bluuebunny/crossref_metadata_2025 huggingface dataset:
Envy and positional bias in the evolutionary psychology of management
Authors: Hill Sarah E. , Buss David M.
Published: March 2006

We propose that humans have evolved at least two specialized cognitive adaptations shaped by selection to solve problems associated with resource competition: (1) a positional bias by which individuals judge success in domains that affect fitness in terms of standing relative to their reference group; and (2) envy, an emotion that functions to alert individuals to fitness‐relevant advantages enjoyed by rivals and to motivate individuals to acquire those same advantages. We present new data supporting the existence of design features of these hypothesized psychological adaptations and discuss implications for economists, organizations, marketers, and managers. Copyright © 2006 John Wiley & Sons, Ltd.
The opt‐out revolution in the United States: implications for modern organizations
Authors: Still Mary C.
Published: March 2006

For the first time since American women joined the labor force in the 1970s, the number of working mothers has decreased. Dubbed the ‘opt‐out revolution’ byThe New York Times, the so‐called exodus has left companies confused, social conservatives jubilant and feminists incensed. This article explores the reasons for women's workforce departure and argues that it is a predictable result of organizations' failure to understand differences between male and female workers, an ignorance that leads to flawed incentive structures which eventually drive women out of the workplace. I discuss three of the most problematic assumptions made by organizations: (1) men and women are motivated by the same things; (2) managers determine promotion and pay on merit; and (3) implementing policies designed for women, such as family–friendly benefits, will solve retention problems. Copyright © 2006 John Wiley & Sons, Ltd.
Applying evolutionary psychology in understanding the Darwinian roots of consumption phenomena
Authors: Saad Gad
Published: March 2006

Consumer scholars have amassed an impressive body of knowledge using a wide range of methodological approaches and paradigms. Despite the scientific rigor of the consumer behavior discipline, most scholars that have reviewed the field agree that it has yielded a fragmented and confused literature. It is argued here that this is in part due to the near paucity of evolutionary‐based theorizing within the theoretical frameworks used by consumer scholars. While evolutionary psychology focuses on ultimate causation namely the adaptive origins of a particular cognition, emotion, preference, or behavior, the consumer behavior discipline has overwhelmingly addressed proximate mechanisms. Both levels of analyses are needed for a full understanding of consumption phenomena. Copyright © 2006 John Wiley & Sons, Ltd.
Requirements planning for modular products
Authors: Paul Anand , Vakharia Asoo J.
Published: March 2006

The focus of this paper is on determining the requirements of different component options of a modular end‐product in an uncertain environment. We explicitly model two distinct sources of uncertainty: stochastic end‐product demand and unknown market proportions for the different product options available. Our cost minimizing model focuses on determining the optimal requirements policies for component options that meet a pre‐set service level. We show that simple common‐sense requirements policies are not generally optimal; there is a non‐linear connection between service level and component requirements that is hard to characterize without a detailed analysis. © 2006 Wiley Periodicals, Inc. Naval Research Logistics, 2006
Web Services‐based network management: approaches and the WSNET system
Authors: Soldatos John , Alexopoulos Dimitris
Published: March 2006

While the Simple Network Management Protocol (SNMP) is still the dominant protocol for managing network elements in IP‐based networks and the Internet, network managers are acknowledging its limitations with respect to configuration management, application development and decentralization of management tasks. Web Services (WS) have been recently proposed to alleviate these limitations, given their pertinence to both decentralized management paradigms (e.g., CORBA), and XML management systems which provide efficiency in configuration management operations. This paper reviews architectures for WS‐based network management, outlining their advantages and disadvantages. These architectures address management of both individual network elements and composite multi‐device networks. Moreover, the paper introduces the architecture of a prototype system for WS‐based network management, namely WSNET. Along with presentation of the WSNET system, we provide a set of experimental results reporting performance figures for the WSNET system, as well as for systems based on other WS architectures. These figures allow for a comparative evaluation of the various systems, and manifest the benefits of the WSNET implementation. An important conclusion from our work is that WS should be seen as an accompaniment to conventional SNMP management rather than a replacement. However, there are also cases (e.g., need for secure remote access) where WS serve as a core rather than auxiliary solution, given that conventional methods are not applicable. Copyright © 2006 John Wiley & Sons, Ltd.
Fiberoptic bronchoscopy and bronchoalveolar lavage for the evaluation of pulmonary disease in children with primary immunodeficiency and cancer
Authors: Efrati O. , Gonik U. , Bielorai B. , Modan‐Moses D. , Neumann Y. , Szeinberg A. , Vardi A. , Barak A. , Paret G. , Toren A.
Published: March 2006

Background

Patients with childhood cancer or primary immunodeficiencies (PID) are at high risk for developing pulmonary infections and non‐infectious complications. The broad differential diagnoses and the critical condition of these patients often drive physicians to start broad‐spectrum antibiotic therapy before a definite diagnostic procedure is performed. A definite diagnosis may be achieved in these situations by fiberoptic bronchoscopy (FOB) and bronchoalveolar lavage (BAL).

Patients and Methods

The records of 58 PIDs and cancer (immunocompromised group) pediatric patients who underwent 62 fiberoptic bronchoscopies between 2000 and 2004 were retrospectively reviewed and compared to 158 non‐cancer patients who underwent 182 fiberoptic bronchoscopies during the same period.

Results

The overall diagnostic rate achieved by macroscopic inspection of purulent secretions or hemorrhage, abnormal cell count, and infectious agent isolation in the immunocompromised patients was 84%. A definite organism was recovered in 53.2% of the patients. Probable infection defined as purulent secretions or abnormal cell count without infectious agent isolation was diagnosed in another 21% of the patients. The rate of complications was 30.6%. In the control group, the overall diagnostic rate was 76.9% (n.s) and an infectious agent was demonstrated in 12.1% (P < 0.001). Probable infection was diagnosed in 24.2% (n.s) while the rate of complications was lower (15%) (P < 0.01).

Conclusions

Rapid and accurate diagnoses were achieved in most procedures performed on immunocompromised patients. Although the rate of complications was higher in the immunocompromised group, they were usually very mild with no mortality. Based on these results, broncoalveolar lavage should be considered as an initial diagnostic tool in pediatric immunocompromised patients with pulmonary complications. Pediatr Blood Cancer 2007;48:324–329. © 2006 Wiley‐Liss, Inc.
Fetal enterolithiasis: prenatal sonographic and MRI diagnosis in two cases of urorectal septum malformation (URSM) sequence
Authors: Lubusky Marek , Prochazka Martin , Dhaifalah Ishraq , Horak David , Geierova Marie , Santavy Jiri
Published: March 2006

Objectives

Enterolithiasis (multiple calcifications of intraluminal meconium) is a rare, prenatal ultrasonographic finding. In this study, our aim was to evaluate the prenatal diagnostic features and discuss the management of the patients.

Methods

The data of two cases of prenatally diagnosed fetal enterolithiasis were collected from ultrasound scan, magnetic resonance imaging (MRI) and neonatal or postnatal autopsy records. The findings were evaluated in both prenatal and postnatal periods. Chromosomal analysis was performed in one case. An evaluation of primary and secondary malformations was done. Coexisting anomalies were searched for via radiology, neonatal surgery and histopathology.

Results

Malformations in two cases (both males) with partial and complete urorectal septum malformation (URSM) sequence were described. The absence of an anal opening and presence of a fistula between the urinary and gastrointestinal tract were common findings. These features were considered as primary malformations contributing to the formation of enterolithiasis. Secondary anomalies (urinary and gastrointestinal system malformations, pulmonary hypoplasia, genital and other coexisting anomalies) were evaluated.

Conclusions

The prenatal detection of enterolithiasis carries a poor prognosis. Most of the previously reported cases were invariably associated with major fetal malformations of the urinary and gastrointestinal tract. It is a warning sign for large bowel obstruction with or without enterourinary fistula. Therefore, adequate gastrointestinal and urologic studies must be undertaken after birth for the final diagnosis. There is a high mortality rate in the reported cases, mostly attributed to associated anomalies, and all survivors required neonatal surgery. It is important to differentiate the partial from the full URSM sequence because the prognosis in the partial URSM sequence is generally good, with long‐term survival being common. Copyright © 2006 John Wiley & Sons, Ltd.
Karyotype and outcome of fetuses diagnosed with cystic hygroma in the first trimester in relation to nuchal translucency thickness
Authors: Kharrat Richard , Yamamoto Masami , Roume Joelle , Couderc Sophie , Vialard Francois , Hillion Yvette , Ville Yves
Published: March 2006

Objectives

To determine the incidence and to examine the karyotype and the outcome of fetuses diagnosed with cystic hygroma (CH) at 11–14 weeks of gestation.

Methods

The presence of bilateral cystic anechoic cavities in the neck, nuchal translucency (NT), malformations and hydrops was prospectively recorded in 6894 ultrasound examinations in the first trimester, between 2001 and 2004.

Results

Forty‐two fetuses (0.62%) were diagnosed with CH in the first trimester of pregnancy and 60% of these had an abnormal karyotype. NT was ≥3 mm in 83% and hydrops was present in 40% of the cases. The karyotype was abnormal in 25 (69%) of these, showing trisomy 18 and 45,XO more often than trisomy 21. NT was <3 mm in seven cases (17%); no hydrops was present and only one had an abnormal karyotype (47 + 18). Eight babies with CH without aneuploidy or hydrops were born alive, seven among them were without malformations and are developing normally at 1 to 18 months of age, the remaining one presented with CHARGE syndrome.

Conclusions

CH is an independent entity from NT and its association with increased NT carries a poor prognosis. Copyright © 2006 John Wiley & Sons, Ltd.
Buying in specialist time or buying out generalist time for practice development
Authors: Carr Susan M , Lhussier Monique , Wilcockson Jane
Published: March 2006

This paper is a description of two approaches to the implementation of an end of life integrated care pathway in the north east of England. It draws on an evaluation of the introduction of the pathway to explore the transference of knowledge held by the specialist palliative care team to local ownership by primary health care team members. It reports a successful practice development change and details how neighbouring primary care trusts developed two models for managing the resources of time and expertise. One opted to buy in specialist practitioner time, the other to buy out generalist time. The paper focuses on the lessons learned from these two experiences of facilitation of change.

There is already a literature base detailing factors influencing successful care pathway implementation. This discussion adds another dimension to this literature in exploring how a range of success criteria is packaged in two different approaches to practice development.

The resource of time is a central factor in achieving practice development success. However, buying time resource should not be seen as a panacea to overcoming practice development barriers. Other factors such as clear leadership, good education and communication are also required to provide an environment conducive to facilitating practice development. Copyright © 2005 John Wiley & Sons, Ltd.
Synthesis of biodegradable copolymers with low‐toxicity zirconium compounds. V. Multiblock and random copolymers of L‐lactide with trimethylene carbonate obtained in copolymerizations initiated with zirconium(IV) acetylacetonate
Authors: Dobrzynski Piotr , Kasperczyk Janusz
Published: March 2006

Using zirconium(IV) acetylacetonate as an initiator of lactide/trimethylene carbonate copolymerization allowed us to obtain high‐molecular‐weight copolymers with high efficiency. The reactivity ratios of the comonomers were 13.0 for lactide and 0.53 for trimethylene carbonate. Despite the large differences between the values of the reactivity ratios, copolymers with randomized chain structures were obtained. This phenomenon occurred as a result of an intensive intermolecular transesterification process proceeding along with the reaction of copolymer chain growth and modifying its final structure. Conducting the copolymerization at the relatively low temperature of about 110 °C, which minimized the influence of intermolecular transesterification, made it possible to obtain semicrystalline copolymers with multiblock structures. Increasing the temperature of copolymerization up to 180 °C was associated with strong intensification of the transesterification reactions. At this temperature, amorphous copolymers were obtained with identical compositions but highly randomized chain structures. An analysis of the chain microstructures of the obtained copolymers, determining the average length of the blocks, the intermolecular transesterification ratio, and the degree of chain randomization, was conducted by means of NMR spectroscopy. For this purpose, very specific signal assignment in the carbonyl and methylene carbon regions of the 13C NMR spectra to appropriate comonomer sequences of polymeric chains was performed. © 2006 Wiley Periodicals, Inc. J Polym Sci Part A: Polym Chem 44: 3184–3201, 2006
Synthesis of SiO2/poly(styrene‐co‐butyl acrylate) nanocomposite microspheres via miniemulsion polymerization
Authors: Zhou Juan , Zhang Shengwen , Qiao Xiaoguang , Li Xiaoqin , Wu Limin
Published: March 2006

A series of SiO2/poly(styrene‐co‐butyl acrylate) nanocomposite microspheres with various morphologies (e.g., multicore–shell, normal core–shell, and raspberry‐like) were synthesized via miniemulsion polymerization. The results showed that the morphology of the composite latex particles was strongly influenced by the presence or absence of the soft monomer (butyl acrylate), the particle sizes of the silica, and the emulsifier concentrations. The incorporation of the soft monomer helped in forming the multicore–shell structure. © 2006 Wiley Periodicals, Inc. J Polym Sci Part A: Polym Chem 44: 3202–3209, 2006
Inhibition of protein–protein interactions: The discovery of druglike β‐catenin inhibitors by combining virtual and biophysical screening
Authors: Trosset Jean‐Yves , Dalvit Claudio , Knapp Stefan , Fasolini Marina , Veronesi Marina , Mantegani Sergio , Gianellini Laura M. , Catana Cornel , Sundström Michael , Stouten Pieter F.W. , Moll Jürgen K.
Published: March 2006

The interaction between β‐catenin and Tcf family members is crucial for the Wnt signal transduction pathway, which is commonly mutated in cancer. This interaction extends over a very large surface area (4800 Å2), and inhibiting such interactions using low molecular weight inhibitors is a challenge. However, protein surfaces frequently contain “hot spots,” small patches that are the main mediators of binding affinity. By making tight interactions with a hot spot, a small molecule can compete with a protein. The Tcf3/Tcf4‐binding surface on β‐catenin contains a well‐defined hot spot around residues K435 and R469. A 17,700 compounds subset of the Pharmacia corporate collection was docked to this hot spot with the QXP program; 22 of the best scoring compounds were put into a biophysical (NMR and ITC) screening funnel, where specific binding to β‐catenin, competition with Tcf4 and finally binding constants were determined. This process led to the discovery of three druglike, low molecular weight Tcf4‐competitive compounds with the tightest binder having a KD of 450 nM. Our approach can be used in several situations (e.g., when selecting compounds from external collections, when no biochemical functional assay is available, or when no HTS is envisioned), and it may be generally applicable to the identification of inhibitors of protein–protein interactions. Proteins 2006. © 2006 Wiley‐Liss, Inc.
Molecular dynamics study of a calmodulin‐like protein with an IQ peptide: Spontaneous refolding of the protein around the peptide
Authors: Ganoth Assaf , Nachliel Esther , Friedman Ran , Gutman Menachem
Published: March 2006

The Calmodulin (CaM) is a small (16.7 kDa), highly acidic protein that is crucial to all eukaryotes by serving as a prototypical calcium sensor. In the present study, we investigated, through molecular dynamics simulations, the dynamics of a complex between the Mlc1p protein, which is a CaM‐like protein, and the IQ4 peptide. This protein‐peptide interaction is of high importance because IQ motifs are widely distributed among different kinds of CaM‐binding proteins. The Mlc1p‐IQ4 complex, which had been resolved by crystallography to 2.1 Å, confers to a Ca+2‐independent stable structure. During the simulations, the complex undergoes a complicated modulation process, which involves bending of the angles between the α‐helices of the protein, breaking of the α‐helical structure of the IQ4 peptide into two sections, and formation of new contact points between the protein and the peptide. The dynamics of the process consist of fast sub picosecond events and much slower ones that take a few nanoseconds to completion. Our study expands the information embedded in the crystal structure of the Mlc1p‐IQ4 complex by describing its dynamic behavior as it evolves from the crystal structure to a form stable in solution. The article shows that careful application of molecular dynamics simulations can be used for extending the structural information presented by the crystal structure, thereby revealing the dynamic configuration of the protein in its physiological environment. Proteins 2006. © 2006 Wiley‐Liss, Inc.
Comparing programs for rigid‐body multiple structural superposition of proteins
Authors: Hill Anthony D. , Reilly Peter J.
Published: March 2006

Different programs and methods were employed to superimpose protein structures, using members of four very different protein families as test subjects, and the results of these efforts were compared. Algorithms based on human identification of key amino acid residues on which to base the superpositions were nearly always more successful than programs that used automated techniques to identify key residues. Among those programs automatically identifying key residues, MASS could not superimpose all members of some families, but was very efficient with other families. MODELLER, MultiProt, and STAMP had varying levels of success. A genetic algorithm program written for this project did not improve superpositions when results from neighbor‐joining and pseudostar algorithms were used as its starting cases, but it always improved superpositions obained by MODELLER and STAMP. A program entitled PyMSS is presented that includes three superposition algorithms featuring human interaction. Proteins 2006. © 2006 Wiley‐Liss, Inc.
Protonation of metal‐bound α‐hydroxycarboxylate ligand and implication for the role of homocitrate in nitrogenase: Computational study of the oxy‐bidentate chelate ring opening
Authors: Cao Zexing , Jin Xi , Zhou Zhaohui , Zhang Qianer
Published: March 2006

Protonation of the metal‐bound oxy‐bidentate ligand in the model complexes of [(HS)3(NH3)M(OCH2COO)]q (M = Mo, Fe, V, Co; q = −2, −1) in the gas phase and in solutions of water and acetonitrile has been explored by the density functional approach. Calculations show that protonation of the carboxyl oxygen can open the α‐hydroxycarboxylate chelate ring ligated to a transition‐metal center under specific oxidation and spin states. The feasibility of the chelate ring opening by protonation depends on the electronic nature of the metal site in tune with conversion of a six‐coordinate with a five‐coordinate metal atom. Such selective dissociation of the metal‐bound chelate ligand manipulates the availability of an empty site at the metal center and significantly affects reactivity of the metal‐mediated chemical processes. Protonation changes the stability of species with different spin multiplicities and impels spin transition at the metal center in dissociation of the oxy‐bidentate ligand. Solvent environments of water and acetonitrile play an important role in stabilizing the negatively charged species. © 2006 Wiley Periodicals, Inc. Int J Quantum Chem, 2006
A graphical method to construct a phylogenetic tree
Authors: Wang Weiping , Liao Bo , Wang Tianming , Zhu Wen
Published: March 2006

A 3D graphical representation of DNA sequences, which has no circuit or degeneracy, is derived for mathematical denotation of DNA sequence. Based on this graphical representation, we propose a new sequence distance measure. We make use of the corresponding similarity matrix to construct a phylogenic tree by virtue of the fuzzy theory. The examination of phylogenic tree belong to eight species illustrates the utility of our approach. © 2006 Wiley Periodicals, Inc. Int J Quantum Chem, 2006
Auxiliary functions for molecular integrals with Slater‐type orbitals. I. Translation methods
Authors: Fernández J. J. , López R. , Ema I. , Ramírez G. , Fernández Rico J.
Published: March 2006

Many types of molecular integrals involving Slater functions can be expressed, with the ζ‐function method in terms of sets of one‐dimensional auxiliary integrals whose integrands contain two‐range functions. After reviewing the properties of these functions (including recurrence relations, derivatives, integral representations, and series expansions), we carry out a detailed study of the auxiliary integrals aimed to facilitate both the formal and computational applications of the ζ‐function method. The usefulness of this study in formal applications is illustrated with an example. The high performance in numerical applications is proved by the development of a very efficient program for the calculation of two‐center integrals with Slater functions corresponding to electrostatic potential, electric field, and electric field gradient. © 2006 Wiley Periodicals, Inc. Int J Quantum Chem, 2006
Multi‐channel coupling effects for electronic excitations leading to the b3∑, a3∑, and c3∏u states of H2
Authors: Taveira A. M. A. , Brescansin L. M. , Machado A. M. , Lee M.‐T.
Published: March 2006

In this work we use the unitarized distorted wave method to study the effect of multi‐channel coupling on the calculated electronic excitation cross sections in H2. Specifically, such an effect for electronic excitations leading to the excited states b3∑, a3∑, and c3∏u for incident energies varying from 15 to 60 eV is studied. Our results have shown that converged cross sections can be obtained with the inclusion of only triplet intermediate states, except for energies near the excitation thresholds, where the inclusion of singlet intermediate states is important. Also, convergence improves with increasing energies for all excitations considered. Comparison of our calculated cross sections with available experimental and other theoretical results is encouraging. © 2006 Wiley Periodicals, Inc. Int J Quantum Chem, 2006
The initial oxidation of magnesium: an in situ study with XPS, HERDA and ellipsometry
Authors: Kurth M. , Graat P. C. J. , Carstanjen H. D. , Mittemeijer E. J.
Published: March 2006

The initial oxidation of magnesium at oxygen partial pressures between 1.3 × 10−8 and 1.3 × 10−5 Pa and at temperatures ranging from 273 to 550 K has been investigated in situ with X‐ray photoelectron spectroscopy (XPS), ellipsometry and high resolution elastic recoil detection analysis (HERDA). Quantitative analysis of the XPS spectra showed a clear oxygen deficiency with respect to MgO for the initial oxide. HERDA measurements confirmed this relatively low oxygen content in the thin oxide layers formed. Ellipsometry measurements showed that the electronic structure of the initially formed oxide differs significantly from that of bulk MgO. The band gap values at room temperature for the oxide layers investigated are clearly smaller than the value for bulk MgO. Copyright © 2006 John Wiley & Sons, Ltd.
Measurements of ion‐induced ferroelectric emission and surface charge dynamics on LiTaO3(0001) by time‐of‐flight scattering and recoiling spectrometry (TOF‐SARS)
Authors: Lui K. M. , Leang P. S. , Kam Y. K. , Lau W. M.
Published: March 2006

We have derived a special surface analysis method for studying surface charge dynamics on ferroelectrics from time‐of‐flight ion scattering and recoiling spectrometry (TOF‐SARS). In this method, shifts of the TOF‐SARS peaks of a ferroelectric crystal are measured as a function of sample temperature, and these spectral data are used to deduce changes in electrical potential on the sample surface. These changes are then converted to information on surface charge dynamics. In addition, the method is also applicable in extracting data regarding ion‐induced ferroelectric electron emission (FEE) from the TOF‐SARS spectra. In this work, we have tested the method with LiTaO3(0001) crystals having the nominal stoichiometry and single domain properties. Our results show that for temperature changes from 25 to ∼100 °C, the excess amount of surface charge induced by pyroelectricity, ion irradiation, and ion‐induced electron emission is drained mainly by surface conductivity. For temperature changes above 100 °C, the bulk ionic conductivity becomes an important charge drainage channel. Our measurements give an activation energy of 0.75 eV for the thermally activated ionic conductivity, and the result agrees well with the literature value previously obtained by d.c. conductivity measurements. Copyright © 2006 John Wiley & Sons, Ltd.
Study of hydration layers near a hydrophilic surface in water through AFM imaging
Authors: Peng Changsheng , Song Shaoxian , Fort Tomlinson
Published: March 2006

In this work, a hydrophilic silica plate exposed in air, and immersed in an aqueous solution was studied through atomic force microscopy (AFM) imaging in contact‐ and tapping‐mode operations. It was experimentally found that the tapping‐mode AFM images of the silica surface were different when it was immersed in an aqueous solution from those when it was exposed in air. The former showed fewer topographic features. However, the contact‐mode AFM images of the silica surface were almost uninfluenced by the medium in which the surface was placed. This phenomenon might be attributed to the existence of hydration layers near the silica surface in the aqueous solution. The layers are like a large sheet on the surface that hides the details, so that an AFM tip in the tapping mode can read only the hydration layer and therefore image only the rough outline of the surface. This result might suggest the existence of hydration layers near a hydrophilic surface immersed in water. Copyright © 2006 John Wiley & Sons, Ltd.
Cover Picture: Rapid, Room‐Temperature Synthesis of Antibacterial Bionanocomposites of Lysozyme with Amorphous Silica or Titania (Small 5/2006)
Authors: Luckarift Heather R. , Dickerson Matthew B. , Sandhage Kenneth H. , Spain Jim C.
Published: March 2006

The cover graphic illustrates the encapsulation of lysozyme molecules within a self‐assembled nanoscale silica framework. These robust antimicrobial lysozyme/silica composite nanoparticles are synthesized through lysozyme‐induced mineralization. The background SEM image reveals the morphology of the composite nanoparticles. Lysozyme also catalyzed the formation of, and became encapsulated within, titania nanoparticles. For more information, please refer to the Communication "Rapid, Room‐Temperature Synthesis of Antibacterial Bionanocomposites of Lysozyme with Amorphous Silica or Titania" by J. C. Spain and co‐workers on page 640 ff. The lysozyme protein structure was obtained from the NCBI database and visualized using Cn3D 4.1. Illustration by Rodney Walker, ARA Inc.
Impact of Overweight and Pneumoperitoneum on Hemodynamics and Oxygenation during Prolonged Laparoscopic Surgery
Authors: Meininger Dirk , Zwissler Bernhard , Byhahn Christian , Probst Michael , Westphal Klaus , Bremerich Dorothee H.
Published: March 2006

Background

Anesthesia adversely affects respiratory function and hemodynamics in obese patients. Although many studies have been performed in morbidly obese patients, data are limited concerning overweight patients [BMI 25–29.9 kg m−2]. The aim of this study was to evaluate the effects of prolonged pneumoperitoneum in Trendelenburg position on hemodynamics and gas exchange in normal and overweight patients.

Methods

We studied 15 overweight and 15 non‐obese [BMI 18.5–24.9 kg m−2] patients who underwent totally endoscopic robot‐assisted radical prostatectomy under general anesthesia with an inspired oxygen fraction of 0.5. A standardized anesthetic regimen was used, and patients were examined at standard times: after induction of anesthesia and Trendelenburg posture, every 30 minutes after establishing pneumoperitoneum, and after the release of the pneumoperitoneum with the patient still in Trendelenburg position.

Results

After induction of anesthesia and Trendelenburg positioning arterial oxygen pressure [PaO2] and alveolar‐arterial difference in oxygen tension [AaDO2] differed significantly between both groups with lower PaO2 [235 ± 27 versus 164 ± 51 mmHg] and higher AaDO2 [149 ± 48 versus 76 ± 28 mmHg] values in overweight patients. During pneumoperitoneum, PaO2 transient increased above baseline values in overweight patients, whereas AaDO2 decreased. Hemodynamic parameters [HR, MAP, and CVP] did not differ significantly between groups.

Conclusions

Arterial oxygenation and AaDO2 are significantly impaired in overweight patients under general anesthesia in Trendelenburg posture. In overweight patients pneumoperitoneum transient reduced the impairment of arterial oxygenation and lead to a decrease in AaDO2. Hemodynamic parameters were not affected by body weight.
Which Octogenarians Do Poorly After Major Open Abdominal Surgery in Our Asian Population?
Authors: Tan Kok‐Yang , Chen Chung‐Ming , Ng Chin , Tan Su‐Ming , Tay Khoon‐Hean
Published: March 2006

Background

As the elderly population grows and surgeons are faced with more octogenarians, there is a need to know how our Asian patients fair after major surgery.

Methods

A retrospective review of 125 octogenarians who underwent major abdominal surgery between January 1997 and September 2003 was performed. Preoperative condition was assessed using a weighted index of comorbidity used in Charlson Comorbidity Index and classification of patients according to the American Society of Anaesthesiologists (ASA). Outcome was measured as to whether complications developed, 30‐day mortality and whether there was return to premorbid function.

Results

The patients had a mean age of 84.6 years (range: 80–106). Nearly half (48.8%, n = 61) the cases were emergency cases. The median index of comorbidity was 3, and 29.6% of patients were classified either ASA III or IV. The operations were mostly stomach, small bowel or large bowel resection. Multivariate analysis revealed that emergency operations were associated with significantly increased odds of morbidity. The overall 30‐day mortality was 5.6%, being only 4.7% for elective cases, despite high morbidity rates. ASA classification, comorbidity index >5, development of acute coronary syndrome and anastomotic leakage were found on multivariate analysis to significantly increase the odds of mortality. For elective cases, 82.8% of patients were able to return to their premorbid functional status. Development of complications and comorbidity index >5 were found to predict failure of its occurrence. Low serum albumin and haemoglobin and renal impairment were also predictors of adverse outcome.

Conclusions

Efforts to improve outcome in geriatric surgery patients should emphasize a shift of attitude towards elective surgery rather than doing emergency operations when complications occur and also target the optimization of predictors of adverse outcome. Octogenarians should not be denied elective surgery.
Posttraumatic Thromboprophylaxis Revisited: An Argument Against the Current Methods of DVT and PE Prophylaxis after Injury
Authors: Velmahos George C.
Published: March 2006

Background

Thromboprophylaxis after injury is a controversial issue. Practices and outcomes vary widely.

Methods

Review of selected trauma literature on venous thromboprophylaxis after injury.

Results

Multiple trauma articles suggest that the efficacy of different methods of thromboprophylaxis is unproven. Most of the practices on this issue are extrapolated from studies which were performed in non‐trauma patients and therefore, may not be applicable in the unique trauma population.

Conclusions

In the absence of undisputable evidence, none of the current methods of venous thromboprophylaxis after injury should be considered as standard of care. There is a need to discover new methods of thromboprophylaxis for the Trauma patient.
Surgery for “Body Packers” — A 15‐year Experience
Authors: Silverberg Daniel , Menes Tehillah , Kim Unsup
Published: March 2006

Background

“Body packing” of illegal drugs has increased in the last decades, and with it our experience in treating these patients, yet no clear guidelines for surgical treatment are available. We examined the characteristics and outcomes of patients who required surgical intervention.

Study design

Charts of all patients who underwent surgery at our institution for ingested drug packets between January 1990 and January 2005 were reviewed. Patients were identified by a pre‐existing list of names collected prospectively and by admission codes. Reviewed parameters included presentation, method of diagnosis, indication for surgery, procedure, and patient outcome.

Results

Twenty‐five patients were identified, for whom charts were available for review. Main indications for surgery were drug toxicity and small bowel obstruction. Most packets were retrieved using a combination of milking and multiple enterotomies. A high rate (40%) of postoperative wound infection was found. The incidence of wound infection correlated significantly with the number of enterotomies.

Conclusion

Surgical intervention for body packing remains the treatment for a minority of these patients. Patients should be placed in lithotomy to facilitate the exposure of the entire gastrointestinal tract, and to allow milking of the packets and their possible retrieval through the anus. The number of enterotomies should be minimized in order to reduce the risk of wound infection. If multiple enterotomies are used, the surgeon should consider leaving the wound open for delayed closure.
Peritoneal Cytology Does Not Increase the Prognostic Information Provided by TNM in Gastric Cancer
Authors: de Manzoni G. , Verlato G. , Leo A. Di , Tomezzoli A. , Pedrazzani C. , Pasini F. , Piubello Q. , Cordiano C.
Published: March 2006

Background

This study aimed at verifying whether peritoneal cytology could improve the prognostic information provided by TNM staging in gastric cancer patients.

Method

The presence of free peritoneal tumor cells was investigated in 168 patients who underwent curative resection for gastric cancer from January 1992 to July 2002 in Verona, Italy. The influence of peritoneal cytology on survival was evaluated by a Cox regression model, controlling for potential confounders.

Results

Twenty‐three patients (14%) had positive peritoneal cytology. Patients with positive lavage were more likely to present serosal infiltration (100 vs. 46%) and nodal metastases (91 vs. 67%; P < 0.001). Positive lavage was associated with a very poor prognosis: 3‐year survival was only 9% (95% CI 2–27%) when peritoneal cancer cells had been detected, whereas survival reached 50% (95% CI 42–59%) in patients with a negative cytology. In multivariate survival analysis, peritoneal cytology was an independent predictor of mortality when controlling for sex, age, site, histology, and nodal metastases, but not when adjusting also for depth of tumor invasion (RR of positive versus negative = 1.2, 95% CI 0.7–2.0). Similarly, the influence of peritoneal cytology on survival was no longer significant when univariate analysis was restricted to T3/T4 patients (RR = 1.5, 0.9–2.5).

Conclusions

Positive peritoneal cytology was a marker of poor prognosis in gastric cancer patients. Nevertheless, peritoneal lavage did not increase the prognostic information already provided by the TNM staging system in this Italian series.
Factors Predicting Long‐term Responses to Splenctomy in Patients with Idiopathic Thrombocytopenic Purpura
Authors: Ojima Hitoshi , Kato Toshihide , Araki Kenichirou , Okamura Kaori , Manda Ryokuhei , Hirayama Isao , Hosouchi Yasuo , Nishida Yasuji , Kuwano Hiroyuki
Published: March 2006

Background

Idiopathic thrombocytopenic purpura (ITP) is an autoimmune disorder for which appropriate diagnostic treatments are uncertain. The response to splenectomy varies from 60% to 90%, and the remaining patients relapse and require further treatment. Therefore, it is important to predict the outcome of splenectomy before and after surgery. The objective of this study was to evaluate the efficacy of splenectomy in patients diagnosed with ITP.

Materials and Methods

From 1988 to 2004, we splenectomized 32 patients with ITP; 17 underwent laparoscopic splenectomy (LS) and 15 underwent conventional open splenectomy (OS). For analysis, patients were separated retrospectively into two groups: the “responding group,” those who showed good outcomes with splenectomy, and the “non‐responding group,” those who did not show good outcomes with splenectomy. Blood samples were examined before and immediately after surgery (day 0) and on postoperative days (POD) 1, 3, 5, and 7.

Results

The median follow‐up was 8.3 years (range: 1–16 years). The overall 5‐ and 10‐year survival rates after splenectomy were 96.9% (one death). The responding group included 24 patients (75%), and the non‐responding group included 7 (21.9%). Platelet counts in the responding group increased gradually until POD 7, and although platelet counts in the non‐responding group were almost constant until POD 5, they subsequently decreased until POD 7. Average platelet counts in the responding and non‐responding groups were 269 and 124 × 109/l on POD 7, respectively (P < 0.05). The pre‐ to post‐surgery ratio of platelet counts were almost the same as the result of the actual data. Platelet counts during the long‐term follow‐up for the responding and non‐responding groups were related to those noted on discharge.

Conclusions

A high platelet count on POD 7 was associated with a good response to splenectomy, but age at surgery, the time interval between diagnosis and splenectomy, and prior responses to corticosteroid were not. We suggest that long‐term outcomes of splenectomy can easily be predicted by platelet counts on POD 7.
Seed fate of Marah macrocarpus (Cucurbitaceae) following fire: do seedlings recruit from rodent burrows?
Authors: Borchert Mark
Published: March 2006

For numerous species in fire‐prone ecosystems, the passage of fire triggers the release of large quantities of seeds within 2 years of the fire. This special case of masting has been described for species in an array of floras, but few studies have followed the fates of seeds liberated into the postfire environment. In this study, I followed the fates of 990, magnet‐bearing Marah macrocarpus seeds sown at three seed densities in a large, high‐intensity burn area. Seeds disappeared over 6.6 months and removal at all three densities became negatively density‐dependent in late summer until all seeds disappeared in mid winter. I recovered only 5% of the magnets, mostly from rodent tunnels. Based on the recovery of magnets, I estimate rodents moved ~91% of the seeds belowground. Seed burial trials showed that seedlings established from seeds buried up to 16 cm whereas seeds sown on the surface did not germinate. Seedlings also readily established from burial in soils with 50% rock fragments as well as from artificial tunnels in both pot and field experiments. Excavation of 50 natural seedlings suggested up to 20% established in rodent burrows. Findings of this study suggest that ecologists may have underestimated the role of burrows as locations for recruitment of large‐seeded species.
Myxoid liposarcoma metastatic to the thyroid gland: a case report and literature review
Authors: Tysome J R , Sandison A , Clarke P M
Published: March 2006

We present the second reported case of a myxoid liposarcoma metastatic to the thyroid gland in a 51-year-old gentleman with previous liposarcoma of the right thigh. Myxoid liposarcoma has a relatively good prognosis but tends to recur locally. Metastases affecting the thyroid gland are a rare entity and most commonly arise from the kidney, lung or breast. Clinical presentation, patterns of recurrence and prognosis of myxoid liposarcoma and metastases to the thyroid gland are discussed.
Concurrent chemoradiotherapy with carboplatin and uracil–ftegafur in patients with stage two (T2 N0 M0) squamous cell carcinoma of the glottic larynx
Authors: Taguchi T , Tsukuda M , Mikami Y , Horiuchi C , Ishitoya J-I , Katori H
Published: March 2006

This study aimed to evaluate the efficacy and toxicity of concurrent chemoradiotherapy as a primary treatment modality for larynx preservation in patients with stage two squamous cell carcinoma (SCC) of the glottic larynx. Between February 2000 and August 2003, a total of 20 patients received concurrent chemoradiotherapy. Carboplatin was given intravenously once a week during the period of radiotherapy. The weekly carboplatin dose was based on the area under the curve 1 to 1.25. Uracil–ftegafur (UFT) was given in a daily oral dose of 300 mg as tegafur. Radiotherapy was delivered five days a week using a once-daily fractionation of 2.0 Gray (Gy), to a total dose of 66–72 Gy. The three-year overall survival rate with larynx preservation was 100 per cent.

Concurrent chemoradiotherapy with carboplatin and UFT for stage two SCC of the glottic larynx was safe and effective in improving local control with larynx preservation.
A comparative analysis of anterior versus posterior squamous cell carcinoma of the tongue: a 10-year review
Authors: Mackle T , O'Dwyer T
Published: March 2006

Introduction: The study sought to compare and contrast squamous cell carcinoma (SCC) of the anterior mobile tongue with SCC of the tongue base, with emphasis on clinical presentation, management and outcome.

Methods: This was a retrospective, comparative analysis of patients treated for SCC of the tongue over a 10-year period. Cox's regression model was used to assess the effect of tumour site on survival.

Results: The study included 142 patients, of whom 86 were treated for SCC of the anterior tongue and 56 for tongue base lesions. Patients with carcinoma of the anterior tongue tended to present with a visible lump or ulceration of the tongue, whereas the majority of patients with tongue base SCC presented with pain. Sixty per cent of anterior tongue lesions were early stage (I or II) at initial presentation as compared with 21 per cent of tongue base lesions.

Conclusion: Patients with anterior tongue lesions had a better prognosis, but this was not statistically significant when adjusted for stage.
The Brief Core Schema Scales (BCSS): psychometric properties and associations with paranoia and grandiosity in non-clinical and psychosis samples
Authors: FOWLER DAVID , FREEMAN DANIEL , SMITH BEN , KUIPERS ELIZABETH , BEBBINGTON PAUL , BASHFORTH HANNAH , COKER SIAN , HODGEKINS JOANNE , GRACIE ALISON , DUNN GRAHAM , GARETY PHILIPPA
Published: March 2006

Background. Traditional instruments that measure self-esteem may not relate directly to the schema construct as outlined in recent cognitive models. The Brief Core Schema Scales (BCSS) aim to provide a theoretically coherent self-report assessment of schemata concerning self and others in psychosis. The scales assess four dimensions of self and other evaluation: negative-self, positive-self, negative-other, positive-other.

Method. We analysed the psychometric properties of the BCSS using a sample of 754 students recruited by email and 252 people with psychosis recruited as part of a trial of cognitive therapy. We report the internal consistency, stability and the factor structure of the scale, and the association of the BCSS with measures of self-esteem and with symptoms of paranoia and grandiosity.

Results. The BCSS have good psychometric properties and have more independence from mood than the Rosenberg Self-Esteem Schedule. People with chronic psychosis reported extreme negative evaluations of both self and others on these scales, but their levels of self-esteem and positive evaluations of self and others were similar to the student sample.

Conclusions. Extreme negative evaluations of self and others appear to be characteristic of the appraisals of people with chronic psychosis, and are associated with symptoms of grandiosity and paranoia in the non-clinical population. The BCSS may provide a more useful measure of schemata about self and others than traditional measures of self-esteem.
Attribution style and psychosis: evidence for an externalizing bias in patients but not in individuals at high risk
Authors: JANSSEN I. , VERSMISSEN D. , CAMPO J. À. , MYIN-GERMEYS I. , OS J. VAN , KRABBENDAM L.
Published: March 2006

Background. The aims of the study were to investigate whether (i) patients with lifetime presence of non-affective psychosis show an external-personal attribution bias for negative events, (ii) this attribution style can also be detected in first-degree relatives of patients with psychosis and subjects with subclinical psychotic experiences, and (iii) this attribution style is related to the presence of psychotic symptoms, in particular delusions.

Method. Participants were 23 patients with lifetime presence of non-affective psychosis, a high- risk group of 36 first-degree relatives of patients with non-affective psychosis, a high-risk group of 31 subjects with subclinical psychotic experiences and 46 normal controls. Attribution style was measured by the Internal, Personal and Situational Attribution Questionnaire. Positive symptoms were assessed with the Present State Examination (PSE) and the Scale for the Assessment of Positive Symptoms (SAPS).

Results. Relative to the controls, an externalizing bias was apparent in the patient group (β=0·20, p=0·03) but not in the two high-risk groups. There was a dose–response association between externalizing bias and the delusions subscale of the PSE (relative to lowest level: highest level of delusions: β=0·53, p=0·04; intermediate levels of delusions: β=0·23, p=0·35). No significant differences were found in personalizing bias between the four groups.

Conclusions. Patients with psychosis tend to use an externalizing bias in their explanations of negative social events, and this bias is associated with the presence of positive psychotic symptoms, in particular delusions. A deviant attribution style is not part of the vulnerability to psychosis.