biliary duct stones and hepatic biliary duct strictures were associated with more severe cholangitis (P = 0.037 and P = 0.009, respectively), but not with the episodes of cholangitis (P = 0.654 and P = 0.664, respectively). In contrast, the sizes of fistula >1 cm were associated with more frequent episodes of cholangitis (r = 0.774; P < 0.001).

Conclusion:  The larger fistula increases frequency of cholangitis episodes and needs surgical treatment for fistula itself.
DOES MATRIX METALLOPROTEINASE ACTIVITY PREDICT SEVERITY OF ACUTE PANCREATITIS?
Authors: Aynaci Murat , Tuncyurek Pars , Nart Deniz , Zeytunlu Murat , Ozutemiz Omer , Ersoz Galip , Yilmaz Funda , Mayer Jens , Coker Ahmet
Published: August 2006

Background:  Matrix metalloproteinases (MMP) modulate end‐organ complications of acute pancreatitis, but the correlation between increased MMP production and histological severity of disease remains unclear. We examined the role of MMP and pancreas histology on experimental acute pancreatitis.

Methods:  Forty male Wistar albino rats were subjected to cerulein‐induced pancreatitis (8, 16, 24 and 32 h groups) or sham treatment. The animals were killed at different time points and pancreatic tissues were harvested to assess MMP (1, 2 and 9) activity and inflammatory changes.

Results:  Compared with other groups, 8 h group had decreased tissue MMP‐1 concentrations. MMP‐9 concentrations were lower in 24‐h and 32‐h groups, as were histological severity scores. MMP‐2 activity did not differ among groups. Pancreatitis was prominent in 8‐h, 16‐h and 24‐h groups by means of histology.

Conclusion:  Induction of pancreatitis by cerulein altered pancreatic MMP levels in the early phase of inflammation. Inhibition of MMP‐2 and MMP‐9 paralleled histological scores. Therefore, MMP may have a predictive value to assess histological severity.
COMPARISON OF THE POSSUM, P‐POSSUM AND CR‐POSSUM SCORING SYSTEMS AS PREDICTORS OF POSTOPERATIVE MORTALITY IN PATIENTS UNDERGOING MAJOR COLORECTAL SURGERY
Authors: Vather Ryash , Zargar‐Shoshtari Kamran , Adegbola Samuel , Hill Andrew G.
Published: August 2006

Background:  Physiologic and operative severity score for the enumeration of mortality and morbidity (POSSUM), ‘Portsmouth’‐physiologic and operative severity score for the enumeration of mortality and morbidity (P‐POSSUM) and ‘Colorectal’‐physiologic and operative severity score for the enumeration of mortality and morbidity (Cr‐POSSUM) are three related scoring systems, which uses individual patient parameters to predict postoperative mortality. POSSUM overpredicts mortality in low‐risk patients and underpredicts mortality in elderly and emergency patients. P‐POSSUM was developed to compensate for these weaknesses. Cr‐POSSUM was developed specifically for colorectal surgery. We aim to establish which of these scoring systems would be most useful in an Australasian context.

Methods:  Data were collected for 308 patients and predicted mortality risk values were generated using each of the three systems. The Mann–Whitney U‐test was then carried out on the scores for each system. Receiver–operator characteristic curves were designed to determine the relative accuracy of each approach at discriminating between death and survival.

Results:  All three POSSUM scoring systems showed a statistically significant ability to predict postoperative mortality. Additionally, in each system there was a significant difference in the raw physiologic and operative severity scores between survivors and those who died. A risk‐stratification model was applied to each set of data, showing a correlation between an increase in risk and an increase in mortality rate. Finally, the receiver–operator characteristic curves generated showed that in this study group POSSUM, P‐POSSUM and Cr‐POSSUM were all satisfactory predictive tools although the latter tended to be relatively less accurate.

Conclusion:  Physiologic and operative severity score for the enumeration of mortality and morbidity, P‐POSSUM and Cr‐POSSUM are all reliable predictors of postoperative mortality in the Australasian context; although there was a trend towards POSSUM and P‐POSSUM being better predictors than Cr‐POSSUM. However, Cr‐POSSUM requires fewer individual patient parameters to be calculated and is thus easier to generate. An ideal preoperative scoring system remains to be developed for predicting mortality in patients undergoing colorectal surgery.
USE OF THE LIGASURE VESSEL SEALING SYSTEM IN LAPAROSCOPIC ADRENALECTOMY
Authors: Soon Patsy S. H. , Yeh Michael W. , Sywak Mark S. , Sidhu Stan B.
Published: August 2006

Laparoscopic adrenalectomy is the operation of choice for benign adrenal lesions. During laparoscopic surgery, vessels are usually ligated with diathermy, ligaclips, staplers or ultrasonic coagulators. Use of the electrothermal bipolar vessel sealer (LigaSure; Valleylab, Boulder, CO, USA) has recently been described in a variety of procedures, not including adrenalectomy. This article is a retrospective study of 28 patients undergoing laparoscopic adrenalectomy within the University of Sydney Endocrine Surgical Unit at the Royal North Shore Hospital using the LigaSure vessel sealing system. Between July 2004 and August 2005, 28 consecutive patients underwent laparoscopic adrenalectomy using the LigaSure vessel sealing system to divide feeding adrenal vessels as well as the adrenal vein. There were no bleeding complications. The LigaSure vessel sealing system can be safely used to secure haemostasis, including division of the adrenal vein, in laparoscopic adrenalectomy.
MONTGOMERY T‐TUBE INSERTION USING A RIGID BRONCHOSCOPE UNDER DIRECT OBSERVATION
Authors: Liu Yun‐Hen , Wu Yi‐Chen , Hsieh Ming‐Ju , Ko Po‐Jen , Liu Hui‐Ping , Lin Pyng J.
Published: August 2006

The Montgomery T‐tube (T‐tube) is an effective device for relieving tracheal stenosis when lesions are inappropriate for surgical reconstruction. Several techniques have been developed for the insertion of the T‐tube in difficult conditions. The aim of this study was to present our experience using a rigid bronchoscope for T‐tube insertion. A retrospective chart review of patients with tracheal stenosis who underwent T‐tube insertion between April 2002 and July 2005 was conducted. Thirty‐seven patients underwent 53 T‐tube placements. Successful stent placement was achieved in all 37 patients. The T‐tube was not tolerated in six patients because of granulation obstruction of the upper limb or sputum impaction. Thirty‐one patients had good long‐term results and enjoy adequate airway with the T‐tube. There was no procedure‐related mortality and there were no complications. Rigid bronchoscopic insertion of the T‐tube for tracheal stenosis is a safe and an effective procedure. It ensures the correct placement of the T‐tube when the technique described by Montgomery fails.
SUPERIOR MESENTERIC ARTERY SYNDROME FOLLOWING SMALL BOWEL RESECTION
Authors: Boldery Jason , Gleeson Jacob , Jordaan Jacobus
Published: August 2006

Superior mesenteric artery syndrome is a rare cause of mechanical intestinal obstruction. It results from compression of the third part of the duodenum between the superior mesenteric artery and the aorta. It has been described in association with a variety of clinical conditions, including prolonged supine immobilization, application of a body cast, ileal pouch‐anal anastomosis, abdominal aortic aneurysm, spinal surgery and severe weight loss. We present a case of superior mesenteric artery syndrome following resection of a primary adenocarcinoma of the small bowel.
Gender differences in health‐related quality of life among stroke patients
Authors: Kuroda Akiko , Kanda Tadashi , Sakai Fumihiko
Published: August 2006

Background:  To determine whether differences in health‐related quality of life (HRQOL) exist between male and female stroke patients and, if present, to identify factors influencing these differences.

Methods:  A questionnaire assessing HRQOL, measured by the EuroQol questionnaire, and functional outcome was mailed to 792 stroke patients and responded by 604 patients 39.6 ± 18.4 (mean ± standard deviation) months after stroke onset. A total of 480 patients who lived at home after discharge were considered eligible for the analysis.

Results:  The mean quality of life (QOL) utility score for men (0.79 ± 0.22) was significantly higher than that for women (0.69 ± 0.26; P < 0.001). At discharge, men had a significantly better ability to walk than women (P < 0.001). The ability to perform activities of daily living (ADL) was also better among men than women after discharge (P < 0.01). A close relationship was observed between QOL utility scores and performance of ADL in both genders. A higher proportion of women were found to be in a state of anxiety or depression. Multiple regression analysis revealed that the QOL utility scores for men and women were influenced by functional changes, and the ADL items walking and dressing ability after discharge. In addition, the score for women was influenced by walking ability at discharge.

Conclusions:  HRQOL among men was significantly better than that among women. The difference in QOL scores appears to be influenced by the poorer outcome of ADL and the higher proportion of post‐stroke anxiety and depression among women.
Percutaneous vertebroplasty for elderly patients with unhealed osteoporotic spinal fractures
Authors: Harada Atsushi , Matsui Yasumoto , Okuizumi Hiroyasu , Wakao Norimitsu , Suzuki Takeshi , Ito Zenya
Published: August 2006

Background:  Vertebroplasty is a procedure in which bone cement is injected percutaneously into the vertebral body.

Methods:  We used this technique with 15 patients who had pseudarthrosis or delayed union of osteoporotic spinal fractures with vacuum clefts, and in whom conservative treatment did not relieve persistent pain. The procedure was performed in a short time with little blood loss, and no generic complications, leakage of bone cement to blood vessels or the spinal canal, or neural compression.

Results:  At 1 week after the operation, pain was eliminated in seven patients, alleviated in seven patients, unchanged in one patient, and worsened in none. The rate of alleviation or elimination of pain after 1 week and 6 months was 93% and 85%, respectively. Recurrence of the pain was seen in four cases, but this was caused by new spinal fractures in separate locations, confirmed with magnetic resonance imaging, in three patients, and by multiple myeloma in one patient.

Conclusion:  Thus, vertebroplasty, which alleviates pain rapidly and with low invasiveness, is a new and promising therapy for osteoporotic spinal fractures in which conservative treatment has failed. It seems to provide a large benefit to elderly patients if performed with prudent care with regard to complications at the time of bone cement injection, and in conjunction with treatment for osteoporosis.
Serum concentrations of dehydroepiandrosterone sulfate (DHEA‐S) in oldest old Japanese women correlate with cognitive activity rather than activities of daily living
Authors: Yanase Toshihiko , Muta Kazuo , Nawata Hajime
Published: August 2006

Background:  Dehydroepiandrosterone (DHEA) and its interconvertible sulfate ester, DHEA sulfate (DHEA‐S), mainly produced by the adrenal glands, are progressively decreased with aging and are proven markers of longevity. Although serum level of DHEA (‐S) has been shown to be decreased in dementing diseases, the issue remains controversial. We investigated the physiological significance of DHEA‐S in oldest old Japanese women in respect of activities of daily living (ADL) or cognitive activities.

Methods:  Cross‐sectional study of 50 women aged 90–103 years old. Serum concentrations of DHEA‐S levels were measured by radioimmunoassay. ADL and cognitive activity were evaluated by the Bathel index and revised Hasegawa’s dementia rating scale (HDS‐R), respectively. Univariate or multivariate regression analyzes were used for statistics.

Results:  Of the 50 subjects, 80% exceeded the lowest level of the normal range for women in their forties. Serum concentrations of DHEA‐S were significantly correlated with HDS‐R but not with the Barthel index.

Conclusion:  Relatively higher levels of serum DHEA‐S in oldest old women may reflect the longevity of this population and the levels might be associated with cognitive activity rather than ADL.
Aging trends: Population aging in Nepal
Authors: Chalise Hom Nath , Brightman James D.
Published: August 2006

Although population aging is regarded as a worldwide priority, research in this field is in its infancy in Nepal. The older population of that country is increasing both in terms of absolute numbers and as a proportion of the total population; however, traditional family norms and values of supporting the elderly are eroding. The objective of this paper is to provide a brief introduction to population aging as it exists in Nepal through secondary census and survey data for the purpose of further research and inquiry.
Quantifying uncertainty in the potential distribution of an invasive species: climate and the Argentine ant
Authors: Hartley Stephen , Harris Richard , Lester Philip J.
Published: August 2006

Maps of a species’ potential range make an important contribution to conservation and invasive species risk analysis. Spatial predictions, however, should be accompanied by an assessment of their uncertainty. Here, we use multimodel inference to generate confidence intervals that incorporate both the uncertainty involved in model selection as well as the error associated with model fitting. In the case of the invasive Argentine ant, we found that it was most likely to occur where the mean daily temperature in mid‐winter was 7–14 °C and maximum daily temperatures during the hottest month averaged 19–30 °C. Uninvaded regions vulnerable to future establishment include: southern China, Taiwan, Zimbabwe, central Madagascar, Morocco, high‐elevation Ethiopia, Yemen and a number of oceanic islands. Greatest uncertainty exists over predictions for China, north‐east India, Angola, Bolivia, Lord Howe Island and New Caledonia. Quantifying the costs of different errors (false negatives vs. false positives) was considered central for connecting modelling to decision‐making and management processes.
The prognostic impact of the time interval to recurrence for the mortality in recurrent colorectal cancer
Authors: Kaiser A. M. , Kang J.‐C. , Chan L. S. , Beart R. W.
Published: August 2006

Objective  The risk of a cancer recurrence has been correlated with the stage of the primary tumour at the time of presentation. However, once a recurrence has developed, the primary tumour stage may not be the determining prognostic factor anymore. The objective of this study was (i) to evaluate the association between the recurrence interval and the outcome of the recurrence, and (ii) to determine whether that interval was affected by the use of adjuvant radiation and/or chemotherapy.

Method  This retrospective study analysed 212 patients who developed recurrent colorectal cancer from 1987 to 1993. Primary parameters such as age, gender, primary tumour site and stage, and use of postoperative adjuvant treatment were correlated with the recurrence interval, the type and site of the recurrence (i.e. locoregional vs distant metastases), and the outcome. Uni‐ and multivariate analysis was used to compare the recurrence interval and survival between different subgroups as defined by risk factors.

Results  The mean time between the primary and the recurrent tumour was 25 months (range 1–252 months) with 82% of the recurrences developing within 3 years after surgery. The recurrence interval was inversely correlated with the initial tumour stage. Poor survival was associated with a short recurrence interval (less than 12 months) and a distant recurrence site. Even after adjusting for the initial tumour stage, the use of adjuvant treatment did not prolong the interval, i.e. delay the onset of recurrent cancer.

Conclusion  The recurrence interval of colorectal cancer is a prognostic factor. However, the use of adjuvant therapy did not prolong that interval.
Meditation, Social Change, and Undergraduate Education
Authors: Rockefeller Steven C.
Published: August 2006

This article argues that meditation guided by a competent teacher can be a positive influence in contemporary American society and even a force for progressive social change. A number of critical issues requiring further study are identified, including the need for a better understanding of meditation from the perspective of developmental psychology and of the relation between meditation and psychotherapy. The article proposes that American educational institutions can benefit from a deeper appreciation of the contemplative dimension of life. Special attention is given to how the American undergraduate college can provide students with opportunities to learn about and experience various forms of meditation. The role of teachers, chaplains, psychological counselors, and health care professionals in introducing meditation to students is discussed.
Meditation, Creativity, and Consciousness: Charting Future Terrain within Higher Education
Authors: Sarath Ed
Published: August 2006

This article explores the role of contemplative practices within an emerging interdisciplinary area that I refer to as “creativity and consciousness studies.” Within this new area, consciousness is studied from an “integral” perspective that brings together insights from a range of wisdom traditions and modern science. Meditation is presented as an essential first-person modality for investigating consciousness, and formal and nonformal approaches to meditation are delineated to establish important guidelines for the introduction of meditation into an academic setting. The role of “first-person” experience helps to develop new notions of rigor and interdisciplinary learning that can lead to an expanded educational experience, which can help to develop qualities such as mental clarity, inner calm, insight, compassion, and creativity. The article closes with reflections on the importance of expanding our approach to education in light of the demanding challenges and creative opportunities in today's world.
Contemplative Practices: Educating for Peace and Tolerance
Authors: Hill Clifford , Herndon Akbar Ali , Karpinska Zuki
Published: August 2006

This article describes a course offered at Teachers College, Columbia University, which focuses on contemplative practices from various wisdom traditions in order to increase awareness of what they share and to encourage educators to view these practices as sources of peace and tolerance. The article also presents various ways in which the students participated in the course and ends with an essay on “right teaching,” written as a final project by Akbar Ali Herndon and Zuki Karpinska.
MARKET ORGANIZATION AND THE PRICES OF FINANCIAL ASSETS*
Authors: CONSTANTINIDES GEORGE M.
Published: August 2006

Several empirical regularities in the prices of financial assets are at odds with the predictions of standard economic theory. I address these regularities and explore the extent to which they are resolved in the context of two markets organized in very different ways. The first setting is a neoclassical economy with incomplete markets and heterogeneous agents. Market incompleteness naturally arises because of the non‐existence of markets in which consumers or households can co‐insure idiosyncratic income shocks for obvious moral hazard reasons. The second setting is an overlapping generations economy with three generations in which the young generation is constrained from borrowing and investing in equities. The borrowing constraints naturally arise because human capital alone does not collateralize major loans in modern economies for reasons of moral hazard and adverse selection.
A MODEL OF BANK CAPITAL, LENDING AND THE MACROECONOMY: BASEL I VERSUS BASEL II*
Authors: ZICCHINO LEA
Published: August 2006

The revised framework for capital regulation of internationally active banks (known as Basel II) introduces risk‐based capital requirements. This paper analyses the relationship between bank capital, lending and macroeconomic activity under the new capital adequacy regime. It extends a model of the bank capital channel of monetary policy—developed by Chami and Cosimano—by introducing capital constraints à la Basel II. The results suggest that bank capital is likely to be less variable under the new capital adequacy regime than under the current one, which is characterized by invariant asset risk‐weights. However, bank lending is likely to be more responsive to macroeconomic shocks.
The International Debate on the Punishment of War Crimes During the Balkan Wars and the First World War
Authors: Segesser Daniel Marc
Published: August 2006

Although the issue of the punishment of war crimes had been discussed for a long time before the Balkan Wars and the First World War, it only rose to a place of prominence in the context of these wars. The present article sets out to analyze the international debate amongst jurists and other academics in the period of 1912 to 1918 looking at whether violations of the laws and customs of war merited prosecution at all, what kinds of crimes were considered war crimes, what courts should be used, and to what extent superior's orders was to be considered a valid defense. It argues that the concept of civilization played an important role when looking at the question: which war crimes were discussed and which war crimes were passed over in silence and why. The present article also shows that jurists integrated themselves into the mobilization effort of the belligerent countries and that many liberal jurists, especially on the side of the Allies, saw their participation as a continuation of their prewar intellectual efforts to replace might by right.
The Enjoyment of Rights and Freedoms: A New Conception of the ‘Ambit’ under Article 14 ECHR
Authors: Baker Aaron
Published: August 2006

Article 14 of the European Convention on Human Rights, as applied by the UK judiciary under the Human Rights Act 1998, is in danger of becoming as ‘parasitic’ as it is often described. Judges have inappropriately narrowed the scope of the ‘ambit’ of other Convention articles, and thus limited the number of claims to which Article 14 can apply, by defining it according to considerations more properly weighed in a justification analysis incorporating proportionality. The emerging approach departs from Strasbourg jurisprudence, and fails to give full effect to the language and intent of Article 14. This trend need not continue. This article begins the process of fashioning a new conception of the ambit of Convention articles: one that could change the fortunes of Article 14 cases in the UK, but that flows naturally from the precedents of the European Court of Human Rights, and gives effect to the spirit of the HRA.
The End of Domestic Violence
Authors: Reece Helen
Published: August 2006

In this article, I examine the rationales that have been given for extending domestic violence legislation to associated persons. I argue that the empirical and principled rationales are unfounded and that the ideological rationale is reactionary. With regard to the empirical rationale, the extent of violence that the aggregate of associated persons suffers is not high enough to justify privileging associated persons over other citizens with regard to protection from violence. In relation to the principled rationale, the impetus for domestic violence legislation was based on isolation and inequality, which are not experienced in particular by the category of associated persons when taken as a whole. With regard to the ideological rationale, it is worrying that intimacy and equality are emerging as the touchstones of a newer rationale for domestic violence legislation, which rightly has more to do with isolation and inequality than intimacy and equality.
Perceived involvement of network members in courtships: A test of the relational turbulence model
Authors: KNOBLOCH LEANNE K. , DONOVAN‐KICKEN ERIN
Published: August 2006

We seek to understand how the climate of courtship predicts people’s appraisals of the behavior of close friends and family members. To that end, we employ the relational turbulence model to examine the associations among intimacy, relational uncertainty, interference and facilitation from partners, and perceived network involvement. We conducted a cross‐sectional study in which 260 participants reported their perceptions of how much network members help and hinder their courtships. As we hypothesized, people perceived the least helpfulness and the most hindrance from network members at moderate levels of intimacy. Relationship uncertainty mediated the concave curvilinear association between intimacy and perceived helpfulness from network members, but interference from partners mediated the convex curvilinear association between intimacy and perceived hindrance from network members. We discuss how our findings (a) contribute to the literature on perceived network involvement, (b) illuminate nuances in perceived hindrance from network members, (c) extend the relational turbulence model, and (d) suggest the utility of educating people about how the climate of courtship may color their views of network members.
Stability and change of attachment representations during emerging adulthood: An examination of mediators and moderators of change
Authors: SCHARFE ELAINE , COLE VALERIE
Published: August 2006

Using Bartholomew’s model of attachment (K. Bartholomew, 1990; K. Bartholomew & L. Horowitz, 1991), we explored stability and change of attachment in a group of young adults graduating from university and examined reasons for change of attachment. Consistent with previous research, we found that attachment dimensions were moderately stable; however, several variables predicted change. We explored the effect of changing relationship status and parental divorce on attachment and found that individuals who remained single reported lower stability of avoidance over time. Next, we tested whether distress reported before the transition would mediate stability of attachment. The results provided some support for J. Bowlby’s (1969/1982) proposal that distress would be associated with stability and change of attachment. We found that participants who reported low distress at Time 1 (T1) were more likely to report changes in attachment anxiety than participants who reported high distress at T1.
Helicobacter pylori Eradication for the Prevention of Gastric Cancer
Authors: Kuipers Ernst J. , Sipponen Pentti
Published: August 2006

Even though Helicobacter pylori infection is an obvious cause of chronic non‐atrophic and atrophic gastritis, as well as gastric dysplasia and cancer, several recent controlled intervention trials for the prevention of gastric cancer by H. pylori eradication have yielded disappointing results. They showed that cancer eradication may still appear in relatively high frequency after successful treatment of H. pylori. One explanation for this observation is that H. pylori treatment has less influence in development of gastric cancer in atrophic gastritis than in development of cancers in non‐atrophic gastritis, and that eradication does not prevent the progression of precancerous lesions and small invisible early cancers to overt tumors. Noteworthy however, the available intervention trials show that gastric cancer can be prevented by H. pylori treatment in patients with non‐atrophic gastritis. Trials with higher number of patients, with longer follow‐up periods, and with more careful controlling of cancer type and underlying gastric mucosal conditions are needed.
Extragastric Manifestations of Helicobacter pylori Infection – Other Helicobacter Species
Authors: Solnick Jay V. , Franceschi Francesco , Roccarina D. , Gasbarrini Antonio
Published: August 2006

Recent studies have indicated a strong link between Helicobacter pylori and idiopathic thrombocytopenic purpura and iron deficiency anemia. Interesting results have also been obtained for ischemic heart disease, though most putative associations between H. pylori infection and extragastric disease remain speculative. With regard to other Helicobacter species, Helicobacter felis has been shown to play a role in gastric carcinogenesis in mouse models. An increased susceptibility to cholesterol gallstone formation has been described in animals fed a lithogenic diet and infected with Helicobacter bilis, or co‐infected with Helicobacter hepaticus and Helicobacter rodentium. Finally, enterohepatic Helicobacter species have also been exploited to better understand inflammatory bowel disease.
The Strange Budgetary Politics of Agricultural Research Earmarks
Authors: LAW MARC T. , TONON JOSEPH M.
Published: August 2006

This article explores how members of the House and Senate Subcommittees on Agricultural Appropriations use the appropriations process to earmark special grants for agricultural research projects without forming a majority logroll. It also shows how subcommittee members coerce the USDA into administering individual earmarked research grants even though the precise allocation of these grants does not have the force of law. This article makes an important contribution because it analyzes an institutional development within the appropriations process that has not been explored in the existing literature, and it examines the consequences that this development has had on the quality of USDA‐funded agricultural research.
Using Panel Data to Determine the Effect of the Americans with Disabilities Act on Per‐Student Public Education Expenditures at the State Level
Authors: GIUS MARK P.
Published: August 2006

The purpose of the present study is to determine whether passage of the American with Disabilities Act (ADA) in 1990 resulted in a statistically significant increase in per‐student public education expenditures at the state level. Although numerous studies have estimated educational cost functions, no prior study has examined the impact of the ADA on per capita education spending. The results of the present study are consistent with anecdotal evidence in that enactment of the ADA has had a positive effect on per‐student educational expenditures; this result suggests that legislative mandates may lead to increased government spending. In addition to the ADA, several of the leading determinants of per‐student education spending include population density, per capita income, percentage of the state that is over the age of 65, percentage of state's residents who have a four‐year college degree, percentage of state's residents who are homeowners, and total student population.
Parallel Screw Cylinder Implants: Comparative Analysis Between Immediate Loading and Two‐Stage Healing of 1005 Dental Implants with a 2‐Year Follow Up
Authors: Degidi Marco , Piattelli Adriano , Carinci Francesco
Published: August 2006

Background  Recently, several authors have focused on the possibility of an immediate functional loading of dental implants to minimize the delay between surgical and prosthetic phases.

Purpose  The aim of this study was a reevaluation of the XiVE® dental implant (Dentsply‐Friadent, Mannheim, Germany) with: (1) a longer follow‐up period; (2) a higher number of fixture; and (3) a proper statistical method.

Materials and Methods  In July 2001 and December 2002, 371 patients (180 males and 191 females; ages ranging from 17 to 83; mean age, 53 years) were consecutively enrolled in this study. In 371 patients, a total of 1005 XiVE dental implants were distributed as follows: 484 immediately loaded implants (test group) were inserted in 130 patients, whereas 521 unloaded implants were inserted in 241 patients (control group).

Results  The implant survival was 98.7 and 99.4% in immediate loading and control group, respectively. Univariate analysis showed no statistically significant difference between the two groups.

Conclusion  In a previous report, we showed that immediate loading offered a predictable and reliable procedure also for XiVE implants, at least in the short period. In this study, we confirmed the results of the previous study and added information regarding the survival rate and marginal bone level stability with a 2‐year follow up.
Syncrystallization: A Technique for Temporization of Immediately Loaded Implants with Metal‐Reinforced Acrylic Resin Restorations
Authors: Degidi Marco , Gehrke Peter , Spanel Andre , Piattelli Adriano
Published: August 2006

Background  Rigid temporization has been recognized to have a significant impact on the peri‐implant tissue response in immediate implant loading since it reduces the mechanical stress exerted on each implant.

Purpose  A successful protocol for immediate loading of multiple implants depends on an adequate fixation and immobility of the implants to prevent the risk of micromovements in relation to the surrounding bone. The objective of this article was to evaluate a prosthetic concept for an accelerated rigid splinting of multiple implants for same‐day immediate loading with metal‐reinforced provisional restorations using a technique of welding temporary implant abutments with a prefabricated titanium bar directly in the oral cavity (syncrystallization).

Materials and Methods  Between June 2004 and January 2005, immediate loading of threaded implants with a metal‐ reinforced acrylic resin provisional restoration at stage 1 surgery was evaluated in 40 consecutive patients. A total of 192 implants were placed in selected edentulous or partially edentulous patients using the syncrystallization technique. Once the titanium bar was welded intraorally to the abutments, opaque was applied and the provisional restoration was relined and screw‐retained the same day. In addition, a comparison of deformations and stress distributions in implant‐supported, metal‐reinforced and nonmetal‐reinforced resin provisional restorations was analyzed in the edentulous mandible by a three‐dimensional finite element model (FEM).

Results  All of the 192 rigidly temporized immediately loaded implants osseointegrated. An implant success rate of 100% was achieved over a period of 6 months postplacement. No fracture or luting cement failure of the provisional restoration occurred during the observation time. Compared to mere acrylic superstructures, a significant reduction of deformation and strain within metal‐reinforced provisional restorations was detected by FEM analysis.

Conclusion  The results of this study indicate that the syncrystallization technique allows an expedite and adequate rigid splinting of multiple immediately loaded implants. The advantages of the technique are: (1) reduction of treatment time for immediate temporization at stage 1 surgery; (2) predictable fixation and immobility of implants in the early stages of bone healing; and (3) less time for repairing provisional restorations as a result of no or rare fracture.
Geometric Reasoning on Molding Planning for Multishot Mold Design
Authors: Yin Zhou-Ping , Ding Han , Xiong You-Lun
Published: August 2006

This paper presents algorithms for automated design of multishot molds for manufacturing multimaterial or multicolor objects, and focuses on molding planning that determines a sequence of mold stages required to produce the desired object. By modeling a multimaterial object as an assembly of homogenous components, a geometric reasoning approach is proposed to generate feasible or practical mold stage sequences by combining the assembly planning approach and the two-plate mold design method. First, a graph-based assembly model, namely the attributed contact graph, is derived from the B-rep models of the constituent components of the gross object by detecting and representing all the contacts between mating components explicitly. Then, all feasible mold stage sequences, represented by an AND/OR graph, are generated by reasoning on geometric constraints due to the demoldability and connectedness requirements using an assembly-by-disassembly strategy. Depending on its demoldability, each component is to be made by one of the three basic molding strategies with varied mold stages and/or mold pieces. To narrow the choice, an optimal or practical molding plan is searched from the feasible molding plans according to some criteria such as the number of mold stages, the number of side cores, and flatness of the parting line. Finally, starting from the last mold stage, mold pieces for each mold stage of the selected molding plan are constructed recursively. The feasibility of the proposed algorithms is demonstrated through an implemented prototypical system, which has been tested successfully with various multi-material objects.
Computer-Aided Reconfiguration Planning: An Artificial Intelligence-Based Approach
Authors: Tang Li , Koren Yoram , Yip-Hoi Derek M. , Wang Wencai
Published: August 2006

The manufacturing industry today faces a highly volatile market in which manufacturing systems must be capable of responding rapidly to market changes while fully exploiting existing resources. Reconfigurable manufacturing systems (RMS) are designed for this purpose and are gradually being deployed by many mid-to-large volume manufacturers. The advent of RMS has given rise to a challenging problem, namely, how to economically and efficiently reconfigure a manufacturing system and the reconfigurable hardware within it so that the system can meet new requirements. This paper presents a solution to this problem that models the reconfigurability of a RMS as a network of potential activities and configurations to which a shortest path graph-searching strategy is applied. Two approaches using the A* algorithm and a genetic algorithm are employed to perform this search for the reconfiguration plan and reconfigured system that best satisfies the new performance goals. This search engine is implemented within an AI-based computer-aided reconfiguration planning (CARP) framework, which is designed to assist manufacturing engineers in making reconfiguration planning decisions. Two planning problems serve as examples to prove the effectiveness of the CARP framework.
Occupational noise exposure and ischaemic heart disease mortality
Authors: McNamee R , Burgess G , Dippnall W M , Cherry N
Published: August 2006

Aims:To investigate the hypothesis that long term exposure to excessive noise can increase the risk of ischaemic heart disease.

Methods:A case-control design, nested within a cohort of nuclear power workers employed at two sites in England over the period 1950–98, was used. Cases were men who died from ischaemic heart disease (ICD-9: 410–414) aged 75 or under; each was matched to a surviving control of the nearest age who joined the same site at the same time. Personal noise exposure was assessed retrospectively for each man by hygienists using (1) company work histories, (2) noise survey records from 1965–98, and (3) judgements about likely use of hearing protection devices. Men were classified into four groups according to their cumulative exposure to noise, with men whose exposure at the company never exceeded 85dB(A) for at least one year being considered “unexposed”. Risks were compared via odds ratios (ORs) using conditional logistic regression and adjusted for systolic and diastolic blood pressure, height, BMI, and smoking, as measured at recruitment to the company.

Results:Analysis was based on 1101 case-control pairs. There was little difference between the exposure groups at recruitment. There was no evidence of increased risk at site A: the ORs for ischaemic heart disease mortality among low, medium, and high exposure categories, compared to unexposed men, being 1.04, 1.00, and 0.77. The corresponding ORs (95% CIs) at site B were 1.15 (0.81–1.65) 1.45 (1.02–2.06), and 1.37 (0.96–1.96). When the comparison was confined to men with at least five years of employment, these dropped to 1.07 (0.64–1.77), 1.33 (0.88–2.01), and 1.21 (0.82–1.79) respectively.

Conclusions:The authors did not find statistically robust evidence of increased risk but the estimates at site B are consistent with those in a major cohort study. A strength of the present study is that the validity of noise estimation at site B has been demonstrated elsewhere.
Comparison of parental reports of smoking and residential air nicotine concentrations in children
Authors: Gehring U , Leaderer B P , Heinrich J , Oldenwening M , Giovannangelo M E C A , Nordling E , Merkel G , Hoek G , Bellander T , Brunekreef B
Published: August 2006

Background:Using questionnaires to assess children’s residential exposure to environmental tobacco smoke (ETS) may result in misclassification from recall and response bias. Questionnaire data have frequently been validated against urinary cotinine measurements, but rarely against actual measurements of residential air nicotine.

Objective:To compare questionnaire reported smoking with air nicotine concentrations in a large population of children and with urinary cotinine levels in a subpopulation; and to assess the potential impact of the symptom status of the children on the agreement between different measures of exposure.

Methods:The authors assessed residential exposure to ETS in 347 German, 335 Dutch, and 354 Swedish preschool and schoolchildren by questionnaire and air nicotine measurements, and in a subset of 307 German children by urinary cotinine measurements. They then compared the different measures of ETS exposure.

Results:In all countries, air nicotine concentrations increased with increasing questionnaire reported smoking in a dose-response fashion. Specificity and negative predictive values of questionnaire reports for nicotine concentrations were excellent. Sensitivity and positive predictive values were moderate to good. Excluding occasional smokers, the overall percentage of homes misclassified was 6.9%, 6.7%, and 5.1% in Germany, the Netherlands, and Sweden, respectively. Similar results were found for the agreement of urinary cotinine concentrations with questionnaire reports and air nicotine levels. There was no indication of underreporting by parents of symptomatic children.

Conclusion:Despite some misclassification, questionnaire reports are an inexpensive and valid estimate of residential ETS exposure among preschool and school children.
Rectal cancer and exposure to metalworking fluids in the automobile manufacturing industry
Authors: Malloy Elizabeth J , Miller Katie L , Eisen Ellen A
Published: August 2006

Background:Rectal cancer has been previously associated with exposure to metalworking fluids in a cohort mortality study of autoworkers.

Objective:To better specify the exposure–response relationship with straight metalworking fluids (mineral oils) by applying non-parametric regression methods that avoid linearity constraints and arbitrary exposure cut points and by lagging exposure to account for cancer latency, in a nested case–control analysis.

Methods:In addition to the classical Poisson regression with categorical exposure, survival models with penalised splines were used to estimate the exposure–response relationship between cumulative exposure to straight metalworking fluid and mortality from rectal cancer. Exposures to water-based metalworking fluids were treated as potential confounders, and all exposures were lagged by 5, 10, 15 and 20 years to account for cancer latency. The influence of the highest exposures was dealt with by a log transformation and outlier removal. The sensitivity of the penalised splines to alternative criteria for model selection and to the placement of knots was also examined.

Results:The hazard ratio for mortality from rectal cancer increased essentially linearly with cumulative exposure to straight metalworking fluid (with narrow confidence bands) up to a maximum of 2.2 at the 99th centile of exposure and then decreased (with wide confidence bands). Lagging exposure up to 15 years increased the initial steepness of the curve and raised the maximum hazard ratio to 3.2.

Conclusions:Non-parametric smoothing of lagged exposures has shown stronger evidence for a causal association between straight metalworking fluid and rectal cancer than was previously described using standard analytical methods. This analysis suggests an exposure–response trend that is close to linear and statistically significant over most of the exposure range and that increases further with lagged exposures. Smoothing should be regularly applied to environmental studies with quantitative exposure estimates to refine characterisation of the dose–response relationship.
Risk of tuberculin conversion among healthcare workers and the adoption of preventive measures
Authors: Baussano Iacopo , Bugiani Massimiliano , Carosso Aurelia , Mairano Dario , Pia Barocelli Anna , Tagna Marina , Cascio Vincenza , Piccioni Pavilio , Arossa Walter
Published: August 2006

Background:In industrialised countries, occupational tuberculosis among healthcare workers (HCWs) is re-emerging as an important public health issue. To prevent and control tuberculosis transmission, several institutions have issued and implemented recommendations and practice guidelines.

Objectives:To estimate the annual rate of tuberculosis infection (ARTI; per 100 person-years) among HCWs in Turin, the capital of the Piedmont region of Italy, to identify factors associated with variations in the ARTI and to evaluate the efficacy of the regional guidelines to prevent and control tuberculosis.

Methods:The study was conducted between 1997 and 2004 on a cohort of HCWs. The tuberculosis infection was diagnosed through tuberculin skin testing (TST) conversion and defined as an induration increase of at least 10 mm from a previous negative TST. The ARTI and the hazard ratio for each at-risk subgroup, categorised according to working activities and settings, was estimated using exponential survival models. The efficacy of the regional guidelines was estimated by stratifying the analysis according to the moment of the implementation of the guidelines (before/after).

Results:The 2182 study participants were drawn from the dynamic cohort. The overall adjusted ARTI was 1.6 (95% CI: 1.3 to 1.9)/100 person-years. Different workplaces (eg, administrative and infectious diseases inpatient services) and occupations (eg, clerical and medical workers) were associated with significantly different ARTIs, ranging between 0.62 and 2.62 and between 0.61 and 1.71, respectively, whereas the TST conversion risk differed by about 16–68% and 30–60%, respectively. The implementation of the guidelines coincided with overall ARTI reductions of 1.3/100 person-years, and concurrently the variations between ARTIs of different occupations and workplaces disappeared.

Conclusions:The occupational risk categories for targeting the surveillance and prevention of tuberculosis transmission among HCWs were identified, and the introduction of preventive measures was observed to be effective in decreasing the overall risk of tuberculosis infection among HCWs.