bluuebunny/crossref_metadata_2025 huggingface dataset:
Amniotic Fluid Embolism with Haemostasis Complications: Primary Fibrinogenolysis or Disseminated Intravascular Coagulation?
Authors: Biron-Andréani C. , Morau E. , Schved J.-F. , Hédon B. , Dechaud H.
Published: May 2004

Amniotic fluid embolism (AFE) is characterized by the passage of amniotic fluid (AF) into the maternal circulation during or just after childbirth. AFE is a rare disorder occurring in 1/8,000 to 1/80,000 deliveries but with a maternal morbidity ranging from 26% in a recent report to 86% in earlier ones [1-3]. In patients who survive, AFE may affect coagulation resulting in severe bleeding [3, 4]. While disseminated intravascular coagulation (DIC) is usually seen in such cases, we reported a case of AFE in which the hemostatic abnormalities were compatible with primary fibrinogenolysis rather than with DIC.
Self-Assembly and Type III Protein Export of the Bacterial Flagellum
Authors: Minamino Tohru , Namba Keiichi
Published: May 2004

The bacterial flagellum is a supramolecular structure consisting of a basal body, a hook and a filament. Most of the flagellar components are translocated across the cytoplasmic membrane by the flagellar type III protein export apparatus in the vicinity of the flagellar base, diffuse down the narrow channel through the nascent structure and self-assemble at its distal end with the help of a cap structure. Flagellar proteins synthesized in the cytoplasm are targeted to the export apparatus with the help of flagellum-specific chaperones and pushed into the channel by an ATPase, whose activity is controlled by its regulator to enable the energy of ATP hydrolysis to be efficiently coupled to the translocation reaction. The export apparatus switches its substrate specificity by monitoring the state of flagellar assembly in the cell exterior, allowing this huge and complex macromolecular assembly to be built efficiently by a highly ordered and well-regulated assembly process.
Dual Flagellar Systems Enable Motility under Different Circumstances
Authors: McCarter Linda L.
Published: May 2004

Flagella are extremely effective organelles of locomotion used by a variety of bacteria and archaea. Some bacteria, including Aeromonas, Azospirillum, Rhodospirillum, and Vibrio species, possess dual flagellar systems that are suited for movement under different circumstances. Swimming in liquid is promoted by a single polar flagellum. Swarming over surfaces or in viscous environments is enabled by the production of numerous peritrichous, or lateral, flagella. The polar flagellum is produced continuously, while the lateral flagella are produced under conditions that disable polar flagellar function. Thus at times, two types of flagellar organelles are assembled simultaneously. This review focuses on the polar and lateral flagellar systems of Vibrio parahaemolyticus. Approximately 50 polar and 40 lateral flagellar genes have been identified encoding distinct structural, motor, export/assembly, and regulatory elements. The sodium motive force drives polar flagellar rotation, and the proton motive force powers lateral translocation. Polar genes are found exclusively on the large chromosome, and lateral genes reside entirely on the small chromosome of the organism. The timing of gene expression corresponds to the temporal demand for components during assembly of the organelle: RpoN and lateral- and polar-specific σ54-dependent transcription factors control early/intermediate gene transcription; lateral- and polar-specific σ28 factors direct late flagellar gene expression. Although a different gene set encodes each flagellar system, the constituents of a central navigation system (i.e., chemotaxis signal transduction) are shared.
The Periplasmic Flagellum of Spirochetes
Authors: Limberger Ronald J.
Published: May 2004

Although spirochete periplasmic flagella have many features similar to typical bacterial flagella, they are unique in their structure and internal periplasmic location. This location provides advantages for pathogenic spirochetes to enter and to adapt in the appropriate host, and to penetrate through matrices that inhibit the motility of most other bacteria. These flagella are complex, and they dynamically interact with the spirochete cell cylinder in novel ways. Electron microscopy, tomography and three-dimensional reconstructions have provided new insights into flagellar structure and its relationship to the spirochetal cell cylinder. Recent advances in genetic methods have begun to shed light on the composition of the spirochete flagellum, and on the regulation of its synthesis. Because spirochetes have a high length to width ratio, their cells provide an opportunity to study two important features. These include the polarity or distribution of flagellar synthesis as well as the mechanisms required for coordination of the movement of the cell ends, to enable it to move in the forward or reverse direction.
The Junctional Pore Complex and the Propulsion of Bacterial Cells
Authors: Wolgemuth Charles W. , Oster George
Published: May 2004

Gliding motility is defined as translocation in the direction of the long axis of the bacterium while in contact with a surface. This definition leaves unspecified any mechanism and, indeed, it appears that there is more than one physiological system underlying the same type of motion. Currently, two distinct mechanisms have been discovered in myxobacteria. One requires the extension, attachment, and retraction of type IV pili to pull the cell forwards. Recent experimental evidence suggests that a second mechanism for gliding motility involves the extrusion of slime from an organelle called the ‘junctional pore complex’. This review discusses the role of slime extrusion and the junctional pore complex in the gliding motility of both cyanobacteria and myxobacteria.
Direct Medical Costs Attributable to Acute Myocardial Infarction and Ischemic Stroke in Cohorts with Atherosclerotic Conditions
Authors: Sloss Elizabeth M. , Wickstrom Steven L. , McCaffrey Daniel F. , Garber Steven , Rector Thomas S. , Levin Regina A. , Guzy Peter M. , Gorelick Philip B. , Dake Michael D. , Vickrey Barbara G.
Published: May 2004

Background: The cost of acute ischemic events in persons with established atherosclerotic conditions is unknown. Methods: The direct medical costs attributable to secondary acute myocardial infarction (AMI) or ischemic stroke among persons with established atherosclerotic conditions were estimated from 1995–1998 data on 1,143 patients enrolled in US managed care plans. Results: The average 180-day costs attributable to secondary AMI or stroke were estimated as USD 19,056 in the AMI cohort having a private insurance (commercial; n = 344), USD 16,845 in the AMI cohort having government insurance (Medicare, age ≧65 years; n = 200), USD 10,267 for stroke commercial (n = 108), USD 16,280 for stroke Medicare (n = 113), USD 15,224 for peripheral arterial disease commercial (n = 170), and USD 15,182 for peripheral arterial disease Medicare (n = 208). Conclusion: These estimates can be used to study the cost-effectiveness of interventions proven to reduce these secondary events.
Mishaps in the Management of Stroke: A Review of 214 Complaints to a Medical Responsibility Board
Authors: Johansson Åsa , Lagerstedt Katarina , Asplund Kjell
Published: May 2004

Background: This is the first survey of formal complaints to a Medical Responsibility Board (MRB) in the literature concerning stroke management and the disciplinary actions to which the complaints lead. Methods: All available complaints submitted to the Swedish MRB during a 5-year period that concerned stroke management (n = 214) were reviewed. We compiled information on the plaintiffs, the health care staff the complaints were directed against, the area of stroke management involved and the disciplinary actions taken by the MRB. Results: Only 1% of all complaints to the MRB concerned stroke. Three quarters of these complaints were directed against physicians and one fifth against nurses. 23 complaints (11%) resulted in a warning or an admonition. Nearly all disciplinary actions against physicians (12 of 13) concerned misdiagnoses, of subarachnoid hemorrhage in particular. The most common reason for a nurse receiving a warning or an admonition was negligent handling of drugs. Conclusions: The survey has identified two areas in which educational programs to improve patient safety seem essential. The small number of formal complaints and disciplinary actions suggest that other, blameless procedures have a greater potential than MRB actions to reduce mishaps in routine stroke care.
Time Trends in the Published Risks of Stroke and Death due to Endarterectomy for Symptomatic Carotid Stenosis
Authors: Bond R. , Rerkasem K. , Shearman C.P. , Rothwell P.M.
Published: May 2004

Background: Large randomised trials performed in the 1980s and early 1990s showed that carotid endarterectomy (CEA) is beneficial for patients with recently symptomatic severe stenosis. Some surgeons have argued that the operative risk of stroke and death has fallen over the last decade due to refinements in operative technique, and that the indications for surgery should therefore now be broadened. Yet, studies of routinely collected data report higher operative mortality than in the trials, and surgical case series without independent post-operative assessment by a neurologist may not provide reliable data on stroke risk. Methods: We performed a systematic review of all studies published between 1994 and 2001 inclusive that which reported the risks of stroke and death for symptomatic carotid stenosis, and compared the reported risks and patient characteristics with those in the ECST and NASCET and with our previous review of studies published prior to 1995. Pooled estimates of the operative risk of stroke and death were obtained by Mantel-Haenszel meta-analysis. Results: Of 383 studies published between 1994 and 2001, only 45 reported operative risks for patients with symptomatic stenosis separately. The pooled operative risk of stroke and death reported in studies published by surgeons only (4.2%, 95% CI = 2.9–5.5, 34 studies) was significantly lower (p < 0.0001) than that in the ECST and NASCET combined (7.0%, 95% CI = 6.2–8.0), whereas the pooled risk reported in studies that involved neurologists was similar (6.5%, 95% CI = 4.3–8.7, 11 studies, p = 0.6). In contrast, operative mortality in ECST and NASCET was significantly lower than in other studies published between 1994 and 2001. By comparison with our previous review, when stratified according to involvement of neurologists, we found no evidence of a reduction in published risks of death or stroke and death due to CEA between 1985 and 2001. Conclusions: There is no evidence of a systematic reduction over the last decade in the published risks of stroke and death due to CEA for symptomatic stenosis. Operative risks in studies with comparable outcome assessment are similar to ECST and NASCET. The surgical data from the large trials are still likely therefore to be applicable to routine clinical practice.
Epidemic Asthma in Barcelona: An Evaluation of New Strategies for the Control of Soybean Dust Emission
Authors: Rodrigo María-José , Cruz María-Jesús , García María-del-Mar , Antó Josep-María , Genover Teresa , Morell Ferran
Published: May 2004

Background: Asthma attacks and mortality due to inhalation of soybean antigens in Barcelona have been well documented. Strict protective measures in the unloading process were established in 1998 to avoid the release of soybean dust into the atmosphere. The present study was undertaken to assess the effectiveness of these latest environmental measures, and, if effective, to recommend their implementation in the many harbours where soybean is unloaded. Methods: Levels of soybean aeroallergen were analysed daily during a period of 5 years and 2 months in a total of 1,854 samples, 125 from the pre-intervention period and 1,729 from the postintervention period. Additionally, the number of asthma admissions to the emergency rooms of the city’s three largest hospitals was recorded. Asthma patients attended at home by the public home emergency service and judicial autopsies registering asthma deaths were also investigated. Results: The mean concentration of soybean aeroallergen was 159 U/m3 in the pre-intervention period and 39 U/m3 in the postintervention period (p < 0.0001). Significant differences in postintervention aeroallergen concentrations were found between days of soybean unloading (42 U/m3) and days of no unloading (33 U/m3), with p < 0.0001. No significant relationship was found between concentrations of environmental soybean aeroallergens and the number of emergency room admissions for asthma. Conclusions: Implementation of stricter protective measures in silos for the soybean unloading process has reduced the concentration of soybean dust in the atmosphere and evidences the effectiveness of the measures adopted.
Impact of Serum Parathyroid Hormone Concentration and Its Regulatory Factors on Arterial Stiffness in Patients Undergoing Maintenance Hemodialysis
Authors: Suzuki Takayuki , Yonemura Katsuhiko , Maruyama Yukitaka , Takahashi Toshiyuki , Takita Takako , Furuhashi Mitsuyoshi , Hishida Akira
Published: May 2004

Background: Cardiovascular mortality is extremely high in patients on hemodialysis. Among a variety of pathophysiological conditions, deranged calcium homeostasis including secondary hyperparathyroidism may be one of the factors contributing to cardiovascular disease in patients on hemodialysis. This study was designed to evaluate the role of the serum parathyroid hormone (PTH) concentration and its regulatory factors in serum on arterial stiffness in patients on maintenance hemodialysis. Methods: Arterial stiffness was assessed by pulse wave velocity (PWV) in 73 non-diabetic patients undergoing maintenance hemodialysis. At the same time, serum concentrations of calcium, phosphate, and intact PTH were measured. Results: Single regression analyses revealed that arterial PWV was positively correlated with age (r = 0.505, p < 0.0001), systolic blood pressure (r = 0.250, p = 0.043), and pulse pressure (r = 0.306, p = 0.012). It was inversely correlated with the serum phosphate concentration (r = –0.240, p = 0.041) and the duration of hemodialysis treatment (r = –0.343, p = 0.003), but not with serum concentrations of calcium and intact PTH or the calcium × phosphate product in serum. By multiple regression analysis age was found to be the most significant variable affecting arterial PWV, and the duration of hemodialysis treatment negatively influenced arterial PWV. Conclusion: Age is an independent risk factor for arterial stiffness in patients on maintenance hemodialysis, and the serum PTH concentration and its regulatory factors in the serum are not.
Expression of Reg Iα Protein in Human Gastric Cancers
Authors: Fukui Hirokazu , Fujii Shigehiko , Takeda Jun , Kayahara Takahisa , Sekikawa Akira , Nanakin Apichart , Suzuki Katsumasa , Hisatsune Hiroshi , Seno Hiroshi , Sawada Mitsutaka , Fujimori Takahiro , Chiba Tsutomu
Published: May 2004

Background/Aims: Although regeneratinggene(Reg) Iα protein has a trophic effect on gastric epithelial cells, it is unclear whether Reg Iα protein and its receptor are involved in gastric carcinogenesis. Therefore, we investigated the Reg Iα protein expression in human gastric cancers and assessed its relationship to clinicopathological factors. Methods: Sixty-one gastric cancer specimens were examined, using immunohistochemistry, for Reg Iα protein, p53, and proliferating cell nuclear antigen. The expression of both Reg Iα and Reg receptor mRNA was examined in seven human gastric cancer cell lines (MKN1, MKN28, MKN45, MKN74, KATOIII, GCIY, and AGS) by reverse transcription-polymerase chain reaction and Northern blot analysis. Results: Twenty-three (37.7%) of the 61 gastric cancer tissues samples were positive for Reg Iα protein. The Reg Iα expression was significantly related to the presence of lymphatic invasion but not to tumor size, tumor stage, Lauren’s classification, presence of venous invasion, lymph node metastases, or p53 overexpression. Gastric cancers positive for Reg Iα protein showed a significantly higher proliferating cell nuclear antigen labeling index than negative ones. The expression of both Reg Iα and Reg receptor mRNA was detected in all seven gastric cancer cell lines. Conclusion: Reg Iα protein may play a role in the development of gastric cancers.
Irritable Bowel Syndrome and Bronchial Hyperresponsiveness: Is There a Link?
Authors: Riccioni G. , Della Vecchia R. , Menna V. , Staniscia T. , Di Ilio C. , Conti P. , D’Orazio N.
Published: May 2004

Background/Aim: Many studies have demonstrated a high prevalence of bronchial hyperresponsiveness in patients with irritable bowel syndrome (IBS). The aim of this 24-month prospective study was to evaluate the prevalence of IBS in asthmatic patients. Methods: We analyzed 623 asthmatic patients that were evaluated for body mass index, sex, and age before undergoing both a methacholine challenge test (MCHt) and skin prick tests. Results: We found that 276 asthmatic patients (44.3%) were positive on the MCHt, while 347 (55.7%) were negative. We also found that 27 (9.7%) of the 276 patients with a positive MCHt and 44 (12.7%) of the 347 patients with a negative MCHt were affected by IBS. Therefore, there was no statistically significant difference between positive MCHt tests and IBS. The PC20 (mean provocation concentration of methacholine producing a 20% reduction in forced expiratory volume in 1 s ≤16 mg/ml) in all patients tested was 8.64 ± 2.58 mg/ml, being 8.75 ± 2.52 and 8.55 ± 2.32 mg/ml for males and females, respectively. Conclusions: These results do not demonstrate a relationship between MCHt and IBS. However, a relationship might still exist in a subpopulation of patients whose symptoms worsen by stress.
Continuous Simulation, Differential Inclusions, Uncertainty, and Traveling in Time
Authors: Raczynski Stanislaw
Published: May 2004

Differential inclusions (DIs) represent an important extension of differential equations. The other term used for DI is differential equations with a set-valued right-hand side. This tool can be used when the model reveals uncertainty that is given in terms of limits or permissible sets rather than random variables. A model of stock exchange dynamics with uncertain information and a model with an ideal predictor are presented to illustrate possible applications. The ideal predictor problem is equivalent to the problem of passing the information from the future to the present, or traveling into the past to use the present information and change the model trajectory. It is shown that the uncertainty over the future can be simulated using differential inclusions. A differential inclusion solver is described.
GESAS II: A Better Relationship between Efficiency and Efficacy While Experimenting with Simulation Models
Authors: Otamendi Javier
Published: May 2004

A general methodology that solves the decision-making problem associated with simulation models is needed to find a very good compromise solution between efficacy and efficiency. Several methodologies in the literature try to solve the problem, but every one of them includes hypotheses that usually hamper efficacy by improving efficiency. GESAS, first, and GESAS II, now, try to use the constantly improving power of computers to examine as many alternatives as possible, with the aim of exhaustive evaluation of alternatives for medium-size problems. The objective is to develop a efficient rejection algorithm by reducing the necessary number of repetitions to analyze the subpar alternatives. Several methodologies are tested against the common example of inventory control, which includes in this case three input variables (that account for 2646 different alternatives) and two competing criteria.
Hierarchical Modeling and Simulation Environment for Intelligent Transportation Systems
Authors: Lee Jong-Keun , Lim Ye-Hwan , Chi Sung-Do
Published: May 2004

This article presents a hierarchical and modular traffic simulation environment for intelligent transportation systems (ITS). A conventional traffic simulation model is classified as microscopic or macroscopic; however, abstraction-level, vehicle-level, cell-level, road-level, and street-level traffic models can be coherently integrated and developed. Such an abstraction process is important for flexible traffic analysis since it reduces the complexity of a model, retaining its validity relative to the modeling objectives and experimental condition. To do this, the authors have proposed the four-layered approach: (1) system entity structure/model base, (2) model abstraction, (3) traffic modeling, and (4) ITS simulation systems layer. A proposed methodology has been successfully applied for building the advanced traveler information system and the advanced traffic management system. The abstraction method of a road network in traffic modeling and simulation will be widely used because it is possible to express and analyze various requirements of the traffic analyst hierarchically and structurally.
Persistence and Change in Contemporary African Religion
Authors: Gifford Paul
Published: June 2004

In recent years the religious scene in Sub-Saharan Africa has changed enormously. Everywhere new (charismatic) churches are proliferating, and at the expense of other strands of Christianity. It is possible to see this as generational change; the .rst generation being the mission churches, the second, the African Independent (or Instituted) Churches which peaked about the 1960s, and the third, these charismatic churches. The author examines the nature of this new Christianity, in all its diversity. He argues that its main characteristics are an emphasis on success or wealth, and the persistence of the “enchanted” imagination which sees spiritual forces at work everywhere. He claims that the emergence of this Christianity cannot be divorced from the economic plight of Africa and its political marginalization.
Les Associations Des Cinq Religions Officiellement Reconnues En République Populaire De Chine
Authors: Daiber Karl-Fritz
Published: June 2004

In the People’s Republic of China seven religious organizations are officially recognized: the China Islamic Association, the China Buddhist Association, the China Protestant Three-Self Patriotic Movement, the China Christian Council, the China Taoist Association, the Chinese Patriotic Catholic Association and the Chinese Catholic Bishops College. The author analyses structures and functions of these organizations within the framework of the political system in the People’s Republic. The thesis is that the present situation depends not only on the influence of Marxist-Maoist theories and practical problems of the Communist State but also on the long Chinese traditions of regulating the state–religion relationship. The theoretical reflections end with a comparison between China and the former German Democratic Republic.
Violence and the Scientific Vocation
Authors: Thorpe Charles
Published: June 2004

This article examines the implications for the notion of scientific vocation of the modern intersection between science and violence, realized most powerfully in the atomic bomb. Tracing the career and political trajectory of atomic physicist J. Robert Oppenheimer and drawing on the theories of Max Weber, Julien Benda and Michel Foucault, the article addresses ethical ambiguities and tensions in the modern scientific vocation. I argue that Oppenheimer’s moral and political struggles in relation to nuclear weapons were attempts to come to terms with the collapse of legitimacy of the role of ‘universal intellectual’ and with the limitations of the more contemporary role of ‘specific intellectual’. Oppenheimer was faced with the problem of handling the relationship between scientific expertise and moral and political responsibility. His struggles demonstrate the continuing relevance of Weber’s conception of political responsibility for conceptualizing the ethical dilemmas inherent in the modern relationship between science, the state and violence.
The Mental Health of Residents of Approved Premises in the Greater Manchester probation Area: A Cohort Study
Authors: Hatfield Barbara , Ryan Tony , Pickering Laura , Burroughs Heather , Crofts Roger
Published: June 2004

This article reports on a 12-month cohort study of mental disorder among residents of approved premises within the Greater Manchester probation area which had contracted psychiatric support via the local NHS Trust. Generally high rates of mental health problems were identified, particularly at the premises with psychiatric support and the women’s premises, and also amongst bailees across all premises. Not all of those with mental health problems were receiving mental health services. Implications for service development within the probation service and alongside health and social care agencies are considered.
Hypnosis in Sweden during the Twentieth Century – the Life and Work of John BjÖrkhem
Authors: Stolt Carl-Magnus , Bjorkhem-Bergen Linda
Published: May 2004

In this paper we present a study of hypnosis in Swedish medicine during the twentieth century. We focus on the life and work of the hypnotist and Swedish physician John Björkhem. He was a controversial person and his therapeutic ideas were not accepted in the medical establishment. The biography of Björkhem and the history of hypnosis in Swedish medicine during the twentieth century are intimately related to each other. We describe an outsider in medicine, both with respect to person and topic. In the case of Björkhem the situation was especially complicated because of his multidisciplinary activities, with three different faculties involved. Finally we deal with the condition of a pioneer, and his struggle for acceptance and understanding.
The beer Ration in Victorian Asylums
Authors: McCrae Niall
Published: May 2004

Routine distribution of alcoholic beverages to mental hospital patients would be a fanciful prospect today, yet in the formative decades of lunatic asylums, beer was standard issue. A staple item in the supposedly healthy Victorian asylum diet, beer also served as inducement for patient labour. Around the mid-1880s, this commodity was abolished throughout Britain’s mental institutions. This paper explores the factors that combined to condemn the beer barrel to asylum history, and, in particular, how this small comfort for inmates fell foul of the medicalization of the asylum and of the professional project of psychiatry.
Prisoner or Patient? The Official Debate on the Criminal Lunatic in Nineteenth-Century Ireland
Authors: Prior Pauline M.
Published: May 2004

Nineteenth-century Ireland was colonized and strictly controlled from Britain. In this highly regulated society, reports of the Inspectorate of Lunacy in Ireland were used to express an official medical view on criminal lunacy. This view was based on experiences gained in the Central Criminal Lunatic Asylum for Ireland, opened at Dundrum in 1850. This paper will examine some of the ideas expressed in these reports, including views on the treatment of criminal lunatics, on their potential for dangerous behaviour, and on emigration as a form of after-care.
Manic-Depressive Illness in Children: An Early Twentieth-Century View by Theodor Ziehen (1862–1950). Introduction
Authors: Baethge Christopher , Glovinsky Ira , Baldessarini Ross J.
Published: May 2004

The German psychiatrist and philosopher Theodor Ziehen (1862–1950), little known in psychiatry today, wrote one of the first systematic treatises on child psychiatry in the early years of the twentieth century. This report provides the first English translation of Ziehen's chapters on major mood disorders of children and adolescents, with detailed biographical notes and commentary on his contributions to the foundation of child psychiatry and to characterizing manicdepressive illnesses in this age group.
Equity in Dyads: the Notion of ‘More Equitable’
Authors: Thon Dominique , Wallace Stein W.
Published: June 2004

The idea that equity has to do with allocating, say, income, between different actors proportionately to their inputs, deserts, or needs goes back at least to Aristotle, and has been the object of a number of modern examinations, reformulations, and refinements. We base our analysis on a partial order and are concerned with the de.nition and properties of ‘a step in the direction of more equity’ when the total to be allocated is constant. While this approach to equity seems to be novel, we obtain results that are remarkably consistent with those of earlier work.
A Framework of Product Styling Platform Approach: Styling as Intangible Modules
Authors: Fung Richard Y. K. , Chong Steven P. Y. , Wang Yi
Published: May 2004

This exploratory paper argues that pleasure-oriented product development with manufacturing flexibility is the next challenge of mass customization if seeking pleasure is the nature of mankind. Preferable product style of a fashion trend is widely accepted to visually enhance a product to satisfy today’s consumer demands. Considerable work remains to be done to integrate product styling (process to create and deliver visual pleasure) with manufacturing flexibility, i.e. platform approach, reusability. This paper reports on the initial findings from an exploratory study that consists of interviews and research on ‘ i-Mac look’ style. It examines the relationships between product style/styling and fashion trend on consumer preferences. The findings indicate that style can be manipulated by a proposed set of complex attributes. A particular style plus its application method(s) together function as an intangible module to refresh ordinary products. Implications are drawn to develop two frameworks: product styling platform and a case-based indexing device for product styling. The case-based indexing device serves as a support for the product styling platform. This paper opens up an inquiry of visual pleasure aspects in present and future challenges of mass customization.
Decision Support System for Product Configuration in Mass Customization Environments
Authors: Frutos Juan Diego , Santos Eduardo Ribas , Borenstein Denis
Published: May 2004

Mass customization (MC) is an emergent concept in industry intended to provide customized products or services through flexible process in high volumes and at reasonably low costs. Product customization is an important strategy for accomplishing customer satisfaction with exclusive products at reasonable prices. This paper proposes a decision support system for facilitating design and customer collaboration in the process of selecting product configuration in MC environments. The system integrates object-oriented programming, multiattribute decision analysis, and integer linear programming to support product/service customization where customer choice is managed by the relative relevance of a set of attributes as well as a set of component combinations offered by the company, and restrained by a set of technical, aesthetical, and financial constraints defined interactively by designers and customers. The integration of these models results in the representation of the MC business process taking into account simultaneously the technical, explicit, and objective view taken by designers and the customer’s view based on intentions and perceptions. Using the system, the customer can define rules and provide information that can be used to represent tacit knowledge which is incorporated in an integer linear programming (ILP) model that optimizes the utility of a specific customer. As a result, the computer system is capable of implementing in an explicit, dynamic, and flexible way the cognitive process that characterizes the product configuration in MC strategy. The DSS can be considered as a concurrent engineering environment for MC production systems. A simple case study is presented that demonstrate how the program is utilized and the type of output it provides.
Physico-Chemical and Sensory Characteristics of Dry-Cured Loin from Different Iberian Pig Lines
Authors: Muriel E. , Ruiz J. , Martin D. , Petron M. J. , Antequera T.
Published: May 2004

The influence of the line of Iberian pigs (Entrepelado, Lampino, Retinto and Torbiscal) on dry-cured loin sensory traits and its relationship with several physico-chemical characteristics were analysed. Entrepelado and Lampino lines showed a higher intramuscular fat content (P 1/4 0.034). These lines reached the highest 0.010) and flavour (P 1/4 scores for brightness (P 1/4 0.005), odour intensity (P 1/4 0.043), marbling (P 1/4 0.017). Weight losses showed a positive relationship with some texture features, as hardness and dryness, and a negative one with juiciness according to the principal component analysis (PCA). Marbling was positively linked to odour intensity, juiciness and flavour intensity. These latter sensory traits have been previously linked to dry-cured meat products acceptability. Thus, dry-cured loins from Entrepelado and Lampino Iberian pigs seem to have better sensory profiles, mainly due to their more intense marbling.
Changes in Selected Nutrients and Microstructure of White Starch Quality Maize and Common Maize During Tortilla Preparation and Storage
Authors: Mora-Escobedo R. , Osorio-Diaz P. , Garcia-Rosas M. I. , Bello-Perez A. , Hernandez-Unzon H.
Published: May 2004

Raw maize, masa, and fresh and stored tortillas of white starch quality maize (Costeno) and common maize were analysed for chemical composition, dietary fibre, digestible (DS) and resistant (RS) starches. Changes in starch crystallinity and microstructure were also evaluated. Protein content was lower in masa and tortillas than in the original maize samples. Insoluble (IDF) and soluble (SDF) dietary fibres were higher in Costeno than in common maize, but stored tortillas showed the highest value in both samples. DS decreased and RS increased during tortillas storage, made with both starches. The development of RS explained the observed decrease in DS in masa (enthalpy of gelatinisation). Differential scanning calorimetry studies showed peak gelatinisation temperatures (Tp) of 75.1 and 69.4 C for Costeno and common maize respectively. Masa of common maize showed a second transition endotherm (Tp, 108.9 C) which corresponded to amylose–lipid complexation. Tortillas with 5 and 10 days of storage showed an endothermic event at 53 and 55.7, and 54.5 and 59.9 C for Costeno and common maize respectively, due to starch retrogradation. These values were in accordance with the higher total RS contents recorded after prolonged storage. Microscopic structures for masa and fresh tortillas showed that the high temperature imposed on the masa and the influence of mechanical stress during tortillas making were great enough to disrupt starch granules. In general, structural changes were in agreement with changes in starch.
Cognitive Citizenship: Access to Hip Surgery for People with Dementia
Authors: Graham Ruth
Published: June 2004

Dementia and chronic hip disease are both more prevalent with advancing age. Given this, the number of people with both dementia and hip disease is likely to increase in an ageing population such as the UK. This article raises questions about how people with dementia and chronic hip disease are conceptualized in the context of evidence-based medicine, and whether this conceptualization may limit unfairly their access to surgical services. The published clinical research discourse at the interface of hip disease and dementia is taken as an ‘evidence-base’, and is evaluated in terms of its suitability for informing professional decisions about viability for surgery. The analysis suggests that the outcomes criteria used to determine patient viability serve to discriminate unfairly against people with dementia. If such discrimination exists, it necessarily militates against the promotion of health-related citizenship rights of the cognitively impaired, creating an evidence-based culture that encourages a problematic model of cognitive citizenship.
Male Callers to NHS Direct: The Assertive Carer, the New Dad and the Reluctant Patient
Authors: Goode Jackie , Hanlon Gerard , Luff Donna , O’Cathain Alicia , Strangleman Tim , Greatbatch David
Published: June 2004

It has been suggested in the light of mortality and morbidity rates, and men’s reluctance to seek medical help and advice, that there is a crisis in men’s health. Little is known about men’s experiences of using health care services, despite an emergent UK men’s health movement. NHS Direct, the new telephone advice line, was designed to be more accessible, convenient and responsive to the public’s needs for health care. In-depth interviews with male callers to the service, aged between 29 and 59, reveal that they sought help in their roles as fathers, partners and on their own behalf. Having used it once, they anticipated doing so again. Their learning about health matters, from both the formal structure and the informal agenda of the telephone consultation, suggests the potential of men’s use of this service for ‘normalizing’ help seeking by men, and thereby for longer-term improvements in men’s health.
Effects of volume resuscitation on splanchnic perfusion in canine model of severe sepsis induced by live Escherichia coli infusion
Authors: Lagoa Claudio Esteves , de Figueiredo Luiz FranciscoPoli , Cruz Ruy Jorge , Silva Eliézer , Rocha e Silva Maurício
Published: May 2004

Introduction

We conducted the present study to investigate whether early large-volume crystalloid infusion can restore gut mucosal blood flow and mesenteric oxygen metabolism in severe sepsis.

Methods

Anesthetized and mechanically ventilated male mongrel dogs were challenged with intravenous injection of live Escherichia coli (6 × 109 colony-forming units/ml per kg over 15 min). After 90 min they were randomly assigned to one of two groups – control (no fluids; n = 13) or lactated Ringer's solution (32 ml/kg per hour; n = 14) – and followed for 60 min. Cardiac index, mesenteric blood flow, mean arterial pressure, systemic and mesenteric oxygen-derived variables, blood lactate and gastric carbon dioxide tension (PCO2; by gas tonometry) were assessed throughout the study.

Results

E. coli infusion significantly decreased arterial pressure, cardiac index, mesenteric blood flow, and systemic and mesenteric oxygen delivery, and increased arterial and portal lactate, intramucosal PCO2, PCO2 gap (the difference between gastric mucosal and arterial PCO2), and systemic and mesenteric oxygen extraction ratio in both groups. The Ringer's solution group had significantly higher cardiac index and systemic oxygen delivery, and lower oxygen extraction ratio and PCO2 gap at 165 min as compared with control animals. However, infusion of lactated Ringer's solution was unable to restore the PCO2 gap. There were no significant differences between groups in mesenteric oxygen delivery, oxygen extraction ratio, or portal lactate at the end of study.

Conclusion

Significant disturbances occur in the systemic and mesenteric beds during bacteremic severe sepsis. Although large-volume infusion of lactated Ringer's solution restored systemic hemodynamic parameters, it was unable to correct gut mucosal PCO2 gap.
Accidental catheter removal in critically ill patients: a prospective and observational study
Authors: Lorente Leonardo , Huidobro María S , Martín María M , Jiménez Alejandro , Mora María L
Published: June 2004

Introduction

The importance of accidental catheter removal (ACR) lies in the complications caused by the removal itself and by catheter reinsertion. To the best of our knowledge, no studies have analyzed accidental removal of various types of catheters in the intensive care unit (ICU). The objective of the present study was to analyze the incidence of ACR for all types of catheters in the ICU.

Methods

This was a prospective and observational study, conducted in a 24-bed medical/surgical ICU in a university hospital. We included all consecutive patients admitted to the ICU over 18 months (1 May 2000 to 31 October 2001). The incidences of ACR for all types of catheters (both per 100 catheters and per 100 catheter-days) were determined.

Results

A total of 988 patients were included. There were no significant differences in ACR incidence between the four central venous access sites (peripheral, jugular, subclavian and femoral) or between the four arterial access sites (radial, femoral, pedal and humeral). However, the incidence of ACR was higher for arterial than for central venous catheters (1.12/100 catheter-days versus 2.02/100 catheter-days; P < 0.001). The incidences of ACR/100 nonvascular catheter-days were as follows: endotracheal tube 0.79; nasogastric tube 4.48; urinary catheter 0.32; thoracic drain 0.56; abdominal drain 0.67; and intraventricular brain drain 0.66.

Conclusion

We found ACR incidences for central venous catheter, arterial catheter, endotracheal tube, nasogastric tube and urinary catheter that are similar to those reported in previous studies. We could not find studies that analyzed the ACR for thoracic, abdominal, intraventricular brain and cardiac surgical drains, but we believe that our rates are acceptable. To minimize ACR, it is necessary to monitor its incidence carefully and to implement preventive measures. In our view, according to establish quality standards, findings should be reported as ACR incidence per 100 catheters and per 100 catheter-days, for all types of catheters.
A Calibrated Paper Clip Is a Reliable Measure of Two‐point Discrimination
Authors: Finnell John T. , Knopp Robert , Johnson Phelps , Holland Patrick C. , Schubert Warren
Published: June 2004

Objectives: The primary objective of this study was to compare two different instruments for assessing digital nerve function; a secondary aim was to determine interobserver agreement among emergency physicians by using static two‐point testing of digital nerve function. Methods:This was a prospective, blinded, observational study of static two‐point discrimination involving healthy volunteers aged 18–59 years. The authors compared two instruments (paper clip set or Disk‐Criminator) to assess two‐point discrimination of the index and long fingers of the dominant hand. For each subject, the initial investigator and initial testing instrument were randomized. Two‐point testing was conducted at 4, 5, and 6 mm by using six randomly selected stimuli (1 or 2 points) for each distal phalanx tested. The study was designed to detect a 25% difference in mean two‐point distance with a power of 80%. Results: Seventy‐five subjects were entered into the study, of which two were excluded. Interinstrument agreement for a given investigator ranged from 77% to 84% for absolute agreement and 98% to 100% within 2 mm. Weighted kappa values for interobserver differences of 2 mm or less was 0.79 to 1.00. There was no statistically significant difference between instruments. Conclusions: Using a clinically relevant threshold of 2 mm, the authors found that a properly calibrated set of paper clips performed as well as the Disk‐Criminator.
A Model of Ischemically Induced Ventricular Fibrillation for Comparison of Fixed‐dose and Escalating‐dose Defibrillation Strategies
Authors: Niemann James T. , Rosborough John P. , Walker Robert G.
Published: June 2004

Objectives: Fixed‐ and escalating‐dose defibrillation protocols are both in clinical use. Clinical observations suggest that the probability of successful defibrillation is not constant across a population of patients with ventricular fibrillation (VF). Common animal models of electrically induced VF do not represent a clinical VF etiology or reproduce clinical heterogeneity in defibrillation probability. The authors hypothesized that a model of ischemically induced VF would exhibit heterogeneous defibrillation shock strength requirements and that an escalating‐dose strategy would more effectively achieve prompt defibrillation. Methods:Forty‐six swine were randomized to fixed, lower‐energy (150 J) transthoracic shocks (group 1) or escalating, higher‐energy (200 J–300 J–360 J) shocks (group 2). VF was induced by balloon occlusion of a coronary artery. After 1 or 5 minutes of VF, countershocks with a biphasic waveform were administered. The primary endpoint was successful defibrillation (termination of VF for 5 seconds) with ≤3 shocks. Results: VF was induced with occlusion or after reperfusion in 35 animals. Only five of 17 group 1 animals (29%, 95% CI = 10 to 56) could be defibrillated with ≤3 shocks; 15 of 18 group 2 animals (83%, 95% CI = 59 to 96) were defibrillated with ≤3 shocks (p < 0.002 vs. group 1). Nine of the group 1 animals (75%) that could not be defibrillated with 150‐J shocks were rescued with ≤3 shocks ranging from 200 to 360 J. Conclusions: In this ischemic VF animal model, defibrillation shock strength requirements varied among individuals, and when defibrillation was difficult, an escalating‐dose strategy was more effective for prompt defibrillation than fixed, lower‐energy shocks.
Raising Our HEADSS: Adolescent Psychosocial Documentation in the Emergency Department
Authors: Van Amstel Leanne L. , Lafleur Daniel L. , Blake Kim
Published: June 2004

Objectives: To determine the effectiveness of a chart stamp featuring the acronym “HEADSS” (Home, Education, Alcohol, Drugs, Smoking, Sex) at improving adolescent psychosocial documentation in the emergency department (ED) chart. Methods:The study sample consisted of ten emergency physicians. The ED charts of 306 adolescent patients (aged 13–18 years) completed by these physicians were surveyed. An analysis of ED chart psychosocial documentation was conducted that compared a six‐week control phase (with no chart stamp) with a four‐week intervention phase (with a chart stamp featuring the HEADSS acronym). Presenting complaints in the ED, psychosocial documentation in the ED, and information from past medical records were compared between the two groups. Results: The ED charts surveyed consisted of 153 charts from each phase. HEADSS documentation ranged from 8% to 12% in the intervention phase and 0% to 7% in the control phase. Emergency physicians were more likely to document the topics of education (p = 0.029), alcohol (p = 0.045), and smoking (p = 0.009) as well as whether the patient was interviewed alone (p = 0.0001) in the intervention phase charts. Documentation of a detailed psychosocial assessment (>4/6 HEADSS topics addressed; p = 0.003) was more likely during the intervention phase. Conclusions: The HEADSS stamp is useful in prompting psychosocial documentation in the ED chart. Further study is needed to determine whether routine use of the HEADSS stamp technique can improve the detection and management of adolescent psychosocial problems.