bluuebunny/crossref_metadata_2025 huggingface dataset:
Autologous bone marrow transplantation as consolidation therapy in the treatment of adult patients under 60 years with acute myeloid leukaemia in first complete remission: a prospective randomized Dutch–Belgian Haemato‐Oncology Co‐operative Group (HOVON) and Swiss Group for Clinical Cancer Research (SAKK) trial
Authors: Breems Dimitri A. , Boogaerts Marc A. , Dekker Adriaan W. , Van Putten Wim L. J. , Sonneveld Pieter , Huijgens Peter C. , Van der Lelie Johannes , Vellenga Edo , Gratwohl Alois , Verhoef Gregor E. G. , Verdonck Leo F. , Löwenberg Bob
Published: December 2004

The question as to whether autologous stem cell transplantation (SCT) after consolidation chemotherapy improves the probability of survival of patients with acute myeloid leukaemia (AML) in first remission has not been settled. Here, we present the results of a phase III study conducted in newly diagnosed adult AML patients aged <60 years. Patients who had reached a complete remission (CR) after two courses of induction chemotherapy and who were not eligible for a human leucocyte antigen‐matched sibling SCT (n = 130), were randomized after a third consolidation cycle of chemotherapy between high‐dose cytotoxic treatment and autologous bone marrow transplantation or no further treatment. No significant differences in disease‐free survival and overall survival were observed between the two treatment arms. A slightly better overall survival in the no further treatment arm was because of fewer deaths in the first CR and a significantly better overall survival after the first relapse. The results are discussed in relation to the generic problems of applying autologous transplantation and in the perspective of the limited statistical power of this and other previously published studies.
Fabry disease: overall effects of agalsidase alfa treatment
Authors: Beck M. , Ricci R. , Widmer U. , Dehout F. , De Lorenzo A. García , Kampmann C. , Linhart A. , Sunder‐Plassmann G. , Houge G. , Ramaswami U. , Gal A. , Mehta A.
Published: December 2004

Background  Fabry disease is a rare X‐linked disorder caused by deficient activity of the lysosomal enzyme α‐galactosidase A. Progressive accumulation of the substrate globotriaosylceramide in cells throughout the body leads to major organ failure and premature death. The Fabry Outcome Survey (FOS) is a European outcomes database which was established to collect data on the natural history of this little‐known disease and to monitor the long‐term efficacy and safety of enzyme replacement therapy (ERT) with agalsidase alfa. This paper presents the first analysis of the FOS database on the effects of ERT on renal function, heart size, pain and quality of life.

Design  The effects of 1 and 2 years of ERT with agalsidase alfa on renal function (assessed by estimated glomerular filtration rate), heart size (assessed by echocardiography), pain (assessed by the Brief Pain Inventory) and quality of life (assessed by the European Quality of Life Questionnaire EQ‐5D) were analyzed in a cohort of 545 patients, 314 of whom were receiving treatment (188 for at least 12 months and 92 for at least 24 months; mean duration of treatment, 17 months; maximum duration, 56 months).

Results  Treatment with agalsidase alfa stabilized renal function in patients with a mild or moderate deterioration in renal function at baseline, reduced left ventricular size in patients who had an enlarged heart at baseline, and improved pain scores and quality of life. These improvements were similar in hemizygous men and heterozygous women with Fabry disease.

Conclusions  Enzyme replacement therapy with agalsidase alfa leads to significant clinical benefits in patients with Fabry disease, and treatment is likely to alter the natural history of this disorder.
Natriuretic peptides and the prevalence of congestive heart failure in patients with pacemakers
Authors: Gwechenberger M. , Huelsmann M. , Graf S. , Berger R. , Bonderman D. , Stanek B. , Rauscha F. , Pacher R.
Published: December 2004

Aim  The aim of the study was to investigate the diagnostic potential of natriuretic cardiac peptide measurement in the context of left ventricular dysfunction and comorbidities in a pacemaker population.

Material and methods  Ninety‐five consecutive patients with pacemakers were included in the study. All patients underwent echocardiography and were asked to complete the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Brain natriuretic peptide (BNP), N‐terminal proatrial natriuretic peptide (N‐ANP) and atrial natriuretic peptide levels in plasma were measured.

Results  Twenty‐six percent of patients had reduced systolic left ventricular function; only 16 patients had a history of congestive heart failure. BNP was abnormally elevated in 64%, N‐BNP in 72% and N‐ANP in 96% of patients. Both BNP (r = 0·30; P < 0·01) and N‐ANP (r = 0·39; P < 0·0005) correlated with MLHFQ. The strongest correlation was found between N‐ANP and the ejection fraction (r = 0·6; P < 0·0001). Patients were stratified in a high‐risk group and a low risk‐group according to their N‐ANP (N‐ANP > 5000 fmol L−1; n = 63 and N‐ANP < 5000 fmol L−1, n = 32) and BNP levels (BNP > 400 pg mL−1; n = 17 and BNP < 400 pg mL−1, n = 78). N‐ANP was correlated with hypertension (P < 0·003) and atrial fibrillation (P < 0·03), and BNP with mitral insufficiency (P < 0·002).

Conclusions  Cardiac natriuretic peptides are markedly elevated in the majority of patients with pacemakers. The prognostic significance of BNP and N‐ANP in left ventricular dysfunction warrants close follow‐up schedules.
Probiotics and gastrointestinal diseases
Authors: SULLIVAN Å. , NORD C. E.
Published: December 2004

There is increasing evidence indicating health benefits by consumption of foods containing microorganisms, i.e. probiotics. A number of clinical trials have been performed to evaluate the effects in the prevention and treatment of gastrointestinal diseases caused by pathogenic microorganisms or by disturbances in the normal microflora. Gastrointestinal infections caused by Helicobacter pylori, traveller's diarrhoea, rotavirus diarrhoea, antibiotic‐associated diarrhoea (AAD) and Clostridium difficile‐induced diarrhoea are conditions that have been studied. There are also studies performed on the preventive effect of probiotics on radiation‐induced diarrhoea and diarrhoea in tube‐fed patients. Inflammatory bowel disease and irritable bowel syndrome, two idiopathic conditions where alterations in the normal microflora have been implicated as responsible for initiation, are two further areas where the use of probiotics has been regarded as promising. The results from clinical studies have not been conclusive in that the effects of probiotics have been strain‐dependent and different study designs have been used. Treatment of acute diarrhoea in children and prevention of AAD are the two most justified areas for the application of probiotics.
Advances in the management of hereditary medullary thyroid cancer
Authors: MACHENS A. , UKKAT J. , BRAUCKHOFF M. , GIMM O. , DRALLE H.
Published: December 2004

This work draws on recent advances during the era of codon‐oriented prophylactic surgery for hereditary medullary thyroid cancer (MTC). Milestones included identification of RET (REarranged during Transfection) as the susceptibility gene, introduction of prophylactic surgery on evidence of a RET germline mutation, revelation of genotype–phenotype correlations within the MEN 2 spectrum and demonstration of age‐related progression of MTC. Novel surgical techniques, notably systemic microdissection and compartment‐oriented surgery, have greatly enhanced surgical cure. Uncovering molecular pathways from RET genotype to MEN 2 phenotype should provide treatment options for RET mutation carriers whose MTC currently is too advanced for cure.
Parathyroid surgery in familial hyperparathyroid disorders*
Authors: CARLING T. , UDELSMAN R.
Published: December 2004

The management of hyperparathyroidism (HPT) in the setting of familial HPT differs between the specific syndromes and is generally complex because of the underlying disease, which predisposes patients to persistent and recurrent HPT. The basic principles of surgery include achieving and maintaining normocalcaemia for the longest time possible, avoiding both iatrogenic hypocalcaemia and operative complications, and facilitating future surgery for recurrent disease. Multiple endocrine neoplasia type 1 (MEN1) is treated with either subtotal parathyroidectomy or total parathyroidectomy with immediate heterotopic autotransplantation of parathyroid tissue. MEN2A, familial isolated HPT and HPT‐associated with the hyperparathyroidism‐jaw tumour (HPT‐JT) syndrome typically can be treated with parathyroidectomy, i.e. subtotal or less. The increased risk of parathyroid cancer in HPT‐JT requires special attention. Parathyroid surgery in familial HPT syndromes in the setting of underlying mutations in the calcium receptor (CASR) gene involves radical subtotal parathyroidectomy. Intraoperative parathyroid hormone (PTH) measurements may help guide the extent of parathyroid resection, particularly in the case of multigland HPT. The vast majority of patients with familial HPT who require surgery are best served with bilateral cervical explorations. However, minimally invasive parathyroidectomy (MIP) techniques that have become routine for sporadic HPT at selected institutions may be extrapolated to a subset of cases of familial HPT.
Counselling in multiple endocrine neoplasia syndromes: from individual experience to general guidelines
Authors: LIPS C. J. , HÖPPENER J. W. , VAN NESSELROOIJ B. P. , VAN DER LUIJT R. B.
Published: December 2004

Counselling of patients and closely related family members has to take a central place in management of hereditary diseases, like multiple endocrine neoplasia (MEN) syndromes including von Hippel‐Lindau (VHL) disease. In the strategy of health care, preventive medicine such as periodic clinical examination of families at‐risk needs a high priority, because in general it is assumed that continuity in attendance is cost‐effective. Counselling has to be based on individual medical experience of the doctor, adjusted to common guidelines and the findings in the family. Information leaflets, appropriate outpatient departments and an extensive network of specialists will facilitate continuity in care. Flow diagrams involving practical guidelines for diagnosis, treatment and follow up need to be applicable and after adjustment, should be accepted generally. Specially trained paramedics for counselling are required as a network that will guarantee periodic clinical examination and secure optimal prevention. Such paramedics will coordinate nationwide multidisciplinary guidance, and organize preventive and emergency cure for these patients. They will be supervised by expert clinicians in the field, and collaborate with specialists for social and psychological issues, patient organizations and clinical genetic centres. All of these professionals are responsible together for providing patients with up to date clinical information (via newsletters, Internet, etc.). Recently, in the Netherlands, a project was initiated to guarantee continuity in care and study the delivery of care. In order to realize this plan, funding has to be provided in the current research programme. In a future system support has to be obtained on a continuous base, preferably by the government and health care insurers and supervised by the national institute for health care.
Restructuring and verb‐initial order in chamorro
Authors: Chung Sandra
Published: December 2004

Abstract.  The Austronesian language Chamorro has a restructuring construction in which the embedded clause‐like constituent looks like a finite realis clause. Following Bhatt's (2002) minimalist analysis of Hindi‐Urdu, I argue that Chamorro restructuring permits long‐distance Agree but not long‐distance licensing of objective Case. I then bring the word order of restructuring to bear on the larger issue of how verb‐initial order is derived. Along the way, an account is developed in which some of the distinctive characteristics of restructuring are determined in the syntax, but others are the result of post‐Spell‐Out operations.
Thrombotic thrombocytopenic purpura and pregnancy: a review of ten cases
Authors: Castellá M. , Pujol M. , Juliá A. , Massague I. , Bueno J. , Ramón Grifols J. , Puig L.
Published: December 2004

Background and Objectives  A series of women with pregnancy‐associated thrombotic thrombocytopenic purpura, is presented. This study will focus on the relationship between thrombotic thrombocytopenic purpura and pregnancy and on maternal and neonatal outcomes.

Materials and Methods  Among forty‐six consecutive patients with thrombotic thrombocytopenic purpura, nine pregnant patients were identified.

Results  Seven patients presented an acute single episode associated with pregnancy and two patients had a chronic relapsing form of the disease. None of these two patients were diagnosed during pregnancy or in the postpartum period. There was one maternal death. Fetal mortality was 33%.

Conclusions  The recurrence is rare in women who had the prior episode related to pregnancy. The risk of death for these patients seems not higher than that of the remaining patients in the series. Preterm delivery and intrauterine fetal death were frequent complications of these pregnancies.
Influence of blood prestorage conditions and white blood cell filtration on the bacterial load of blood deliberately inoculated with Gram‐positive and Gram‐negative pathogens
Authors: Siblini L. , Lafeuillade B. , Ros A. , Garraud O. , Pozzetto B.
Published: December 2004

Background and Objectives  Currently, the bacterial contamination of blood constitutes one of the major infectious risks of transfusion. The aim of this study was to evaluate the bactericidal effect of blood on various bacterial species and to determine the influence of prestorage conditions and white blood cell (WBC) filtration on the reduction of the bacterial load in isolated red blood cells (RBCs).

Materials and Methods  The growth kinetics of eight different species of bacteria were studied at 20 °C in deliberately contaminated RBC units. Further experiments evaluated the effect of prestorage conditions and WBC filtration on the viability of two model bacteria (Klebsiella oxytoca and Staphylococcus epidermidis) in comparison to previous results obtained with Yersinia enterocolitica.

Results  For bacteria susceptible to the bactericidal effect of blood (mainly Gram‐negative rods), a reduction of the bacterial load was obtained within 2 h of prestorage at 20 °C. When the prestorage period was prolonged beyond 3 h at 20 °C, rapid growth was observed with some Enterobacteriaceae. Whereas WBC filtration reduced dramatically the viability of Y. enterocolitica, it had only a minimal effect on the viability of S. epidermidis and K. oxytoca. However, the two latter species of bacteria did not survive prolonged storage at 4 °C.

Conclusions  Experiments conducted under realistic conditions are needed to determine whether it would be worthwhile recommending the rapid storage of RBCs at 4 °C after WBC reduction of the blood product.
Plasticity in the self‐incompatibility system of Solanum carolinense
Authors: TRAVERS STEVEN E. , MENA‐ALI JORGE , STEPHENSON ANDREW G.
Published: December 2004

Solanum carolinense has a gametophytic self‐incompatibility (GSI) system that is typical of the Solanaceae in which pistils produce specific S‐RNase proteins that disrupt the growth of pollen tubes sharing the same S‐allele. However, unlike most self‐incompatible plants Solanum carolinense is a weed. Self‐incompatibility is uncommon in weeds because disturbed habitats require frequent recolonization (hence populations are repeatedly founded by few individuals bearing a limited number of S‐alleles), effective population sizes are small (supporting few S‐alleles) and habitats are ephemeral (so there is limited time for the migration of additional S‐alleles into populations). We carried out a series of greenhouse experiments using clonal replicates (rhizome cuttings) of plants from two natural populations of S. carolinense to determine if there is variation in the strength of GSI within these populations. We found that the growth rate of self‐pollen tubes and self‐fertility increases with floral age. That is, flowers become more self‐compatible as they age. Moreover, we found that self‐fertility increases on plants in which the first 20 flowers receive no cross pollen. That is, when few or no fruits are produced on the first 20 flowers, self‐pollination is more likely to result in fruit/seed set. Finally, we found that genotypes differ in their degree of self‐fertility indicating that there is broadsense heritability for plasticity in the strength of self‐incompatibility. These findings indicate that some genotypes of S. carolinense are capable of producing self‐seed when cross pollen is scarce, even though the plants have a functional GSI system.
ENDOSCOPIC COAGULATION THERAPY IS USEFUL FOR IMPROVING ENCEPHALOPATHY IN CIRRHOTIC PATIENTS WITH GASTRIC ANTRAL VASCULAR ECTASIA
Authors: Zushi Shinichiro , Imai Yasuharu , Fukuda Kazuto , Yabuta Takamasa , Tsujino Seiko , Yamada Takuya , Kurokawa Masanori
Published: December 2004

Background:  Gastric antral vascular ectasia (GAVE) is an uncommon but treatable cause of chronic gastrointestinal bleeding often associated with severe cirrhosis. Efficacy of endoscopic treatment is well known; however, long‐term outcome after endoscopic treatment is not clear.

Methods:  We studied 16 cases of GAVE patients with liver cirrhosis that were endoscopically treated using heater probe unit or argon plasma coagulator. Endoscopic finding of GAVE and clinical finding of hepatic encephalopathy in particular was evaluated after endoscopic therapy.

Results:  After endoscopic ablation therapy, mucosal vascular lesion of GAVE and rebleeding occurred in four patients during follow up; however, re‐treatment was effective and long‐term hemostasis was achieved. Moreover, a case report herein revealed the effectiveness of endoscopic therapy on hepatic encephalopathy of GAVE patients with cirrhosis. In the follow‐up study of 13 patients of GAVE with cirrhosis that suffered from encephalopathy, the coma level of nine patients was improved after endoscopic therapy.

Conclusion:  Endoscopic treatment, such as heater probe coagulation and argon plasma coagulation therapy, are effective and useful for long‐term follow up. Also, the beneficial effect of endoscopic therapy on hepatic encephalopathy for GAVE with cirrhosis encourages us to find and treat the mucosal lesion intensively to improve the quality of life of such patients.
Student Involvement in University Life — Beyond Political Activism and University Governance: a view from Central and Eastern Europe
Authors: BATESON ROSITSA , TAYLOR JOHN
Published: December 2004

Since the 1980s and early 1990s, much attention has focused on the position of students as stakeholders in the process of higher education. The importance of student evaluation is now widely recognised; in many countries, the move toward fee‐based funding has increased the power of students as ‘consumers’ of their education. At the same time, it is often asserted that students are reluctant to participate in university life, concerned primarily (sometimes exclusively) with obtaining their formal qualification and less with wider aspects of higher education. The views and attitudes prevalent in the student population and within institutions themselves on such issues vary widely. This debate is an international one, but is especially relevant in the rapidly changing higher education systems of Central and Eastern Europe.
The Effects of Disability on Labour Force Status in Australia
Authors: Wilkins Roger
Published: December 2004

Using the Australian Bureau of Statistics 1998 Survey of Disability, Ageing and Carers, this study examines the effects of disability on four labour market outcomes: not in the labour force, unemployed, part‐time employed and full‐time employed. The detailed information on health available in the dataset also facilitates investigation of the dependence of effects on the characteristics of the disability, including severity, impairment type and age of onset. Disability is found to have substantial effects on labour force status, on average acting to decrease the probability of labour force participation by one‐quarter for males and one‐fifth for females. For males, the decrease in fulltime employment accounts for almost all of the decrease in labour force participation associated with disability; for females, disability has negative effects on both full‐time and part‐time employment. Analysis of disability characteristics shows that adverse effects on labour force status are increasing in the severity of the disability and are also worse for those with more than one type of impairment and for those who experience disability onset at older ages. There is evidence that the adverse effects of disability are lower for males who completed their education after the onset of the disability.
Problems of Fit: Changing Employment and Labour Regulation
Authors: Dickens Linda
Published: December 2004

This paper indicates key issues in identifying and assessing change in the employment relationship. It explores various challenges that the changing shape of employment poses for both legal regulation and regulation provided through collective bargaining. It suggests different rationales for seeking a better fit and discusses various adjustments and changes to achieve this. Finally, I argue that problems of fit (misfit), and the need for adaptation to which this gives rise, are relevant also to the study of industrial relations.
The Effect of Entering the WTO on the Oil Industry and the Economy of Taiwan
Authors: Liang Chi‐yuan
Published: December 2004

The crude oil price of the world increased two‐fold during 1999–2002. The price of domestic oil products for the same period increased with a smaller percentage, i.e., 27 per cent. This phenomenon could be attributed to Taiwan's oil market liberalisation after 2000 and its entering the WTO since November 2001. According to this study, the effect of entering the WTO itself suppressed the oil price from increase by 15.455 per cent in 2002. It also reduced the inflation rate by 0.74 per cent and increased the economic growth by 0.39 per cent. Nevertheless, entering the WTO also increases the competition in the oil industry, which is a big challenge to the domestic oil refinery sector and the state‐owned Chinese Petroleum Corporation in particular. The price decrease of oil products also increases the demand for oil products and exacerbated air pollution and CO2 emissions. For minimising the negative impact of entering the WTO on the economy, the Taiwan government has devised a series of preparations in the last decade. Those preparations include a step‐by‐step market liberalisation plan, a strategy taken by the state‐owned CPC, a new taxation implementation and the legislative works such as the Petroleum Act. This experience might be worthwhile for the reference of other economies.
Progress, decline, growth: product and productivity in Italian agriculture, 1000–2000
Authors: FEDERICO GIOVANNI , MALANIMA PAOLO
Published: December 2004

This article estimates agricultural production and output per worker in Italy, from about the year 1000 to the present. The millennium may be divided neatly into three periods. Output per worker increased until the fourteenth century, declined, with some fluctuations, until the end of the nineteenth century, and then recovered, booming in the past 50 years.
The empire strikes back: Hong Kong and the decline of sterling in the 1960s1
Authors: SCHENK CATHERINE R.
Published: December 2004

The aftermath of the sterling devaluation of 1967 is usually portrayed only in terms of the performance of the British economy, but it had more far‐reaching implications, exposing the changed financial relationship between Britain and its overseas dependencies and prompting the end of the sterling reserve system. This article explores the reasons why Britain was forced to offer its first exchange guarantee to Hong Kong in May 1968. Prolonging the colonial monetary system devised in the period from the 1930s to the late 1960s created problems for Britain that shifted the balance of power to the point where Hong Kong and other colonies were able to force a re‐negotiation of their link to sterling.
Plasma viral load of Epstein–Barr virus and risk of multiple sclerosis
Authors: Wagner H.‐J. , Munger K. L. , Ascherio A.
Published: December 2004

Elevated antibody titers to Epstein–Barr virus (EBV) have been found prior to the onset of multiple sclerosis (MS) and EBV has been found in serum of patients with MS exacerbations. We conducted a prospective, nested case–control study in the Nurses’ Health Study and Nurses’ Health Study II cohorts to determine whether plasma EBV viral load in healthy adults predicts the risk of MS. MS cases with blood collected before onset (n = 18) or diagnosis (n = 13) and 62 healthy controls were matched by age and time of blood collection. EBV viral load in plasma was measured by real time polymerase chain reaction. Presence of EBV in plasma was associated with an increased risk of MS (relative risk = 2.5, 95% CI 0.78–7.8, P = 0.12). Adjusting for smoking, ancestry, and latitude of residence at birth did not materially change this result. However, no association was found between the EBV viral load and risk of MS. These results support a role for EBV in the etiology of MS, but need to be confirmed in a larger study.
Skin vasodilator response to local heating in human chronic spinal cord injury
Authors: Nicotra A. , Asahina M. , Mathias C. J.
Published: December 2004

Local heating evokes an increase in skin blood flow (SkBF), which consists of an initial peak (axon‐reflex mediated) followed by a brief nadir and a secondary rise to a plateau. The aim of this study was to investigate whether heat provoked vasodilatation detects sympathetic vasomotor dysfunction and completeness of injury in patients with spinal cord injury (SCI). Twelve (seven complete, and five incomplete; level C4‐L4) SCI patients, and nine healthy subjects as controls were studied. Thermostatic laser Doppler probes, which heat the skin locally, were placed on the dorsum of the hand and foot. SkBF was measured by laser Doppler flowmetry at baseline and at the first peak of vasodilatation (SkBFmax). On the hand, SkBF at baseline and SkBFmax were similar between the three groups. On the foot, SkBF at baseline was similar between the three groups but SkBFmax was significantly diminished in complete SCI patients compared with controls (P < 0.01). In conclusion, heat provoked axon‐reflex vasodilatation was diminished in the foot, below the level of lesion, in complete SCI. This test, that evaluates localized sympathetic vasomotor dysfunction, may be a useful non‐invasive technique to detect completeness of autonomic disruption after SCI.
Beginning treatment for paediatric acute myeloid leukaemia: diagnosis and the early hospital experience
Authors: McGrath Pam , Paton Mary Anne , Huff Nicole
Published: December 2004

Despite the plethora of clinical literature on the medical treatment for paediatric acute myeloid leukaemia (AML), there is a dearth of psycho‐social literature on how families cope with either the disease or its treatments. The present article seeks to make a contribution by placing psychosocial aspects of childhood AML on the agenda. The findings are from a 5‐year longitudinal, qualitative study on the psychosocial aspects of paediatric leukaemia. Qualitative data is gathered from open‐ended interviews at three points in time on the experience of illness. The holistic findings from T1 present the impact of diagnosis and early treatment for childhood AML from the perspective of mothers, father, sibling and child patients. The study is also following up families with related disorders, thus it is possible to assess difference to other haematological groups. The findings indicate that the families bring scant prior understanding of the illness, and experience the diagnosis with fear and seriousness as a confrontation with death. At the point of entering treatment they are in a profound sense of shock and grief, which is exacerbated by a distressing, all pervading, sense of uncertainty. Families can be overwhelmed by the exhaustion of attending to the escalating practical demands of the situation combined with fatigue, worry and poor nutrition. All families find dealing with the invasive procedures and aggressive drug protocols emotionally challenging. However, in spite of the difficulties, parents have a strong desire to be with their child and find any separation painful. Families come to view the ward as a comfort zone where they have the support of the health and allied health team and the camaraderie of others experiencing a similar situation. However, even this support has to be qualified by the need for personal space, the difficulty of handling complex emotions, and the fear of being overwhelmed by difficulties other families face. The insights argue strongly for sensitive support for all individuals coping with childhood AML.
Elderly participants of social and rehabilitative day centres
Authors: Svidén Gerd Andersson , Tham Kerstin , Borell Lena
Published: December 2004

As it develops, an ageing society has increased need of services that can promote the health and well‐being of the elderly. Community‐based day programmes are one kind of service intended to support elderly people with restricted function in their daily lives. There are several different forms of day programmes for the elderly in Sweden, but guidelines are vague about their aim and implementation and little is known about the persons using them. The aim of this study was to identify characteristics of the elderly people living in their own home who participated in social day centres in comparison with participants who attended a rehabilitative day centre. The focus was on perceived functioning and competence in daily life. Twelve social day centre participants and 12 rehabilitative day centre participants answered two questionnaires, the sickness impact profile (SIP) and occupational self‐assessment (OSA). The results show that the majority of participants from both centres were elderly persons living alone who experienced severely restricted physical function. This demonstrates that the day centres serve the needs of a specific group of elderly people, namely, those with highly restricted functioning living on their own. A significant difference between the groups was that those who attended the social day centre perceived better psychosocial function than the group attending the rehabilitative centre. The fact that the social centre group had better psychosocial function than the other group, but yet had severely restricted physical function indicates that it is preferably the psychosocial well‐being of elderly persons with restricted functioning that is possible to influence. This result implies that these centres serve as an important meeting place for elderly persons who would otherwise be isolated in their homes because of their physical restrictions. To fulfil this challenge, the day centres might need to accommodate a wider range of persons with restricted functioning.
On the absence of a ‘Socio‐emotional Enablement’ discourse component in international socio‐economic development thought
Authors: Affolter Friedrich W.
Published: December 2004

Socio‐emotional well‐being, established through nurturing relationships and community experiences, enables children and adults to evolve into caring, nonviolent, emotionally healthy citizens.

This paper analyses purposefully selected development texts, authored by three prominent contributors of socio‐economic development discourse: the United Nations, the World Bank and the International Monetary Fund. On the basis of a socio‐emotional capacity development framework that draws from research produced in the areas of developmental psychology, biopsychology, brain research and peace psychology, the study evaluates texts’ tendencies to make socio‐emotionally conducive – or neglectful – programme recommendations.

The study finds that United Nations conference reports indirectly acknowledge the relevance for socio‐emotional enablement and protection, in the context of discussions related to human and children's rights, education or women's empowerment. However, they only marginally discuss the need to foster socio‐emotional well‐being as a human capacity development rationale per se.

The International Monetary Fund, while acknowledging responsibility for the social conduciveness of macro‐economic development interventions, does not address socio‐emotional capacity development issues. The World Bank's strategic plan and other strategy papers touch on issues of socio‐emotional capacity development only tangentially.

The study concludes that the discourse communities authoring the selected development texts largely ignore the question of socio‐emotional capacity development. Their discourses ‘background’ discussions about the kind and nature of social structures necessary for nurturing socio‐emotional enablement. Developmental psychologists are challenged to ‘infect’ socio‐economic development discourse by calling for the effective integration of the theme of socio‐emotional well‐being into socio‐economic development publications.
Dilemmas and advances in corporate social responsibility in Brazil. The work of the Ethos Institute
Authors: Young Ricardo
Published: December 2004

This article discusses the development of corporate social responsibility (CSR) in Brazil from the perspective of the Ethos Institute of Business and Social Responsibility. The Institute is a not‐for‐profit, non‐governmental organization, that has played a leading role in the Brazilian CSR effort. In Brazil, CSR initiatives have a long tradition of philanthropy, a consequence of the country's great social inequalities. The increased attention to corporate social responsibility has paralleled growing concern about sustainable development and the intensifying activities of pressure groups (consumers, customers, investors, NGOs, labour unions, the media, among others) that have been increasing since the 1990s as natural resources are progressively becoming exhausted, social tensions rising and environmental conditions deteriorating worldwide. This article identifies problems and obstacles to the growth of corporate social responsibility in Brazil, as well as advances and alternatives for CSR and towards creating conditions for the country to be internationally competitive and sustainable in the financial, social and environmental areas.
PIV Investigations of the Flow Field in the Volute of a Rotary Blood Pump
Authors: Sankovic John M. , Kadambi Jaikrishnan R. , Mehta Mehul , Smith William A. , Wernet Mark P.
Published: December 2004

A full-size acrylic model of a rotary blood pump was developed in order to utilize Particle Image Velocimetry (PIV) to make measurements of the fluid velocities and turbulent stresses throughout the device. The development of an understanding of the hemodynamics within the blood pump is critical to the development and validation of computational models. A blood analog solution, consisting of sodium iodide solution and glycerin, was developed to match physiological kinematic viscosity. The refractive indecies of the fluid, the pump casing, and the impeller were matched to facilitate the use of PIV to make velocity measurements. Velocity measurements made in the volute exit/diffuser region are presented for pumps speeds of 3000–3850 rpm. At each speed data were obtained at a physiological pressure of 12 kPa and at a maximum flow condition. Four hundred data pairs were used for each resultant mean velocity vector value, representing greater than an order of magnitude more data pairs than reported previously in the literature on similar devices and resulting in velocity uncertainty levels of approximately ±2.9%.
Characteristics of the Liquid Film and Pressure Drop in Horizontal, Annular, Two-phase Flow Through Round, Square and Triangular Tubes
Authors: Shedd Timothy A. , Newell Ty A.
Published: December 2004

A unique set of liquid film thickness and pressure drop data has been obtained for horizontal, annular flow of air and water through round, square and triangular tube using a noninvasive, optical liquid film thickness measurement system. In the square and triangular tubes, the liquid film was thinned in the corners, indicating an effect of turbulent secondary flows in these geometries. In addition, when the film thickness is nondimensionalized using a friction velocity based on the total pressure drop, it is found that virtually all the data lie below h+=35 and that dryout occurs at approximately h+=5. The two-phase friction factor for the annular flows examined in all the tubes can be correlated using the Lockhart–Martinelli parameter, Xtt, when adjustments are made for the hydraulic diameters of the nonround tubes.
Large-Scale Disturbances and Their Mitigation Downstream of Shallow Cavities Covered by a Perforated Lid
Authors: Jordan Stephen A.
Published: December 2004

Flow past cavities covered by perforated lids pose a challenging problem for design engineers. Kelvin–Helmholtz waves appear early in the separated shear layers above the perforations that quickly mature into large-scale coherent structures far downstream. This evolution is sustained by a hydrodynamic feedback mechanism within the cavity even when its aft wall is far removed from the lid. Herein, the results from large-eddy simulations show analogous fundamental characteristics between open and perforated-cover cavities. Both adequately scale the fundamental frequency of the large-scale disturbance using the freestream velocity and the cavity width (or lid length). Moreover, the dimensionless frequencies jump to higher modes at equivalent length scales. Unlike the open cavity, one can invoke certain conditions that instigate the instability above the perforations but not a simultaneous long-term feedback mechanism necessary to fully sustain the periodic oscillation. The lid itself offers options for mitigating (or even eliminating) the instability. Results (for laminar separation) show the perforation spacing as the key factor. While maintaining the same fundamental frequency, one can easily dampen its spectral peak to complete disappearance by extending the perforation spacing.
Four‐dimensional (4D) PET/CT imaging of the thorax
Authors: Nehmeh S. A. , Erdi Y. E. , Pan T. , Pevsner A. , Rosenzweig K. E. , Yorke E. , Mageras G. S. , Schoder H. , Vernon Phil , Squire O. , Mostafavi H. , Larson S. M. , Humm J. L.
Published: December 2004

We have reported in our previous studies on the methodology, and feasibility of 4D‐PET (Gated PET) acquisition, to reduce respiratory motion artifact in PET imaging of the thorax. In this study, we expand our investigation to address the problem of respiration motion in PET/CT imaging. The respiratory motion of four lung cancer patients were monitored by tracking external markers placed on the thorax. A 4D‐CT acquisition was performed using a “step‐and‐shoot” technique, in which computed tomography (CT) projection data were acquired over a complete respiratory cycle at each couch position. The period of each CT acquisition segment was time stamped with an “x‐ray ON” signal, which was recorded by the tracking system. 4D‐CT data were then sorted into 10 groups, according to their corresponding phase of the breathing cycle. 4D‐PET data were acquired in the gated mode, where each breathing cycle was divided into ten 0.5 s bins. For both CT and PET acquisitions, patients received audio prompting to regularize breathing. The 4D‐CT and 4D‐PET data were then correlated according to respiratory phase. The effect of 4D acquisition on improving the co‐registration of PET and CT images, reducing motion smearing, and consequently increase the quantitation of the SUV, were investigated. Also, quantitation of the tumor motions in PET, and CT, were studied and compared. 4D‐PET with matching phase 4D‐CTAC showed an improved accuracy in PET‐CT image co‐registration of up to 41%, compared to measurements from 4D‐PET with clinical‐CTAC. Gating PET data in correlation with respiratory motion reduced motion‐induced smearing, thereby decreasing the observed tumor volume, by as much as 43%. 4D‐PET lesions volumes showed a maximum deviation of 19% between clinical CT and phase‐ matched 4D‐CT attenuation corrected PET images. In CT, 4D acquisition resulted in increasing the tumor volume in two patients by up to 79%, and decreasing it in the other two by up to 35%. Consequently, these corrections have yielded an increase in the measured SUV by up to 16% over the clinical measured SUV, and 36% over SUV's measured in 4D‐PET with clinical‐CT Attenuation Correction (CTAC) SUV's. Quantitation of the maximum tumor motion amplitude, using 4D‐PET and 4D‐CT, showed up to 30% discrepancy between the two modalities. We have shown that 4D PET/CT is clinically a feasible method, to correct for respiratory motion artifacts in PET/CT imaging of the thorax. 4D PET/CT acquisition can reduce smearing, improve the accuracy in PET‐CT co‐registration, and increase the measured SUV. This should result in an improved tumor assessment for patients with lung malignancies.
Segmentation of the prostate from suprapubic ultrasound images
Authors: Yu Yongjian , Molloy Janelle A. , Acton Scott T.
Published: December 2004

We present a technique for semiautomated segmentation of human prostates using suprapubic ultrasound (US) images. In this approach, a speckle reducing anisotropic diffusion (SRAD) is applied to enhance the images and the instantaneous coefficient of variation (ICOV) is utilized for edge detection. Segmentation is accomplished via a parametric active contour model in a polar coordinate system that is tailored to the application. The algorithm initially approximates the prostate boundary in two stages. First a primary contour is detected using an elliptical model, followed by a primary contour optimization using an area‐weighted mean‐difference binary flow geometric snake model. The algorithm was assessed by comparing the computer‐derived contours with contours produced manually by three sonographers. The proposed method has application in radiation therapy planning and delivery, as well as in automated volume measurements for ultrasonic diagnosis. The average root mean square discrepancy between computed and manual outlines is less than the inter‐observer variability. Furthermore, 76% of the computer‐outlined contour is less than manual outline variance away from “true” boundary of prostate. We conclude that the methods developed herein possess acceptable agreement with manually contoured prostate boundaries and that they are potentially valuable tools for radiotherapy treatment planning and verification.
Effect of MLC leaf width on the planning and delivery of SMLC IMRT using the CORVUS inverse treatment planning system
Authors: Burmeister Jay , McDermott Patrick N. , Bossenberger Todd , Ben‐Josef Edgar , Levin Kenneth , Forman Jeffrey D.
Published: December 2004

This study investigates the influence of multileaf collimator (MLC) leaf width on intensity modulated radiation therapy (IMRT) plans delivered via the segmented multileaf collimator (SMLC) technique. IMRT plans were calculated using the Corvus treatment planning system for three brain, three prostate, and three pancreas cases using leaf widths of 0.5 and . Resulting differences in plan quality and complexity are presented here. Plans calculated using a leaf width were chosen over the leaf width plans in seven out of nine cases based on clinical judgment. Conversely, optimization results revealed a superior objective function result for the leaf width plans in seven out of the nine comparisons. The leaf width objective function result was superior only for very large target volumes, indicating that expanding the solution space for plan optimization by using narrower leaves may result in a decreased probability of finding the global minimum. In the remaining cases, we can conclude that we are often not utilizing the objective function as proficiently as possible to meet our clinical goals. There was often no apparent clinically significant difference between the two plans, and in such cases the issue becomes one of plan complexity. A comparison of plan complexity revealed that the average leaf width plan required roughly 60% fewer segments and over 40% fewer monitor units than required by leaf width plans. This allows a significant decrease in whole body dose and total treatment time. For very complex IMRT plans, the treatment delivery time may affect the biologically effective dose. A clinically significant improvement in plan quality from using narrower leaves was evident only in cases with very small target volumes or those with concavities that are small with respect to the MLC leaf width. For the remaining cases investigated in this study, there was no clinical advantage to reducing the MLC leaf width from . In such cases, there is no justification for the increased treatment time and whole body dose associated with the narrower MLC leaf width.
Model‐based microwave image reconstruction: simulations and experiments
Authors: Ciocan Razvan , Jiang Huabei
Published: December 2004

We describe an integrated microwave imaging system that can provide spatial maps of dielectric properties of heterogeneous media with tomographically collected data. The hardware system was built based on a lock‐in amplifier with 16 fixed antennas. The reconstruction algorithm was implemented using a Newton iterative method with combined Marquardt‐Tikhonov regularizations. System performance was evaluated using heterogeneous media mimicking human breast tissue. Finite element method coupled with the Bayliss and Turkel radiation boundary conditions were applied to compute the electric field distribution in the heterogeneous media of interest. The results show that inclusions embedded in a 76‐diameter background medium can be quantitatively reconstructed from both simulated and experimental data. Quantitative analysis of the microwave images obtained suggests that an inclusion of in diameter is the smallest object that can be fully characterized presently using experimental data, while objects as small as in diameter can be quantitatively resolved with simulated data.
Quasimonochromatic x‐ray computed tomography by the balanced filter method using a conventional x‐ray source
Authors: Saito Masatoshi
Published: December 2004

A quasimonochromatic x‐ray computed tomography (CT) system utilizing balanced filters has recently been developed for acquiring quantitative CT images. This system consisted of basic components such as a conventional x‐ray generator for radiography, a stage for mounting and rotating objects, and an x‐ray line sensor camera. Metallic sheets of and were used as the balanced filters for obtaining quasimonochromatic incident x rays that include the characteristic lines of the doublet from a tungsten target. The mean energy and energy width of the quasimonochromatic x rays were determined to be 59.0 and , respectively, from x‐ray spectroscopic measurements using a high‐purity detector. The usefulness of the present x‐ray CT system was demonstrated by obtaining spatial distributions of the linear attenuation coefficients of three selected samples—a diameter cylindrical water phantom, a diameter aluminum rod, and a human head phantom. The results clearly indicate that this apparatus is surprisingly effective for estimating the distribution of the linear attenuation coefficients without any correction of the beam‐hardening effect. Thus, implementing the balanced filter method on an x‐ray CT scanner has promise in producing highly quantitative CT images.