bluuebunny/crossref_metadata_2025 huggingface dataset:
Labor's Critical Role in Workplace Health and Safety in California and Beyond—As Labor Shifts Priorities, Where Will Health and Safety Sit?
Authors: Brown Marianne P.
Published: February 2007

Organized labor has been largely responsible for the health and safety protections many U.S. workers take for granted. This article provides a brief history of labor's influence on California's health and safety policies—sometimes with ripple effects beyond its borders. Six cases where various successful strategies were used are examined. These gains were achieved with strong support from international health and safety staff, and, on some issues, support from the state labor federation. But in most cases local union staff involvement was key. Now that labor mobilizes to build its shrinking membership—with only 1 out of 12 workers in the private sector organized—resources are being re-directed toward organizing. Understandably, health and safety advocates have expressed concern that worker protections may suffer. Time will tell, but there is evidence that health and safety demands are front and center in a number of current and upcoming organizing campaigns. Now more than ever, it is in health and safety professionals' interest to tie their research and clinical work into these emerging campaigns.
Four Year Cross-Sectional Comparison of Death Distress among Nursing College Students
Authors: Al-Sabwah Mohammed N. , Abdel-Khalek Ahmed M.
Published: February 2007

The aim of the present study was to determine the change in death distress (anxiety, depression, and obsession) among four cross-sectional samples during four years of academic study in two Arabic woman nursing colleges ( N = 570). The Templer's Death Anxiety Scale, the Arabic Scale of Death Anxiety, the Death Depression Scale-Revised, and the Death Obsession Scale were administered to students in small group sessions. It was found that the only significant difference was between freshmen and sophomores on death obsession. We tend to consider this single difference as negligible. In general, the differences between the four groups on the three scales of death anxiety and death depression were not significant. That is, no significant change in mean scores on these scales had happened over time, as a result of shifting from theoretical study courses to practical ones, including dealing with the terminally-ill patients. The main aspect to elucidate this finding was the insufficient number and hours of practicum courses in general and, in particular, the experience to deal with the critical patients was not sufficient.
Hitting Home: A Survey of Housing Conditions of Homes Used for Long-Term Care in Ontario
Authors: McKeever Patricia D. , Scott Helen M. , Chipman Mary L. , Osterlund Katherine , Eakin Joan M.
Published: February 2007

A telephone survey of a random sample of 811 long-term home care clients from three geographically distinct regions in Ontario was conducted to illuminate the living and working conditions in households receiving long-term care services. The median age of clients was 77 years and 75 percent were female. The majority had not completed high school. Almost half were widowed, had income levels of $20,000 (Canadian) or less, and lived alone. Approximately one-third needed help with most basic activities of daily living. The vast majority could not bathe or dress themselves. More than three-quarters needed help with preparing meals, housekeeping, and shopping. Few clients could perform yardwork and home repairs. Many clients' homes required major and minor repairs, were not suitable in size, were not affordable, and lacked important household amenities. More than 30 percent required modifications to enable clients to live and be cared for comfortably and safely, and half the clients had not completed these because of exorbitant costs. Overall, many clients were living in homes less than optimal for domestic life and long-term care provision. These results highlight significant gaps in care provision and a need to link housing to health and social service policies.
Dialogues in Diversity: An Invited Series of Papers, Advance Directives, DNRs, and End-of-Life Care for African Americans
Authors: Barrett Ronald Keith
Published: February 2007

The article utilizes a meta-analysis of the existing empirical research and theory on health care directives to provide some insights into the documented pattern of African Americans to use advance directives less than Whites. A number of relevant factors are highlighted and examined. In addition the article attempts to provide some insights into African American family life and traditional values regarding the care of the elderly and end-of-life care. The African American tradition of employing a family-centered decision making process during family crisis, as well as a significant cultural mistrust of institutionalized care is also explored. The article also attempts to offer some practical suggestions for clinical care givers working with African Americans to enhance culturally sensitive care giving and the utilization of advanced directives among African Americans at the end-of-life.
Basic Family Budgets: Working Families' Incomes Often Fail to Meet Living Expenses around the United States
Authors: Allegretto Sylvia A.
Published: February 2007

The ability of families to meet their most basic needs is an important measure of economic stability and well-being. While poverty thresholds are used to evaluate the extent of serious economic deprivation in our society, family budgets—that is, the income a family needs to secure safe and decent-yet-modest living standards in the community in which it resides—offer a broader measure of economic welfare. Basic family budgets take into account differences in both geographic location and family type. In total, this report presents basic budgets for more than 400 U.S. communities and six family types (either one or two parents with one, two, or three children). That the budgets differ by location is important, since certain costs, such as housing, vary significantly depending on where one resides. This geographic dimension of family budget measurements offers a comparative advantage over using poverty thresholds, which only use a national baseline in their measurements.
The Effects of Student Receptivity on College Achievement and Retention
Authors: Smith Joshua S.
Published: February 2007

When students enter college, they experience a series of equally exhilarating and challenging events. Those who experience more of the latter may in fact leave. For a variety of reasons—some personal, some academic—many students dropout or transfer from their first institution. Colleges are committed to providing a quality education for all students. Particularly for students who enter the institution “at-risk” of attrition, additional resources are available to assist in the transition from high school to college. This study examined the effects of student receptivity to services on the relationship between high school achievement and college achievement and retention. The results of a study with 991 students at a four-year public institution in the Northeast suggest that variation in student receptivity to services moderate the relationship between high school achievement and college retention after five semesters. For students identified as at-risk of attrition, higher levels of receptivity were associated with an increased likelihood of being retained.
An Investigation into the Efficacy of the Studio Model at the High School Level
Authors: Faro Salvatore , Swan Karen
Published: February 2007

The Studio Model was developed at Rensselaer Polytechnic Institute (RPI) to improve teaching and learning in introductory science classes. The study reported in this article explored the efficacy of the Studio Model at the high school level. The Studio Model combines collaborative learning with the use of online materials designed to support and augment in-class activities. The study explored the effects of the Studio Model on student learning of Earth Science concepts. In addition, the research investigated the potential attribution of such effects to either of the Studio Model's component parts (collaborative learning or online materials) by comparing student learning and attitudes across four treatment groups: a Studio Model group, a Cooperative Only group, an Online Materials Only group, and a Control group who received traditional science instruction. Findings demonstrate the superiority of the Studio Model, and the Studio Model alone, over traditional science instruction. They suggest the Studio Model may be an important new method for increasing learning in high school science, and that its positive effect may derive from the support it gives to collaboration within and beyond science classes.
Adolescent Sexuality and Reproductive Health in Taiwan
Authors: Sun Tom Te-Hsiung
Published: February 2007

This article presents a review of recent social survey findings on adolescent sexuality, fertility, and reproductive health in Taiwan. Increases in more liberal sexual attitudes and behavior as well as a high incidence of induced abortion from the 1980s to the 2000s are noted. The need for more education, both in and out of the school setting, is discussed, and recommendations made for a more adolescent-friendly approach.
How Do Primary Care Clinicians Manage Childhood Mood and Anxiety Syndromes?
Authors: Wren Frances J. , Scholle Sarah H. , Heo Jungeun , Comer Diane M.
Published: February 2007

Objective:

To describe how primary care clinicians manage children in whom they diagnose mood or anxiety syndromes.

Method:

This study is a secondary analysis of data from the multi-site Child Behavior Study (CBS)—a cross-sectional survey of primary care management of psychosocial problems. The management of children in whom clinicians identified mood or anxiety syndromes is described and compared with the management of children in whom they identified other psychosocial problems. Recruitment for the CBS occurred in 206 primary care practices in the United States, Puerto Rico, and Canada from October 1994 through June 1997. Participants were 20,861 consecutively sampled primary care attendees aged 4–15 years and 395 clinicians. Primary outcome measures for this report are rates of referral to specialized mental health care and rates of active primary care management (i.e., scheduling a follow-up appointment and/or providing ongoing counseling and/or psychotropic prescription).

Results:

Identification of a mood or anxiety syndrome was associated with increased rates of referral to mental health compared with rates for children with other psychosocial problems. There was no effect on the proportion of children counseled during the visit. In fact, unless accompanied by a co-morbid behavioral syndrome, children receiving the diagnosis of a mood or anxiety syndrome were less likely to be offered a scheduled follow-up appointment. Rates of prescription of antidepressants or anti-anxiety agents were higher for mood/anxiety groups but this was still uncommon (6.7%).

Conclusions:

Active management of childhood mood and anxiety syndromes in primary care was uncommon in the United States, Puerto Rico, and Canada in the mid-1990s.
It's Not What You Know: A Transactive Memory Analysis of Knowledge Networks at NASA
Authors: Garner Johny T.
Published: February 2007

Much of America was stunned into mourning on February 1, 2003 as the space shuttle Columbia was reported to have broken up over Texas. The ensuing investigation revealed that debris at liftoff was the cause of the crash, but the official report suggested that NASA's organizational communication was just as much to blame. This article uses transactive memory theory to argue that there were significant gaps in the knowledge network of NASA organizational members, and those gaps impeded information flow regarding potential disaster. E-mails to and from NASA employees were examined (the “To” and “From” fields) to map a network of communication related to Columbia's damage and risk. Although NASA personnel were connected with each other in this incident-based network, the right information did not get to the people who needed it. The article concludes with extensions of theory and practical implications for organizations, including NASA.
Instrumental Neutron Activation Analysis of Pottery from the George C. Davis (41Ce19) Site, Texas
Authors: Descantes Christophe , Speakman Robert J. , Glascock Michael D. , Creel Darrell , Wilson Samuel
Published: February 2007

The George C. Davis Site (41CE19) in central East Texas holds a prominent position in American archaeology. Fifty prehistoric ceramic specimens from early Caddoan contexts (A.D. 800–1200) were analyzed by instrumental neutron activation analysis (INAA) at the Missouri University of Missouri Research Reactor Center (MURR). The chemical compositions of the Davis ceramics were compared with previously identified Caddoan ceramic compositional groups. Early Caddoan ceramics from the Davis site likely originate from local alluvial clays in the Neches River Basin. Investigating issues of ceramic production, we conclude that clays from multiple sources and/or different ceramic recipes were used to make various Caddoan pottery types.
Women and Cabin Sites: Understanding the Iroquoian Economic System
Authors: Bursey Jeffrey A.
Published: February 2007

One positive result of CRM excavations in the northeast over the last 20 years has been the increased attention devoted to smaller sites. Among those recognized because of this new focus are Late Woodland or Iroquoian cabin sites. In this article, one type of cabin site, referred to as field cabins, is examined in the context of the evolution of the intensification of Iroquoian horticulture. It is argued that field cabins represent an attempt by Iroquoian women to maintain control over crops grown in the fields and to use this control to strengthen their overall status in Iroquoian society. I argue that the interpretation offered here is consistent with what we know about Iroquoian society and culture as it has been documented in the 17th century and beyond. It is also argued that the ideas presented here allow for the generation of additional hypotheses regarding the evolution of Iroquoian culture that may be testable using a variety of lines of evidence and logic.
Pre-Enrollment and Post-Enrollment Predictors of the Academic Success of Developmental Education Students
Authors: Moore Randy
Published: February 2007

I studied how the grade point averages (GPA, a post-enrollment descriptor) of first-year developmental education students relate to two pre-enrollment descriptors: students' Academic Aptitude Ratings (AAR, a pre-enrollment criterion) and students' voluntary or forced attendance at a mandatory summer-orientation program. Students who involuntarily participated in the orientation had an average AAR score of 94, an average GPA of 2.1, and a 32% chance of being placed on academic probation (i.e, having a GPA less than 2.0) after their first semester of college. However, students who voluntarily attended the orientation had an average AAR of 91, a GPA of 2.9, and an 11% chance of being placed on academic probation after their first semester of college. These results: 1) suggest that developmental education students' voluntary compliance with a pre-enrollment admission requirement (in this case, their voluntary attendance at a summer orientation program) is a strong predictor of subsequent academic success; and 2) AAR scores are poor predictors of the academic success of developmental education students. These results are discussed relative to how developmental education students' motivation toward and involvement in their education contribute to their academic success.
Preparation and characterization of macroporous poly(2‐hydroxyethyl methacrylate)‐based biomaterials: Water sorption property and in vitro blood compatibility
Authors: Bajpai A. K. , Kankane Sanjana
Published: February 2007

A semi‐interpenetrating polymer network (IPN) comprising gelatin and poly(2‐hydroxyethyl methacrylate‐co‐acrylamide) was prepared and characterized by FTIR, environmental scanning electron microscopy (ESEM) and differential scanning calorimetry (DSC) techniques. The water sorption potential of the prepared semi‐IPNs was investigated for varying chemical architecture of the IPN, and experimental conditions such as pH, temperature and ionic strength of the swelling media. The semi‐IPNs were also judged for in vitro blood compatibility by performing blood clot, percent hemolysis, protein adsorption and platelet adhesion tests. © 2007 Wiley Periodicals, Inc. J Appl Polym Sci 104: 1559–1571, 2007
The effect of allylation degree on processing properties, thermal cure, and thermal properties of BMAN resins
Authors: Luo Zhenhua , Wei Liuhe , Liu Feng , Zhao Tong
Published: February 2007

A series of allyl‐functional novolac (AN) resins with various allylation degree, from 32.4 to 114.6%, were synthesized and blended reactively with 4,4′‐bismaleimide biphenyl methane (BMI) at a weight ratio of 2.50 : 1 to get BMI‐modified and allyl‐functional novolac (BMAN) resins. Structural characteristics of the resins were determined by Fourier transform infrared spectroscopy (FTIR) and proton nuclear magnetic resonance (1HNMR) techniques. Processing properties of BMAN resin system was evaluated by solubility, rheology, and thermal gelation, and the results show that processing properties of BMAN resins were excellent and could be tailored by changing allylation degree of AN resins. Differential scanning calorimetry (DSC) was used to evaluate cure reactivity of BMAN resin system, and the results reveal that the resins with higher allylation degree possessed better cure reactivity. Thermal properties were evaluated by means of dynamic mechanical analysis (DMA) and thermogravimetry analysis (TGA) techniques. The results reveal that with increase in allylation degree of resins the thermal stability of BMAN resins increased because of increase in crosslinking density, but char‐yields of the above resins at 800°C decreased in turn. Understanding of the relationship between allylation degree and properties of the resins would be useful to direct the design of material to meet different requirements of applications. © 2007 Wiley Periodicals, Inc. J Appl Polym Sci 2007
Effect of molecular weight on spherulitic growth rate of poly(ϵ‐caprolactone) and poly(ϵ‐caprolactone)‐b‐poly(ethylene glycol)
Authors: Du Zi‐Xiu , Yang Yong , Xu Jun‐Ting , Fan Zhi‐Qiang
Published: February 2007

The spherulitic growth rates of a series poly (ϵ‐caprolactone) homopolymers and poly(ϵ‐caprolactone)‐b‐ poly(ethylene glycol) (PCL‐b‐PEG) block copolymers with different molecular weights but narrow polydispersity were studied. The results show that for both PCL homopolymers and PCL‐b‐PEG block copolymers, the spherulitic growth rate first increases with molecular weight and reaches a maximum, then decreases as molecular weight increases. Crystallization temperature has greater influence on the spherulitic growth rate of polymers with higher molecular weight. Hoffman–Lauritzen theory was used to analyze spherulitic growth kinetics and the free energy of the folding surface (σe) was derived. It is found that the values of σe decrease with molecular weight at low molecular weight level and become constant for high molecular weight polymers. The chemically linked PEG block does not change the values of σe significantly. © 2007 Wiley Periodicals, Inc. J Appl Polym Sci 2007
Microstructure‐property relationships in a tissue‐engineering scaffold
Authors: Johnson Jed , Ghosh Anirban , Lannutti John
Published: February 2007

Electrospinning can produce tissue‐engineering scaffolds possessing appropriate strength, biomimetic structure, economic appeal, and biocompatibility. To investigate how microstructural changes could potentially affect adherent mammalian cells, tensile samples were strained to 10, 40, and 80% extension, and adhered to double‐sided carbon tape to maintain specific states of strain. While establishing the stress–strain response, we invoked polymer sintering to help verify that the “point bonding” concept is more significant than previously realized at both the macroscopic and microscopic length scales. Sintering successfully established the effects of deliberate, extensive point bonding/localized “notch” generation on mechanical properties and microstructural response without requiring chemical changes within the structure. We also found that fibers experience significant hysteresis in terms of their orientation following exposure to high values of strain. Aligned fibers provide higher strengths (σave = 2.8 ± 0.3 MPa vs. σave = 1.29 ± 0.04 MPa for unaligned fibers) but considerably lower elongation [εave = (30 ± 2)% vs. εave = (102 ± 6)%]. Conversely, when strain occurs perpendicular to the aligned fiber direction total strain increases [εave = (188 ± 6)%] while strength decreases (σave = 0.38 ± 0.01 MPa). Elastic response to low strains appears to estimate ultimate tensile strength. In many ways, electrospun fibers behave similarly to classic interpretations of polymer chains in that when strained in both cases elements can rearrange and translate to align along the direction of loading. © 2007 Wiley Periodicals, Inc. J Appl Polym Sci 2007
Coral community decline at a remote Caribbean island: marine no‐take reserves are not enough
Authors: Coelho Vânia R. , Manfrino Carrie
Published: February 2007

Coral reefs around the world have been deteriorating over decades owing to anthropogenic pressure. In the Caribbean recent rates of decline are alarming, particularly for coral reefs under high local human impact, many of which are severely degraded, although regions with lower direct anthropogenic influence seem less affected.

Little Cayman is a relatively undeveloped island, with less than 150 permanent residents. About 20% of its reefs have been protected by no‐take marine reserves since the mid‐1980s. We analysed the dynamics of coral communities around the island from 1999 to 2004 in order to test the hypothesis that a lack of major local anthropogenic disturbances is enough to prevent decline of coral populations.

Live hard coral coverage, coral diversity, abundance, mortality, size, and prevalence of disease and bleaching were measured using the Atlantic and Gulf Rapid Reef Assessment methodology (line transects) at nine sites. Despite the apparent undisturbed condition of the island, a 40% relative reduction of mean live coral coverage (from 26% to 16%, absolute change was 10%) was recorded in five years. Mean mortality varied from year to year from 23% to 27%. Overall mean diameter and height have decreased between 6% and 15% on average (from 47 to 40 cm for diameter, and from 31 to 29 cm for height).

The relative abundance of large reef builders of the genus Montastraea decreased, while that of smaller corals of the genera Agaricia and Porites increased. Disease prevalence has increased over time, and at least one relatively large bleaching event (affecting 10% of the corals) took place in 2003.

Mean live coral cover decline was similar inside (from 29% to 19%) and outside (from 24% to 14%) marine no‐take reserves. No significant difference in disease prevalence or clear pattern in bleaching frequency was observed between protected and non‐protected areas. It is concluded that more comprehensive management strategies are needed in order to effectively protect coral communities from degradation.

Copyright © 2007 John Wiley & Sons, Ltd.
Visualization of three‐dimensional nephron structure with microcomputed tomography
Authors: Bentley Michael D. , Jorgensen Steven M. , Lerman Lilach O. , Ritman Erik L. , Romero J. Carlos
Published: February 2007

The three‐dimensional architecture of nephrons in situ and their interrelationship with other nephrons are difficult to visualize by microscopic methods. The present study uses microcomputed X‐ray tomography (micro‐CT) to visualize intact nephrons in situ. Rat kidneys were perfusion‐fixed with buffered formalin and their vasculature was subsequently perfused with radiopaque silicone. Cortical tissue was stained en bloc with osmium tetroxide, embedded in plastic, scanned, and reconstructed at voxel resolutions of 6, 2, and 1 μm. At 6 μm resolution, large blood vessels and glomeruli could be visualized but nephrons and their lumens were small and difficult to visualize. Optimal images were obtained using a synchrotron radiation source at 2 μm resolution where nephron components could be identified, correlated with histological sections, and traced. Proximal tubules had large diameters and opaque walls, whereas distal tubules, connecting tubules, and collecting ducts had smaller diameters and less opaque walls. Blood vessels could be distinguished from nephrons by the luminal presence of radiopaque silicone. Proximal tubules were three times longer than distal tubules. Proximal and distal tubules were tightly coiled in the outer cortex but were loosely coiled in the middle and inner cortex. The connecting tubules had the narrowest diameters of the tubules and converged to form arcades that paralleled the radial vessels as they extended to the outer cortex. These results illustrate a potential use of micro‐CT to obtain three‐dimensional information about nephron architecture and nephron interrelationships, which could be useful in evaluating experimental tubular hypertrophy, atrophy, and necrosis. Anat Rec, 2007. © 2007 Wiley‐Liss, Inc.
Endothelial dysfunction in psoriatic arthritis patients without clinically evident cardiovascular disease or classic atherosclerosis risk factors
Authors: Gonzalez‐Juanatey Carlos , Llorca Javier , Miranda‐Filloy Jose A. , Amigo‐Diaz Encarnacion , Testa Ana , Garcia‐Porrua Carlos , Martin Javier , Gonzalez‐Gay Miguel A.
Published: February 2007

Objective

To determine whether endothelial dysfunction was present in a cohort of patients with psoriatic arthritis (PsA) without overt cardiovascular disease or classic cardiovascular risk factors attended to in a community hospital.

Methods

Fifty patients with PsA who fulfilled the Moll and Wright criteria were recruited from Hospital Xeral‐Calde (Lugo, Spain). Patients seen during the period of recruitment who had classic cardiovascular risk factors or had experienced cardiovascular or cerebrovascular events were excluded. Fifty healthy matched controls were also studied. In all patients and controls, endothelial function was determined by measuring flow‐mediated endothelial dependent vasodilatation (FMD%) and endothelial independent vasodilatation (GTN%) by brachial ultrasonography.

Results

FMD% was significantly impaired in patients compared with controls (mean, median [range] 6.3%, 6.1% [0.3–13.4%] versus 8.2%, 8.2% [0.0–21.2%]; P = 0.008). However, no significant difference existed between patients and controls in GTN% or baseline diameter. A significant correlation between C‐reactive protein level and erythrocyte sedimentation rate at the time of disease diagnosis and FMD% was found (P < 0.04). No significant FMD% and GTN% differences were observed when patients with PsA with polyarticular pattern were compared with the remaining patients with PsA.

Conclusion

The present study demonstrates that patients with PsA without cardiovascular risk factors or clinically evident cardiovascular disease also exhibit endothelial dysfunction. These observations provide a basis for the potential association between PsA and atherosclerotic disease.
Pulmonary involvement in systemic sclerosis: Associations with genetic, serologic, sociodemographic, and behavioral factors
Authors: Mcnearney Terry A. , Reveille John D. , Fischbach Michael , Friedman Alan W. , Lisse Jeffrey R. , Goel Niti , Tan Filemon K. , Zhou Xiaodong , Ahn Chul , Feghali‐Bostwick Carol A. , Fritzler Marvin , Arnett Frank C. , Mayes Maureen D.
Published: February 2007

Objective

To determine the relative contributions of genetic, clinical, serologic, sociodemographic, and behavioral/psychological variables to early pulmonary involvement in the Genetics versus Environment in Scleroderma Outcome Study cohort.

Methods

At the baseline visit (V0), 203 patients with systemic sclerosis (SSc) were examined (104 whites, 39 African Americans, and 60 Hispanics). We obtained sociodemographic, behavioral/psychological (illness behavior, social support, learned helplessness, smoking, drinking), clinical, serologic (autoantibodies), and genetic (HLA class II and FBN1 genotypes) factors; pulmonary function test results; electrocardiograms; and chest radiographs. Data analysis included Fisher's exact test, chi‐square test, Student's t‐test, analysis of variance, and stepwise linear and logistic regression methods.

Results

Significant pulmonary involvement was seen in 25% of patients within 2.8 years of SSc diagnosis. At V0, pulmonary fibrosis was significantly higher in African Americans compared with whites or Hispanics. African Americans had significantly lower percent predicted forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) compared with whites and significantly lower percent predicted diffusing capacity for carbon monoxide (DLCO) compared with whites and Hispanics. Significant, independent associations impacting early pulmonary involvement included African American ethnicity, skin score, serum creatinine and creatine phosphokinase values, hypothyroidism, and cardiac involvement. Anticentromere antibody seropositivity was a significant, independent, protective factor for restrictive lung disease and FVC or DLCO values. African Americans had significantly increased frequencies of anti–topoisomerase I, fibrillarin, and RNP autoantibodies compared with whites. African Americans scored significantly lower on the Interpersonal Support Evaluation List and significantly higher on the Illness Behavior Questionnaire.

Conclusion

Early pulmonary involvement in SSc appears to be influenced by several factors delineated by ethnicity, including racial, socioeconomic, behavioral, and serologic determinants.
Bacteriophages in dairy products: Pros and cons
Authors: Mc Grath Stephen , Fitzgerald Gerald F. , van Sinderen Douwe
Published: February 2007

Since the time bacteriophages were first identified as a major cause of fermentation failure in the dairy industry, researchers have been struggling to develop strategies to exclude them from the dairy environment. Over 70 years of research has led to huge improvements in the consistency and quality of fermented dairy products, while also facilitating an appreciation of the beneficial properties of bacteriophages with respect to dairy product development. With specific reference to Lactococcus lactis and cheese production, this review outlines some recently reported novel methods aimed at limiting the bacteriophage infection as well as highlighting some beneficial aspects of bacteriophage activity.
Primary carcinoma of the liver: With report of case successfully treated by partial hepatectomy
Authors: Abel A Lawrence
Published: February 2007

Carcinoma occurs only very rarely as a primary disease of the liver, in marked contrast to secondary growths, which are extremely common in this organ. Up to sixty years ago observers belived the reverse to be the case, and, in spite of Virchow's warning in regard to the importance of searching for a primary focus with meticulous care, many cases were reported which were later discredited.
A chloride-secreting papilloma in the gall-bladder a tumour of heterotopic intestinal epithelium containing paneth cells and enterochromaffine cells and associated with massive chloride loss: With a critical review of papilloma of the gall-bladder
Authors: Kerr Archibald B , Lendrum Alan C
Published: February 2007

The case to be described is one of cholecystostomy for presumed mucocele in which, during a drainage period of thirty-four days, there was an excessive out-pouring of chloride and water; the source of this fluid was revealed only on subsequent cholecystectomy, when there was found in the gall-bladder a papilloma composed of intestinal epithelium. It is presented in detail on account of the difficulties in diagnosis, the peculiar biochemical behaviour, and the unique underlying pathology.
Encrustation of the bladder as a result of alkaline cystitis
Authors: Letcher H G , Matheson N M
Published: February 2007

Although calcareous deposits of a somewhat localized extent are not infrequently observed in the more chronic types of urinary disease, generalized encrustation of the bladder wall is far from common. The following case, occurring in a young patient, illustrates several characteristic features of the advanced condition.
Results after restorative proctocolectomy and ileal pouch-anal anastomosis in patients with familial adenomatous polyposis and coexisting colorectal cancer
Authors: Ziv Y , Church J M , Oakley J R , McGannon E , Schroeder T K , Fazio V F
Published: February 2007

Although the operation of choice for patients with familial adenomatous polyposis (FAP) is restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA), its place in the management of patients with FAP and cancer has not been defined. The authors have reviewed their experience with these patients to determine the safety of IPAA and its efficacy as a cancer operation. The records of 55 patients with FAP who had undergone IPAA were examined. Follow-up studies included an annual questionnaire and physical examination. Eight patients had FAP with coexisting colorectal cancer. Median age at diagnosis was 25 (range 13–46) years, and at operation 33 (range 22–36) years. Of the eight patients (four men), four had colonic cancer and four had rectal cancer. Synchronous colorectal carcinoma was found in two patients. Staging according to the tumour node metastasis classification showed that five patients had stage 1 tumour, two had stage 2 and one had stage 3. Tumours were well, moderately or poorly differentiated in one, five and two patients respectively. During a median follow-up of 56 (range 14–98) months, metastasis developed in the liver of one patient 66months after surgery. Two patients suffered complications: one had small bowel obstruction and the other mucosal prolapse. Tubular adenomas were found in the pouch of two patients and in the anal transitional zone of one. Pouch function is good to excellent in all surviving patients. Restorative proctocolectomy for patients with FAP and coexisting colorectal cancer can be undertaken with a favourable prognosis and function. It is compatible with curative intent.
Problems in diagnosis and management of goitre in childhood and adolescence
Authors: Webb A J , Brewster S , Newington D
Published: February 2007

This study is a retrospective review of 17 patients aged 16 and under with a total of 18 goitres, who were investigated and treated at Bristol Children's Hospital and Bristol Royal Infirmary between 1967 and 1994. There were five neoplasms, comprising follicular adenoma (three) and papillary carcinoma (two). Other benign causes of goitre included nodular goitre (four), non-toxic hyperplasia (three) and chronic lymphocytic thyroiditis (three). The authors suggest some guidelines to help in the diagnosis and management of goitre in young patients, as a consequence of significant difficulties encountered in 12 of the 17 patients in this series.
Reduced collagen accumulation after major surgery
Authors: Jorgensen L N , Kallehave F , Karlsmark T , Gottrups F
Published: February 2007

The preoperative and postoperative wound-healing capacity of 23 patients undergoing elective major abdominal, thoracic or urological surgery was tested objectively by the subcutaneous accumulation of hydroxyproline and proline in an expanded polytetrafluoroethylene (ePTFE) tube. Before scheduled surgery two ePTFE tubes were implanted for removal after 5 and 10days. This was repeated for each patient immediately after surgery. After 10 days a higher amount of hydroxyproline was measured before than after operation median 2·91 (range 0·37–14·45) versus 1·45 (range 0·26–6·94) pglcm, P = 0·01. This decline was significantly higher in the six patients who had a postoperative infection (median 3·02 (range −0·06 to 6·14) versus 0·36 (range −1·56 to 12·60) μg/cm, P = 0·02). This study shows that major surgery is associated with impairment of subcutaneous collagen accumulation in a test wound, suggesting diminished systemic woundhealing capacity in such patients.
D2 gastrectomy: Lessons from a prospective audit of the learning curve
Authors: Parikh D , Johnson M , Chagla L , Lowe D , McCulloch P
Published: February 2007

A 3-year prospective study of the learning curve for D2 gastrectomy was carried out by one surgeon beginning to perform the operation independently after intensive specialist training. Some 38 patients were treated; there were four postoperative deaths and 22 patients had complications. Postoperative morbidity decreased significantly with time (rs= -0·38, P = 0·02, 95 per cent confidence interval - 0·62 to - 0·07). The physiological component of POSSUM (Physiological and Operative Severity Score for the enumeration of Mortality and morbidity) was significantly lower in the third year (median value 15, 16 and 14 for years 1, 2 and 3, n = 31, χ2 = 7·5, 2 d.f., P = 0·02, Kruskal-Wallis test), but the operative POSSUM scores and the number of lymph nodes found were not decreased (median operative POSSUM score 19, 18 and 21, n = 31, χ2 = 0·2, 2 d.f., P = 0·91, Kruskal-Wallis test). The results suggest a learning curve lasting about 18–24 months or 15 to 25 procedures before a plateau is reached. Improved results were associated with changes in case selection and operative tactics but not with reduced extent of lymphadenectomy. D2 gastrectomy should be restricted to specialist centres where adequate training and supervision can be provided during the learning curve.
Prospective randomized study of a new method of providing postoperative pain relief following femoropopliteal bypass
Authors: Griffith J P , Whiteley S , Gough M J
Published: February 2007

The extensive incision required for femoropopliteal bypass using saphenous vein causes significant postoperative pain, principally within the distribution of the cutaneous branches of the femoral nerve. This prospective randomized study investigated the efficacy of continuous postoperative femoral nerve block in reducing both pain (visual analogue pain score) and the requirement for opiate analgesia. Ten patients received a femoral nerve block by infusion of 0.5 per cent bupivacaine (5 ml/h for 48 h) via an epidural catheter together with a patient-controlled analgesia (PCA) device containing morphine; a further ten patients used a PCA device alone. The median postoperative intravenous morphine requirement was significantly reduced in patients with a nerve block at 24 h (4 versus 33 mg, P< 0.01) and at 48 h (5 versus 37 mg, P< 0.01) compared with controls. Postoperative pain was effectively abolished in the former group. The addition of a nerve block to PCA provides superior pain control after femoropopliteal bypass.
Prospective randomized study of sulindac versus calcium and calciferol for upper gastrointestinal polyps in familial adenomatous polyposis
Authors: Seow-Choen F , Vijayan V , Keng V
Published: February 2007

Eighteen patients with familial adenomatous polyposis (FAP) who had previously undergone colectomy but had upper gastrointestinal polyps were studied in a double-blind randomized crossover trial comparing sulindac with calcium and calciferol. Sulindac produced a reduction in the crypt proliferation index in the gastric epithelium of patients but did not significantly affect duodenal mucosa. Calcium with calciferol did not have any effects on crypt proliferation index in patients with FAP.
Abnormal suntanning following transthoracic endoscopic sympathectomy
Authors: Whiteley M S , Ray-Chaudhuri S B , Galland R B
Published: February 2007

Transthoracic endoscopic sympathectomy (TES) has become the method of choice for treating patients with palmar hypcrhidrosis. There are few complications reported with this procedure. A complication not described previously is reported here.
Cost–effectiveness analysis of local, regional and general anaesthesia for inguinal hernia repair using data from a randomized clinical trial
Authors: Nordin P , Zetterström H , Carlsson P , Nilsson E
Published: February 2007

Background

Inguinal hernia repair is a common operation in general surgery and can be performed under local, regional or general anaesthesia. This multicentre randomized trial was undertaken to compare the costs of the three anaesthetic methods in general surgical practice.

Methods

Between January 1999 and December 2001, 616 patients at ten hospitals who underwent primary inguinal hernia repair were randomized to local, regional or general anaesthesia. The primary endpoints were direct costs. Secondary endpoints were indirect costs and recurrence rates.

Results

Total intraoperative, as well as total early postoperative, data showed local anaesthesia to have significant cost advantages over regional and general anaesthesia (P < 0·001). The advantage was also significant for total hospital and total healthcare costs (P < 0·001), whereas there was no significant difference between regional and general anaesthesia.

Conclusion

The use of local anaesthesia for inguinal hernia repair was significantly less expensive than regional or general anaesthesia.
Systemic Heparinization During Percutaneous Coronary Angiography: Evaluation of Effectiveness in Decreasing Thrombotic and Embolic Catheter Complications
Authors: Luepker Russell V. , Bouchard Richard J. , Burns Roberta , Warbasse J. Richard
Published: February 2007

Systemic heparinization has been advocated as preventive for thrombotic and embolic complications of arterial catheterization. To test this hypothesis, 95 patients undergoing coronary angiography via the percutaneous femoral arterial approach were randomized into heparinized and nonheparinized groups.

Evaluation for thrombotic and embolic complications by clinical means and noninvasive electrical impedance flow measurements in the lower limbs was performed precatheterization, postcatheterization, and at 4 and 24 hr. Clinical data reveal loss of distal leg pulses in 11% (5/47) of the nonheparinized group, with two of these individuals developing signs of claudication and requiring embolectomy. No individuals (0/48) in the heparinized group lost distal leg pulses. Immediate, 4‐hr, and 24‐hr postcatheterization bloodflow was 12%, 10%, and 12% lower, respectively, in the catheterized limb of those in the nonheparinized group. At 24 hr 52% of the nonheparinized group had bloodflow levels lower than the precatheterization levels in the right (catheterized) extremity, while 2% (2/48) of the heparinized group had a similar reduction.

One possible complication of excess bleeding was noted with heparin.

It is concluded that systemic heparinization is safe and can be an important adjunct in the reduction of thromboembolic complications of percutaneous coronary angiography.
Premature Coronary Artery Disease in Identical Male Twins Studied by Selective Coronary Arteriography
Authors: Kreulen Thomas H. , Cohn Peter F. , Gorlin Richard
Published: February 2007

Identical twin brothers with premature coronary artery disease are described. Repeat selective cine‐coronary arteriograms were performed in this unique twin model and demonstrated a close similarity in location and extent of atherosclerotic lesions.
Quantification of Ventricular Performance: A Computer‐Based System for the Analysis of Angiographic Data
Authors: Brower R. W. , Meester G. T. , Hugenholtz P. G.
Published: February 2007

A computer‐based quantitative angiography system for the acquisition and analysis of ventriculographic data has been developed. In addition to the apparatus normally required for angiography and left ventricular pressure recording, a digitizing tablet, PDP 11/20 mini computer, and TV monitor with a hard‐copy device is employed. Four modes of operation are currently in use: data acquisition, analysis, mini cine, and data tape editor. Data acquisition facilitates forming a magnetic tape record of the digitized pressure, timing, and event identification, together with anywhere from 4 to 100 digitized LV contours. A number of error checks and feedbacks are incorporated to provide some measure of quality control. In the event an error is written onto the magnetic tape record, the data tape editor can be used to review the record and correct most errors. Analysis of the generated data tape consists of several options which include: pump function, muscle function, pressure derived Indices of contractility and systolic time intervals, and contour pattern recognition which is still under development. If the complete analysis option is chosen, a summary of the analysis, referred to as the quick‐sight list, is also presented. The so called mini cine option employs a separate and independent acquisition‐analysis program. This requires only the end‐diastolic (with a segment of wall) and end‐systolic contours (without pressure data) to extract the most essential parameters (EDV, EF, CI, HR, and wall mass). As a result of the relative straightforward processing and inherent simplicity, the mini cine option is most frequently used.

This system has done much to reduce the time required for analysis of angiographic data, while at the same time maintaining and even improving the quality of the results. Other less tangible benefits include: the possibility to build a readily accessible library of patient data files facilitating a posteriori studies, precise and uniform definition of the rules to input and analyze data, and finally providing a useful step towards fully automatic ventriculographic processing.
A Clinically Useful Coding System for Normal Coronary Artery Anatomy
Authors: Vieweg W. V. R. , Smith D. C. , Hagan A. D.
Published: February 2007

Cine coronary arteriograms of 121 patients with normal coronary arteriograms with and without associated valvular or myocardial disease were reviewed to describe normal coronary artery anatomy and the distribution of potentially graftable vessels. Coronary arterio grams were divided into right, mixed, and left interior emphasis systems, depending upon the blood supply to the inferior surface of the left ventricle. Whether a coronary artery at its origin was less than 50%, between 50–70%, or greater than 70% of the left anterior descending coronary artery (LAD) at its origin was described in a simple lettering and numbering code to allow easy comparison. The diameter of the LAD at its origin averaged 4.2 mm. All vessels greater than 70% of the LAD were clearly graftable. The frequency (in percent) with which that vessel was greater than 70% of the LAD in right, mixed, and left systems, respectively, was as follows:
equation image

This simple method of classification is recommended to provide more accurate comparison in published series and to assist the coronary arteriographer in his interpretations.