bluuebunny/crossref_metadata_2025 huggingface dataset:
Gait outcomes after additional backward walking training in patients with stroke: a randomized controlled trial
Authors: Yang Yea-Ru , Yen Jyh-Geng , Wang Ray-Yau , Yen Lu-Lu , Lieu Fu-Kong
Published: March 2005

Objective: To examine the effectiveness of additional backward walking training on gait outcome of patients post stroke.

Design: Randomized controlled trial.

Setting: Medical centre.

Subjects: Twenty-five subjects with stroke, who were lower extremity Brunnstrom motor recovery stage at 3 or 4 and were able to walk 11 m with or without a walking aid or orthosis, randomly allocated to two groups, control (n = 12) and experimental (n = 13).

Interventions: Subjects in both groups participated in 40 min of conventional training programme three times a week for three weeks. Subjects in experimental group received additional 30 min of backward walking training for three weeks at a frequency of three times per week.

Main measures: Gait was measured using the Stride Analyzer. Gait parameters of interest were walking speed, cadence, stride length, gait cycle and symmetry index. Measures were made at baseline before commencement of training (pre-training) and at the end of the three-week training period (post-training).

Results: After a three-week training period, subjects in experimental group showed more improvement than those in control group for walking speed (change score: 8.609 ± 6.95 versus 3.659 ± 2.92, p-value = 0.032), stride length (change score: 0.0909 ± 0.076 versus 0.00649 ± 0.078, p-value = 0.006), and symmetry index (change score: 44.079 ± 53.29 versus 5.309 ± 13.91, p-value = 0.018).

Conclusions: This study demonstrated that asymmetric gait pattern in patients post stroke could be improved from receiving additional backward walking therapy.
Effect of pulsed short-wave diathermy on pain and function of subjects with osteoarthritis of the knee: a placebo-controlled double-blind clinical trial
Authors: Laufer Y , Zilberman R , Porat R , Nahir A M
Published: March 2005

Objective: To examine the effects of pulsed short-wave diathermy (PSWD), delivered at an intensity sufficient to induce a thermal sensation and at an athermal intensity, in comparison with a placebo short-wave diathermy treatment, on reported pain, stiffness and functional ability and on mobility performance of patients with osteoarthritis of the knee.

Design: A placebo-controlled double-blind trial with sequential allocation of patients to different treatment groups.

Setting: Outpatient physiotherapy department.

Subjects: One hundred and three consecutive patients, mean age 73.7 (9 = 6.6) years with osteoarthritis of one or both knees for at least three months.

Interventions: All participants received three 20-min-long treatments per week for three weeks. One group received PSWD with mean power of 18 W (thermal effect), one group received PSWD with mean power of 1.8 W (athermal effect), and one group received sham short-wave diathermy treatment. Patients were assessed before the initial treatment, immediately following the last treatment, and at a three-month follow-up.

Main measures: Outcome measures included the WOMAC Osteoarthritis Index, which assessed reported pain, stiffness, and functional ability, and four measures of mobility performance: Timed Get Up and Go test (TGUG), stair-climbing, stairdescending and a 3-min walk.

Results: A difference across time was observed for the pain and stiffness categories of the WOMAC Osteoarthritis Index (p < 0.033 and p < 0.008, respectively), with no differences between groups. No other significant differences across time or between groups were observed in any of the other measures.

Conclusion: The findings do not demonstrate pulsed short-wave diathermy, as it is utilized in clinical settings, to be effective in the treatment of osteoarthritis of the knee.
The association of marital status and hospice use in the USA
Authors: Lackan Nuha A , Ostir Glenn V , Kuo Yong-Fang , Freeman Jean L
Published: March 2005

Background: Married individuals are more likely to use hospice than unmarried individuals. We examine this association and how it is influenced by gender.

Methods: Medicare beneficiaries dying of cancer were studied.

Results: Currently married (OR 1.36 95% C.I. 1.28 1.45) or ever married (OR 1.23 95% C.I. 1.16 1.31) subjects were more likely to use hospice than never married subjects. A significant interaction between marital status and gender (PB .001) was observed.

Conclusions: Subjects likely to enroll in hospice are subjects likely to have greater supportive relationships.
Physician-assisted death: attitudes and practices of community pharmacists in East Flanders, Belgium
Authors: Bilsen Johan , Bauwens Marc , Bernheim Jan , Stichele Robert Vander , Deliens Luc
Published: March 2005

This study investigates attitudes and practices of community pharmacists with respect to physician-assisted death. Between 15 February and 15 April 2002, we sent anonymous mail questionnaires to 660 community pharmacists in the eastern province of Flanders, Belgium. The response rate was 54% (n-359). Most of the pharmacists who responded felt that patients have the right to end their own life (73%), and that under certain conditions physicians may assist the patient in dying (euthanasia: 84%; physician-assisted suicide: 61%). Under the prevailing restrictive legislation, a quarter of the pharmacists were willing to dispense lethal drugs for euthanasia versus 86% if it were legalized, but only after being well informed by the physician. The respondents favour guidelines for pharmacists drafted by their own professional organizations (95%), and enforced by legislation (90%) to ensure careful end-of-life practice. Over the last two years, 7.3% of the responding pharmacists have received a medical prescription for lethal drugs and 6.4% have actually dispensed them. So we can conclude that community pharmacists in East Flanders were not adverse to physician-assisted death, but their cooperation in dispensing lethal drugs was conditional on clinical information about the specific case and on protection by laws and professional guidelines.
Estimating the spatial scale of pollen dispersal in the cultural landscape of southern Sweden
Authors: Broström Anna , Sugita Shinya , Gaillard Marie-José , Pilesjö Petter
Published: March 2005

The primary aim of the study was to estimate the spatial scale of pollen dispersal and deposition for pollen assemblages from moss polsters in the cultivated landscape of southern Sweden, as a mean to improve future studies of the pollen/vegetation relationship in the region, and interpretation of fossil pollen data in terms of past cultural landscapes. This can be done by estimating the ‘relevant source area of pollen’ (RSAP) defined as the area around the pollen sampling point beyond which the pollen-vegetation relationship does not improve. Forty-two sites from nonfertilized grasslands in the traditional open agricultural (Open Region) and semi-open forested (Semi-Open Region) regions of southern Sweden were selected. The vegetation survey was performed within a 1500 m radius area around the moss polsters sampling area. The extended R-value (ERV) model was used to evaluate the pollen-plant abundance relationship. The RSAP for moss polsters in the Open Region was estimated to c. 400 m from empirical data. In the Semi-Open Region, however, the likelihood function score, an indicator of the goodness-of-fit of the data to the ERV model, showed an unexpected pattern of change, making it difficult to evaluate the RSAP. Simulations using hypothetical landscapes suggest that systematic selection of sampling sites could cause this pattern. Simulations also demonstrate that the size of vegetation patches affect the RSAP, i.e., the larger the vegetation patches are, the larger the RSAP becomes. Similar RSAP for the Open and Semi-Open Regions is obtained in simulations using the same patch size, and random selection. In the actual vegetation, patch size is comparable in the two regions, which would suggest that the RSAP for moss polsters in the Semi-Open Region is c. 400 m as well.
Holocene environmental change in southwestern Crimea (Ukraine) in pollen and soil records
Authors: Cordova Carlos E. , Lehman Paul H.
Published: March 2005

Pollen records and soil development sequences from the Heraklean Peninsula and the Chyornaya Valley provide information on climatic change and fluctuation of ecological boundaries (mesic forests, steppes and sub-Mediterranean shrublands) in southwestern Crimea during the Holocene. Forests of Quercus, Ulmus, Corylus and Carpinus existed in the Heraklean Peninsula between 12 ka and 11 ka. The subsequent reduction of arboreal pollen and the expansion of Artemisia and Knautia, in conjunction with chernozem soil development, indicate prevailing steppe conditions between 11 ka and 7.5 ka. An increase in arboreal pollen, dominated by sub-Mediterranean and Mediterranean taxa, and the development of brown cinnamonic (calfersic) soil suggest higher temperatures and summer drought between 7.5 ka and 5 ka. An increase in arboreal pollen and the development of a meadow cinnamonic soil suggest an increase in moisture between 5.4 ka and 4.6 ka. A subsequent decrease in AP and the development of calcic horizons in cinnamonic soils indicate that a dry phase occurred between 4.2 ka and 3.5 ka. Woodland expansion occurred again after 3.2 ka, only to be interrupted by the establishment of Greek farms in the fifth century BC. An increase in AP on or after the first century BC was the result of climatic amelioration in conjunction with farm abandonment prompted by political crisis and steppe warrior raids. Although Holocene pollen and soil records from the Ukrainian steppes present climate trends similar to the Heraklean Peninsula, differences in plant taxa and soil response to climatic changes exist due to their different position with respect to marine influences.
Utilizing physical sediment variability in glacier-fed lakes for continuous glacier reconstructions during the Holocene, northern Folgefonna, western Norway
Authors: Bakke Jostein , Lie øyvind , Nesje Atle , Dahl Svein Olaf , Paasche øyvind
Published: March 2005

The maritime plateau glacier of northern Folgefonna in western Norway has a short (subdecadal) response time to climatic shifts, and is therefore well suited for reconstructing high-resolution glacier fluctuations. The reconstruction presented here is based on physical parameters of glaciolacustrine sediments retrieved from two glacier-fed lakes and a peat bog north of the ice cap. Bulk density and modelled glacier net mass balance for the last 200 years show a remarkably similar pattern, where maximum sediment yield lags the glacier net mass balance by-10 years. The record of glacier variations has been transferred into an equilibrium-line altitude (ELA) variation curve. Glaciers respond primarily to changes in summer temperature and winter precipitation. At present there is a high correlation between the North Atlantic Oscillation (NAO) index and measured (since the early 1960s) net mass balance on maritime glaciers in western Norway (r=-0.8). Reconstructed glacier variations from maritime western Norway are therefore considered indicative of the strength of the westerly airflow associated with NAO during the Holocene. The early phase of mid-Holocene glacier growth (5200 cal. yr BP) was characterized by gradual glacier expansion culminating in the first Subatlantic glacial event at 2300 cal. yr BP The climate during the last 2200 years has favoured increased glacier activity at Folgefonna. High-amplitude shifts in ELA may be explained by unstable modes of the westerlies causing significant variability of winter precipitation. During the last 2000 years, Folgefonna expanded and decayed with significant decadal variability. During the latest period of the‘Mediaeval Warm Epoch’, Folgefonna advanced. The Neoglacial maximum, however, was reached during the‘Little Ice Age’ at AD 1750 and AD 1870. The northern Folgefonna glacial record is compared to other Holocene glacier records in Scandinavia.
Change in surface debris cover on Mont Blanc massif glaciers after the‘Little Ice Age’ termination
Authors: Deline Philip
Published: March 2005

Because of insulation by supraglacial debris, the dynamics of debris-covered glaciers differ from those of‘clean’ glaciers. Thus, changes in debris cover have to be taken into account when interpreting glacier fluctuations in terms of climate forcing. Three large glaciers in the Mont Blanc massif were investigated for the period since the termination of the‘Little Ice Age’ (LIA) using historical and scientific documents of the eighteenth and nineteenth centuries. Although debris cover was limited to its frontal area until the 1840s, Miage Glacier exhibited a continuous debris cover in the first decades after the LIA, increasing to its present extent by the 1930s. On the Mer de Glace, a partial debris cover formed by coalescence of two of the four medial moraines at the close of the LIA; until 1890, these moraines have formed the present Veine noire (‘Black vein’). In contrast, Brenva Glacier had a continuous debris cover at the end of the eighteenth century, possibly following a rock avalanche in 1767. For glaciers like Mer de Glace and Miage Glacier, the close of the LIA represents a threshold marked by a rapid change in state from‘clean’ to debris-covered; for others, long-term debris accumulation or frequent rock avalanching (e.g., Brenva Glacier) mask the climate control of a slow post-LIA expansion of debris cover.
Mycophenolate mofetil and neurological diseases
Authors: Vermersch P , Stojkovic T , De Seze J
Published: March 2005

We describe experience with the use of mycophenolate mofetil (MMF) in neurological diseases. Although only small series of patients or case reports were described, MMF is promising in immunemediated neuromuscular disorders. MMF has been used for the treatment of polymyositis, chronic inflammatory demyelinating polyradiculoneuropathy, and multifocal motor neuropathy. These studies showed that MMF is well tolerated and may be useful in some patients. MMF can be effective alone but mainly as an adjuvant therapy by reducing steroid requirements or the frequency of infusions of IVIg. MMF has also been tested alone as a single drug treatment or in combination with immunomodulatory drugs in multiple sclerosis in open surveillance trials or in phase II studies. None of these studies have been designed to demonstrate a clinical efficacy but preliminary results are very promising.
Mycophenolate mofetil in systemic vasculitis
Authors: D'cruz DP
Published: March 2005

The systemic vasculitides are a group of potentially life-threatening multi-system autoimmune connective tissue diseases characterized by vascular inflammation. The gold standard therapies include corticosteroids and cyclophosphamide as induction therapy and other agents such as azathioprine and methotrexate to maintain remission. Mycophenolate mofetil (MMF) is increasingly being used in autoimmune disorders and this article reviews the use of this agent in the systemic vasculitides.
Mycophenolate mofetil in patients with hepatitis C virus infection
Authors: Ramos-Casals M , Font J
Published: March 2005

Diagnosis and treatment of hepatitis C virus (HCV) -related autoimmune features has become a clinical challenge in HCV-infected patients, in whom chronic liver disease associated with severe autoimmune features may contribute to a very poor prognosis. Both antiviral and immunosuppressive therapies, either alone or in combination, seem likely to have a key role. Based on the experience of mycophenolate mofetil (MMF) use in HCV patients receiving organ transplantation, this new immunosuppressive agent might represent a safe and effective therapeutic option to treat HCV-related extrahepatic features. Recent data are available for the use of MMF in HCV patients with autoimmune manifestations, mainly for autoimmune cytopenias and vasculitic features. MMF may be used as monotherapy or in association with other drugs for cases of HCV-related autoimmune diseases refractory or intolerant to common immunosuppressive treatments, allowing the reduction of the drug dosage and avoiding serious side effects.
Language aptitude and its relationship to instructional effectiveness in second language acquisition
Authors: Erlam Rosemary
Published: March 2005

Experimental second language acquisition research typically investigates the effectiveness of instruction in terms of overall group gains. A particular instructional method may not, however, benefit all learners uniformly. This study, conducted in a New Zealand secondary school, establishes whether there is any relationship between the effectiveness of three instructional methods, and learner aptitude. Students (n = 60) were assigned to one of three groups (deductive instruction group, inductive instruction group, structured input instruction group) and received instruction that targeted direct object pronouns in L2 French. All students were assessed on the following three measures of language aptitude: (a) language analytic ability, (b) phonemic coding ability and (c) working memory.

Results indicate that deductive instruction that gives students opportunities to produce language output may neutralize individual differences in language aptitude.
Measuring gains in pupils’ foreign language competence as a result of participation in a school exchange visit: the case of Y9 pupils at three comprehensive schools in the UK
Authors: Evans Michael , Fisher Linda
Published: March 2005

This article examines evidence provided by quantitative and qualitative measurement of second language (L2) proficiency by elementary-level learners of French, following participation in a school foreign exchange visit. Based on a study consisting of a controlled analysis of test results from 68 pupils studying French at three secondary schools in England, the paper discusses the short-term impact on performance in the four language skills as well as longer-term correlations with the pupils’ results in the public GCSE examination. In addition, the paper attempts to define the profile of improvers in each language skill (as four separate subgroups) through analysis of their results in the four tests and through correlation with their reports on linguistic support provided by their exchange partner and host family. The findings suggest that the exchange had greatest impact on the strengthening of proficiency in listening comprehension and in writing performance (in relation to communicative content and fluency, but not with respect to grammatical accuracy). The paper also presents a more qualitative account of the writing test data, reporting on the output in terms of variety of tenses used and instances of expressive language.
Anterior knee pain
Authors: Miller David , Tumia Nezar , Maffulli Nicola
Published: March 2005

Idiopathic anterior knee pain, also known as patellofemoral pain syndrome (PFPS) is common in young adults and athletes. Its aetiology is still not fully understood, and three major factors can be attributed to its aetiology: quadriceps muscle imbalance, lower extremity malalignment, and increased physical activity. It is essential to exclude any intra-articular pathology before diagnosing PFPS. The main presentation of PFPS is spontaneous onset of anterior knee pain exaggerated by increased physical activity. The mainstay of management is conservative in the form of a rehabilitation programme focusing on proprioception, strength, flexibility, endurance, and a gradual progression of the musculoskeletal load. Surgical management is maximized by accurately determining the source of the pain, and is most successful in patients who have an underlying mechanical abnormality.
Current concepts in the pathophysiology and treatment of inhalation injury
Authors: Cancio Leopoldo C
Published: March 2005

The opinions or assertions contained herein are the private views of the author, and are not to be construed as official or as reflecting the official views of the Department of the Army or Department of Defense. Smoke inhalation injury occurs in about 10% of patients admitted to burn centres, and increases the mortality of burn patients by up to 20% over predictions based on age and burn size alone. The primary lesion in smoke inhalation injury is localized to the small airways, with alveolar injury and pulmonary oedema exercising a less prominent role during the initial phases. Injury incites a cascade of events that include ventilation-perfusion mismatch, secondary lung injury, systemic inflammation, impaired immune function, and pneumonia. The most important recent developments in the treatment of inhalation injury have included improved methods of pulmonary care targeted at the pathophysiology of the injury, such as high-frequency percussive ventilation and gentle mechanical ventilation.
Asphyxiation: a review
Authors: Richards Claire E , Wallis Daniel N
Published: March 2005

Asphyxia may be broadly defined as any condition that leads to tissue oxygen deprivation. This article reviews traumatic causes of asphyxia, including the syn drome known as traumatic asphyxia, where a crush injury to the thoracoabdominal area gives the striking clinical triad of cervicofacial cyanosis and oedema, subcon junctival haemorrhage and cutaneous petechial haemorrhages of the face, neck and upper chest. Other traumatic causes of asphyxia reviewed are strangulation due to hanging and autoerotic asphyxiation. However bleak the initial prognosis may appear, any patient who presents with a history of asphyxiation should initially be resuscitated according to the prioritized approach: airway with cervical spine control, oxygenation and ventilation, and circulation. The clinical appearance of the patient is not an indicator of outcome. The identification and treatment of associated compli cations and injuries is vital, since these are a major cause of morbidity and mortality if the patient survives the initial asphyxiation insult.
Trauma to the ear
Authors: De Ranit , Reid A
Published: March 2005

Trauma of the ear is a common presentation to the emergency room, and consists of a variety of pathologies encompassing simple trauma to the auricle at one end of the spectrum and extending to temporal bone fractures complicated by facial nerve palsy and leak of cerebrospinal fluid. This paper looks at the application of fundamental principles in the assessment of such patients, and identifies manage ment strategies that can limit morbidity and improve outcomes. It is written as a simple guide for nonotolaryngologists, and emphasizes clinical assessment and disposal rather than actual treatment.
Of bandits and saints: Jesús Malverde and the struggle for place in Sinaloa, Mexico
Authors: Price Patricia L.
Published: March 2005

Jesús Malverde, a bandit who was assassinated in 1909, crystallizes the struggle for place-understood both literally and metaphorically-in northern Mexico. The socially and economically marginal people who revered him in the nineteenth century adore him as a lay saint today. Contention over building a chapel to Malverde in Culiacán, the capital city of the northern Mexican state of Sinaloa, distils broader tensions over the Mexican state’s persistent deferral of the poor from inclusion in the official landscape of the nation. Malverde’s appropriation by Sinaloa’s narcotraffickers as their patron saint extends this symbolic and material claim to legitimacy to include those who exist outside the official boundaries. The border between the sacred and the profane is often a site of social struggle, and the case of Malverde is no exception. While the legend of Malverde may well have been invented, its negotiation has proven remarkably long-lived and powerful in shaping and reshaping the iconographic and material landscapes of social inclusion and exclusion. Malverde thus offers an empty signifier whose multiple interpretations yield a surplus of symbolic meanings and material production based on the circulation, negotiation, appropriation, and reinterpretation of those meanings.
‘Nature’, nationhood and the poetics of meaning in Ruhuna (Yala) National Park, Sri Lanka
Authors: Jazeel Tariq
Published: March 2005

Ruhuna, or Yala as it is more commonly known, is Sri Lanka’s most famous national park, attracting hundreds of thousands of nature lovers annually. Included in the wealth of attractions that Ruhuna offers its visitors are transcendent landscape experiences amidst what is popularly considered to be its sacred and premodern ‘nature’. This paper traces the powerful connections between this popular poetics of landscape experience and the creation of racialized difference and political enmity, in the context of a modern nation-state that has only just seen the end of a fiercely contested civil war between a Sinhalese Buddhist majority and Tamil separatists. It suggests that movement through Ruhuna’s space variously fosters senses of belonging, attachment and exclusion in relation to Sri Lankan soil. The paper begins with the history of the reinscription of meaning in this former colonial game reserve. It then proceeds to show how the park’s contemporary and sacred meanings shape experiences in the present, mapping subjects’ bodies with historical, religious and territorial discourses that configure Tamils as ‘invaders’ and ‘interlopers’ in national space that has become Sinhalese and Buddhist by ‘nature’. Ruhuna emerges as a powerful tool whose Sinhala history and Buddhist ‘nature’ are not merely palimpsests of a primordial and premodern antiquity, but map and signify Sri Lanka’s exclusive topographies in the present.
Biomarker Changes During Neoadjuvant Anastrozole, Tamoxifen, or the Combination: Influence of Hormonal Status and HER-2 in Breast Cancer—A Study from the IMPACT Trialists
Authors: Dowsett Mitch , Ebbs Steve R. , Dixon J. Michael , Skene Anthony , Griffith Clive , Boeddinghaus Irene , Salter Janine , Detre Simone , Hills Margaret , Ashley Susan , Francis Stephen , Walsh Geraldine , Smith Ian E.
Published: March 2005

Purpose

To investigate the relationships between biomarker changes in breast cancer during neoadjuvant (preoperative) endocrine therapy.

Patients and Methods

The IMPACT trial compared the preoperative use of tamoxifen with anastrozole alone or in combination in postmenopausal women (n = 330) with primary breast cancer. Biomarkers were measured in tumor biopsy specimens taken at baseline, and after 2 and 12 weeks of treatment.

Results

A decrease in the proliferation marker Ki67 occurred in the majority of patients: 52 (93%) of 56, 46 (85%) of 54, and 37 (84%) of 44 patients in the anastrozole, tamoxifen, and combination groups, respectively. There was a significantly greater suppression of Ki67 in the anastrozole-treated group than in the tamoxifen- or combination-treated groups, which is parallel to the greater efficacy seen for anastrozole over these two treatments in the Arimidex, Tamoxifen, Alone or in Combination adjuvant trial. A positive relationship was noted between estrogen-receptor level and Ki67 suppression in all patients. Ki67 was reduced to a greater extent in progesterone receptor-positive tumors compared with progesterone receptor-negative tumors. HER-2-negative tumors tended to show a greater reduction in Ki67 compared with HER-2-positive tumors, but the difference was only significant in the tamoxifen group after 2 weeks, and in the anastrozole group after 12 weeks.

Conclusion

These results confirm the value of Ki67 as a molecular marker, and provide information regarding the relationships between treatment-induced changes in Ki67 and other important biomarkers. Studies such as this should help integrate agents targeted at growth factor signaling with endocrine agents in breast cancer.
Randomized Placebo-Controlled Study of Low-Dose Warfarin for the Prevention of Central Venous Catheter–Associated Thrombosis in Patients With Cancer
Authors: Couban Stephen , Goodyear Michael , Burnell Margot , Dolan Sean , Wasi Parveen , Barnes David , MacLeod Darlene , Burton Erica , Andreou Pantelis , Anderson David R.
Published: March 2005

Purpose

In this multicenter, randomized, placebo-controlled clinical trial, we studied whether warfarin 1 mg daily reduces the incidence of symptomatic central venous catheter (CVC) –associated thrombosis in patients with cancer.

Patients and Methods

Two hundred fifty-five patients with cancer who required a CVC for at least 7 days were randomly assigned to receive warfarin 1 mg or placebo.

Results

There were 11 (4.3%) symptomatic CVC-associated thromboses among 255 patients, with no difference in the incidence of symptomatic CVC-associated thrombosis between patients taking warfarin 1 mg daily (six of 130 patients; 4.6%) and patients taking placebo (five of 125 patients; 4.0%; hazard ratio, 1.20; 95% CI, 0.37 to 3.94). Warfarin had no effect on CVC life span (84 days v 63 days in control and warfarin groups, respectively; 95% confidence limit, −16 to 55 days; P = .09), and it did not affect the number of premature CVC removals (23.2% v 25.4% in control and warfarin groups, respectively; 95% confidence limit of difference −8.34 to 12.71; P = .68) or the frequency of major bleeding episodes (2% v 0% in control and warfarin groups, respectively; P = .5, Fisher's exact test).

Conclusion

Symptomatic CVC-associated thrombosis in patients with cancer, although significant, is less common than previously reported. In this study, the administration of warfarin 1 mg daily did not reduce the incidence of symptomatic CVC-associated thrombosis in patients with cancer. However, the low rate of symptomatic CVC-associated thrombosis means that a much larger trial is required to address this issue definitively.
Chemoimmunotherapy With Fludarabine, Cyclophosphamide, and Rituximab for Relapsed and Refractory Chronic Lymphocytic Leukemia
Authors: Wierda William , O’Brien Susan , Wen Sijin , Faderl Stefan , Garcia-Manero Guillermo , Thomas Deborah , Do Kim-Anh , Cortes Jorge , Koller Charles , Beran Miloslav , Ferrajoli Alessandra , Giles Francis , Lerner Susan , Albitar Maher , Kantarjian Hagop , Keating Michael
Published: March 2005

Purpose

The efficacy, toxicity, and tolerability of chemoimmunotherapy with the combination of fludarabine, cyclophosphamide, and rituximab (FCR) were evaluated in previously treated patients with chronic lymphocytic leukemia (CLL). The purpose of this study was to improve the complete remission (CR) rate for previously treated patients and evaluate the quality of bone marrow response.

Patients and Methods

One hundred seventy-seven previously treated patients with CLL were evaluated. Treatment consisted of rituximab 375 mg/m2 day 1 of course 1 and 500 mg/m2 day 1 of courses 2 to 6; fludarabine 25 mg/m2/d days 2 to 4 of course 1 and days 1 to 3 of courses 2 to 6; and cyclophosphamide 250 mg/m2/d days 2 to 4 of course 1 and days 1 to 3 of courses 2 to 6. Courses were repeated every 4 weeks.

Results

CR was achieved in 25% of 177 patients, and nodular partial remission and partial remission were achieved in 16% and 32% of patients, respectively; the overall response rate was 73%. Twelve (32%) of 37 complete responders tested achieved molecular remission in bone marrow. Univariate and multivariate analyses were used to identify pretreatment patient characteristics associated with CR and overall remission, longer time to progression, and overall survival.

Conclusion

The FCR regimen was an active and well-tolerated treatment for previously treated patients with CLL. Myelosuppression was the most common toxicity. FCR induced the highest CR rate reported in a clinical trial of previously treated patients with CLL. Furthermore, molecular remissions were achieved in a third of patients achieving CR.
What's in a Name? Persuasion Perhaps
Authors: Gamer Randy
Published: March 2005

Four studies demonstrate the potential influence of name similarity on perceptions of similarity to oneself in general, liking, and compliance. Some participants received a scenario in which the protagonist's name was similar to their own. These participants indicated that the character was more similar to themselves, reported greater liking for the person, and expressed more willingness to comply with a request for help than control participants did. In addition, the persuasive influence of name similarity on questionnaire return rates indicated that both undergraduates and college professors completed and returned questionnaires more frequently if the name on the cover letter was similar to their own. The influence of name similarity was independent of name familiarity. The importance of name similarity in eliciting overt behavioral action is discussed.
Price‐Matching Guarantees and Consumer Evaluations of Price Information
Authors: Lurie Nicholas H. , Srivastava Joydeep
Published: March 2005

In 3 experiments, we show that price‐matching guarantees affect the process through which consumers translate price information into subjective judgments. In Experiment 1, we find that price‐matching guarantees appear to change the standard used in price evaluation by raising consumers’ estimates of the lowest and average prices in the market. This leads consumers to perceive products and stores that offer price‐matching guarantees as less expensive. In Experiment 2, we show that evaluations of product price information are affected by the presence of a price‐matching guarantee only when consumers do not know the range of market prices. In Experiment 3, we extend these findings to show that consumer evaluations of the cost of products in a store, inferred on the basis of store characteristics, are also influenced by the presence of a price‐matching guarantee.
A Selective Hypothesis Testing Perspective on Price‐Quality Inference and Inference‐Based Choice
Authors: Cronley Maria L. , Posavac Steven S. , Meyer Tracy , Kardes Frank R. , Kellaris James J.
Published: March 2005

Consumers often rely heavily on price as a predictor of quality and typically overestimate the strength of this relation. Furthermore, the inferences of quality they make on the basis of price can influence their actual purchase decisions. Selective hypothesis testing appears to underlie the effects of information load and format on price–quality inferences. Results of 5 experiments converge on the conclusion that quality inferences are more heavily influenced by price when individuals have a high need for cognitive closure, when the amount of information presented is high (vs. low), and when the information presented is rank ordered in terms of quality rather than presented randomly. Furthermore, because consumers are willing to purchase more expensive brands when they perceive a high price–quality correlation, these variables can also influence their purchase decisions.
A structured search for applications of the incremental sheet-forming process by product segmentation
Authors: Allwood J M , King G P F , Duflou J
Published: March 2005

A methodology for identifying applications of a new production technology is proposed and tested. It is applied to the incremental sheet-forming process, showing a preference for low-volume high-value applications and identifying the importance of improving process accuracy. The methodology could in future help to identify novel applications.
Intelligent scheduling using a neural network model in conjunction with reinforcement learning
Authors: Fourie C J
Published: March 2005

This paper describes the use of an artificial neural network in conjunction with reinforcement learning techniques to develop an intelligent scheduling system that is capable of learning from experience. In a simulated environment the model controls a mobile robot that transports material to machines. States of ‘happiness’ are defined for each machine, which are the inputs to the neural network. The output of the neural network is the decision on which machine to service next. After every decision, a critic evaluates the decision and a teacher ‘rewards’ the network to encourage good decisions and discourage bad decisions. From the results obtained, it is concluded that the proposed model is capable of learning from past experience and thereby improving the intelligence of the system.
Laser short-pulse heating with time-varying intensity and thermal stress development in the lattice subsystem
Authors: Yilbas B S , Arif A F M
Published: March 2005

Laser short-pulse heating of solid surfaces results in non-equilibrium energy transport in the region irradiated by the laser beam. Owing to the large temperature gradients in the lattice subsystem, high stress levels develop in the surface region of the substrate material. In the present study, temperature and stress fields in the substrate material are presented for the case of the laser short-pulse heating of gold. Electron kinetic theory and a two-equation heating model are introduced to account for non-equilibrium energy transport during the laser heating pulse. Laser pulses exponentially decaying with time are accommodated in the simulations. It is found that lattice site temperature gradients attain high values inspite of the low magnitude of the lattice site temperature. This, in turn, results in high stress levels in the surface region of the substrate material. Thermal stress is compressive owing to high thermal strain development and low displacement of the surface.
Model structure correction and updating of aeroengine casings using fictitious mass modifications
Authors: Shahverdi H , Mares C , Mottershead J E
Published: March 2005

In this paper the results of a finite element model updating exercise, carried out on closely axisymmetric aeroengine casings, are presented. The correction of the combustion chamber outer casing (CCOC) model is considered and, after assembly with the turbine casing (TC), the quality of the resulting combined model is investigated. The dynamics of both casings is characterized by pairs of close modes, which may be separated by fictitious point mass modifications. The natural frequencies and mode shapes of the fictitiously modified CCOC are determined from receptances obtained from the CCOC in its original (unmodified) configuration. The modifications are shown to improve the understanding of both the CCOC and the system formed by connecting the CCOC to the TC. A particular problem is revealed when model updating is applied to the CCOC. An analysis of the mode shapes locates a modelling error on an inner shell of the structure but it is found that the finite element model is unable to be parameterized for the correction of two pairs of wrongly ordered predicted modes. This can only be achieved by firstly correcting the ‘structure’ of the model itself. The main error is found to be a geometrical inaccuracy, and, when this is put right, the sequence of the modes is corrected. Model updating is then applied to the thickness of certain shell elements and the CCOC is found to be in excellent agreement with measured data, as is the complete model formed from the two models of the CCOC and the TC together.
Shape optimization on double-chamber mufflers using a genetic algorithm
Authors: Chang Y-C , Yeh L-J , Chiu M-C
Published: March 2005

In an effort to meet the demands of operation and maintenance inside a constrained machine room, the volume of the muffler system is often compromised. Therefore, the need to enhance the level of muffler performance under limited space conditions becomes even more expedient in the field of practical engineering work. The present paper proposes a novel scheme for the shape optimization of double-chamber mufflers by using a genetic algorithm (GA). The new approach utilizes the four-pole transfer matrix - a technique for evaluating the sound transmission loss (STL) on the basis of plane wave theory - in conjunction with the GA method. A numerical case of the sound elimination of pure tone is discussed in this study. To achieve optimization in the GA, several test parameter values were used. Results showed that the maximum value of the STL was optimally obtained at the desired frequency of 250 Hz. The approach used in this study for optimum design of the STL is both easy and quite effective.
Personalised image-based templates for intra-operative guidance
Authors: Berry E , Cuppone M , Porada S , Millner P A , Rao A , Chiverton N , Seedhom B B
Published: March 2005

The high rate of unplanned perforation, poor fixation, and nerve injury with freehand pedicle screw insertion has led to the use of image-guided navigation systems. Although these improve accuracy, they have several drawbacks that could be overcome by using image-based drilling guide templates. The accuracy of such templates was tested in a cadaveric study of screw placement in the lumbar, thoracic, and cervical regions of the spine. The dimensional stability with autoclaving of duraform polyamide, to be used for manufacturing the guides, was first determined using test specimens. Computed tomography (CT) images were acquired of 4 cadaveric spines, and placement of 4 cervical, 32 thoracic, and 14 lumbar screws was planned. Eighteen personalized drilling guide templates, in four different designs, were built. Orthopaedic surgeons experienced in the freehand techniques used the templates. CT images were acquired to assess placement position with respect to the pedicle. Duraform polyamide was found to be unaffected by sterilization. Two of the template designs facilitated the placement of 20/20 screws without error. Templates can lead to successful screw placement, even in small pedicles, providing their design is optimized for the application area, e.g. with enhanced rotational stabilization.
Aerobiology in the operating room and its implications for working standards
Authors: Friberg B , Friberg S
Published: March 2005

Two novel operating room (OR) ventilation concepts, i.e. the upward displacement or thermal convection system and the exponential ultra-clean laminar air flow (LAF) designed to function without extra walls, were evaluated from a bacteriological point of view. The thermal convection system (17 air changes/h) was compared with conventional ventilation (16 air changes/h) with an air inlet at the ceiling and evacuation at floor level. The exponential LAF was compared with the vertical ultra-clean LAF and the horizontal ultra-clean LAF, both with extra side walls. The comparison was made using strictly standardized simulated operations and, except for the horizontal LAF, it was performed in the same OR where the type of ventilation was changed.

In the different areas important for surgical asepsis, the thermal system resulted in a twofold to threefold increase in bacterial air and surface counts compared to the conventional system (statistical significance = p < 0.05-0.0001). The bacteriological efficiency of the exponential LAF was equal to the horizontal and vertical LAF units with extra walls in the OR, and all three systems easily fulfilled the criteria for ultra-clean air, i.e. bacteria-carrying particles <10/m3. In the areas important for surgical asepsis the turbulent ventilation systems yielded highly significant correlation between air and surface contamination (p < 0.02-0.0006). No such correlation existed in the LAF systems.
Design aspects of compliant, soft layer bearings for an experimental hip prosthesis
Authors: Scholes S C , Unsworth A , Blamey J M , Burges I C , Jones E , Smith N
Published: March 2005

Currently, an artificial hip joint can be expected to last, on average, in excess of 15 years with failure due, in the majority of cases, to late aseptic loosening of the acetabular component. A realistic alternative to the problem of wear in conventional joints is the introduction of bearing surfaces that exhibit low wear and operate in the full fluid-film lubrication regime. Contact analyses and friction tests were performed on compliant layer joints (metal-on-polyurethane) and the design of a prototype ovine arthroplasty model was investigated. When optimized, these components have been shown to achieve full fluid-film lubrication.
CO2 and H2O diluted oxy-fuel combustion for zero-emission power
Authors: Richards G. A. , Casleton K. H. , Chorpening B. T.
Published: March 2005

Concerns about climate change have encouraged significant interest in concepts for zero-emission power generation systems. These systems are intended to produce power without releasing CO2 into the atmosphere. One method to achieve this goal is to produce hydrogen from the gasification of fossil or biomass fuels. Using various membrane and reforming technologies, the carbon in the parent fuel can be shifted to CO2 and removed from the fuel stream, followed by direct CO2 sequestration. The hydrogen fuel can be used directly in gas turbines fitted with low-NO x combustors. A second approach to producing zero-emission power is to replace the nitrogen diluent that accompanies conventional combustion in air with either CO2 or H2O. In this concept, CO2 or H2O is added to oxygen to control combustion temperatures in oxygen-fuel reactions. In the absence of nitrogen, the primary combustion products for any hydrocarbon under lean conditions are then simply CO2 and H2O. Thus, merely cooling the exhaust stream condenses the water and produces an exhaust of pure CO2, ready for sequestration. The dilute oxy-fuel combustion strategy can be incorporated in power cycles that are similar to Brayton or Rankine configurations, using CO2 or H2O as the primary diluent respectively. While the relative merits of the various strategies to zero-emission power are the subject of various technical and economic studies, very little work has focused on defining the combustion issues associated with the dilute oxy-fuel option. In this paper, the expected combustion performance of CO2 and H2O diluted systems are compared. Experimental results from a high-pressure oxy-fuel combustor are also presented.
Expanding fuel flexibility of gas turbines
Authors: Moliere M
Published: March 2005

Gas turbines are continuous-flow engines that develop steady aerodynamics and flame kinetics. These features reduce the constraints placed on fuel properties for combustion and provide a considerable margin for clean combustion. In particular, heavy-duty gas turbines can operate on a large number of primary fuels that are available in many branches of the industry. These accessible fuels include natural gas (NG) and diesel fuel (DF), as well as a number of industry byproducts generated by the refining and petrochemical sectors, coal and oil and gas activities, steel and mining branches, and by the agricultural industry (biofuels). This fuel flexibility enhances the existing qualities demonstrated by gas turbines, such as efficiency, reliability, versatility in applications [mechanical drive, simple and combined cycle, combined heat and power (CHP)], strong integration potential [integrated gasification combined cycle (IGCC), gas to liquid (GTL)], and low emissions. As a result, gas turbines that use local fuel resources, synfuels or industrial byproducts — and are deployed in simple or combined cycles or in CHP units — can play a prominent role in the creation of reliable, clean, and energy-efficient power systems. This article provides the energy community with comprehensive information about alternative gas turbine (GT) fuels, covering volatile fuels [naphtha, natural gas liquid (NGL), condensates], weak gas fuels from the coal/iron industry [coalbed gas, coke oven gas (COG), blast furnace gas (BFG)], ash-forming oils, and hydrogen-rich byproducts from refineries or petrochemical plants. The main technical considerations essential to the success of alternative fuel applications are reviewed and key experience milestones are highlighted. A special emphasis is placed on the combustion of hydrogen in gas turbines.