bluuebunny/crossref_metadata_2025 huggingface dataset:
PROSPECTIVE AUDIT OF COLORECTAL RESECTIONS IN A PERIPHERAL PUBLIC HOSPITAL
Authors: Gollop Susan J. , Fancourt Michael W. , Gilkison William T. C. , Kyle Stephen M. , Mosquera Damien A.
Published: August 2006

Background:  Colorectal disease requiring surgery is common in New Zealand where there is no established national colorectal screening programme. We established an audit to review our current practice in colorectal surgery.

Methods:  Prospective audit data were collected on consecutive patients undergoing colorectal resection between April 2003 and December 2004, using a standardized pro forma.

Results:  In all, 170 colorectal resections were carried out of which 117 (69%) were for malignancy and 120 (71%) were elective. Median patient age was 72 years (interquartile range 62–78 years) and median length of stay was 10 days (interquartile range 8–14 days). Colonoscopy was the most common method of investigation. In elective patients with malignancy, the average delay between onset of symptoms and surgery was 25 weeks. Duke’s stage C was the most common stage at presentation (44%). Complications developed in 83 (49%) of patients including 20 (12%) patients returned to theatre, 5 (3%) anastomotic leaks and 8 deaths (5%). In patients undergoing surgery aged over 80 (n = 40) the median length of stay was 10 days (7–14) with a complication rate of 21 (55%) including 5 (13%) who were returned to theatre and 6 (16%) deaths.

Conclusion:  This audit has confirmed that there is an acceptable level of care at Taranaki Base Hospital when compared with those in published work. Elective patients with malignancy have a delay of nearly 6 months between the onset of symptoms and surgery. Patients in Taranaki are more likely to present with an advanced stage of tumour compared with other unscreened populations.
Reviewing the definition of “elderly”
Authors: Orimo Hajime , Ito Hideki , Suzuki Takao , Araki Atsushi , Hosoi Takayuki , Sawabe Motoji
Published: August 2006

Conventionally, “elderly” has been defined as a chronological age of 65 years old or older, while those from 65 through 74 years old are referred to as “early elderly” and those over 75 years old as “late elderly.” However, the evidence on which this definition is based is unknown. We have attempted to review the definition of elderly by analyzing data from long‐term longitudinal epidemiological studies, and clinical and pathological studies that have been accumulated at the Tokyo Metropolitan Geriatric Hospital and the Tokyo Metropolitan Institute of Gerontology. Our recommendation might be a starting point in developing a strategy for a successful society by reviewing the definition of elderly based on comprehensive evidence in all aspects of social, cultural and medical sciences.
Comprehensive studies of cognitive impairment of the elderly with type 2 diabetes
Authors: Sakurai Takashi , Yokono Koichi
Published: August 2006

Type 2 diabetes mellitus is associated with cognitive dysfunction and increases the risk of dementia for the elderly. The aim of the study presented here was to provide a brief review of how disturbance of glucose and metabolic homeostasis may be implicated in the cognitive decline of patients with type 2 diabetes. Several risk factors such as nutrition, cerebrovascular disorders and the neurotoxic effects of hyperglycemia may combine for the formation of mechanisms of cognitive decline in the diabetic elderly. It should be noted that cognitive deficits of diabetes are accompanied by neuroradiological changes in the brain, so that cognitive dysfunction both with and without brain structural changes may overlap during cognitive decline of the diabetic elderly. Recently, we conducted two studies to explore, by means of brain imaging, hierarchical relationships among clinical profiles of diabetes, cognitive function, white matter hyperintensity and brain atrophy. The results suggested that subcortical brain atrophy and hyperintensity constitute predictors of the rate of progression of cognitive dysfunction in the diabetic elderly, while cortical atrophy is associated with high diastolic blood pressure and lower HbA1c. These hypotheses may explain in part the underlying mechanisms of cognitive impairment in the diabetic elderly. Prospective intervention studies are needed, however, to clarify the mechanism of cognitive dysfunction of the diabetic elderly and what the targets are for preventive measures.
Temporal variation in plant–soil feedback controls succession
Authors: Kardol Paul , Martijn Bezemer T. , van der Putten Wim H.
Published: August 2006

Soil abiotic and biotic factors play key roles in plant community dynamics. However, little is known about how soil biota influence vegetation changes over time. Here, we show that the effects of soil organisms may depend on both the successional development of ecosystems and on the successional position of the plants involved. In model systems of plants and soils from different successional stages, we observed negative plant–soil feedback for early‐successional plant species, neutral feedback for mid‐successional species, and positive feedback for late‐successional species. The negative feedback of early‐successional plants was independent of soil origin, while late‐successional plants performed best in late‐ and worst in early‐successional soil. Increased performance of the subordinate, late‐successional plants resulted in enhanced plant community diversity. Observed feedback effects were more related to soil biota than to abiotic conditions. Our results show that temporal variations in plant–soil interactions profoundly contribute to plant community assemblage and ecosystem development.
The effect of population structure on the adaptive radiation of microbial populations evolving in spatially structured environments
Authors: Habets Michelle G. J. L. , Rozen Daniel E. , Hoekstra Rolf F. , de Visser J. Arjan G. M.
Published: August 2006

Spatial structure is thought to be an important factor influencing the emergence and maintenance of genetic diversity. Previous studies have demonstrated that environmental heterogeneity, provided by spatial structure, leads to adaptive radiation of populations. In the present study, we investigate not only the impact of environmental heterogeneity on adaptive radiation, but also of population fragmentation and niche construction. Replicate populations founded by a single genotype of Escherichia coli were allowed to evolve for 900 generations by serial transfer in either a homogeneous environment, or a spatially structured environment that was either kept intact or destroyed with each daily transfer. Only populations evolving in the structured environment with intact population structure diversified: clones are significantly divergent in sugar catabolism, and show frequency‐dependent fitness interactions indicative of stable coexistence. These findings demonstrate an important role for population fragmentation, a consequence of population structure in spatially structured environments, on the diversification of populations.
The use of a dedicated rectosigmoidoscope for ultrasound staging of tumours of the upper and middle third of the rectum
Authors: Santoro G. A. , D'Elia A. , Battistella G. , Di Falco G.
Published: August 2006

Objective  Tumours of the upper rectum, and many in the middle third, are not accessible to endorectal ultrasound staging because of the difficulty in reaching all sites of the rectum with a rigid probe. The aim of this prospective study was to assess whether using a dedicated rectosigmoidoscope, endorectal ultrasonography (ERUS) can accurately stage any rectal lesion irrespective of its distance from the anal verge.

Method  A total of 173 consecutive patients with a primary rectal tumour were included. A rotating, high multifrequency (5.0–10 MHz) endoprobe was introduced through a dedicated rectosigmoidoscope and advanced above the lesion. A computer allowed for three‐dimensional (3D) reconstruction of 2D images. Treatment was selected on the basis of 3D‐ERUS findings. ERUS staging was correlated with pathological staging.

Results  The depth of invasion was correctly determined by 3D‐ERUS in 78.2% of tumours of the lower rectum, 76.4% of tumours extending between the lower and middle third of the rectum, 80.9% of tumours of the middle third of the rectum, 78.5% of tumours extending between the middle and upper third of the rectum and 78.9% of tumours of the upper rectum. The accuracy for the absence of lymph node metastases was 81.2% for tumours of the lower rectum, 78.5% for tumours extending between the lower and middle third of the rectum, 85.7% for tumours of the middle third of the rectum, 83.3% for tumours extending between the middle and upper third of the rectum and 78.5% for tumours of the upper rectum. Analysis showed that there was no difference between the various tumour sites.

Conclusion  Our findings indicate that using a dedicated proctosigmoidoscope, tumours of the upper and middle third of the rectum are equally accessible to ultrasonographic evaluation. The distance of the tumour from the anal verge does not influence the accuracy of examinations considered adequate by the operator.
Risk factors for severity and relapse of pseudomembranous colitis in an elderly population
Authors: Moshkowitz M. , Ben‐Baruch E. , Kline Z. , Shimoni Z. , Niven M. , Konikoff F.
Published: August 2006

Objective  Pseudomembranous colitis (PMC) is well recognized as an important cause of diarrhoea in patients receiving antibiotics, with significant consequences of morbidity and mortality. Mortality among elderly patients is high, and even with successful treatment, a significant number of patients relapse.

To evaluate the outcome of elderly patients with PMC, and to try to identify risk factors that might influence mortality or relapse.

Method  We studied 72 consecutive hospitalized patients with endoscopically proven PMC. The medical records of all patients with their clinical history and laboratory data were reviewed in detail. These data included: pre‐hospitalization residence and physical status, background medical history, presenting symptoms, antibiotic history, haematological and biochemical parameters, treatment, duration of hospitalization, complications, mortality within 30 days of hospitalization and relapse.

Results  Of the 72 patients (M/F = 34/38, mean age = 77 years), 47% were nursing home residents. Prior to hospitalization, 91.6% of patients had received antibiotic treatment (cephalosporins – 64%, penicillins – 42% and quinolones – 28%), 26% of patients received antacid therapy and 36% had been fed with a nasogastric tube (NGT). Thirty‐seven (51%) patients recovered without complications, 21 (29%) patients died within 30 days of hospitalization and 14 (19%) patients were re‐hospitalized because of relapse of PMC. Multivariate analysis revealed that white blood cell count above 20 × 103/mm3 (P = 0.009), serum albumin level of less than 2.5 g/dl (P = 0.02), and pre‐hospitalization NGT feeding (P = 0.01) were associated with high mortality. Treatment with acid‐reducing drugs (P = 0.01) and living at a nursing home (P = 0.06) were associated with high relapse rates.

Conclusion  Pseudomembranous colitis is an important complication of antibiotic therapy and is associated with high mortality and recurrence rate, especially in old and debilitated persons. Pre‐admission NGT feeding, severe leucocytosis and hypoalbuminaemia on admission are associated with increased mortality. Pre‐hospitalization acid reducing treatment and nursing home residency are associated with increased risk of recurrence.
Surgical treatment of complicated pilonidal disease: limited separate elliptical excision with primary closure
Authors: Akinci O. F. , Coskun A. , Ozgonul A. , Terzi A.
Published: August 2006

Objective  We aimed at treating complicated pilonidal sinus (PS) patients by a simple and effective surgical procedure.

Method  Between 2000 and 2004, 24 selected complicated PS patients were treated with ‘limited separate elliptical excision and primary closure’. Patients with extensive or bilateral gluteal involvement, having more lateral, caudal or cephalic sinuses, multiple recurrences and unhealed chronic wounds after pilonidal surgery were included. Asymmetric excision and primary closure was performed to main diseased tissue in the midline. Additionally, small separate elliptical excisions with primary closure were performed in other involved tissues. The fistula tract or granulation tissue were excised subcutaneously if present. All patients were operated under local anaesthesia. The fascial attachments between the skin and coccyx were released at the deep point in the midline and at one side of wound. Suction drains and prophylactic antibiotics were used; subcutaneous tissues were closed with running polyglactin sutures and skin with polypropylene subcutaneously.

Results  The mean age of patients was 28.4 years (range 18–38). The mean follow‐up time was 2.8 years. One recurrence, one seroma, one wound infection and one wound breakdown were recorded. Healing was always by first intention except in patients with wound infection and breakdown.

Conclusion  Most of the complicated PS patients can be operated with acceptable rates of recurrences and complications by using ‘limited separate elliptical excisions with primary closure’.
Results of a survey of the role of multidisciplinary team coordinators for colorectal cancer in England and Wales
Authors: Soukop M. , Robinson A. , Soukop D. , Ingham‐Clark C. L. , Kelly M. J.
Published: August 2006

Objective  Over the last 6 years, multidisciplinary teams (MDTs) have been established and play a key role in organizing the delivery of cancer care in the UK. There are no published data on the roles of their co‐coordinators.

To seek the views of colorectal multidisciplinary team co‐ordinators (MDTCs) on what they do and how they do it.

Method  Questionnaires were sent to the colorectal MDTC, or equivalent, in all 180 NHS hospital trusts in England and Wales where colorectal cancer surgery is performed.

Results  There was a 70% response rate. Seventy‐one per cent of trusts now have a dedicated MDTC, whereas in 2002, only 40% had one. MDTCs generally keep their information on databases, but these differ, and are not coordinated with data entry into the national colorectal cancer database of the Association of Coloproctology of Great Britain and Ireland. In only 26 trusts does the MDTC communicate decisions to primary care, and the patients seem almost completely excluded from this process.

Conclusion  The recently formed national MDTC Forum should grasp the opportunity of coordinating all of this well‐intentioned but pluralistic activity to the benefit of patients, primary care and hospital teams. An effective MDTC with a robust database will be the key in achieving cancer waiting time targets with useful audit, thereby improving patient care.
Anorectal three‐dimensional endosonography and anal manometry in assessing anterior rectocele in women: a new pathogenesis concept and the basic surgical principle
Authors: Regadas F. S. P. , Murad‐Regadas S. M. , Wexner S. D. , Rodrigues L. V. , Souza M. H. L. P. , Silva F. R. , Lima D. M. R. , Regadas Filho F. S. P.
Published: August 2006

Objective  The anatomy of the anal canal, the anorectal junction and the lower rectum was studied with 3‐D ultrasound.

Method  Seventeen women with normal bowel transit, without rectocele (group 1) and 17 female patients with a large anterior rectocele (group 2) were examined with a B&K Medical Rawk®. Mean age was 44.5 and 51.6 years respectively. In group 1, one (5.8%) patient was nuliparous, five (29.4%) had a caesarian section, 11 (64.7%) had a vaginal delivery while in group 2, two (11.7%) patients were nuliparous, four (23.5%) had a caesarian section and 11 (64.7%) had a vaginal delivery. Images were reconstructed in midline longitudinal (ML) and transverse (T) planes. The external (EAS) and internal (IAS) anal sphincters were measured in both projections.

Results  In the ML plane, the EAS length was longer in group 1 (1.94 cm vs 1.61 cm, P < 0.05), the gap length was shorter (1.54 cm vs 1.0 cm P < 0.01) and the wall thickness was shorter in group 2 (0.40 cm vs 0.50 cm P < 0.01). The IAS (0.18 cm vs 0.23 cm P < 0.01) and EAS thickness (0.68 cm vs 0.77 cm, P < 0.05) (left lateral of the posterior quadrant) was greater in group 2. In group 1, the anterior upper anal canal wall in normal females was an extension of the rectal wall and the circular muscle was thicker in the mid‐anal canal to form the IAS. In group 2, however, the wall layers were not identified and the IAS was found to be more distal. The differences were not statistically significant in the anal canal resting and squeeze pressures in the two groups.

Conclusion  Obstetric trauma does not seem to play any role in rectocele pathogenesis because the anal sphincter muscles are anatomically and functionally normal and rectocele is also present in nuliparous and in women with caesarian sections. It seems that it is associated with the absence of EAS and thinner IAS in the anterior upper anal canal. Herniation starts at the upper anal canal extending to the lower rectum in high or large rectoceles and maybe produced by rectal intussusception because of excessive and prolonged straining during defecation. In fact, the denomination ‘rectocele’ should be changed to ‘anorectocele’.
Anxieties should not be forgotten when screening relatives of colorectal cancer patients by colonoscopy
Authors: Williams G. L. , Clarke P. , Vellacott K. D.
Published: August 2006

Objective Individuals with a strong family history have a high risk of developing colorectal cancer. They could well benefit from targeted screening and their increased risk warrants an invasive procedure such as colonoscopy. This study aims to assess the anxieties of symptom‐free relatives offered screening by colonoscopy.

Method A simple questionnaire was sent to 50 consecutive people who had colorectal cancer screening by colonoscopy because of a strong family history.

Results Forty‐five questionnaires were answered. On assessing their anxiety levels before and after colonoscopy, 56% noticed an improvement after the test, 33% were still as anxious and 11% had raised anxiety levels despite screening. Although most of the screening colonoscopies were normal, 44% of asymptomatic relatives undergoing invasive screening had no improvement of their cancer anxieties.

Conclusion Screening people with a strong family history of colorectal cancer may be an efficient, cost‐effective and focussed way of detecting early neoplasms rather than screening the general population. Using colonoscopy alone however, a large proportion of people still have cancer anxieties after being screened. This small study suggests that in order to attempt to alleviate anxieties, a colonoscopy alone is insufficient for some in this high‐risk group.
The Fruit of Silence
Authors: Nelson Marilyn
Published: August 2006

This presentation explores how contemplative practices, especially those anchored in an active listening to silence, are integrated into creative writing courses. It pays particular attention to a course taught at the United States Military Academy at West Point and to a course on the poetry of war and peace taught at the University of Connecticut. The presentation includes not only excerpts from student writing during the courses but also ongoing correspondence with students as they have maintained meditation practices during their military service in Iraq.
The Contemplative Life and the Teaching of the Humanities
Authors: Stock Brian
Published: August 2006

Meditation nowadays plays a part in mind/body medicine and in some branches of educational psychology. In ancient and medieval times, these functions formed a part of the humanities curriculum as it was taught in philosophical schools, monastic communities, and universities. This article claims that it is by returning to a holistic view of the functions of the humanities by means of meditative disciplines that the value and usefulness of the humanities can be most successfully integrated into Western life and institutions. In bringing about this perspective, teachers in the humanities have a great deal to learn from research in the cognitive neurosciences.
Meditation and Education: India, Tibet, and Modern America
Authors: Thurman Robert A. F.
Published: August 2006

This article explores Asian traditions of meditation, with particular attention to Buddhism as it was developed in ancient India. It delineates a core curriculum, initially developed in monastic institutions of higher education, that has been most fully preserved in Tibet. It then explores how this curriculum might be adapted so that it can help support a genuinely humanistic education within American higher education. This exploration focuses not only on the inherent values of Buddhist meditation but also on practical strategies that can be used to introduce these values in the academic curriculum and in the broader campus life.
Descriptive Inquiry as Contemplative Practice
Authors: Kesson Kathleen , Traugh Cecelia , Perez Felix
Published: August 2006

This article draws upon and integrates a number of distinct but overlapping areas of inquiry in the literature on teaching: teacher inquiry, reflective practice, spirituality and education, and contemplative practice. In it, we examine the implementation of a particular phenomenological form of teacher inquiry, the Descriptive Review, in an urban teacher preparation program. The authors participated in a longitudinal study of graduates of the program and are engaged in the continual examination of student work to assess the efficacy of the inquiry process in helping students overcome bias and habitual thinking, become more mindful of the basis of their professional judgments, and develop a moral framework that might help them resist dehumanizing and ineffective policies and imposed practices. The article includes the authors’ autobiographical reflections about what brought them to this form of practice, a description of the theory and practice of the Descriptive Review as it is carried out in their teacher preparation graduate programs, a description of the urban context in which the work takes place, and a student narrative of practice, which is analyzed in relation to the theory of phenomenological inquiry. The conclusions are tentative; although the efficacy of the method is clearly demonstrated in the narratives that students produce about their inquiries into practice, the complex and challenging environments that new urban teachers are facing are problematic in terms of the capacity to develop contemplative practice.
Teaching Counselors Self-Care through Mindfulness Practices
Authors: Newsome Sandy , Christopher John Chambers , Dahlen Penny , Christopher Suzanne
Published: August 2006

Few counseling programs directly address the importance of self-care in reducing stress and burnout in their curricula. A course entitled Mind/Body Medicine and the Art of Self-Care was created to address personal and professional growth opportunities through self-care and mindfulness practices (meditation, yoga, qigong, and conscious relaxation exercises). Three methods of evaluating this 15-week 3-credit mindfulness-based stress reduction (MBSR) course for counseling students indicated positive changes for students in learning how to manage stress and improve counseling practice. Students reported positive physical, emotional, mental, spiritual, and interpersonal changes and substantial effects on their counseling skills and therapeutic relationships. Information from a focus group, qualitative reports, and quantitative course evaluations were triangulated; all data signified positive student responses to the course, method of teaching, and course instructor. Most students reported intentions of integrating mindfulness practices into their future profession.
Language and sexuality in Spanish and English dating chats1
Authors: del‐Teso‐Craviotto Marisol
Published: August 2006

Three half‐hour conversations each from five English and four Spanish dating chat rooms were analyzed following conversation analytic methodologies. Participants in the chats often engaged in playful and humorous erotic conversations, using a set of interactionally negotiated conventions about chatting that constitute a play frame, characterized linguistically by graphemic representations of laughter, appropriations, reproduction of a humorous pronunciation, and interactions throughalter personae. Such playfulness enhances participants' pleasure while allowing them to maintain critical distance, and balances the constraints of public interaction with the pursuit of private erotic pleasures. This study contributes to our understanding of the social and discursive dimension of sexuality, going beyond issues of sexual identity and focusing on the conversational negotiation of eroticism and desire.
MACROECONOMETRIC MODELLING WITH A GLOBAL PERSPECTIVE*
Authors: PESARAN M. HASHEM , SMITH RON
Published: August 2006

This paper provides a synthesis and further development of a global modelling approach introduced in Pesaran et al. (Journal of Business and Economic Statistics, Vol. 22 (2004), pp. 129–162), where country‐specific models in the form of VARX* structures are estimated relating a vector of domestic variables, xit, to their foreign counterparts, , and then consistently combined to form a global vector autoregression. It is shown that the VARX* models can be derived as the solution to a dynamic stochastic general equilibrium model where overidentifying long‐run theoretical relations can be tested and imposed if acceptable. This gives the system a transparent long‐run theoretical structure. Similarly, short‐run overidentifying theoretical restrictions can be tested and imposed if accepted. Alternatively, if one has less confidence in the short‐run theory the dynamics can be left unrestricted. The assumption of the weak exogeneity of the foreign variables for the long‐run parameters can be tested, where variables can be interpreted as proxies for regional and global factors. Rather than using deviations from ad hoc statistical trends, the equilibrium values of the variables reflecting the long‐run theory embodied in the model can be calculated. The paper also provides some new results on the relative importance of external shocks for the UK and the Euro area economies.
DO EUROPEAN CENTRAL BANK'S STATEMENTS STEER INTEREST RATES IN THE EURO ZONE?*
Authors: MUSARD‐GIES MARIE
Published: August 2006

In this study, we aim at testing whether press conferences held after the meeting of the European Central Bank's monetary policy council steer market interest rates in the Euro zone. To meet this goal, we quantify the statements according to whether they are neutral, hawkish or dovish. We show, using a principal components analysis, that market interest rates react significantly to the bias in statements, and more particularly to changes in statements from one meeting to the next. Moreover, we find that the short end of the yield curve reacts more sharply to statements than the long segment: the effect of statements peaks on interest rates with a maturity of 6 or 12 months and is smaller for the longer maturities. Using non‐parametric tests confirms our previous results.
Bridging the Gap: Building Peace Norwegian Style
Authors: Kelleher Ann , Taulbee James Larry
Published: August 2006

Over the past 25 years, Norway has emerged as an important player in peacemaking efforts. As a small power on the periphery of Europe, it does not command the wherewithal to be a primary broker, but has been able to provide both tangible and intangible resources that have produced a “value‐added” component. In this respect, Norwegian initiatives rely upon a judicious blending of the resources of government and the “field experience” garnered at the grassroots level by their NGOs. The close relationship between Norwegian NGOs and the Norwegian government has produced both detailed knowledge and essential channels at many different levels for trust and consensus building. We have in turn characterized the Norwegian approach to conflict resolution as Track I ½ diplomacy because successive Norwegian governments have consciously sought to draw upon the strengths of their NGOs and build upon activities normally described as Track II.
Doves Among Hawks: Republican Opposition to the Vietnam War, 1964–1968
Authors: Johns Andrew L.
Published: August 2006

Most historians of the Vietnam conflict have extrapolated the Republican commitment to anticommunism generally and in Southeast Asia specifically into full‐scale support for the war within the party. Yet the evidence demonstrates that a number of influential Republicans—including John Sherman Cooper and George Aiken—vocally opposed the Johnson administration's Vietnam policies and advocated negotiations and de‐escalation as early as 1964. Unfortunately, their dissent has been almost totally neglected by the same historians who laud the antiwar efforts of prominent Democratic critics of the conflict. This article seeks to redress this oversight, examining Republican opposition to the war and contrasting the views of GOP doves with their hawkish counterparts.
A Potential Framework For Privacy? A Reply To Hello!
Authors: Mulheron Rachael
Published: August 2006

In Douglas v Hello! Ltd (No 3), the Court of Appeal noted that one ramification of ‘shoehorning’ invasions of privacy into the cause of action of breach of confidence is that ‘it does not fall to be treated as a tort under English law’. In contrast, this article contends that English courts should explicitly recognise and develop a framework for a tort of privacy, and outlines one possible version—comprising both privacy interests and the elements of the potential tort. The framework draws upon longstanding Canadian and United States jurisprudence, as well as recent fascinating Australasian decisions that have grappled with privacy claims. In reality, breach of confidence is becoming an unrecognizable cousin of the creature which Megarry J described in Coco v AN Clark (Engineers) Ltd in 1969. If, however, it is to be buttressed by a judicially‐created tort of privacy, then that tort's elements must be capable of being feasibly articulated and applied.
Electro‐optical synergy (ELOS™) technology for nonablative skin rejuvenation: a preliminary prospective study
Authors: Hammes S , Greve B , Raulin C
Published: August 2006

Background and objectives  In this preliminary prospective study, we evaluated the efficacy and safety of nonablative wrinkle treatment using combined radiofrequency (RF) and optical energy (Polaris™). The dual energy technology of Polaris™, called ELOS™, which stands for electro‐optical synergy, uses synchronous pulses of bipolar RF current and pulsed visible light (diode laser) delivered in the same pulse.

Materials and methods  Twenty‐four subjects with periorbital and perioral wrinkles received six treatments at 4‐week intervals with the Polaris™ WR (Syneron, Inc., Israel, 900 nm, max. RF energy 100 J/cm3, max. laser energy 50 J/cm2). Each treatment consisted of two passes over the treatment area using pulsed optical and RF parameters that were determined by the patient's skin phenotype and distribution of target chromophores. The follow‐up period was 3 months after the last treatment.

Results  Independent scoring of blinded photographs showed a wrinkle score improvement of at least 1 (0 = no improvement, 1 = medium, 2 = good, 3 = excellent improvement) 3 months after the last of six treatment sessions. There was no difference between periorbital and perioral wrinkle reduction. Fifty‐eight per cent (14/24) of the subjects reported a notable wrinkle reduction; 16% noted mild to moderate oedema and erythema lasting for no more than 1 day. Scarring or pigmentary changes were not detected. The average pain score was 0.6 (0 = no pain, 5 = intolerable pain).

Conclusion  Multiple treatments with the Polaris™ WR produced objective and subjective reduction of periorbital and perioral wrinkles. The occurrence of side‐effects and pain was very low. The clinical effect may be caused by matrix coagulation of the deep dermis by the RF and selective thermolysis of blood vessels with the 900 nm diode laser.
The EU Neighbourhood Policy: Implications for Economic Growth and Stability*
Authors: DODINI MICHAELA , FANTINI MARCO
Published: August 2006

The article discusses the incentives, economic effects and risks of the European Neighbourhood Policy (ENP). The ENP should support growth provided that integration with the EU internal market is concrete and wide‐ranging. It should not endanger macro stability but involves two specific risks: over‐regulation and fragmentation of the internal market.
Relationship problems and physical aggression: The moderating role of temporal comparison
Authors: FRYE NANCY E.
Published: August 2006

Because physical aggression in relationships frequently occurs within the context of disagreements, partners with more fodder for disagreements (e.g., more relationship problems) may be especially prone to engage in aggression. However, this may be less true among partners who have a means of coping with their relationship problems. Because previous research suggests that perceptions of improvement serve as a coping strategy in a wide range of adverse circumstances, the current study examined whether this coping strategy would prove effective in the context of relationship problems by examining data from a sample of married and cohabiting individuals. In both groups, perceived changes in problems moderated the association between problems and aggression; number of relationship problems was only significantly associated with level of physical aggression among partners who perceived low levels of improvement in those problems over time. Results are discussed in terms of implications for intervention strategies.
Inflammation, Immunity, Vaccines for Helicobacter Infection
Authors: Chmiela Magdalena , Michetti Pierre
Published: August 2006

The reason why some individuals remain Helicobacter pylori infected for life but without any symptoms while others develop severe diseases is only partially clarified. Presumably, it depends on multifactorial interactions among host immunologic and physiologic factors, bacterial virulence determinants, and environmental influences modulating the host response. Much effort has been made to identify host genetic factors that may explain an individual susceptibility of the host to H. pylori infection. The identification of H. pylori determinants and the elucidation of their role in modifying the host immune responses were further delineated. The ability of H. pylori to overcome the defense mechanisms on mucosal surfaces as well as to modulate the immune response by interfering with host recognition and transduction systems has been shown. Also new bacterial anti‐inflammatory defense systems have been described. Findings in experimental animal models and humans with natural H. pylori infection suggested a double role of regulatory T cells in the course of H. pylori infection: protecting the infected host against excessive gastric inflammation and, in contrast, promoting bacterial colonization.
Diagnosis of Helicobacter pylori Infection
Authors: Dzierżanowska‐Fangrat Katarzyna , Lehours Philippe , Mégraud Francis , Dzierżanowska Danuta
Published: August 2006

A growing interest in non‐invasive tests for the detection of Helicobacter pylori has been observed recently, reflecting a large number of studies published this year. New tests have been validated, and the old ones have been used in different clinical situations or for different purposes. Stool antigen tests have been extensively evaluated in pre‐ and post‐treatment settings both in adults and children, and the urea breath test has been studied as a predictor of bacterial load, severity of gastric inflammation, and response to eradication treatment. Several studies have also explored the usefulness of some serologic markers as indicators of the gastric mucosa status. With regard to invasive tests, molecular methods are being used more and more, but the breakthrough this year was the direct in vivo observation of H. pylori during endoscopy.
Pathogenesis of Helicobacter pylori Infection
Authors: Hatakeyama Masanori , Brzozowski Tomasz
Published: August 2006

Much interest has been shown in the relationship between Helicobacter pylori infection and gastric carcinogenesis. It is becoming clearer that H. pylori strains carrying a functional cag pathogenicity island (cagPAI), which encodes the type IV secretion system (TFSS) and its effector CagA, play an important role in the development of gastric carcinoma. Furthermore, genetic polymorphism present in the cagA gene appears to influence the degree of an individual cagPAI‐positive H. pylori to elicit gastric mucosal lesions, and this process is significantly affected by host genetic polymorphisms such as proinflammatory cytokine gene polymorphisms. Pathomechanism of gastric carcinogenesis associated with H. pylori includes bacteria–host interaction leading to morphologic alterations such as atrophic gastritis and gastrointestinal metaplasia mediated by COX‐2 overexpression, cancer cell invasion, and neo‐angiogenesis via TLR2/TLR9 system and transcription factors (e.g., NF‐κB) activation. In addition, H. pylori infection triggers adhesion molecule expression and activity and produces an enhancement in oxidative stress interacting with gastric production of appetite hormone ghrelin and nonsteroidal anti‐inflammatory drugs.
Helicobacter pylori and Non‐Malignant Diseases
Authors: Matysiak‐Budnik Tamara , Laszewicz Wiktor , Lamarque Dominique , Chaussade Stanislas
Published: August 2006

The prevalence of Helicobacter pylori‐associated peptic ulcers, in particular duodenal ulcers, is decreasing following decreasing prevalence of H. pylori infection, while the frequency of non‐steroidal anti‐inflammatory drugs (NSAIDs)‐induced and H. pylori‐negative idiopathic ulcers is increasing. The incidence of bleeding ulcers has been stable during the last decades. Several putative H. pylori virulence genes, i.e., cag, vacA, babA, or dupA, as well as host‐related genetic factors like IL‐1β and TNFα‐gene polymorphism, have been proposed as risk factors for duodenal ulcer. H. pylori eradication may prevent NSAID complications, in particular, when it is performed before introduction of NSAIDs. There is a complex association between H. pylori and gastroesophageal reflux disease (GERD), and the impact of H. pylori eradication on the appearance of GERD symptoms depends on various host‐ and bacteria‐related factors. Eradication of H. pylori in GERD is recommended in patients before instauration of a long‐term PPI treatment to prevent the development of gastric atrophy. A small proportion (10%) of non‐ulcer dyspepsia cases may be attributed to H. pylori and may benefit from eradication treatment. A test‐and‐treat strategy is more cost‐effective than prompt endoscopy in the initial management of dyspepsia.
Treatment of Helicobacter pylori Infection
Authors: Cavallaro Lucas G. , Egan Brian , O'Morain Colm , Di Mario Francesco
Published: August 2006

In clinical practice the recommended treatment regimens achieve only an 80%Helicobacter pylori eradication rate and this rate is lower in patients who have failed first‐line treatment. The increasing indications for H. pylori treatment (idiopathic thrombocytopenia and iron deficiency anemia) and an increasing trend of antibiotic resistance (especially in southern Europe) emphasize the need for more effective H. pylori eradication. Smoking and a short duration of treatment, especially in patients with functional dyspepsia, are predictors of eradication failure. In first line, the best option remains the clarithromycin‐based regimens but an extended treatment duration is now indicated. Following first‐line treatment failure, 14‐day proton pump inhibitor triple therapy employing alternative antibiotics or quadruple therapy could be used. Levofloxacin‐based 10‐day triple therapy seems to be an encouraging strategy following one or more eradication failures.
Epidemiology of Helicobacter pylori Infection
Authors: Magalhães Queiroz Dulciene Maria , Luzza Francesco
Published: August 2006

Differences may occur in the mode of transmission of Helicobacter pylori between developed and developing countries: direct human‐to‐human contacts have been suggested as the primary route in the former while the fecal–oral route, also, through contaminated water, in the latter. Data on intrafamilial transmission of H. pylori among children continue to be produced. The importance of low socioeconomic conditions on the acquisition of H. pylori infection has been confirmed in a number of population‐based studies. Due to the improvement of living standards, the prevalence of the infection has fallen dramatically in many countries. It varies from 8.9 to 72.8% among children from developed and developing countries, respectively, the re‐infection rate being also significantly higher in the latter. Conflicting data have been reported on the effect of breastfeeding against H. pylori colonization in infancy as well as on the occupational risk for acquiring H. pylori. This review summarizes recent results from the literature on these topics.
A Framework for Understanding State Balanced Budget Requirement Systems: Reexamining Distinctive Features and an Operational Definition
Authors: HOU YILIN , SMITH DANIEL L.
Published: August 2006

Studies of state fiscal and budgetary policies often use balanced budget requirements (BBRs) as explanatory variables. While current measures laid the crucial groundwork for a basic understanding of state BBRs, their lack of comprehensiveness threatens the validity of empirical work. Based on comprehensive legal research, this article offers a framework for analyzing state requirements: each state's BBRs form a coherent system for achieving budget balance through budget cycles; a fully developed BBR system offers a three‐line construct against imbalance; and the more complete, developed, and explicit a BBR system is, the more stringent it will be in achieving budgetary balance.
Demographic, Employment, Expenditure, and Income‐Related Dependency Ratios: Population Aging in the Fifty States
Authors: BRUCKER ERIC
Published: August 2006

Old‐age dependency ratios (OADR) are frequently used to measure the economic impact of U.S. population aging. However, at the state level youth‐dependence, and the “birth dearth,” are important. While federal expenditures on elder Social Security, Medicare, and Medicaid are large, state expenditures on dependent youth are much higher than on elders. The states are ranked by the OADR and three other dependency ratios that consider youth and a state's employment, fiscal outlay, and per‐capita income. Very different rankings are found. States with higher OADR ratios had lower total dependency expenditures. Projections for 2030 are compared with 2000 results.
Dendritic Sublimation of Sapphire
Authors: Kim Seong Gyoon , Yang Jin Seok , Kim Won Tae
Published: August 2006

We report on the morphological evolution of macrosteps on the vicinal (0001) surface of sapphire during sublimation in vacuum. Preparation of a wide flat terrace and isolation of a step source by chemical etching, followed by high‐temperature annealing, allowed the formation of various step patterns depending on the secondary annealing temperature. The observed step patterns such as smooth lines, faceted lines, isolated dendrites, dendritic array, and the morphological transitions between them bear striking resemblance to the interface patterns observed in the solidification of materials. The relative area of upper terrace to lower terrace plays an important role in determining the stability of step. By using a phase‐field simulation, we show that the dynamics of the observed pattern formation can be reproduced by the Burton–Cabrera–Frank model.
Tissue Characteristics at Microthreaded Implants: An Experimental Study in Dogs
Authors: Abrahamsson Ingemar , Berglundh Tord
Published: August 2006

Purpose  The aim of the present study was to analyze bone tissue reactions at implants with and without a microthread configuration.

Materials and Methods  In six beagle dogs, one test and two control implants were installed in one side of the mandible. While both implant types had a similar dimension and surface roughness, the test implants were designed with a microthread configuration in the marginal portion. Abutment connection was performed after 3 months. Another 3 months later, fixed partial dentures (FPDs) were cemented to the maxillary canine and premolars and FPDs were connected to the implants in the mandible. Ten months later, the animals were sacrificed and biopsies from each implant region were processed for histological analysis. Radiographs were obtained at implant placement after FPD connection and at the termination of the experiment.

Results  The radiographic examination revealed that the marginal bone level was well preserved at both test and control implants during the entire 16‐month period. The degree of bone‐implant contact within the marginal portion of the implants was significantly higher at the test (microthread) implants (81.8%) than at the control implants (72.8%).

Conclusions  It was suggested that the microthread configuration offered improved conditions for osseointegration.
Achieving Online Coordination in Real-Time Collaborative Assembly Modeling: A Supervisory Control Approach
Authors: Feng Lei , Chen Li
Published: August 2006

A real-time collaborative assembly modeling process involves the teamwork of multiple designers. Without adequate coordination, this multi-user based modeling process could be more time consuming, or even divergent, than the conventional single-user-based process. This paper thus presents a supervisory control approach to achieving online operational coordination of the multi-user based assembly modeling process. In this approach, we treat the real-time collaborative modeling process as a discrete-event system (DES) and then obtain an effective coordinator for the process control via the supervisory control theory (SCT). Our work extends the framework of SCT to this new application so that the assembly modeling operations and its desired operational behaviors can be modeled and controlled by a set of automata. With them, we further propose a modular supervision approach to find a group of modular supervisors. These supervisors compose the online coordinator to enforce the control specifications and to yield a nonblocking controlled process. The results show much promise for SCT in the new application domain of collaborative CAD (CCAD).
Geometric Interoperability With Epsilon Solidity
Authors: Qi Jianchang , Shapiro Vadim
Published: August 2006

Geometric data interoperability is critical in industrial applications where geometric data are transferred (translated) among multiple modeling systems for data sharing and reuse. A big obstacle in data translation lies in that geometric data are usually imprecise and geometric algorithm precisions vary from system to system. In the absence of common formal principles, both industry and academia embraced ad hoc solutions, costing billions of dollars in lost time and productivity. This paper explains how the problem of interoperability, and data translation in particular, may be formulated and studied in terms of a recently developed theory of ε-solidity. Furthermore, a systematic classification of problems in data translation shows that in most cases ε-solids can be maintained without expensive and arbitrary geometric repairs.