bluuebunny/crossref_metadata_2025 huggingface dataset:
Sulfate Decomposition and Sodium Oxide Activity in Soda–Lime–Silica Glass Melts
Authors: Beerkens Ruud G. C.
Published: January 2007

Reaction equilibrium constants for the sulfate decomposition process, which releases oxygen and sulfur oxide gas in soda–lime–silica glass melts, have been determined. The chemical solubility of SO2, probably in the form of sulfite ions in soda–lime–silica melts, has also been determined. The chemical solubility value of SO2, dissolving as sulfite, ranges between 0.02 and 0.06 wt% SO32− at 1 bar SO2 pressure in the temperature range of 1600–1800 K. Results of square‐wave‐voltammetry studies and measurements of the temperature‐dependent sulfur retention after the fining process of commercial float glass melts and a model soda–lime–silica melt, with 74 wt% SiO2, 16 wt% Na2O, and 10 wt% CaO, are presented. The measured sulfur retention data and the results of the square‐wave‐voltammetry studies are used to determine the equilibrium constant of the sulfate decomposition reaction in the temperature range of 1600–1800 K. The thermodynamic relations and properties found for sulfate decomposition are used to derive activities of sodium oxide in soda–lime–silica melts. Literature values for sodium oxide activities in these glass melts are rare. In this study, these activities have been determined by a method, based on the measurement of sulfate decomposition equilibrium constants and the residual sulfate concentrations in glass melts, equilibrated with almost pure sodium sulfate galls.
Hot‐Pressed Silicon Nitride with Lu2O3 Additives: Oxidation and Its Effect on Strength
Authors: Guo Shuqi , Hirosaki Naoto , Nishimura Toshiyuki , Yamamoto Yoshinobu , Mitomo Mamoru
Published: January 2007

The oxidation behavior and effect of oxidation on room‐temperature flexural strength were investigated for hot‐pressed Si3N4 ceramics, with 3.33 and 12.51 wt% Lu2O3 additives, exposed to air at 1400° and 1500°C for up to 200 h. Parabolic oxidation behavior was observed for both compositions. The oxidation products consisted of Lu2Si2O7 and SiO2. The Lu2Si2O7 grew out of the surface silicate in preferred orientations. The morphology of oxidized surfaces was dependent on the amount of additive; Lu2Si2O7 grains in the 3.33 wt% composition appeared partially in a needlelike type, compared with a more equiaxed type exhibited in the 12.51 wt% case. The high resistance to oxidation shown for both compositions was attributed to the extensive amounts of crystalline, refractory secondary phases formed during the sintering process. Moreover, after 200 h of oxidation at 1400° and 1500°C, the strength retention displayed by the two compositions was 93%–95% and 85%–87%, respectively. The strength decrease was associated with the formation of new defects at the interface between the oxide layer and the Si3N4 bulk.
Fractal Perimeters of Polishing‐Induced Pull‐Outs Present on Polished Cross Sections of Plasma‐Sprayed Yttria‐Stabilized Zirconia Coatings
Authors: Li Jianfeng , Liao Hanlin , Wang Xiaoyan , Coddet Christian
Published: January 2007

Polished cross sections of plasma‐sprayed yttria‐stabilized zirconia coatings deposited using different process parameters were prepared with both hot‐ and vacuum‐mounting techniques and investigated by image analysis. It was found that polishing‐induced pull‐outs were evidently present on the hot‐mounted cross sections, and that the perimeter of these pull‐outs could be described statistically by means of fractal analysis. In this work, values of the corresponding fractal dimension range from 1.45–1.54; they increase linearly while increasing fracture toughness, and decrease with the increase in porosity of the coatings. Thus, this fractal dimension may be regarded as a measure of the fracture toughness of the coatings, but only for hot‐mounted samples.
Phase Composition and Vaporization Study of LaGa1–xAlxO3, 0 ≤x≤ 1, and La0.9Sr0.1Ga0.8–xAlxMg0.2O2.85, x= 0.1, 0.2, 0.3
Authors: Matraszek Aleksandra , Miller Miroslaw , Singheiser Lorenz , Hilpert Klaus
Published: January 2007

The vaporization of the LaGa1–xAlxO3 solid solution, 0 ≤x≤ 1, of the perovskite structure, was investigated using Knudsen effusion mass spectrometry in the temperature range of 1623–1928 K. The partial pressures of the gaseous species O2, Ga, GaO, Ga2O, and LaO were determined for the samples investigated. The equilibrium partial pressures were used for the computation of thermodynamic activities of Ga2O3 and La2O3 at 1800 K. Thermodynamic activities of Al2O3 were obtained using Gibbs–Duhem integration. Gibbs energies of formation of the solid‐solution LaGa1–xAlxO3 resulted from the thermodynamic activities of the oxide components. Samples of the chemical composition La0.9Sr0.1Ga0.8–xAlxMg0.2O2.85, x= 0.1, 0.2, 0.3, were of practical importance in solid oxide fuel cell (SOFC) technology and also were investigated. The influence of the aluminum concentration in the perovskite phase on the thermodynamic activity and volatility of Ga2O3 is presented and implications for the potential use of this material in SOFC technology are discussed.
Corrosion of Borosilicate Sealing Glasses for Molten Carbonate Fuel Cells
Authors: Pascual Maria J. , Pascual Luis , Valle Francisco J. , Durán Alicia , Berjoan Rene
Published: January 2007

The development of a new sealant for molten carbonate fuel cells (MCFC) requires a study of the attack of molten carbonates on selected materials. Silica and Pyrex® glasses have better corrosion resistance against molten carbonates than other glasses, but they have unsuitable thermal expansion coefficients. Comparisons have also been made between borosilicate glasses of suitable thermal expansion for sealants for MCFC and silica and Pyrex® glasses. The corrosion kinetics in molten carbonates follows two limiting relations and involves two corrosion mechanisms. The weight loss varied linearly with time, indicating a dissolution of the glass network at short times. Longer times show corrosion, depending on the square root of time, typical of a diffusion mechanism and indicating formation of a protective layer on the surface of the glass. The main crystalline corrosion product is lithium methasilicate. The glass‐corrosion rate follows the well‐known Arrhenius law. These studies used scanning electron microscopy, X‐ray diffraction, X‐ray photoelectron spectroscopy, and chemical analysis. A general corrosion mechanism of borosilicate glasses in molten carbonates is proposed.
Calorimetric Study of Nickel Molybdate: Heat Capacity, Enthalpy, and Gibbs Energy of Formation
Authors: Morishita Masao , Navrotsky Alexandra
Published: January 2007

The thermodynamic properties of the α and β polymorphs of NiMoO4 were directly investigated by calorimetry. The standard entropies of formation, ΔfS°T, of α and β were determined from measuring the molar heat capacity, Cp,m, from near absolute zero (2 K) to high temperature (1380 K) by a relaxation method and differential scanning calorimetry. The standard enthalpies of formation, ΔfH°T, of α and β were determined by combining Cp,m with the standard enthalpy of formation, ΔfH°298, at 298 K obtained from drop solution calorimetry in molten sodium molybdate at 973 K. The standard Gibbs energies of formation, ΔfG°T, of α and β were determined from their ΔfS°T and ΔfH°T values. The ΔfG°T values indicate that the polymorphic transformation from α to β occurs at 1000 K, consistent with the observed phase transformation at 1000 K.
Homogeneity Region of Strontium‐ and Magnesium‐Containing LaGaO3 at Temperatures between 1100° and 1500°C in Air
Authors: Rozumek Michael , Majewski Peter , Sauter Linda , Aldinger Fritz
Published: January 2007

Phase stability studies were performed within the quasi‐ternary system LaGaO3‐SrGaO2.5‐“LaMgO2.5”. Emphasis was cast on the temperature dependence of the homogeneity region of La1−xSrxGa1−yMgyO3−δ perovskite solid solutions. Isothermal sections were determined at 1100°, 1250°, 1400°, and 1500°C in a static air atmosphere. The single‐phase homogeneity region was found to considerably diminish with decreasing temperature, indicating a reduction of the solid solubility of Sr and Mg, and below 1100°C the doped perovskite becomes unstable. Consequently, the cubic perovskite phase was found to exist only at elevated temperatures and for high Sr and Mg amounts. Sample preparation was performed by the mixed‐oxide process as well as by a modified combustion synthesis.
Synthesis of Magnesium Aluminate Spinel Platelets from α‐Alumina Platelet and Magnesium Sulfate Precursors
Authors: Hashimoto Shinobu , Zhang Shaowei , Lee William Edward , Yamaguchi Akira
Published: January 2007

Spinel platelets were formed from a powder mixture of 3–5 μm wide and 0.2–0.5 μm thick α‐Al2O3 and 1–8 μm (average 3 μm) MgSO4 heated 2 h at 1200°C. The hexagonal platelet shape of the original α‐Al2O3 platelet was maintained in the spinel, although their size was slightly increased and their surface roughened. When a mixture of α‐Al2O3 platelets and MgO powder was heated 3 h at 1400°C, the spinel formed lost the platelet morphology of the alumina.
Mullite–Aluminum Phosphate Laminated Composite Fabricated by Tape Casting
Authors: Kim Dong‐Kyu , Kriven Waltraud M.
Published: January 2007

Mullite–aluminum phosphate (3Al2O3·2SiO2/AlPO4) laminated composites were fabricated by tape casting. AlPO4 had a density of 1.56 g/cm3, which corresponds to 61% of theoretical density, and a bending strength of 1.5 MPa after sintering at 1600°C for 10 h. The aluminum phosphate functioned as a porous, weak, and chemically stable interphase which was able to deflect cracks in a laminated composite. To increase the strength of the weak interphase material, 10 and 30 vol% of mullite were added.
Crack–Tip Toughness of a Soft Lead Zirconate Titanate
Authors: Njiwa Alain B. Kounga , Fett Theo , Lupascu Doru C. , Rödel Jürgen
Published: January 2007

Crack–opening displacement (COD) measurements were performed on a commercial lead zirconate titanate (PZT). The intrinsic fracture toughness (or crack–tip toughness) of this material was determined using a new evaluation procedure, which takes into account the near–tip CODs and complete crack profile CODs. The crack–tip toughness KI0 was determined from an extrapolation of COD data obtained at various loading stages, thus avoiding the complications caused by subcritical crack growth in PZT. Results for plane strain and plane stress condition are presented.
Food‐dependent exercise‐induced anaphylaxis with a high level of plasma noradrenaline
Authors: KATO Yukihiko , NAGAI Ayako , SAITO Masuyoshi , ITO Tomonobu , KOGA Michiyuki , TSUBOI Ryoji
Published: January 2007

Ingesting certain foods sometimes triggers anaphylaxis when followed by exercise (food‐dependent exercise‐induced anaphylaxis, FDEIA). Specific food‐induced mucocutaneous urticaria may also progress to anaphylaxis (oral allergy syndrome, OAS). A positive skin test and/or radioallergosorbent test (RAST) to the foods suggest involvement of immunoglobulin (Ig)E‐anaphylaxis in both disorders. The triggering foods and initial target organs are usually different in each case. In the present study, a 32‐year‐old male reported dyspnea accompanied by wheals, and symptoms of low blood pressure while walking after eating Chinese noodles and donuts. He also reported uncomfortable sensations in his mouth and throat after ingesting melon. Exercise challenge tests were administered. Serum histamine, plasma adrenaline, noradrenaline and dopamine were measured pre‐ and post‐test. No symptoms were induced by exercise or by the ingestion of any single food item before exercise. However, numerous wheals appeared when exercise followed the combined ingestion of foods. Likewise, the sequence of eating pancakes and then exercising resulted in numerous wheals and anaphylaxis. Olopatadine hydrochloride and ketotifen fumarate completely inhibited this anaphylaxis. The skin prick tests resulted in fruit‐induced erythema and wheals. The results of these tests with wheat, butter and sugar were negative, and no symptoms were induced by the exercise test after ingestion of watermelon, melon or apple. The anaphylactoid symptoms were accompanied by a significant increase of plasma noradrenaline. In this case, not only wheat, but sugar and butter may induce the onset of FDEIA. There was no significant correlation between the intensity of the symptoms and the serum histamine levels in the present case. Noradrenaline may be involved in the onset of FDEIA, since noradrenaline may selectively inhibit T‐helper (Th)1 functions while favoring Th2 responses. The tests showed no cross‐reactivity between the causative foods of OAS and FDEIA, indicating that the mechanisms of onset are different between them.
Lipedematous scalp and lipedematous alopecia: Report of three cases in white adults
Authors: YAŞAR Şirin , MANSUR A. Tülin , GÖKTAY Fatih , SUNGURLU Faik , VARDAR AKER Fügen , ÖZKARA Selvinaz
Published: January 2007

Lipedematous scalp (LS) and lipedematous alopecia (LA) are rare conditions of unknown etiology characterized by a thick and boggy scalp due to increase in the subcutaneous fat layer. Besides the changes in the texture of skin, varying degrees of hair loss are seen in patients with LA. In this report, we present two cases with LA and one case with LS in white adults. On examination, a boggy and soft swelling of the scalp was detected in all patients. In addition, the patients with LA had alopecic areas over the boggy scalp. Histopathologic examinations of skin biopsy specimens and magnetic resonance imaging of the scalp showed increased thickness of subcutaneous fat tissue in all patients. The exact etiopathogenesis of LA and LS remain unknown. These conditions may be either reactive or compansatory responses versus yet undetected stimuli, or represent a genetic tendency. Both of the these entities have been initially reported mostly in adult black females, however, we believe that LA and LS may well occur in white subjects and may be more widespread and frequently observed than previously supposed.
Ulcerative lichen planus associated with Sjögren's syndrome
Authors: TSUBOI Hiromi , KATSUOKA Kensei
Published: January 2007

Ulcerative lichen planus is a rare variant of lichen planus that is characterized by ulcerations of the feet and toes that are accompanied by toenail loss. However, the nail, oral mucosa, genital mucosa and the scalp are also sometimes affected by ulcerative lichen planus. Several authors have drawn attention to the association of ulcerative lichen planus and autoimmune diseases. We report a patient who had ulcerative lichen planus, with ulcerative erythema on the soles and palms, nail dystrophy and oral lesions, as well as Sjögren's syndrome; she was successfully treated with etretinate.
Experimental vertical transmission of Macrobrachium rosenbergii nodavirus (MrNV) and extra small virus (XSV) from brooders to progeny in Macrobrachium rosenbergii and Artemia
Authors: Sudhakaran R , Ishaq Ahmed V P , Haribabu P , Mukherjee S C , Sri Widada J , Bonami J R , Sahul Hameed A S
Published: January 2007

White tail disease (WTD) is a serious problem in hatcheries and nursery ponds of Macrobrachium rosenbergii in India. Experiments were carried out to determine the possibility of vertical transmission of M. rosenbergii nodavirus (MrNV) and extra small virus (XSV) in M. rosenbergii and Artemia. Prawn broodstock inoculated with MrNV and XSV by oral or immersion challenge survived without any clinical signs of WTD. The brooders spawned 5–7 days after inoculation and the eggs hatched. The survival rate of larvae gradually decreased, and 100% mortality was observed at the post‐larvae (PL) stage. Whitish muscle, the typical sign of WTD, was seen in advanced larval developmental stages. The ovarian tissue and fertilized eggs were found to be positive for MrNV/XSV by reverse transcriptase‐polymerase chain reaction (RT‐PCR) whereas the larval stages showed positive by RT nested PCR (nRT‐PCR). In Artemia, reproductive cysts and nauplii derived from challenged brooders were normal and survival rates were within the expected range for normal rearing conditions. The reproductive cysts were found to be positive for MrNV/XSV by RT‐PCR whereas the nauplii showed MrNV/XSV‐positive by nRT‐PCR. The PL of M. rosenbergii fed nauplii derived from challenged Artemia brooders died at 9 days post‐inoculum with clinical signs of WTD.
Detection of the bacterium Flavobacterium psychrophilum from a natural infection in rainbow trout, Oncorhynchus mykiss (Walbaum), using formalin‐fixed, wax‐embedded fish tissues
Authors: Crumlish M , Diab A M , George S , Ferguson H W
Published: January 2007

The bacterial pathogen Flavobacterium psychrophilum was successfully identified from formalin‐fixed, wax‐embedded tissue blocks of infected rainbow trout heart and spleen tissues, using a polymerase chain reaction (PCR)‐based assay. Filamentous bacteria were observed in haematoxylin and eosin and Giemsa‐stained sections but no bacteria were recovered from the diseased fish using standard bacteriology isolation techniques. All infected fish had histopathological evidence of myocarditis or rainbow trout fry syndrome. Immunohistochemistry was attempted using three different anti‐F. psychrophilum sera but the results were inconclusive, and an alternative molecular approach was therefore attempted. This paper describes the use of a PCR‐based assay to help identify bacteria present in formalin‐fixed, wax‐embedded tissue samples. This is the first time that this technique has been used for the detection of fish bacteria from diagnostic samples.
The pathology of the early stages of the crustacean parasite, Lernaeocera branchialis (L.), on Atlantic cod, Gadus morhua L.
Authors: Smith J L , Wootten R , Sommerville C
Published: January 2007

Lernaeocera branchialis is a penellid copepod, the adults of which are commonly found on gadoids in the North Atlantic and North Sea. L. branchialis has a severe negative impact on wild gadoids and is a potentially serious pathogen of farmed cod, Gadus morhua. This paper describes an experimental infection by cohabiting the intermediate host, the flounder, Platichthys flesus, heavily infected with juvenile stages of L. branchialis, with hatchery‐reared cod in order to study the pathology of the early stages of infection of the final host. Early stages of L. branchialis induce extensive local gill hyperplasia, large intravascular thrombus formation and a moderate cellular immune response in the cardiac and branchial tissues of G. morhua. The parasite appears to migrate within the lumen of the afferent branchial artery, ventral aorta and in turn, that of the bulbus arteriosus. These findings are consistent with the presence of a haematophagous, voluminous and rapidly invasive parasite.
Field weed population dynamics: a review of model approaches and applications
Authors: HOLST N , RASMUSSEN I A , BASTIAANS L
Published: January 2007

Mathematical modelling is a commonly used tool for studying the long‐term dynamics of weed populations in agriculture. This was reflected in our review by the large number of scientific papers (134 original publications) and the continuing need to gain an overview over this fast developing field (20 previous review papers were found). In this article, we provide a more comprehensive review than earlier seen, striving to include all relevant publications. Thus, we cover models of the population dynamics of 60 weed species in 40 crops. An online, accompanying database provides an indexed bibliography. Despite the large variation in crops, weeds and geography, the models were surprisingly similar in their approach: structured around the weed life cycle, excluding environmental factors and giving little attention to validation or even documentation of model construction. In addition, their application was similar, limited mostly to strategic decision making. We hope that the overview provided by this review will inspire weed modellers and that it will serve as a basis for discussion and as a frame of reference when we proceed to advance the modelling of weed populations to a new level, developing new approaches and tackling new application domains.
Prohexadione‐calcium induces sunflower (Helianthus annuus) resistance against the root parasitic weed Orobanche cumana
Authors: FAN Z‐W , BUSCHMANN H , SAUERBORN J
Published: January 2007

Prohexadione‐calcium (PHDC) is a plant growth retardant that inhibits gibberellin biosynthesis and transiently alters the spectrum of flavonoids and their phenolic precursors. In this study, root chamber and pot experiments were conducted to evaluate the effects of PHDC on Orobanche cumana seed germination and induction of sunflower resistance to this root parasitic weed. Root chamber experiments indicated that PHDC did not interfere with the progress of Orobanche seed germination, but retarded O. cumana tubercle formation and development. In pot experiments, control of O. cumana by PHDC depended on its dose, method of application and sunflower cultivar. In sunflower cv. HA89, PHDC at 10 mg LS−1 (litre soil) as two drenches or at 1 mm as two foliar sprays significantly reduced the total number and dry matter of O. cumana without influencing flower, leaf and root development. In sunflower cv. Albena, PHDC at 20 and 30 mg LS−1, but not at 10 mg LS−1, as two drenches significantly reduced O. cumana infection. Sunflower cv. HA89 was less susceptible to O. cumana and more inducible by PHDC than sunflower cv. Albena. The biochemical analysis of root extracts revealed a significantly higher accumulation of free phenolics in sunflower cv. HA89 after PHDC soil drench, but not in Albena. No significant lignification was observed after PHDC treatments. The results suggest that PHDC reduces O. cumana infection in sunflower by inducing host resistance, not by directly interfering with the parasite. Free phenolics play an important role in sunflower response to the parasite.
Readmission and survival following hospitalization for chronic obstructive pulmonary disease: long‐term trends
Authors: Geelhoed E. A. , Brameld K. J. , Holman C. D. J. , Thompson P. J.
Published: January 2007

Background: Exacerbations requiring hospital admission for chronic obstructive pulmonary disease (COPD) contribute to a decline in health status and are costly to the community. Long‐term trends in admissions and associated outcomes are difficult to establish because of frequent readmissions, high case fatality and potential diagnostic transfer between COPD and asthma. The Western Australian Data Linkage System provides a unique opportunity to examine admissions for patients with COPD over the long term.

Method: Nineteen years of hospital morbidity data, based on International Classification of Diseases‐9 criteria were extracted from the Western Australian Data Linkage System (1980–1998) and merged with mortality records to examine trends in hospital admissions for COPD.

Results: The rate of hospital admissions for COPD has declined overall and the rate of first presentation declined in men and remained constant in women. The risk of readmission increased throughout the period (P < 0.0001) and more than half of all admissions were followed by readmission within a year. Median survival following first admission was 6 years (men 5 years; women 8 years). Age, sex and International Classification of Diseases subcategory each showed an independent effect on the risk of mortality (P < 0.0001). The poorest survival was in patients subcategorized as emphysema. For patients with multiple admissions, the likelihood of cross‐over between COPD and asthma was high and increased with the total number of admissions.

Conclusion: The rate of admission for COPD has declined in Western Australia; however, the resource burden will continue to increase because of the ageing population. This has policy implications for the development of acute care treatment programmes for COPD.
Managing scientific uncertainty in health legislation
Authors: Lipworth W.
Published: January 2007

Legislation and regulation of biomedical research is seldom a one‐off process since biomedical science evolves rapidly, dynamically and often unpredictably. This paper discusses the challenges faced by regulators who need to produce legislation and policy in rapidly changing fields and outlines some practical suggestions for managing law reform and policy‐making under these circumstances.
Diagnosing cancer: changing patterns of care
Authors: Lim E. , Rosenthal M. A
Published: January 2007

We prospectively assessed 100 consecutive inpatient referrals made to the Medical Oncology Unit. The major end‐point was the time to diagnostic biopsy. Referral trends and treatment outcomes were also recorded. Our results show that the referring units undertook the diagnostic process in the vast majority and the time to inpatient diagnostic biopsy has fallen from 10 to 4.6 days, compared with a similar study 13 years ago. This emphasizes the changing role of the oncologist in current day multidisciplinary cancer care.
Recruitment of volunteers to improve vitality in the elderly: the REVIVE* study
Authors: Caplan G. A. , Harper E. L.
Published: January 2007

Background: Delirium is a common problem for frail, older patients in hospital and a marker of poor outcome and mortality. The aim of this study was to test a volunteer‐mediated delirium prevention programme for efficacy, cost‐effectiveness and sustainability on an Australian geriatric ward.

Methods: Two controlled before‐and‐after studies were conducted. In study 1, 37 patients (>70 years, admitted to the geriatric wards) were enrolled during 5 months in 2003 for intensive individual study. Twenty‐one patients received usual care and 16 patients received the volunteer‐mediated intervention of daily orientation, therapeutic activities, feeding and hydration assistance, vision and hearing protocols. In study 2, we examined the effects of a general implementation for the whole department by measuring use of assistants in nursing, who were employed for individual nursing of delirious patients.

Results: In study 1, we found a lower incidence (intervention vs control, 6.3% vs 38%; P = 0.032) and lower severity of delirium (1.2 vs 5.1; P = 0.045). There was a trend towards decreased duration of delirium (5.0 vs 12.5; P = 0.64). In study 2, use of assistants in nursing was reduced by 314 h per month suggesting a total annual saving of A$129 186 for the hospital.

Conclusion: The programme prevents delirium and improves outcomes for elderly inpatients. Cost‐effectiveness supports the continuation of the programme and extension to other geriatric units.
The electronic, ‘paperless’ medical office; has it arrived?
Authors: Gates P. , Urquhart J.
Published: January 2007

Modern information technology offers efficiencies in medical practice, with a reduction in secretarial time in maintaining, filing and retrieving the paper medical record. Electronic requesting of investigations allows tracking of outstanding results. Less storage space is required and telephone calls from pharmacies, pathology and medical imaging service providers to clarify the hand‐written request are abolished. Voice recognition software reduces secretarial typing time per letter. These combined benefits can lead to significantly reduced costs and improved patient care. The paperless office is possible, but requires commitment and training of all staff; it is preferable but not absolutely essential that at least one member of the practice has an interest and some expertise in computers. More importantly, back‐up from information technology providers and back‐up of the electronic data are absolutely crucial and a paperless environment should not be considered without them.
Evidence for functional expression of vascular angiotensin II type 2 receptors in patients with insulin resistance
Authors: Brillante D. G. , O’Sullivan A. J. , Johnstone M. T. , Howes L. G.
Published: January 2007

Aim: Angiotensin II type 2 (AT2) receptors are believed to become over‐expressed in response to cardiovascular damage and to mediate beneficial effects (e.g. vasodilation). It is unknown whether AT2 receptors are functionally expressed in patients with insulin resistance (INSR). In this study, we investigated the role of the highly selective AT2 receptor antagonist, PD123319, on arterial stiffness and haemodynamic parameters in patients with INSR, compared with an age‐ and gender‐matched control (N) group to determine whether there is functional expression of vascular AT2 receptors in patients with INSR.

Methods: We studied 10 subjects with INSR [mean age 28 ± 5 years, body mass index (BMI) 30.4 ± 5.4 kg/m2, mean cholesterol level 4.7 ± 0.7 mmol/l, mean homeostasis model assessment 2.78 ± 0.84] and 10 age‐ and gender‐matched normal subjects (mean age 27 ± 7 years, BMI 23.6 ± 2.5 kg/m2, mean cholesterol level 3.9 ± 0.6 mmol/l). All were normotensive, non‐smokers and on no medications. Subjects received a 3‐min infusion of PD123319 (10 μg/min). At the end of the infusion, arterial stiffness indices [stiffness index (SI) and reflective index (RI)] and haemodynamic parameters [cardiac index, systemic vascular resistance index (SVRI) and stroke index (ZI)] were measured.

Results: RI (mean % change: INSR 13.8 ± 15.5%, N −0.2 ± 4.6, p = 0.04) and SVRI (mean % change: INSR 13.5 ± 9.7%, N −1.5 ± 5.7, p = 0.005) increased significantly in response to PD123319 infusion in patients with INSR compared with controls. There were no significant changes in SI, systolic blood pressure, diastolic blood pressure and ZI.

Conclusion: The results suggest the functional expression of AT2 receptors in small vessels that determine the inflection of the digital volume pulse wave in patients with INSR, possibly as an indicator of early vascular damage.
Improved glycaemic control of thrice‐daily biphasic insulin aspart compared with twice‐daily biphasic human insulin; a randomized, open‐label trial in patients with type 1 or type 2 diabetes
Authors: Clements M. R. , Tits J. , Kinsley B. T. , Råstam J. , Friberg H. H. , Ligthelm R. J.
Published: January 2007

Aim:  This trial evaluated the potential for improving glycaemic control by intensifying a conventional twice‐daily therapy with premixed human insulin (HI) to a thrice‐daily regimen using premixed formulations of biphasic insulin aspart (BIAsp) in patients with type 1 or type 2 diabetes.

Methods:  This was a multicentre, open‐label, parallel group trial. After a 4‐week run‐in period, patients were randomized 1 : 1 to 16 weeks of treatment. A total of 748 patients were screened, 664 were exposed to trial drug and 604 completed the trial.

Results:  Haemoglobin A1c, the primary efficacy endpoint, was shown to be significantly lower for the BIAsp treatment group compared with the biphasic HI (BHI) 30 group [estimated mean difference: −0.32, 95% confidence interval (CI) (−0.48; −0.16), p = 0.0001]. The average blood glucose level was significantly lower in the BIAsp group [estimated mean difference: −0.79, 95% CI (−1.17; −0.40), p = 0.0001]. There were few major hypoglycaemic episodes, 11 in the BIAsp group and 7 in the BHI 30 group. Although intensification of insulin therapy with BIAsp three times a day was associated with a higher risk of minor hypoglycaemia (relative risk = 1.58, p = 0.0038), the overall rate of minor hypoglycaemia remained low with both the BIAsp and the BHI treatments (13.1 vs. 8.3 episodes/patient year respectively). Overall safety and patient satisfaction were similar with the two insulin therapies.

Conclusions:  This trial confirmed that a thrice‐daily BIAsp regimen can safely be used to intensify treatment for patients inadequately controlled on twice‐daily BHI. A treat‐to‐target trial is required to explore the full potential of the BIAsp regimens and evaluate their use as a viable alternative to intensification with a basal‐bolus regimen.
Simple enucleation for the treatment of renal angiomyolipoma
Authors: Minervini Andrea , Giubilei Gianluca , Masieri Lorenzo , Lanzi Federico , Serni Sergio , Carini Marco
Published: January 2007

OBJECTIVES

To report on the role of simple enucleation for treating renal angiomyolipoma (AML) in a series of patients treated in our department.

PATIENTS AND METHODS

We retrospectively reviewed the data of all 37 patients with a histopathological diagnosis of renal AML who had either radical nephrectomy (three) or nephron‐sparing surgery by simple enucleation (34) between January 1986 and December 2005. Indications for intervention included either symptomatic AML or a tumour of >4 cm, regardless to the presence of symptoms or renal masses suspicious of malignancy. The patients’ status was evaluated last in October 2006.

RESULTS

The mean (sd, median, range) pathological tumour size was 5.2 (3.4, 4.8, 1.5–15) cm; five patients (15%) were affected by tuberous sclerosis. Simple enucleation was successful in all patients but in three (9%) a sharp dissection a few millimetres from the tumour was used during critical steps of the procedure where it seemed difficult to define the right plane of enucleation. Warm ischaemia was used in 79% of patients, with a mean ischaemic time of 11.2 min. Two patients (6%) required renal hypothermia. A simple parenchymal compression was used in five cases (15%). The mean (range) intraoperative blood loss was 170  (70–650) mL. None of the patients had postoperative bleeding requiring re‐intervention but one (3%) required two units of blood after surgery. There were no major complications, e.g. prolonged acute tubular necrosis/chronic renal insufficiency and urinary leakage/urinoma, but two patients had urosepsis not associated with perirenal fluid collection and that required targeted antibiotic therapy. At a mean (median, range) follow‐up of 56 (50.5, 10–120) months none of the patients had local tumour recurrence. Two patients had a small AML elsewhere in the operated kidney, detected 18 and 36 months after surgery, with a kidney recurrence rate of 6%.

CONCLUSIONS

Our data confirm the optimum results of simple enucleation for renal AMLs; this technique provides excellent long‐term local control and no patient had urinary leakage/fistula afterward.
Clinically localised prostate cancer is microsatellite stable
Authors: Azzouzi Abdel‐Rahmene , Catto James W.F. , Rehman Ishtiaq , Larre Stephane , Roupret Morgan , Feeley Kenneth M. , Cussenot Oliver , Meuth Mark , Hamdy Freddie C.
Published: January 2007

OBJECTIVES

To determine the frequency of microsatellite instability (MSI) change with mono‐, di‐ and tetranucleotide markers in clinically localized prostate cancer, and to correlate those markers with clinical and pathological variables.

MATERIALS AND METHODS

Two forms of MSI have been described in human cancer: MSI typical of hereditary nonpolyposis colon cancer, defined with mono‐ and dinucleotide repeat MS; and a second variety of MSI is best seen at selective tetranucleotide repeats, i.e. elevated microsatellite alterations at select tetranucleotides (EMAST). Prostate specimens were taken from 50 patients. The MS analysis used the Bethesda consensus panel (BCP) and four tetranucleotide loci shown to detect the presence of EMAST.

RESULTS

All but four tumours were stable for the 14 loci investigated. There were two (4%) cases with adenomatous polyposis coli (APC) instability among the BCP markers and the same instability rate (4%) amongst the EMAST markers. These four tumours were all unstable at one locus of the 10 markers of the BCP that classified them as MS stable.

CONCLUSIONS

The MSI related to a mismatch repair deficiency or to the EMAST does not seem to be important in prostate cancer in the early stages of the disease.
The incidence of high‐grade prostatic intraepithelial neoplasia and atypical glands suspicious for carcinoma on first‐time saturation needle biopsy, and the subsequent risk of cancer
Authors: Schoenfield Lynn , Jones J. Stephen , Zippe Craig D. , Reuther Alwyn M. , Klein Eric , Zhou Ming , Magi‐Galluzzi Cristina
Published: January 2007

OBJECTIVE

To investigate the detection rate and extent of high‐grade prostatic intraepithelial neoplasia (HGPIN) and atypical glands (AG) suspicious for prostate cancer, and the cancer risk in subsequent biopsies, diagnosed by a first 24‐core saturation biopsy, as although the optimum extent of biopsy is controversial there is a trend to increase the number of cores taken, and apart from detecting prostate cancer, identifying HGPIN and AG is associated with a greater risk of finding cancer in subsequent biopsies, thus warranting a closer follow‐up.

PATIENTS AND METHODS

The study included 100 men with consecutive first‐time saturation biopsies; the indications for biopsy were an abnormal digital rectal examination and/or a serum prostate‐specific antigen (PSA) level of >2.5 ng/mL. Each biopsy specimen was reviewed retrospectively by two pathologists to confirm the histological diagnosis. The number and percentage of cores positive for HGPIN, bilateral involvement and multifocality (HGPIN involving two or more cores) were recorded in each case. The presence of AG and cancer was also recorded. An extended (10–12 cores) repeat biopsy was available in 23 patients.

RESULTS

The median (range) age and PSA level of the patients was 63 (41–80) years and 4.9 (1.5–67.0) ng/mL, respectively. Of the 100 patients, 34% had normal findings (benign prostatic tissue, BPT), 39% had cancer, 26% had HGPIN and cancer, 22% had HGPIN alone, and 5% had AG. Repeat biopsies were available in nine of the 22 (41%) patients with HGPIN, four of five with AG, and 10 of the 34 (29%) with BPT. The median (range) interval between the first and second biopsy was 13 (4–36) months. Prostate cancer was detected at the second biopsy in a third of patients with isolated HGPIN on the first biopsy, and one of the four with AG. None of the patients with BPT had cancer on re‐biopsy. The cancer detection rate was significantly greater in patients with multifocal than in those with unifocal HGPIN (80% vs none, P = 0.010). The median number of cores and percentage of tissue involved by HGPIN was 3.5 (2–5) and 1.0 (0.5–1.2)%, respectively, in patients with cancer detected in repeat biopsies, compared to 1.0 (1–3) and 0.2 (0.2–0.6)% in patients without cancer on repeat biopsy (P = 0.023 and 0.015, respectively).

CONCLUSION

Identifying multifocal HGPIN on first saturation biopsy is associated with an overall cancer detection rate of 80% on repeat 10–12‐core biopsy. Although there were few patients, the detection of multifocal HGPIN warrants additional searches for concurrent invasive carcinoma by repeated biopsy.
Is the use of parasympathomimetics for treating an underactive urinary bladder evidence‐based?
Authors: Barendrecht Maurits M. , Oelke Matthias , Laguna Maria P. , Michel Martin C.
Published: January 2007

An underactive urinary bladder (UUB), often occurring after surgery, can lead to urinary retention even in otherwise healthy people. We systematically reviewed published reports to determine whether the use of parasympathomimetic agents is warranted in patients with a UUB. Agents allegedly useful in treating UUB were identified from urology and pharmacology textbooks. A systematic search for randomized clinical trials in patients with UUB using these agents revealed 10 such studies. Controls typically received placebo or no treatment. While three studies reported statistically significant improvements relative to the control group, six did not and one even reported a significant worsening of symptoms. There was no evidence for differences between individual drugs, specific uses of such drugs, or in outcome measures. We conclude that the available studies do not support the use of parasympathomimetics for treating UUB, specifically when frequent and/or serious possible side‐effects are taken into account.
Meaning and normativity in nurse–patient interaction
Authors: Nordby Halvor
Published: January 2007

Abstract It is a fundamental assumption in nursing theory that it is important for nurses to understand how patients think about themselves and the contexts they are in. According to modern theories of hermeneutics, a nurse and a patient must share the same concepts in order to communicate beliefs with the same content. But nurses and patients seldom understand medical concepts in exactly the same way, so how can this communicative aim be achieved in interaction involving medical concepts? The article uses a theory of concepts from recent cognitive science and philosophy of mind to argue that nurses and patients can share medical concepts despite the diversity of understanding. According to this theory, two persons who understand medical language in different ways will nevertheless possess the same medical concepts if they agree about the normative standards for the applications of the concepts. This entails that nurses and patients normally share medical concepts even though patients’ conceptions of disease and illness are formed in idiosyncratic ways by their social and cultural contexts. Several practical implications of this argument are discussed and linked to case studies. One especially important point is that nurses should seek to make patients feel comfortable with deferring to a medical understanding. In many cases, an adequate understanding of patients presupposes that nurses manage to do this. Another implication is that deference‐willingness to normative meaning is not equivalent to the actual application of concepts. Deference‐willingness should rather be thought of as a pre‐communicative attitude that it is possible for patients who are not fully able to communicate to possess. What is important is that nurses and patients have the intention of conforming to the same meaning.
The will to health: a Nietzschean critique
Authors: Betts Clinton E.
Published: January 2007

Abstract The purpose of this paper is to propose a critique of the prevailing attitude of human health, what I refer to asthe will to health, using a Nietzschean perspective. First, I briefly discuss the purpose and manner of Nietzsche’s methodological approach to philosophy and his problem with modernity. Second, I explicate the two current ideological paradigms of health that, in my view, constitute the prevailing will to health. Third, Nietzsche’s general understanding of human health is presented and following this, a critique of some contemporary health matters from this perspective is undertaken. Strictly speaking, there is no specific thesis to be found in this paper. I do not presume to prove or disprove anything, rather I avail myself of Nietzsche’s unique insight into the human condition as a rubric from which to illuminate something of the nature of human health.
Democracy: From City-states to a Cosmopolitan Order?
Authors: Held David
Published: January 2007

This article traces the development of the idea of democracy from city-states and the early republican tradition to liberalism and Marxism. The relevance of leading conceptions of democracy to contemporary circumstances are then explored. In light of the complex interconnections among states and societies, a set of arguments are developed which offer a new agenda for democratic theory which departs from an exclusive focus on particular political communities and the nation-state. After an examination of a number of key models of the international order – the states system, the UN Charter framework – the case is made for a cosmopolitan international democracy. While such a case is fraught with difficulties, strong grounds are presented for its indispensability to the maintenance and development of democracy both within pre-established borders and across them.
Liberal Democracy and the Limits of Democratization
Authors: Beetham David
Published: January 2007

Liberalism has provided both a necessary basis for modern democracy and also a constraint upon it. This duality makes a democratic critique of liberalism both imperative and also problematical, in so far as it threatens the conditions of liberal democracy itself. Two of these conditions are examined – the institution of representation and the principle of the limited state – to discover what limits they might impose on the justifiable ambitions of democratizers, to extend political participation on the one hand, and the social agenda for democratization on the other.
Must Feminists Give up on Liberal Democracy?
Authors: Phillips Anne
Published: January 2007

Feminists have taken issue with liberal democracy on a number of counts, including the conditions necessary to achieve political equality and the importance to be attached to political participation. This paper considers issues currently raised under the rubric of citizenship, earlier and continuing arguments for a more actively participatory democracy, and questions associated with representing social heterogeneity and group difference. The argument throughout is that while liberal democracy has signally failed to deliver on its promises to women, it does not help to address these failings in terms of giving up on liberal democracy.
Democracy, Markets and Capital: Are there Necessary Economic Limits to Democracy?
Authors: Pierson Christopher
Published: January 2007

This article reviews the neo-liberal case for economic limits to democracy, assesses the counterposed argument of socialists and social democrats and considers why the latters' practical experience in ‘democratizing economic life’ has been so unsatisfactory. The second half of the paper considers the claim that some form of market socialism can overcome these limitations. While the market socialists have some success in undermining the claims of the neo-liberals, there are acute difficulties in transforming their agenda for economic democracy into a practicable politics. At the same time, it is suggested that while there may indeed be some economic limits to democracy, we are still very far from reaching them.
Democracy and the Media — Without Foundations
Authors: Keane John
Published: January 2007

In exploring whether or not the free and equal communication of citizens is a feasible ideal at the end of the twentieth century, this article presents a new account of the importance of the media to democracy. It offers a revised interpretation of the public service model of communications, in a risk-ridden society, and spells out the implications of these arguments for conventional views of democracy. After considering and rejecting foundationalist and relativist accounts of democracy, it offers a novel conception of democracy as a project of flexibly controlling the exercise of power.
The Cultural Particularity of Liberal Democracy
Authors: Parekh Bhikhu
Published: January 2007

Liberal democracy is liberalized democracy: that is, democracy defined and structured within the limits set by liberalism. The paper outlines the constitutive features of liberalism and shows how they determined the form and content of democracy and gave rise to liberal democracy as we know it today. It then goes on to argue that liberal democracy is specific to a particular cultural context and cannot claim universal validity. This, however, does not lead to cultural relativism as it is possible to formulate universal principles that every good government should respect. The paper offers one way of reconciling universalism and cultural diversity.