bluuebunny/crossref_metadata_2025 huggingface dataset:
Migration of Intergranular Liquid Films and Formation of Core‐Shell Grains in Sintered TiC–Ni Bonded to WC–Ni
Authors: Ko Ji Yeon , Park Sin‐Young , Yoon Duk Yong , Kang Suk‐Joong L.
Published: February 2005

When TiC–20 wt% Ni powder mixtures are sintered at 1400°C, relatively large TiC grains possibly containing some Ni form with near‐equilibrium shapes. When these specimens are heat‐treated again at 1400°C in contact with sintered WC–20 wt% Ni pieces, the liquid films between the TiC grains in the contact region migrate against their increasing curvatures, forming (Ti,W)C solid solution behind them. These migrating liquid films reverse their directions on further heat‐treatment. As in other alloys, this liquid film migration must be driven by the coherency strain energy produced by W diffusion at the surface of the dissolving TiC grains. Shells of (Ti,W)C solid solution also form around the cores of TiC grains near the contact region, and this process is probably driven by both coherency strain energy and free energy of mixing. At some contact regions, (Ti,W)C precipitates nucleate and grow, probably driven mainly by the free energy of mixing. In powder mixtures, the formation of core‐shell grains is expected to be driven by the coherency strain energy, the free energy of mixing, and the capillary effect.
Production of Nanosized YAG Powders with Spherical Morphology and Nonaggregation via a Solvothermal Method
Authors: Li Xia , Liu Hong , Wang Jiyang , Cui Hongmei , Han Feng , Boughton R. I.
Published: February 2005

Monodispersed nanosized yttrium aluminum garnet (YAG) powder was synthesized via a mixed‐solvent thermal method using stoichiometric amounts of inorganic aluminum and yttrium salts. Pure‐phase YAG crystalline powder was obtained at low temperature (290°C) and low pressure (10 MPa). The resulting products were characterized by X‐ray powder diffraction (XRD), infrared, and transmission electron microscopy (TEM). XRD results showed that single‐phase YAG could be formed directly from an amorphous precursor at 280°C and become fully developed at 290°C. TEM images showed that the YAG powder particles in the study were basically spherical in shape and well‐dispersed with a mean grain size of about 60 nm.
Chemical Speciation of Trace Zinc in Ordinary Portland Cement Using X‐ray Absorption Fine Structure Analysis
Authors: Tsuyumoto Isao , Uchikawa Hiroshi
Published: February 2005

Chemical change of trace zinc in ordinary portland cement (205.1 ppm) was investigated in hydration process using X‐ray absorption near‐edge structure (XANES) and extended X‐ray absorption fine structure (EXAFS). Intensities of the peaks appearing at the same energy of ZnO in XANES spectra were decreased with cement hydration. The interatomic distances and the coordination numbers of the first and the second shells calculated from EXAFS spectra indicated that ZnO hydrolyzed to zincate ion [Zn(OH)4]2− with cement hydration keeping their fundamental structure of ZnO4 tetrahedra.
Perception is reality: Parisian and Provençal perceptions of regional varieties of French1
Authors: Kuiper Lawrence
Published: February 2005

Though spoken French has tended toward standardization and homogenization, stereotypes of regional language are maintained, and thrive. The present study explores speakers’ perceptions of regional varieties, and relates those perceptions to linguistic security and prescriptivism in two regions: Ile de France (Paris) and Provence. Respondents from these two regions rated regional French varieties for correctness, pleasantness and difference from their own speech. The quantitative data, which is supported by interviews and a perceptual mapping task, reveals that speakers from these two regions have strikingly similar views about the region where French is most correct (Paris) and where it is most pleasant (Provence). Qualitative data from interviews and perceptual mapping show that respondent perceptions about normative language have little basis in empirical reality (i.e. language performance), but still may have a strong effect on speaker self‐image.
Self‐presentation in sociolinguistic interviews: Identities and language variation in Panambi, Brazil
Authors: Zilles Ana M. S. , King Kendall
Published: February 2005

This paper contributes to recent work examining the role of identity, and in particular the uses of language for self‐presentation and the expression of individual identity, through the analysis of two sociolinguistic interviews from a community of German origin in southern Brazil. Drawing from a quantitative study of variation in the southern state of Rio Grande do Sul, we conducted a detailed analysis of the interviews of two women of different ages and social backgrounds. We first describe the social, cultural and historical context of the interviews, and then discuss how our two speakers use their linguistic resources to express varied, and at times conflicting, aspects of their identities. More specifically, we show how our participants seem to maintain certain in‐group, German‐linked features, yet also use out‐group or Brazilian features in order to index both the (local) German and (regional) Brazilian aspects of their identities. Our data and analysis highlight how participants’ identity and language use patterns can be better understood through close analysis of the content of their discourse.
An online study of Australian Enrolled Nurse conversion
Authors: Kenny Amanda J. , Duckett Stephen
Published: February 2005

Aim.  This paper reports the findings of a study exploring the reasons why rural Enrolled Nurses have chosen to convert to level 1 of the nursing register.

Background.  Whilst the Project 2000: A New Preparation for Practice report resulted in the cessation of second level or Enrolled Nurse training in the United Kingdom, Australia has continued to educate enrolled nurses. Currently Australia is facing critical shortages of level 1 nurses and nowhere is this more acute than in rural areas. There are indications that there are large numbers of rural Enrolled Nurses who are interested in ‘converting’ from level 2 to level 1 of the nursing register.

Method.  Using a computer program that facilitates engagement and interaction, an ‘online’ focus group was conducted with 38 Enrolled Nurses undertaking a conversion programme at a rural university in Victoria, Australia. During a period of 2 months the Enrolled Nurses participated in a discussion focusing on their reasons for undertaking a conversion programme. Their responses were categorized into five interrelated broad themes.

Findings.  These Enrolled Nurses suggested that disillusionment with their role and role ambiguity were the primary reasons for their decision to undertake a conversion programme. All participants suggested that their scope of practice as an Enrolled Nurse is significantly broadened in rural areas. They argued that, following conversion, they are in an ideal position to manage the diversity of rural nursing practice.

Conclusions.  In Australia, Enrolled Nurse conversion has the potential to ease some of the workforce shortages, particularly in rural areas. By supporting Enrolled Nurses to undertake conversion programmes, rural areas may benefit from having nurses with the knowledge and skills to deal with the rural environment.
Cognitive coping intervention for acutely ill HIV‐positive men
Authors: Côté José K , Pepler Carolyn
Published: February 2005

Aim. A nursing intervention was designed that is intended to develop, maintain and strengthen the patient's cognitive coping skills to regulate emotional response to severe physical symptoms. It was tested in a randomized trial reported elsewhere and this article describes the intervention and discusses its application.

Background. Research shows that psychological distress and depressive symptoms are likely to increase with the development of human immunodeficiency virus (HIV)‐related physical symptoms. Nurses who work with HIV‐positive individuals have an opportunity to influence their patients’ health experiences substantially.

Clinical application. The intervention was carried out with hospitalized HIV patients who had to cope with an acute period of stress due to an exacerbation of HIV‐related symptoms. The intervention was administered on three consecutive days, in 20–30‐minute sessions. The features of the intervention in relation to two examples of patient profiles are described: patients needing to develop their cognitive skills to regulate severe emotional distress and patients with effective cognitive coping skills.

Relevance to clinical practice. The intervention empowers nurses by offering an effective approach to deal with individuals who are facing severe illness. It has also the potential to empower patients both to take advantage of their own personal resources and to take control over their situation.
The development of a screening tool to identify carers in a general practice by a large‐scale mailed survey: the experience in one Scottish general practice
Authors: Jarvis Alison , Worth Allison
Published: February 2005

Aims and objectives.  To determine the feasibility of a screening tool to identify carers in a general practice.

Background.  The need to support informal carers is well established in policy and practice, but many carers continue to lack the support they need. Identifying carers is a fundamental precondition to providing them with support. Studies often recruit carers who are members of carers’ organizations or via the care recipient in receipt of services. However, as nearly 60% of carers receive no support from the statutory services, this group of carers may not be representative of the majority of carers. This paper describes the results of a study undertaken to identify a broader group of carers in a general practice in a large Scottish city.

Design and methods.  A quantitative research design was employed using a mailed screening survey to identify carers within a general practice. Carers were systematically identified, independent of the care recipient, using a screening tool developed by the researcher which was sent to all adult patients registered with the practice.

Results.  The response rate was 69%. Overall, 11% of the surgery population identified themselves as carers with a mean age of 55 years. The carers were involved in a range of caring activities of varying levels and duration.

Conclusion.  The screening exercise was time consuming and costly. However, it would be feasible and useful to identify carers in smaller groups.

Relevance to practice.  This study tackles issues that are pertinent to health policy and practice. Carers were systematically identified from a general practice population and included those at an early stage of the caring role, prior to being involved with service providers, as well as those established in their role. If carers are identified early in their caring career the primary health care team is more able to support them proactively.
Reproducibility of lateral excursive tooth contact in a semi‐adjustable articulator depending on the type of lateral guidance
Authors: CARO A. J. , PERAIRE M. , MARTINEZ‐GOMIS J. , ANGLADA J. M. , SAMSÓ J.
Published: February 2005

summary  The purposes of this study were (i) to compare the reproducibility of lateral tooth contacts of casts mounted in a semi‐adjustable articulator when condylar guidance was set by different methods and (ii) to assess the margin of error of the variations of condylar guidance without changing lateral tooth contacts, depending on the type of lateral guidance. In subjects with different types of lateral guidance, intraoral lateral tooth contacts identified with occlusal registration strips were compared with those identified by use of a semi‐adjustable articulator, setting the condylar guidance in four different ways: using protrusive wax wafers, by axiography and by adding and subtracting 5° from the value of condylar guidance obtained by protrusive wax wafers. Tolerance to variations of condylar guidance without changing lateral tooth contacts was determined by increasing and decreasing the value of condylar guidance until lateral tooth contacts changed. Different ways of setting condylar guidance on a semi‐adjustable articulator give rise to different values of condylar guidance in the same subject. The occlusal repercussions of these variations of condylar guidance values depend on the type of lateral guidance. Canine protection had the greatest tolerance to variations in the setting of condylar guidance without changing lateral occlusal contacts.
Effect of chemical composition of Ni‐Cr dental casting alloys on the bonding characterization between porcelain and metal
Authors: HUANG H.‐H. , LIN M.‐C. , LEE T.‐H. , YANG H.‐W. , CHEN F.‐l. , WU S.‐C. , HSU C.‐C.
Published: February 2005

summary  The purpose of this study was to investigate the influence of chemical composition of Ni‐Cr dental casting alloys on the bonding behaviour between porcelain and metal. A three‐point bending test was used to measure the fracture load of alloy after porcelain firing. A scanning electron microscope, accompanied by an energy dispersion spectrometer, was used to analyse the morphology and chemical composition of the fracture surface. An X‐ray photoelectron spectrometer and glow discharge spectrometer were used to identify the structure and cross‐sectional chemical composition, respectively, of oxide layers on Ni‐Cr alloys after heat treatment at 990 °C for 5 min. Results showed that the oxide layers formed on all Ni‐Cr alloys contained mainly Cr2O3, NiO, and trace MoO3. The Ni‐Cr alloy with a higher Cr content had a thicker oxide layer, as well as a weaker bonding behaviour of porcelain/metal interface. The presence of Al (as Al2O3) and Be (as BeO) on the oxide layer suppressed the growth of the oxide layer, leading to a better porcelain/metal bonding behaviour. However, the presence of a small amount of Ti (as TiO2) on the oxide layer did not have any influence on the bonding behaviour. The fracture propagated along the interface between the opaque porcelain and metal, and exhibited an adhesive type of fracture morphology.
All‐ceramic fixed partial dentures designed according to the DC‐Zirkon® technique. A 2‐year clinical study
Authors: VON STEYERN P. VULT , CARLSON P. , NILNER K.
Published: February 2005

summary  The aim of the study was to investigate whether the properties of a pre‐sintered, hot isostatic post‐compacted (HIP) ZrO2 are adequate for use in three–five‐unit fixed partial dentures (FPDs) and to evaluate the clinical results. Twenty three–five‐unit FPDs were fabricated for 18 patients on a total of 56 abutments. They were all made on abutments cut with a shoulder preparation and cemented with a zinc phosphate cement. They were clinically followed for 24 months. After 24 months all FPDs were still in use without any fractures or clinical wear but in three cases (15%) minor chip‐of fractures were observed. Marginal integrity was rated excellent at 45 abutments and acceptable at 11. Within the limitations of this 2‐year clinical follow‐up study, FPDs made of pre‐sintered HIP ZrO2 core material veneered with a compatible ceramic is an acceptable alternative in the fabrication of FPDs with the extensions investigated in this study. Special attention, however, must be paid to designing the core for an occlusal shape that provides sufficient support for the veneer.
DELLA proteins: integrators of multiple plant growth regulatory inputs?
Authors: Alvey Liz , Harberd Nicholas P.
Published: February 2005

The DELLA proteins are a family of putative transcriptional regulators that inhibit the cell proliferation and expansion that drives the growth of plant organs. Plant growth is stimulated via destruction of DELLA proteins in the 26S proteasome. Recent advances have shown that the ‘classical’ phytohormones gibberellin (GA), auxin and ethylene control plant growth by influencing DELLA‐destruction. This paper outlines the discovery, molecular characterization and biology of the DELLA proteins, and summarizes the evidence that they act as integrators of response to multiple growth‐regulatory signals.
Integration of signalling pathways in the establishment of the legume‐rhizobia symbiosis
Authors: Mulder Lonneke , Hogg Bridget , Bersoult Anne , Cullimore Julie V.
Published: February 2005

The establishment of the legume‐rhizobia symbiosis requires recognition of the bacterial microsymbiont at the root epidermis followed by initiation of plant infection and nodule organogenesis programmes. These phenomena are initiated by rhizobial lipochitooligosaccharidic symbiotic signals (the Nod factors). Studies of Nod factor activities, coupled with the recent cloning of genes required for their initiation, are leading to an understanding of the first steps in the signalling pathways. Moreover studies, especially on ethylene, auxin and cytokinin, have shown that phytohormones are involved in controlling or mediating symbiotic responses. The challenge for the future will be to establish how Nod factor signalling integrates with phytohormone activities in the control of infection and nodulation in the establishment of this agronomically and ecologically important symbiosis.
Crosstalk and abscisic acid: the roles of terpenoid hormones in coordinating development
Authors: McCourt Peter , Lumba Shelley , Tsuchiya Yuichiro , Gazzarrini Sonia
Published: February 2005

The sesquiterpenoid hormone abscisic acid (ABA) regulates many aspects of plant growth and development. It has been difficult, however, to understand how this hormone functions in a myriad of events. Genetic analysis, particularly in Arabidopsis, has identified genes that modulate ABA responsiveness, but a molecular framework has not been developed to explain how these genes direct ABA‐mediated developmental events. Certainly, some of the diversity of processes influenced by ABA is a result of crosstalk with other signalling pathways. In other cases, the complex development of a multicellular organism with different cell types and growth conditions throughout its life cycle also increases the possible output signals of ABA action. In this article, we touch on some of these issues in the context of ABA signalling during embryogenesis. On a more speculative level, we propose that a developmental and molecular framework of ABA action in the embryo may be gained from two chemically related terpenoid signalling hormones in animals: juvenile hormone (JH) and retinoic acid (RA). Many of the developmental issues with regard to ABA action in plant embryos are mirrored in JH studies from invertebrates, and the molecular action of RA in vertebrates suggests that transcriptional regulation is a direct output of RA addition. Both of these systems may be useful in furthering our developmental and molecular understanding of ABA action in plants.
Auxin regulation of cell cycle and its role during lateral root initiation
Authors: Vanneste Steffen , Maes Lies , De Smet Ive , Himanen Kristiina , Naudts Mirande , Inzé Dirk , Beeckman Tom
Published: February 2005

The plant hormone auxin plays a crucial role in the upstream regulation of many processes, making the study of its action particularly interesting to understand plant development. In this review we will focus on the effects auxin exerts on cell cycle progression, more specifically, during the initiation of lateral roots. Auxin fulfils a dominant role in the initiation of a new lateral root primordium. How this occurs remains largely unknown. Here we try to integrate the classical auxin signalling mechanisms into recent findings on cell cycle regulation. How both signalling cascades are integrated appears to be complex and is far from understood. As a means to solve this problem we suggest the use of a lateral root‐inducible system that allows investigation of the early signalling cascades initiated by auxin and leading to cell cycle activation.
Auxin and the developing root of Arabidopsis thaliana
Authors: Teale William D. , Paponov Ivan A. , Ditengou Franck , Palme Klaus
Published: February 2005

The plant hormone auxin has long been known to play a crucial role in plant growth and development, but how it affects so many different processes has remained a mystery. Recent evidence from genetic and molecular studies has begun to reveal a possible mechanism for auxin action. In this article we will present an overview with specific emphasis on auxin's role in roots of Arabidopsis thaliana, focusing on cell division, elongation and differentiation.
Ultrasonography‐guided fine‐needle aspiration cytology before sentinel node biopsy in patients with penile carcinoma
Authors: Kroon Bin K. , Horenblas Simon , Deurloo Eline E. , Nieweg Omgo E. , Teertstra Hendrik J.
Published: February 2005

OBJECTIVE

To assess the accuracy of ultrasonography (US)‐guided fine‐needle aspiration cytology (FNAC) for detecting occult lymph node metastases in patients with squamous cell carcinoma of the penis.

PATIENTS AND METHODS

Forty‐three patients with 83 clinically node‐negative inguinal regions were assessed with US and FNAC. The results were compared with histology from subsequent dynamic sentinel‐node biopsy (DSNB) or inguinal lymph node dissection.

RESULTS

Thirty‐four groins in 27 patients were considered to be suspicious by US and the lymph nodes were aspirated. Nine nodes contained tumour cells and this was confirmed by subsequent lymph node dissection. The sensitivity and specificity of US‐guided FNAC were 39% (nine of 23) and 100% (60 of 60), respectively. The number of groins requiring DSNB was reduced by 11% (nine of 83).

CONCLUSION

US‐guided FNAC can be used as the initial investigation in clinically node‐negative groins. If tumour is confirmed then therapeutic inguinal lymph node dissection can be earlier and fewer DSNBs are required.
Surgical excision of isolated renal‐bed recurrence after radical nephrectomy for renal cell carcinoma
Authors: Sandhu Sarbjinder S. , Symes Andrew , A’hern Roger , Sohaib S.A. Aslam , Eisen Tim , Gore Martin , Christmas Timothy J.
Published: February 2005

OBJECTIVE

To present our results on managing loco‐regional recurrence of renal cell carcinoma (RCC) with surgical excision, as local recurrence at the site of a previous nephrectomy is resistant to both systemic therapy and radiotherapy.

PATIENTS AND METHODS

In all, 16 patients were operated on between 1994 and 2003 for local recurrence of RCC. The median (mean, range) age at the time of local recurrence was 57.9 (57.4, 28.9–71.7) years, and the median interval from primary surgery 2.22 (3.88, 0.27–14.46) years. Before surgery eight patients had been given systemic immunotherapy, with no response of their local recurrence.

RESULTS

Two patients were deemed inoperable because of direct invasion of the great vessels and the liver by tumour. The remaining 14 patients had recurrence in residual adrenal tissue (two), para‐aortic nodes (three), para‐caval nodes (two), retrocaval nodes (one), renal bed (six), liver, spleen and stomach (one each), and diaphragm (two). Although complete macroscopic en‐bloc clearance was achieved in these patients, only eight had tumour‐free margins on histological examination. The histology was consistent with RCC recurrence in all cases. All of the patients were followed with computed tomography at regular intervals. At a median follow‐up of 1.0 (1.65, 0.25–6.5) years, five patients remain disease‐free, four have local and distant relapse, and five developed distant metastasis only. The presence of tumour at the resection margin was a significant factor in predicting local and distant disease‐free survival (P < 0.05).

CONCLUSIONS

En bloc excision of isolated locally recurrent RCC is possible, and complete surgical extirpation can lead to prolonged disease‐free survival.
An evaluation of urinary function after radical prostatectomy in Japanese men: concordance with definitions of urinary continence
Authors: Namiki Shunichi , Kuwahara Masaaki , Ioritani Naomasa , Akito Terai , Arai Yoichi
Published: February 2005

OBJECTIVE

To determine how well various definitions of continence outcome after radical retropubic prostatectomy (RP) corresponded with each other, using published health‐related quality‐of‐life (HRQoL) questionnaires.

PATIENTS AND METHODS

In all, 198 patients undergoing RP alone were enrolled in a study between November 2000 and June 2003. The baseline interview was conducted before RP and 3, 6 and 12 months afterward. The disease‐specific HRQoL was assessed using the University of California‐Los Angeles Prostate Cancer Index; the correspondence among definitions of incontinence was investigated.

RESULTS

The urinary function score substantially declined at 3 months, continued to recover at 6 and 12 months, but remained lower than at baseline (P < 0.001). The correspondence among definitions of continence varied widely; 97% of men who did not have urine leakage at all claimed to use no pads, but only 63% of those claiming no use of pads had no urine leakage at all. Interestingly, this concordance rate progressively changed from 46% at 3 months to 60% at 12 months, whereas it was 82% at baseline.

CONCLUSIONS

Based on self‐reported questionnaire data, different definitions of continence gave different results when applied to the same patients at the same time. The correspondence among definitions may vary with time after RP. No single question adequately assesses the urinary HRQoL outcome after treatment for prostate cancer.
A retrospective study of the treatment of locally advanced prostate cancer by six institutions in eastern and north‐eastern Japan
Authors: Hachiya Takahiko , Akakura Koichiro , Saito Shiro , Shinohara Nobuo , Sato Kazunari , Harada Masaoki , Kato Tetsuro , Okada Kiyoki
Published: February 2005

OBJECTIVE

To investigate patients with locally advanced prostate cancer treated at six academic institutions in eastern and north‐eastern Japan from 1988 to 2000, to facilitate the establishment of Japanese guidelines for the diagnosis and treatment of locally advanced prostate cancer.

PATIENTS AND METHODS

The study included 391 eligible patients with locally advanced prostate cancer who were treated by radical prostatectomy (RP), radiotherapy and/or primary hormone therapy. Disease‐specific survival rates for these patients were assessed in relation to their clinicopathological characteristics and the types of treatment they received. The Mann–Whitney U‐test, Kruskal–Wallis, chi‐square and log‐rank test were used for statistical analysis, as appropriate.

RESULTS

In all, 128 patient with lower prostate‐specific antigen levels (P = 0.023) and/or better performance status (P = 0.001) had RP. Neoadjuvant hormone therapy before RP was the treatment in 68 (53%) of these 128 patients; 66 (52%) received immediate adjuvant hormone therapy. Of 87 patients treated with radiotherapy, 75 (86%) had external beam radiotherapy (EBRT) as the primary treatment with no brachytherapy, and 12 (14%) had brachytherapy as the primary method. Neoadjuvant hormone therapy was given to 56 of the 87 patients (64%); 48 (55%) received immediate adjuvant hormone therapy. Of the 176 patients treated with primary hormone therapy alone, combined androgen blockade and surgical or medical castration was the treatment in 76 (43%) and 85 (48%), respectively. Disease‐specific survival rates at 5 years for patients treated with RP, EBRT and primary hormone therapy were 90%, 98%, and 89%, respectively.

CONCLUSION

The treatments provided by the participating institutions did not differ significantly from those set out in European and American guidelines, and short‐term disease‐specific survival rates for each treatment did not differ significantly from those of historical controls. Further investigation may facilitate the establishment of Japanese guidelines for the diagnosis and treatment of locally advanced prostate cancer.
Examining the location and cause of death within 30 days of radical prostatectomy
Authors: Alibhai Shabbir M.H. , Leach Marc , Tomlinson George
Published: February 2005

OBJECTIVES

To better characterize the cause and location of death after radical prostatectomy (RP), as early mortality is relatively uncommon after RP, with little known about the cause of death among men who die within 30 days of RP, and the trend toward earlier discharge after surgery means that a greater proportion of early mortality after RP may occur out of hospital.

PATIENTS AND METHODS

Using the Ontario Cancer Registry, we identified 11 010 men (mean age 68 years) who had a RP in the province of Ontario between 1990 and 1999. We identified the occurrence and location of all deaths within 30 days of RP. The cause of death was obtained from death certificate information. Logistic regression was used to examine factors (age, comorbidity, year of surgery) associated with the location of death.

RESULTS

Of the 11 010 men, 53 died within 30 days of RP (0.5%); of these 53 men, 28 (53%) died in hospital. Neither age, comorbidity nor year of surgery were significantly associated with location of death (P > 0.05). Major causes of death included cardiovascular disease (38%) and pulmonary embolism (13%). More than half of the patients who died out of hospital had an unknown cause of death.

CONCLUSIONS

Almost half of all deaths within 30 days of RP occur out of hospital; the two most common causes of death are potentially preventable. More detailed cause‐of‐death information may help to identify opportunities for prevention.
Effects of a shared protocol between urologists and general practitioners on referral patterns and initial diagnostic management of men with lower urinary tract symptoms in Italy: the Prostate Destination study
Authors: Spatafora Sebastiano , Canepa Giorgio , Migliari Roberto , Rotondo Salvatore , Mandressi Alberto , Puppo Paolo ,   the AURO.it Cooperative Group
Published: February 2005

OBJECTIVE

To assess whether adopting a shared protocol between urologists and general practitioners (GPs) might change diagnostic procedures and referral patterns in the management of men with lower urinary tract symptoms (LUTS).

SUBJECTS AND METHODS

Forty‐five urological centres and 263 GPs in Italy participated in this prospective study. Procedures adopted by GPs for evaluating five consecutive patients (aged ≥ 50 years) were compared before (phase 1) and after (phase 2) implementation of the shared protocol. An evidence‐based diagnostic algorithm was developed and approved by participating urologists and presented to local GPs at a training session. Protocol modifications were allowed after discussion with GPs. Direct costs of diagnostic procedures carried out before and after implementing the protocol were calculated from the perspective of the national health service.

RESULTS

In all, 903 patients were evaluable in phase 1 and 856 in phase 2. Implementation of the protocol did not change referral patterns, with about half the patients being managed entirely by GPs. The use of a digital rectal examination by GPs increased from 32% to 41%, use of transrectal and suprapubic ultrasonography decreased from 33% to 23% and 53% to 44%, respectively, (all P < 0.001) and use of the International Prostate Symptom Score increased from 4.5% to 23.1% (P < 0.001). Overall, protocol‐recommended tests were used more frequently, while those not recommended decreased after implementing the protocol. However, overuse of the tests not recommended (i.e. urine culture and free/total prostate specific antigen ratio) remained high. The mean cost per patient of diagnostic procedures ordered by GPs decreased from €71.82 to €61.93, with €9.9 saved for each patient.

CONCLUSION

Our intervention failed to decrease the percentage of cases of LUTS being referred to specialists, but was moderately effective in inducing changes in the diagnostic management by GPs that were indicative of increased compliance with best‐practice principles, and produced cost savings of 13.8%.
Variability of detrusor overactivity on repeated filling cystometry in men with urge symptoms: comparison with spinal cord injury patients
Authors: Ockrim Jeremy , Laniado Marc E. , Khoubehi Bijan , Renzetti Roberto , Finazzi Agrò Enrico , Carter Simon S. , Tubaro Andrea
Published: February 2005

OBJECTIVE

To investigate the variation in urodynamic variables during repeated filling cystometry and the impact that the variability had on the observed incidence of detrusor overactivity, to evaluate the correlation of detrusor overactivity with the symptoms of urge in men with lower urinary tract symptoms (LUTS), and to compare the variability of detrusor overactivity in men with LUTS to that in men with spinal cord injury (SCI).

PATIENTS AND METHODS

Sixty men with LUTS and 35 with neurogenic bladders after SCI were assessed. Investigations included the International Prostate Symptom Score (IPSS), Madsen–Iversen Symptom Score (MSS), uroflowmetry, filling cystometry and pressure‐flow, in three successive studies.

RESULTS

In men with LUTS, a significant decrease in the number and pressure of involuntary detrusor contractions (IDCs) in consecutive cystometries resulted in a reduction of observed detrusor overactivity from 72% to 63% and 48%, in the three studies. Urgency scores were significantly lower in men who became ‘stable’ than in those who remained ‘unstable’ throughout the three studies. In men with SCI, cystometric variables and detrusor overactivity remained consistent over sequential studies.

CONCLUSION

Urodynamic detrusor overactivity is affected by repeated cystometry. In men with LUTS, two populations with detrusor overactivity were identified; one group adapted to repeated filling while another had persistent IDCs and greater urgency scores. The latter group had bladder behaviour similar to that of men with neurogenic bladders secondary to SCI. These findings might be important in explaining the cause of symptoms, initiating further investigation, and predicting the outcome of therapy.
Glycosylated haemoglobin levels and the severity of erectile function in diabetic men
Authors: Rhoden Ernani L. , Ribeiro Eduardo P. , Riedner Charles E. , Teloken Claudio , Souto Carlos A.V.
Published: February 2005

OBJECTIVE

To evaluate the association between the levels of glycosylated haemoglobin (HbA1c) and the severity of erectile dysfunction (ED) in men with diabetes mellitus (DM).

PATIENTS AND METHODS

This cross‐sectional study included sexually active men with a diagnosis of DM attending a urological medical centre from January 2000 to December 2001. The 115 men with ED (95%) completed the International Index of Erectile Function questionnaire, and fasting serum glucose and HbA1c serum levels were measured. The relationship between the severity of ED and serum HbA1c levels was assessed.

RESULTS

Of men with HbA1c levels of < 8%, half had mild, and 18% and 32% had moderate and severe ED, respectively (P = 0.038); of men with HbA1c levels of ≥ 8%, 25%, 29%, and 46% had mild, moderate and severe ED, respectively (P = 0.008). In addition, men with HbA1c levels of ≥ 11% had a statistically higher prevalence of severe ED (P = 0.002). There was no difference in severity of ED in the HbA1c subgroups when the duration of DM was ≤ 5 years (P = 0.87), but most men with HbA1c levels of ≥ 8% and a history of DM of 6–10 or > 10 years had severe ED (P < 0.03).

CONCLUSION

This study suggests that the severity of ED is associated with increasing HbA1c levels in diabetic men.
Percutaneous nephrolithotomy for treating renal calculi in children
Authors: Boormans Joost L. , Scheepe Jeroen R. , Verkoelen Carl F. , Verhagen Paul C.M.S.
Published: February 2005

There are various topics covered in the paediatric section this month. Another series of percutaneous nephrolithotomy is reported, as is the necessity or not to use the GFR in the follow‐up of children who have had a unilateral nephrectomy.

In addition, authors from the USA present a new classification for genital ambiguity and urogenital sinus anomalies. They entitle it the PVE classification, and conclude that it is very helpful in surgical planning and in surgical outcomes research.

OBJECTIVE

To report our experience with the percutaneous management of renal stone disease in children.

PATIENTS AND METHODS

The medical and radiological records of children up to 18 years old who were treated for renal calculi by percutaneous nephrolithotomy (PCNL) at our institution between March 1995 and April 2003 were reviewed. For stone removal a special paediatric 18 F access sheath was used.

RESULTS

In all, 26 PCNLs were used in 23 patients (10 boys and 13 girls, aged 1.7–16.8 years). The presenting symptoms were urinary tract infection, abdominal pain and/or haematuria. Of the 23 patients, 17 (75%) had associated metabolic disease or underlying urological anatomical abnormalities. Urinary tract infections were found in 15 patients (65%). The mean (range) stone burden was 6.0 (0.5–18.2) cm2, and the operative duration 127 (50–260) min. The primary stone‐free rate was 58%, which increased to 81% after treating residual fragments. One blood transfusion was required and one patient developed urosepsis after PCNL, which was treated with antibiotics.

CONCLUSION

PCNL is an effective alternative for treating renal stones in children, and is the treatment of choice for stones refractory to extracorporeal shock wave lithotripsy.
Over- and Underbidding in Central Bank Open Market Operations Conducted as Fixed Rate Tender
Authors: Bindseil Ulrich
Published: February 2005

Open market operations play a key role in allocating central bank funds to the banking system and thereby in steering short-term interest rates in line with the stance of monetary policy. Many central banks apply so-called ‘fixed rate tender’ auctions in their open market operations. This paper presents, on the basis of a survey of central bank experience, a model of bidding in such tenders. In their conduct of fixed rate tenders, many central banks faced specifically an ‘under-’ and an ‘overbidding’ problem. These phenomena are revisited in the light of the proposed model, and the more general question of the optimal tender procedure and allotment policy of central banks is addressed.
Politics and Markets in the Irish ‘Celtic Tiger’
Authors: HARDIMAN NIAMH
Published: February 2005

Ireland's rate of growth and employment creation during the 1990s far outstripped economic performance in the rest of the OECD. Competing explanations are available in accounting for these outcomes, one stressing the primacy of the market, the other focusing on political choice. A case is made for the importance of politics, particularly the successful strategic adaptation to the challenges and opportunities afforded by the completion of the Single European Market during the 1990s. Ireland, as a small open economy, needs to combine effective external adjustment with appropriate domestic adjustment policies. Two policy areas are chosen for particular attention: industrial development strategy, and social partnership arrangements. This experience has implications beyond the Irish case, as the new central European and Baltic EU member states face similar challenges of policy adaptation.
MPs Go Back to Their Constituencies
Authors: GAY OONAGH
Published: February 2005

The growth of the constituency role of MPs has been well documented since the 1960s, in particular the focus on casework. There are clear conventions that MPs should represent all their constituents and should not purport to represent other constituencies. Recent research indicates that these rules are under strain with the advent of devolution and the use of IT such as databases, emails and blogs. More generous allowances enable MPs to employ greater numbers of personal staff to process constituency casework. Parties favour this development, as simultaneously assisting with the permanent campaign and removing potential dissent from Parliament. The incumbency effect is now evident, as MPs believe that assiduous attention to constituents can save their seats. Parliaments are under pressure to improve the capacity of their members, but also to avoid inappropriate use of funds to influence the outcome of elections.
Choosing between Impossible Alternatives: Creating a New Constituency Map for Wales, 2004
Authors: JOHNSTON RON , McLEAN IAIN
Published: February 2005

The allocation of at least 35 parliamentary constituencies to Wales in the 1944 House of Commons (Redistribution of Seats) Act meant that Wales was over‐represented in the House of Commons. Subsequent decisions by the Boundary Commission for Wales, operating within a set of mutually contradictory rules, increased the number of Welsh seats to 40 and exacerbated the country's over‐representation in the House, relative to the situation for England.

In its Fifth Periodic Review, the Boundary Commission has determined not to recommend any further growth in the number of Welsh constituencies, but its method of doing this has created substantial inequalities within the country, with the area around Cardiff significantly under‐represented relative to the situation in North Wales. These inequalities will also apply to the Welsh Assembly. The political parties did not challenge these recommendations, presumably because they felt that their interests were best served by the inequalities. Analysis shows that alternative sets of recommendations would have been somewhat more egalitarian, but within an overall structure of unfairness guaranteed by the unworkable rules under which the Commissions must operate.
Sacrilege: A Study of Sacred Loss and Desecration and Their Implications for Health and Well‐Being in a Community Sample
Authors: PARGAMENT KENNETH I. , MAGYAR GINA M. , BENORE ETHAN , MAHONEY ANNETTE
Published: February 2005

In this study, we proposed that people understand major life events in terms of spiritual as well as psychological, social, and physical dimensions. Specifically, we examined the possibility that life events that are perceived to be sacred losses or violations of the sacred (i.e., desecrations) have significant implications for the health and well‐being of the individual. A total of 117 adults, randomly selected from a community, identified the most negative life event they had experienced in the past two years. They then completed measures of the degree to which they appraised this event as a sacred loss and as a desecration, as well as measures of religious coping, the impact of the event, and four sets of criteria: traumatic impact, physical health, emotional distress, and growth. These hypotheses were largely supported. Sacred loss and desecration were unrelated to physical health. However, they were tied to higher levels, though somewhat differential patterns, of emotional distress. While sacred loss was predictive of intrusive thoughts and depression, desecration was tied to more intrusive thoughts and greater anger. Furthermore, sacred loss was linked to greater posttraumatic growth and positive spiritual change; in contrast, desecration was associated with less posttraumatic growth. The links between the spiritual appraisals and outcomes were partially mediated by positive and negative methods of religious coping. These findings underscore the importance and multidimensionality of the spiritual meanings people attribute to major life stressors.
Strategies for Reducing Stress in Ultrasonic Cutting Systems
Authors: Cardoni A. , Lucas M.
Published: February 2005

Abstract:  Ultrasonic cutting is an established technology in the cutting of food products. As the high‐cost components of an ultrasonic cutting system are the ultrasonic generator and transducer, some designs have concentrated on running several cutting blades from a single power source. This strategy is undoubtedly economic, but problems remain with reliability. Blade failure during cutting is a common problem in ultrasonic systems and therefore strategies are proposed to reduce stress levels at the failure locations. Many alternative blade profiles are investigated using finite element (FE) models, which are validated by experimental modal analysis (EMA) using a 3D laser Doppler vibrometer (LDV). Combining three strategies can reduce the stress level at the failure location on cutting blades. The first investigates the blade profile at the failure location with the aim of incorporating sufficient gain at reduced stress levels. The second concentrates on detuning the block horn and blades in order to move the longitudinal node away from the highest stressed section of the blade. Finally, a redesign of the block horn is studied in order to eliminate the effects of blade flexural vibrations in the longitudinal cutting mode.
Development of a Vibrating Wire Strain Gauge for Measuring Small Strains in Concrete Beams
Authors: Neild S. A. , Williams M. S. , McFadden P. D.
Published: February 2005

Abstract:  A vibrating wire strain gauge capable of measuring strains in concrete elements to an accuracy of better than 0.5 μɛ is presented. This offers some advantages over conventional electrical resistance gauges, the quoted accuracy of which is typically 3 μɛ, and which are often considered unsuitable for concrete because of their inability to span cracks. While vibrating wire gauges are potentially more accurate, they are prone to significant errors because of temperature changes. In the purpose‐built gauge described here, temperature correction is achieved using an unstrained reference gauge. The vibration data are analysed using a moving‐window Fourier transformation in order to identify and remove the geometrically nonlinear portion of the response. The resulting system is accurate, economical and easy to use. The gauges have been used to study the behaviour of cracked concrete specimens. Typical results are presented and discussed.
Antagonist effects of non‐host fruit volatiles on discrimination of host fruit by Rhagoletis flies infesting apple (Malus pumila), hawthorn (Crataegus spp.), and flowering dogwood (Cornus florida)
Authors: Linn Charles , Nojima Satoshi , Roelofs Wendell
Published: February 2005

In previous flight‐tunnel tests Rhagoletis pomonella (Walsh) (Diptera: Tephritidae) flies originating from domestic apple (Malus pumila), hawthorn (Crataegus spp.), and flowering dogwood (Cornus florida), displayed greater numbers of upwind flights to blends of volatiles identified from their natal fruit compared to non‐natal fruit. Here, we show that when certain non‐host volatiles were added to the host blend, significantly fewer apple, hawthorn, and dogwood flies exhibited sustained upwind flight to the source. Specifically, the upwind flight of apple flies to the apple blend was significantly antagonized by the addition of the hawthorn or dogwood blends, the addition of 3‐methylbutan‐1‐ol alone (a key volatile for hawthorn and dogwood flies), or the combination of 3‐methylbutan‐1‐ol and another key dogwood volatile, 1‐octen‐3‐ol. Similarly, the upwind flight of dogwood and hawthorn flies to their respective natal blends was antagonized by the addition of the apple blend or the key apple volatile butyl hexanoate. Experiments were also conducted to determine whether non‐natal fruit volatiles could disrupt the close‐range flight response of flies to the visual stimulus of fruit alone, represented by an odorless red sphere. Tests with apple‐origin flies showed that when the hawthorn blend, the dogwood blend, or the key antagonist volatiles from each (3‐methylbutan‐1‐ol and 1‐octen‐3‐ol) were added to a red sphere fruit mimic, significantly lower proportions of flies were captured, compared with captures when no odor was present. Our results support the hypothesis that agonist and antagonist properties of fruit volatiles can play an important role in host recognition/discrimination by Rhagoletis flies.