bluuebunny/crossref_metadata_2025 huggingface dataset:
Preliminary Results of Total Wrist Arthroplasty Using the RWS Prosthesis
Authors: RAHIMTOOLA Z. O. , ROZING P. M.
Published: February 2003

Twenty-nine wrist prostheses were implanted and followed-up for a mean of 4 (range, 2–8) years. Twenty-four of these patients had rheumatoid arthritis. Pain and range of motion improved significantly. Sixteen patients were graded as excellent, six as good, two as fair and three as poor according to Meuli’s wrist score. There were three frank radiological failures and one revision in this study. Eleven prostheses showed signs of possible loosening without progression or clinical instability. The management of the distal ulna during this procedure and the long-term fixation of the carpal component were problematic.
Diagnosis of Laryngopharyngeal Reflux Disease with Digital Imaging
Authors: Beaver Mary ES , Stasney C. Richard , Weitzel Erik , Stewart Miichael G. , Donovan Donald T. , Parke Robert B. , Rodriguez Margarita
Published: February 2003

OBJECTIVE

The study goal was to assess the use of digital laryngeal videostroboscopy (LVS) in the detection of objective improvement of the larynx after 6 weeks of proton pump inhibitor (PPI) therapy and to evaluate a clinical grading scale for findings of laryngopharyngeal reflux disease (LPRD).

STUDY DESIGN AND SETTING: We conducted a prospective analysis of digital LVS examinations from a tertiary referral center for laryngology by 3 independent blinded examiners.

RESULTS

The mean score on the Laryngopharyngeal Reflux Disease Index for experimental patients was significantly higher than that for control patients (9.50 versus 2.92, P < 0.001), and posttreatment scores were significantly lower than pretreatment scores (7.35 versus 9.50, P < 0.001). Useful items on the grading scale for assessing the presence of LPRD and improvement in LPRD included supraglottic edema and erythema, glottic edema and erythema, and subglottic edema and erythema. Nonuseful items included the presence of pachydermia, granulomas, nodules, leukoplakia, and polyps.

CONCLUSION

Objective improvement of signs of LPRD can be detected after 6 weeks of PPI therapy using digital LVS. The Laryngopharyngeal Reflux Disease Index is a useful valid clinical tool for following treatment response to PPI therapy.
The Role of Hair Shaving in Skull Base Surgery
Authors: Gil Ziv , Cohen Jacob T. , Spektor Sergei , Fliss Dan M.
Published: February 2003

OBJECTIVE

We sought to evaluate surgical wound infection rates in patients undergoing skull base surgery without hair removal.

METHODS

We undertook a retrospective study of 175 skull base operations performed without hair removal. Anterior operations were conducted via the subcranial approach (n = 120) and lateral or posterior procedures via various approaches (n = 55). Wounds were examined daily during hospitalization and at routine outpatient follow‐up (8 to 45 months) and classified according to the Center for Disease Control and Prevention guidelines.

RESULTS

The overall surgical wound infection rate was 1.1% (2 of 175): 0.8% (1 of 120) for anterior and 1.8% (1 of 55) for lateral or posterior procedures. It was similar for clean operations (lateral and posterior) and clean‐contaminated (anterior) procedures and was less than or similar to the rates reported for skull base procedures with hair removal. No wound infection occurred among the infected (trauma, fungal infections, and brain abscess) patients.

CONCLUSIONS

Skull base surgery without hair removal is safe and not associated with increased risk of wound infection. The method may prevent additional psychologic stress, promote restoration of the patient's self‐image, and accelerate his or her return to normal life.
Web‐Based Clinical Decision Support System for Triage of Vestibular Patients
Authors: Kinney William C.
Published: February 2003

OBJECTIVES

We sought to use a clinical decision support system (CDSS) to save costs and to improve scheduling of vestibular patients in an otolaryngology clinic.

STUDY DESIGN AND SETTING

We conducted a concurrent review of 50 vestibular patients scheduled in the University of Missouri otolaryngology clinic with or without testing based on the outcome of a CDSS. The CDSS was implemented using Web‐based technology. Charges incurred by the health care system through tests determined by the CDSS were compared with those incurred using the standard procedure of ordering hearing tests and electronystagmography for all patients.

RESULTS

Thirty‐nine tests were prescheduled using the CDSS. Twenty‐five additional tests were ordered after the visit. The CDSS resulted in savings of $37,904.00 in charges to the health care system. The CDSS showed high specificity and variable sensitivity.

CONCLUSION

A Web‐based CDSS can be used to better manage and coordinate patient encounters.

SIGNIFICANCE

One important reason to use a CDSS in health care management is to lower costs.
Autologous Fat Grafting for the Refractory Patulous Eustachian Tube
Authors: Doherty Joni K. , Slattery William H.
Published: February 2003

The patulous eustachian tube (pET) presents a challenging management problem. Patients with the pET disorder are disturbed to the point of mental illness by their symptoms of aural fullness and autophony, especially the echo of their own voice. Thus far, described treatment methods are often temporary or ineffective. Here, we describe a minimally invasive method for the treatment of pET that involves cauterization with autologous fat graft plugging of the ET at its nasopharyngeal orifice, in conjunction with myringotomy and ventilation tube placement. This procedure has been successful for the treatment of refractory pET in 2 patients at the House Ear Clinic with at least 1‐year follow‐up and we propose that it may accomplish relief of symptoms by permanent stenosis of the ET.
A Practical Assessment Algorithm for Diagnosis of Dizziness
Authors: Kentala Erna , Rauch Steven D.
Published: February 2003

OBJECTIVE

We sought to test a 3‐parameter model for diagnosis of dizziness based on the type and temporal characteristics of the dizziness and on hearing status.

STUDY DESIGN AND SETTING

We conducted a prospective blinded study at a tertiary referral neurotology practice. Before examination, patients completed a questionnaire reporting type and timing of dizziness symptoms and hearing status. Clinical diagnoses were compared with questionnaire results.

RESULTS

Fifty‐seven patients completed the questionnaire. We were able to correctly classify 21 (60%) of the 35 subjects who had a common otogenic cause of vertigo by the diagnostic algorithm.

CONCLUSION

A simple classification of dizziness by type, timing, and hearing status can be self‐reported by patients using a brief questionnaire. This classification scheme is as good as others of much greater complexity.

SIGNIFICANCE

The simple classification scheme reported here is based on history alone and facilitates triage of dizzy patients into diagnostic groups for work‐up and management.
Diagnosis and Treatment of Sudden‐Onset Sensorineural Hearing Loss: A Study of 51 Patients
Authors: Zadeh Mani H. , Storper Ian S. , Spitzer Jaclyn B.
Published: February 2003

OBJECTIVE

The study purpose was to determine the efficacy of steroid and antiviral therapy in the management of idiopathic sudden sensorineural hearing loss (SSNHL).

STUDY DESIGN AND SETTING

We conducted a retrospective study of patients presenting to an academic tertiary care center. Fifty‐one patients were evaluated. All patients were placed on the same treatment protocol.

RESULTS

Thirty‐seven patients (73%) had recovery of hearing. Ninety‐one percent of patients with vertigo and all patients with mid‐frequency hearing loss and up‐sloping hearing loss recovered with treatment (P < 0.05). Recovery was significantly related to age, onset of hearing loss, and audiogram type; however outcome was not significantly related to gender, vertigo, tinnitus, or laterality (P < 0.05).

CONCLUSION

Our treatment protocol produced a recovery rate, which exceeds the spontaneous recovery rate. Unlike prior studies, all patients with up‐sloping and mid‐frequency SSNHL had recovery. In addition, vertigo did not indicate a poor prognosis.

SIGNIFICANCE

Antiviral therapy and increased length of steroid treatment may play a role in the improved recovery rates.
Selected toxic metal levels in seasonal fruits of Pakistan
Authors: Jaffar M. , Masud Khalid
Published: February 2003

Levels of selected essential and non‐essential metals (Cd, Cr, Pb, Cu, Fe and Zn) and those of macro‐nutrients (Ca, K, Mg and Na) are estimated in 15 different seasonal fruits available in local Pakistan markets. The wet digestion oxidation method was used for the analysis of samples by the flame atomic absorption technique. The results indicated almost 100 percent incidence of occurrence of trace metals and macro‐nutrients in all fruits. The highest concentration was observed for zinc, ranging between 0.13 and 79.9mg/kg, wet weight, respectively for banana and mango. The iron levels ranged from 0.55 to 44.8mg/kg, wet weight, for pomegranate and mango. The concentrations of Cd, Cr, Pb and Cu remained at marginal levels, except for certain fruits where the concentrations were very high. The data are compared with allowed safe limits laid down by WHO.
Role of non‐digestible carbohydrates in colon cancer protection
Authors: Niba Lorraine L. , Niba Suh N.
Published: February 2003

The contribution of non‐digestible carbohydrates to colon cancer protection is becoming more clearly established. While the causes of colon cancer are multifold, experimental and epidemiological evidence suggests that various dietary components play a significant role in the mitigation of various colon cancer‐inducing factors. Recent developments in the characterization and quantification of these components, which include fructooligosaccharides, dietary fiber and resistant starch, indicate an association between their intake and colon cancer prevention. Considerable physicochemical modifications occur in the colon with the presence of non‐digestible carbohydrates, primarily because these carbohydrates act as selective prebiotic fermentation substrates for beneficial colonic probiotic bacteria to produce short chain fatty acids (SCFA). These SCFA elicit effects such as alteration in preneoplastic lesions, enzyme induction, suppression of mutations, and binding of potential carcinogens. Prebiotic‐probiotic interaction and activity is therefore key in colon cancer protection by non‐digestible carbohydrates.
Companies’ perceptions of inhibitors and enablers for process improvement activities
Authors: Rich Nick , Bateman Nicola
Published: February 2003

Outlines and describes the results of research at Cardiff Business School into the sustainability of process improvement involving shop floor personnel. The study identified a number of factors that influence the success or inhibit progress in terms of performance and sustainable improvement. The findings identify what companies perceive to be inhibitors and enablers for sustainability, within 21 companies who have conducted process improvement (PI) activities using a common intervention approach. The paper presents five classificatory profiles and concludes that managers can easily identify specific inhibitors in their own companies, but find it difficult to formulate specific enablers associated with successful and sustainable improvement. The general and cultural nature of the identified enablers indicates that managers perceive progressing PI activities are reliant on a change of culture within their organisations in parallel with “up‐skilling” the technical knowledge of employees for change to be successfully enacted. The lack of specific processes to change culture, identified in the enablers, also indicates that managers do not know what to do to change their cultures or how best to deal with the inherently challenging and demanding nature of process improvement with shop floor operators.
REQUIRED CONDITIONS FOR LATE TIME ACCELERATION AND EARLY TIME DECELERATION IN GENERALIZED SCALAR–TENSOR THEORIES
Authors: DIAZ-RIVERA L. M. , PIMENTEL LUIS O.
Published: February 2003

We consider a generalized scalar–tensor theory, where we let the coupling function ω(ϕ) and the effective cosmological constants Λ(ϕ) be undetermined. We obtain general expressions for ω(ϕ) and Λ(ϕ) in terms of the scalar field and the scale factor, and show that ω(ϕ) depends on the scalar field and the scale factor in a complicated way. In order to study the conditions for an accelerated expansion at the present time and a decelerated expansion in the past, we assume a power law evolution for the scalar field and the scale factor. We analyze the required conditions that allow our model to satisfy the weak field limits on ω(ϕ), and at the same time, to obtain the correct values of cosmological parameters, as the energy density Ωm0 and cosmological constant Λ(t0). We also study the conditions for a decelerated expansion at an early time dominated by radiation. We find values for ω(ϕ) and Λ(ϕ) consistent with the expectations of a where the cosmological constant decreases with the time and the coupling function increases until the values are accepted today.
NONPERTURBATIVE DOUBLE SCALING LIMITS
Authors: FERRARI FRANK
Published: February 2003

Recently, the author has proposed a generalization of the matrix and vector models approach to the theory of random surfaces and polymers. The idea is to replace the simple matrix or vector (path)-integrals by gauge theory or nonlinear σ model (path)-integrals. We explain how this solves one of the most fundamental limitations of the classic approach: we automatically obtain nonperturbative definitions in non-Borel summable cases. This is exemplified in the simplest possible examples involving O (N) symmetric nonlinear σ models with N-dimensional target spaces, for which we construct (multi)critical metrics. The nonperturbative definitions of the double scaled, manifestly positive, partition functions rely on remarkable identities involving (path)-integrals.
EVOLUTION OF STRUCTURE FUNCTIONS AND THEIR MOMENTS IN CHIRAL FIELD THEORY
Authors: RAY-MAITY KAKALI , DASGUPTA PADMANABHA
Published: February 2003

Evolution of structure functions and their moments at low and moderate Q2 is studied in the chiral field theory. Evolution equations based on perturbation expansion in the coupling constant of the effective theory are derived and solved for the moments. The kernels of evolution arising from different processes have been calculated with contributions from direct and cross channels, the interference terms being non-negligible in the kinematic regions under consideration. This is shown to lead to flavor-dependence of the kernels which manifests in observable effects. The invalidity of the probabilistic approach to the evolution process is also pointed out.
On the equivalence of Mann and Ishikawa iteration methods
Authors: Rhoades B. E. , Soltuz Stefan M.
Published: February 2003

We show that certain Mann and Ishikawa iteration schemes are equivalent for various classes of functions.
Fuzzy structures of PI(≪,⫅,⫅)BCK‐ideals in hyperBCK‐algebras
Authors: Jun Young Bae , Shim Wook Hwan
Published: February 2003

The fuzzification of PI(≪,⫅,⫅)BCK‐ideals is considered. Using the notion of
α‐cut, characterization of fuzzy PI(≪, ⫅, ⫅) BCK‐ideals is given. Conditions for a fuzzy set to
be a fuzzy PI(≪, ⫅, ⫅) BCK‐ideal are
provided.
On finitely subadditive outer measures and modularity properties
Authors: Traina Charles
Published: February 2003

Let ν be a finite, finitely subadditive outer measure on
P(X). Define
ρ (E) = ν (X) − ν (E′) for E ⊂ X. The measurable sets
Sν and Sρ and the set S = {E ⊂ X/ν (E) = ρ (E)} are investigated in general, and in the
presence of regularity or modularity assumptions on ν. This is also done for
ν0(E) = inf{ν (M)/E ⊂ M ∈ Sν }. General properties of ν are derived when ν is
weakly submodular. Applications and numerous examples are given.
Properness and topological degree for general elliptic operators
Authors: Volpert V. , Volpert A.
Published: February 2003

The paper is devoted to general elliptic operators in Hölder spaces in bounded or unbounded domains. We discuss the Fredholm property of linear operators and properness of nonlinear operators. We construct a topological degree for Fredholm and
proper operators of index zero.
La matière chez Plotin: son origine, sa nature
Authors: O'Brien Denis
Published: February 2003

The origin of matter is one of the last and greatest unsolved mysteries bedevilling modern attempts at understanding the philosophy of the Enneads. There are two stages in the production of Intellect and of soul. The One or Intellect produces an undifferentiated other, which becomes Intellect or soul by itself turning towards and looking towards the prior principle, with no possibility of the One's "turning towards" or "seeing" itself. But where does matter come from? To arrive at his conception of matter, Plotinus has radically altered the definitions of non-being given by Plato and Aristotle in their refutation of Parmenides. Matter, for Plotinus, is a non-being opposed, not to "the being of each thing", as in Plato's Sophist, but to all "the beings properly so-called", i.e. to all the forms. It is then further identified with Aristotle's definition of non-being as privation, with the crucial difference that privation, for Plotinus, is made a permanent substratum of change. This re-formulation of ideas from the Sophist and the Physics proves unmistakably that it is matter which is generated when soul produces a "non-being" which is also a "total lack of definition". The production of matter by soul does not, however, follow the model of the production of Intellect from the One or of soul from Intellect. Since matter is lifeless, it cannot turn towards its source. Soul therefore has to be herself directly responsible both for the production of matter and for the covering of matter with form. Matter is therefore included among the products which stem ultimately from the One. But the origin and the nature of matter have to be understood as very different from the double process of emanation which lies at the origin of Intellect and of soul.
Molecular Design and Applications of Photochromic Crown Compounds —How Can We Manipulate Metal Ions Photochemically?—
Authors: Kimura Keiichi , Sakamoto Hidefumi , Nakamura Makoto
Published: February 2003

The design and applications of photochromic crown compounds are reviewed here. Such compounds exhibit the possibility of distinct photochemical control of metal-ion complexation, based on the ionic interactions of their photoionized photochromic moieties. Crowned spirobenzopyran derivatives which the authors designed, when isomerized to their corresponding merocyanine form by UV irradiation, can afford an additional binding site for a metal ion complexed by their crown ether moiety in a sophisticated way, i.e., by the six-membered chelate formation with the phenolate oxygen atom and the crown-ether-ring nitrogen atom. The crowned spirobenzopyrans, therefore, have their metal-ion complexing properties modified remarkably by photoirradiation, like the crowned spironaphthoxazines that are more photolabile than the spirobenzopyran derivatives. Crowned spirobenzothiopyrans possess an affinity to softer metal ions such as silver ion, which promotes their photoisomerization to the open form. Crowned bis(spirobenzopyran)s are highly selective for multivalent metal ions in the photochemical control of metal-ion complexation. Photochromic crown compounds such as crowned triphenylmethane dyes, when undergoing intermolecular photoionization, exhibit clear-cut photocontrol systems of metal-ion complexation, which are very attractive for applications, especially in materials chemistry. Polymerization of crowned spirobenzopyran and Malachite Green may make it easier to apply the photochromic crown compounds practically. Remarkable polymer effects also appear in the photochromic crown ether polymers; these include photoinduced switching between precipitation and solubilization in vinyl copolymers of spirobenzopyran and crown ether monomers. Several examples are described of the applications of photochromic crown compounds in materials and analytical chemistry, i.e., photo-responsive ionic conduction and photoenhanced ion sensing and separation.
Inclusion Properties and Solid-State Behavior of Thiophene-Condensed Host Compounds
Authors: Kobayashi Keiji
Published: February 2003

A series of new clathrate host molecules, each containing thiophene rings as a rigid and bulky substituent, has been synthesized based on the “wheel and axle”-type of host design. The interest in these hosts is focused on the continuous change in the length of the “axle” part together with their electron-donating ability. Moreover, the tertiary alcohol moiety in the “wheel” part can undergo the substitution reactions in the solid state. Thus, the host : guest ratio and the conformation of the host molecules exhibit novel dependences on the number of the condensed thiophene rings. Guest exchange via gas solid contact has been achieved in the clathrates which provide a channel-type inclusion void. Isostructural and polymorphic transformation of the host lattices has been found upon gas-solid contact. Pseudo-polymorphic change was also observed in guest release. Ternary crystals exhibited novel site-selectivity for random inclusion of two alcohol guests. The donor character of the hosts can afford three-component charge-transfer complexes enclathrating solvent molecules. Cogrinding the host and the acceptor enhanced the solid-state charge transfer interactions, which have been associated with the nucleophilic substitution in the solid state induced by gas-solid contact. These results indicate one future direction for research on crystalline inclusion complexes.
Improved Velocity Distribution Applied to Fokker–Planck–Kramers Equation Treatment for Dynamics of Diffusion-Controlled Reactions in Two Dimensions
Authors: Ibuki Kazuyasu , Nishiguchi Fumihiro , Ueno Masakatsu
Published: February 2003

The validity of theoretical treatments of short-time dynamics of diffusion-controlled reaction based on the Fokker–Planck–Kramers’ equation (FPKE) has been examined using molecular dynamics (MD) simulation in two-dimensional Lennard–Jones fluids. First, we made Langevin dynamics (LD) simulation assuming that the relative diffusion coefficient is given by the sum of the self-diffusion coefficients and that the potential between the reactants is given by the potential of mean force. The LD and the MD simulation results for the time dependence of the survival probabilities of the reactants agree well. This indicates that the FPKE derived from the Langevin equation can be applied to the problem of diffusion-controlled reaction. The time-dependent Harris theory based on the FPKE and the approximation of the half-range Maxwellian velocity distribution showed disagreements with the MD simulation. Such a limitation of the theory has not been recognized in three-dimensional fluids. In the approximation used in the time-dependent Harris theory, the velocity distribution function is not continuous. We have shown that the agreement between the MD simulation and the theory can be improved when we use a new approximation based on a continuous velocity distribution function.
Flux Correlation Approach to Thermal Reactions and Recombination Rates
Authors: Saito Koichi
Published: February 2003

The rate constants for recombination and exchange processes are studied in terms of two different flux correlation approaches: one is the Yamamoto approach, which is based on the linear response theory, and the other is the Miller one. Using those approaches we consider two exactly solvable cases, i.e., the free particle and the parabolic potential models. Since the rate constants for recombination and exchange processes are calculated by Laplace transforms of the flux correlation functions, the two approaches give different results. In the present calculation, we find that the rate constant in the Yamamoto approach is larger than that in the Miller approach by about 40% at low temperature (∼100 K) and high pressure (∼1 GPa). The difference is considerable in the region where quantum effects dominate.
Syntheses and Structures of Three Types of Hybrid Metal Dipicolinato Complexes Induced by Alkali Metal Ion and the Semiconductor Character
Authors: Ma Chengbing , Chen Changneng , Chen Feng , Zhang Xiaofeng , Zhu Hongping , Liu Qiutian , Liao Daizheng , Li Licun
Published: February 2003

Three types of hybrid transition-alkali metal complexes, [MK2(pdc)2(H2O)7]n (H2pdc = 2,6-pyridinedicarboxylic acid, or so-called dipicolinic acid, M = Mn (1), Co (2), Zn (3), Mn0.5Co0.5 (4)), {[Na2(H2O)8(CH3OH)0.5][Mn2Na2(pdc)4(H2O)8]·0.25CH3OH·2H2O}n (5) and [Ni(H2O)6][Ni2K2(pdc)4(H2pdc)2(H2O)2]·2H2O (6) were self-assembled from a reaction system containing a divalent transition metal, alkali metal and H2pdc, and were isolated under different crystallization conditions. In all complexes, [M(pdc)2]2− units were included as independent components to connect to the alkali metal chains or pdc units. Alkali metal ions act as templates for inducing the organization of the [M(pdc)2]2− components into respective special architectures in different fashions. Complexes 1–4 are isostructural with the same space group and similar cell parameters, in which the [M(pdc)2]2− units are bonded to the water-bridged K chains forming neutral 2D lamellar-like polymers, while 5 contains water-bridged Na chains correlated to Mn2Na2 cluster anions by hydrogen bonds, and 6 is a discrete Ni2K2 tetranuclear cluster consisting of Ni(pdc)2 and K(H2pdc) units. The infrared spectra of these complexes show a large difference between the asymmetrical and symmetrical stretching vibrations, Δ(νas − νs) > 200 cm−1, for the carboxyl groups, indicating unidentate and unsymmetrical bridging coordination modes. The variable-temperature electrical conductivities of complexes 1–5 were determined to display semiconductor features, and the magnetic properties of 1, 2, 4 and 5 were also studied.
Synthesis of Novel Thermally Reversible Photochromic Spiro[adamantane-2,7′(6′H)-benzothiophene]
Authors: Yokoyama Yasushi , Nagashima Hitoshi , Shrestha Sujen Man , Yokoyama Yayoi , Takada Kensaku
Published: February 2003

A new thermally reversible photochromic compound, 4′,5′-hexafluoropropano-6′-phenylspiro[adamantane-2,7′(6′H)-benzothiophene], derived from UV-irradiation of 2-(1-adamantylidene-1-phenylmethyl)-3,3,4,4,5,5-hexafluoro-1-(3-thienyl)cyclopentene via the photochemical 6π-electrocyclization followed by the thermal 1,5-hydrogen migration, was synthesized and its photochemical and thermal properties were examined. The structurally more simplified 3,3,4,4,5,5-hexafluoro-2-(2-methyl-1-phenyl-1-propenyl)-1-(3-thienyl)cyclopentene did not yield the thermally reversible photochromic compound upon UV irradiation.
General Preference for Alkyl/Phenyl Folded Conformations. Relevance of the CH/π and CH/O Interactions to Stereochemistry as Evidenced by Ab Initio MO Calculations
Authors: Takahashi Osamu , Kohno Yuji , Gondoh Yoshinobu , Saito Ko , Nishio Motohiro
Published: February 2003

Ab initio MO calculations were carried out, at the MP2/6-311G(d,p)//MP2/6-31G(d) level, to determine the conformational energy of alkyl 1-phenylethyl sulfoxides, CH3CH(C6H5)–S(O)–R (R = CH3, C2H5, i-C3H7, and t-C4H9). In every case, a geometry (rotamer a, R/C6H5 torsion angle φ ∼ 60°) where the alkyl group (R) is gauche to the C6H5 (Ph) and anti to the benzylic methyl group (Me) has been found to be the most stable. Rotamer b (φ ∼ 300°), where R is flanked by Me and Ph, has been shown the next most stable in every case except for isopropyl and t-butyl analogue with the threo configuration. The R/Ph anti conformation (rotamer c: φ ∼ 180°) has been found the least stable. Interatomic distances (CH/π as well as CH/O) at the stable geometries are found to be very short. These results are interpreted in the context of the attractive CH/π and CH/O hydrogen bonds and the unfavorable electrostatic interaction between the S–O dipole and the quadrupole of the phenyl group. In view of the above result and of previous findings, the alkyl/phenyl congested folded conformation of aralkyl compounds has been suggested to be a general phenomenon.
Oxidation of Alkanes with Dioxygen Induced by Visible Light and Cu(II) and Fe(III) Chlorides
Authors: Takaki Ken , Yamamoto Jun , Matsushita Yuka , Morii Hirokazu , Shishido Tetsuya , Takehira Katsuomi
Published: February 2003

Cyclohexane and adamantane were oxidized in acetonitrile with dioxygen to the corresponding alcohols and ketones under irradiation of visible light in the presence of CuCl2 or FeCl3 catalyst. Fairly good selectivity of the products was attained with CuCl2: ca. 50% for cyclohexane and 75% for adamantane at over 50% conversion. Alkyl hydroperoxides were detected during the reactions in 10% and 25% amounts of the products at maximum for the cyclohexane oxidation with CuCl2 and FeCl3, respectively. Moreover, the products were overoxidized by the present system at comparable or slower rates than the alkanes. Other features of the reaction, such as the rate of oxygen uptake and carbon dioxide liberation, isotope effect, and radical inhibitor effect, were also investigated.
Flexibility of Lipase Brought About by Solvent Effects Controls Its Enantioselectivity in Organic Media
Authors: Ueji Shin-ichi , Taniguchi Tomohiko , Okamoto Takashi , Watanabe Keiichi , Ebara Yasuhito , Ohta Hitoshi
Published: February 2003

The behavior of the enantioselectivity of Candida rugosa lipase was investigated in the esterification of 2-(4-substituted phenoxy)propionic acids with 1-butanol in aliphatic, aromatic, and ethereal solvents. The observed enantioselectivity (E value) was greatly affected by the solvent nature. Two key solvent characteristics, dielectric constant (ε) and hydrophobicity (log P), failed to explain the solvent effects on the E value. On the other hand, the variation of the E value was found to be successfully correlated with the lipase flexibility brought about by the solvent effects, the flexibility of which was estimated by the ESR measurements of the spin-labeled lipase. Although organic chemists should often undertake a solvent screening step in the biocatalytic asymmetric resolutions, the obtained correlation will provide a useful guide in the solvent optimization step.
Thermo responsive DNA/Polymer Conjugate for Intelligent Antisense Strategy
Authors: Murata Masaharu , Kaku Wataru , Anada Takahisa , Soh Nobuaki , Katayama Yoshiki , Maeda Mizuo
Published: February 2003

The conjugate between 20-mer antisense oligodeoxynucleotides (ODN) and thermo-responsive polymer, poly(N-isopropylacrylamide) (PNIPAAm), was prepared. Hybridization reaction between the conjugate and their target RNA was modulated by conformational change of polymer moiety depending on temperature condition.
Formation of PbBr-Based Layered Perovskite Structure Having Poly(thiophene) as an Organic Layer by Soaking Thin Film of Hydrogen Bromide Salt of Poly(3-aminododecylthiophene) in Aqueous Lead Bromide Solution
Authors: Era Masanao
Published: February 2003

When a spin-coated film of hydrogen bromide salt of poly(3-aminododecylthiophene), PC12T·HBr, was soaked in an aqueous solution of PbBr2, PbBr-based layered perovskite structure combined with a semiconductor layer of two-dimensional sheets of PbBr6 octahedra and an organic semiconductor layer of poly(thiophene) was formed.
Nanofrictional Properties of Dendron Langmuir–Blodgett Films
Authors: Xu Sai-Long , Kang Shi-Zhao , Deng Guo-Jun , Wu Peng , Fan Qing-Hua , Wang Chen , Wan Li-Jun , Bai Chun-Li
Published: February 2003

The nanofrictional properties of Langmuir–Blodgett (LB) films of three dendrons (G2-COOH, G3-COOH, and G4-COOH) are characterized using atomic force microscopy/friction force microscopy (AFM/FFM). The result shows that the frictional responses of LB films of three dendrons decrease with increasing generation. The origin of the frictional differences measured from these LB films is also discussed.
Pulmonary endothelium as a site of synthesis and storage of interleukin‐6 in experimental congestive heart failure
Authors: Gaertner Roger , Lepailleur‐Enouf Delphine , Gonzalez Walter , Nicoletti Antonino , Mandet Chantal , Philippe Monique , Mercadier Jean‐Jacques , Michel Jean‐Baptiste
Published: February 2003

Background:

Pulmonary endothelium is an early upstream hemodynamic target of left ventricular dysfunction. Interleukin 6 (IL‐6) is a pro‐inflammatory cytokine reported to increase in congestive heart failure (CHF) patients.

Aims:

We sought to determine the origin of IL‐6, IL‐6 receptor (IL‐6R) and gp130 in experimental CHF.

Methods:

We used rats with coronary artery ligation as an experimental model of either compensated or decompensated heart failure. Lung and aorta samples were analysed by RT‐PCR, ELISA and immunohistochemistry for IL‐6 and its receptors.

Results:

IL‐6 mRNA expression increased in the lung of rats with decompensated heart failure and was positively correlated with infarct severity whereas IL‐6R mRNA decreased in the lung of myocardial infarction rats and gp130 mRNA remained unchanged. In contrast, there were no changes in IL‐6 mRNA expression in the aorta and left ventricular myocardium. IL‐6 peptide content as determined by ELISA and Western Blot in lung tissue was 2‐fold higher in decompensated heart failure as compared to control rats. These data were confirmed by immunohistochemistry showing a preferential endothelial localization of IL‐6 in the CHF lung. IL‐6 peptide was also present in the pleural effusion of decompensated heart failure and was positively correlated with IL‐6 mRNA expression in the lungs of decompensated HF rats. Pulmonary IL‐6 overexpression was associated with nuclear translocation of NF‐κB and cytosolic degradation of IκB.

Conclusion:

Dysfunctional pulmonary endothelium is a source of synthesis and storage of IL‐6 in an experimental model of CHF.
Aspirin alters arterial function in patients with chronic heart failure treated with ACE inhibitors: a dose‐mediated deleterious effect
Authors: Meune Christophe , Mahé Isabelle , Mourad Jean‐Jacques , Cohen‐Solal Alain , Levy Bernard , Kevorkian Jean‐Philippe , Jondeau Guillaume , Habib Aïda , Lebret Marilyne , Knellwolf Anne‐Laure , Simoneau Guy , Caulin Charles , Bergmann Jean‐François
Published: February 2003

Background:

By inhibiting prostaglandin synthesis, aspirin can interfere with both arterial functional and angiotensin‐converting enzyme inhibitor (ACEI) properties and be deleterious in chronic heart failure (CHF).

Aim:

Our aim was to prospectively evaluate the effect of aspirin on arterial functional properties in CHF patients treated with ACEIs.

Methods and results:

Over three consecutive treatment periods of 7 days, 18 patients received placebo, followed by aspirin 100 mg/day, and then aspirin 325 mg/day. Single blind prospective assessment of reflected wave and time reflection by radial applanation tonometry; pulse wave velocity; blood pressure; thromboxane B2 (TxB2) and prostaglandins in plasma and urine was performed. Aspirin 325 mg/day induced a significant increase in augmentation index of reflected wave (P<0.0001 and P=0.0013 vs. placebo and aspirin 100 mg, respectively) and a significant decrease in reflected wave traveling times (P=0.0007 vs. placebo). Aspirin 100 mg/day produced a similar, though non‐significant, trend in these parameters compared with placebo. Both aspirin treatments produced a statistically significant decrease in serum TxB2 (P<0.0001) but did not have an effect on the metabolite of prostaglandin I2 (P=0.136).

Conclusion:

This study demonstrates the existence of a dose‐mediated deleterious effect of aspirin upon arterial functional properties in CHF patients treated with ACEI.
PROGESTIN CONTRACEPTIVES
Authors: Schnare Sharon Myoji
Published: February 2003

Progestin contraceptives offer unique advantages, allowing the clinician to tailor optimum regimens for selected women. This article reviews the various progestational drugs, regimens, and delivery systems available presently and in development, with reference to the clinical benefits and limitations of each method.
PHARMACEUTICAL THERAPY IN MIDWIFERY PRACTICE: A CULTURALLY COMPETENT APPROACH
Authors: Doyle Eva I. , Faucher Mary Ann
Published: February 2003

The profession of midwifery can be part of the solution in America's quest for a culturally sensitive and competent health care system. Midwives who are familiar with a variety of health‐related cultural beliefs and practice culturally sensitive inquiry, particularly when using pharmaceutical therapies, can effectively understand and respond to the cultural complexities that impact a client's health. This article describes needed cultural competencies, reviews a variety of health‐related cultural beliefs, and relates how these beliefs impact the use and acceptability of pharmaceutical therapies. Specific examples related to culturally sensitive inquiry are discussed along with recommendations.
PHARMACOLOGIC MANAGEMENT OF COMMON LOWER RESPIRATORY TRACT DISORDERS IN WOMEN
Authors: Leiner Steven , Mays Mary
Published: February 2003

In a primary care setting, midwives collaboratively manage common lower respiratory conditions that require pharmacologic therapy. Current knowledge about the indications, use, adverse effects, and potential side effects of these medications is essential. This article reviews the drugs most frequently used for the outpatient treatment of asthma, tuberculosis, pneumonia, and bronchitis (acute and chronic) in adults. Recommendations from the Centers for Disease Control and Prevention guidelines and professional societies are presented. Drug pharmacology and adverse effects are discussed in detail.
ESTROGEN: PHYSIOLOGY, PHARMACOLOGY, AND FORMULATIONS FOR REPLACEMENT THERAPY
Authors: Ruggiero Ronald J. , Likis Frances E.
Published: February 2003

Estrogen is the central component in 6 of the 100 most widely prescribed medications in the United States today. This steroid has several therapeutic uses including contraceptive applications, treatment of menopausal symptoms, and the prevention of osteoporosis. A wide variety of estrogen replacement therapy (ERT) and estrogen plus progestational hormonal replacement therapy (HRT) preparations are available. In addition, there are an increasing number of products with estrogenic properties that are being promoted as alternatives to drugs containing estrogen, such as phytoestrogens and selective estrogen receptor modifiers (SERMs). This article reviews the physiology of estrogenic effects, estrogen metabolism, and the pharmacokinetics of marketed preparations.
MIDWIVES AND POSTABORTION CARE: EXPERIENCES, OPINIONS, AND ATTITUDES AMONG PARTICIPANTS AT THE 25TH TRIENNIAL CONGRESS OF THE INTERNATIONAL CONFEDERATION OF MIDWIVES
Authors: Miller Suellen , Billings Deborah L. , Clifford Barbara
Published: February 2003

Midwifery practice may not include caring for women experiencing complications from unsafe abortion, despite the importance of this care for the health and lives of millions of women around the world. This article summarizes data collected from midwives from 41 countries who attended the 25th Triennial Congress of the International Confederation of Midwives in 1999, focusing on their experiences with, and attitudes toward, the provision of postabortion care. Barriers to provision of postabortion care and factors for changes in postabortion care‐related policies were explored. Midwives from developing countries, where complications from unsafe abortion present a serious public health problem, were cognizant of the need to authorize, train, and equip midwives in postabortion care, including the use of uterine evacuation of incomplete abortion with manual vacuum aspiration. Changes in policy and practice are needed throughout the world so that women will have access to quality, compassionate postabortion care services regardless of where they live. Ensuring that midwives are able to provide such services will help to reduce abortion‐related morbidity and mortality.
A LIGHT IN THE FOG: CARING FOR WOMEN WITH POSTPARTUM DEPRESSION
Authors: Kennedy Holly Powell , Beck Cheryl Tatano , Driscoll Jeanne Watson
Published: February 2003

It is estimated that at least 1 in 10 women will experience postpartum depression, yet systematic screening for it in clinical practice is too often neglected. The foggy unreality of this affective disorder leads women to believe they are losing their minds, and their efforts to find help can be elusive. Women with postpartum depression who go undetected and untreated are at risk for immediate harm and potential lifelong sequelae for themselves and their families, and especially for their children. This article provides 1) an understanding of the woman's experience of postpartum depression, 2) a review of two instruments, developed through a focused program of research to screen for the disorder, 3) triage in clinical practice, and 4) an overview of the three dimensions of treatment: psychopharmacology, psychotherapy, and psychosocial care. Practical guidance and client information are provided to assist midwives and primary care providers to incorporate systematic screening into clinical practice, to identify effective interdisciplinary treatment teams, and to muster family and community resources to help with this commonly hidden childbearing crisis.
BARRIERS TO POSTPARTUM DEPRESSION PREVENTION AND TREATMENT: A POLICY ANALYSIS
Authors: Sobey Wendy Sand
Published: February 2003

Public policy erects two barriers to adequate prevention and treatment of postpartum depression (PPD) in the United States: 1) the lack of parity between insurance coverage for mental and physical illness decreases access to care and 2) the current model of postpartum care fails to incorporate screening and follow‐up. Treatment for PPD falls into the insurance category of mental health. But many insurance companies either do not cover mental illness at all or provide coverage that is far below that for physical ailments. Because cost‐benefit analyses have shown the benefits of parity laws, legislation to achieve parity between mental and physical health insurance is crucial in addressing this problem. Meanwhile, the U.S. model of post‐partum care should follow the example of care provided in the United Kingdom where nurse‐midwives visit new mothers at home to check on their physical and emotional status. In one program that produced positive psychological health outcomes, midwifery visits were tailored to individual needs and extended to 10‐12 weeks postpartum. Encouraging developments in the United States include 1) an effective program that screens new mothers with signs of PPD and provides telephone follow‐up and rapid treatment referral and 2) proposed legislation to fund organizations working to reduce the incidence of PPD.
HEALTH OUTCOMES OF INCARCERATED PREGNANT WOMEN AND THEIR INFANTS IN A COMMUNITY‐BASED PROGRAM
Authors: Barkauskas Violet H. , Low Lisa Kane , Pimlott Sheryl
Published: February 2003

An experimental, community‐based, residential program, focused on health promotion, was established in 1990 for incarcerated pregnant women with short‐term sentences and histories of drug abuse in a large, midwestern metropolitan area in the United States. Infants resided with mothers after birth. Prenatal care, delivery, postpartum, and family‐planning services were initiated and provided by a nurse‐midwifery service. Community‐based health care, job training, and drug rehabilitation were provided for women during pregnancy through the fourth postpartum month. Program participants' prenatal, delivery, postpartum, and neonatal health outcomes are presented and compared with those of incarcerated women in the same state prison system who experienced usual correctional facility care and support. Program participants represented a group of obstetrically high‐risk women. Health outcomes for both groups of incarcerated women and their infants were similar and more optimal than would have been expected given their preexisting health conditions and risk factors.
VAGINAL BIRTH AFTER CESAREAN BIRTH: A NATIONAL SURVEY OF U.S. MIDWIFERY PRACTICE
Authors: Carr Catherine A. , Burkhardt Patricia , Avery Melissa
Published: February 2003

Midwives have been providing care for women choosing vaginal birth after cesarean birth (VBAC) for over 20 years. The 1999 American College of Obstetrician Gynecologist (ACOG) guidelines and recent studies questioning the relative safety of VBAC have raised concerns about continuing to offer this option. As part of an effort to understand VBAC care provided by midwives, this study used a national survey sample to examine practices, scope, and recent changes in the provision of VBAC care. The survey, which included demographic and practice items was mailed in late 2000 to a purposeful sample of 325 midwifery practices. The return rate was 62%. Nearly all (94%) of the responding practices were providing VBAC care, and almost half of them (43%) stated that their ability to do so had changed within the past 2 years secondary to recent studies in the obstetric literature, the 1999 ACOG statement, and concerns from third‐party payers. Criteria for offering VBAC are stricter, and consent forms are more extensive. Other changes included the need for additional or more intensive support services, in‐house anesthesia, and surgery backup. Midwives continue to provide VBAC care, although with some increased restrictions. This study provides background for future research that will determine how midwifery care affects the rate of successful VBACs.
DOMESTIC VIOLENCE DURING PREGNANCY: IMPLICATIONS FOR PRACTICE
Authors: Espinosa Lisa , Osborne Kathryn
Published: February 2003

Domestic violence affects many women and their families. Although estimates of the prevalence of domestic violence during pregnancy vary, it is likely that most providers of women's health care will encounter pregnant women who experience domestic violence. The purpose of this article is to review research that has investigated associations between domestic violence during pregnancy and other demographic and lifestyle variables, as well as the literature regarding clinical assessment and intervention strategies.
SAFE PRESCRIBING PRACTICES IN PREGNANCY AND LACTATION
Authors: Hansen Wendy F. , Peacock Anne E. , Yankowitz Jerome
Published: February 2003

Midwives and other health care providers face a dilemma when a pregnant woman develops a condition that usually is treated with a pharmacologic agent. Understanding of basic teratology associated with drugs as well as the FDA categorization of agents can assist professionals in recognizing which pharmaceuticals should be used or avoided. In addition to reviewing teratology, this article addresses the use of common drugs for the treatment of upper respiratory conditions, minor pain, gastrointestinal problems, psychiatric illnesses, and neurologic disorders. In each category, current evidence is presented pertaining to which agents should be recommended for pregnant women.
WHAT DO YOU DO WHEN THE BABY IS WINKING AT YOU? CASE REPORT OF A FACE PRESENTATION
Authors: Barger Mary K.
Published: February 2003

Face presentation is an uncommon presentation at birth. The identification of a fetus with a hyperextended neck on ultrasound antenatally warrants close scrutiny for other anomalies. A fetus who presents as a face presentation in labor that is of average estimated fetal weight and has no anomalies in a woman with an adequate pelvis is likely to deliver vaginally if the mentum rotates to anterior prior to birth. Persistent mentum posteriors are best left alone without manual intervention and delivered by cesarean section. Prolonged labor is common. The clinician must be patient and closely monitor descent and rotation. Infants born as face presentations should be assessed closely after birth for normal respiratory transition and the presence of significant pain warranting analgesics.