bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emergency medicine in India: Why are we unable to ‘walk the talk’?
Authors: David Suresh S , Vasnaik Mabel , TV Ramakrishnan 
Published: July 2007

AbstractThe largest democracy on earth, the second most populous country and one of the most progressive countries in the globe, India, has advanced tremendously in most conventional fields of Medicine. However, emergency medicine (EM) is a nascent specialty and is yet to receive an identity. Today, it is mostly practised by inadequately trained clinicians in poorly equipped emergency departments (EDs), with no networking. Multiple factors such as the size of the population, variation in standards of medical education, lack of pre‐hospital medical systems and non‐availability of health insurance schemes are some of the salient causes for this tardy response. The Indian medical system is governed by a central, regulatory body which is responsible for the introduction and monitoring of all specialties – the Medical Council of India (MCI). This organisation has not recognized EM as a distinct specialty, despite a decade of dogged attempts. Bright young clinicians who once demonstrated a keen interest in EM have eventually migrated to other conventional branches of medicine, due to the lack of MCI recognition and the lack of specialty status. The Government of India has launched a nationwide network of transport vehicles and first aid stations along the national highways to expedite the transfer of patients from a crash site. However, this system cannot be expected to decrease morbidity and mortality, unless there is a concurrent development of EDs. The present article intends to highlight factors that continue to challenge the handful of dedicated, full time emergency physicians who have tenaciously pursued the cause for the past decade. A three‐pronged synchronous development strategy is recommended: (i) recognise the specialty of EM as a distinct and independent basic specialty; (ii) initiate postgraduate training in EM, thus enabling EDs in all hospitals to be staffed by trained Emergency physicians; and (iii) ensure that EMs are staffed by trained ambulance officers. The time is ripe for a paradigm shift, since the country is aware that emergency care is the felt need of the hour and it is the right of the citizen.
Emergency medicine in Japan. A look at a current university hospital and the problems faced
Authors: Ezaki Takahiro , Hashizume Makoto 
Published: July 2007

AbstractAt present, some outstanding problems regarding Japanese emergency medicine are a serious lack of staff for emergency departments and a great demand for emergency medicine specialists. Medical associations relevant to emergency medicine should collaborate with each other to share what information they have, as well as putting in place provisions to help solve problems associated with emergency medicine. This collaboration should occur nationwide with the Japanese Association for Acute Medicine.
Emergency medicine in modern Europe
Authors: Fleischmann Thomas , Fulde Gordian 
Published: July 2007

AbstractEmergency medicine in the highly advanced world is traditionally performed in two different ways. The first is the well‐known Anglo‐American system with skilled EDs, and a pre‐hospital emergency medical service utilizing paramedics. The second is the so‐called Franco‐German system, with a highly developed pre‐hospital emergency physician service, but only a basic organization of hospital‐based emergency medicine. This gap is now closing fast because of the rapid advancement of hospital‐based emergency medicine in Europe. Four criteria might be used to measure this: the recognition as a specialty, the specialist training programme, the professional organization of emergency physicians and the presence of academic centres in Europe. Eleven of the 27 European countries recognize hospital‐based emergency medicine as a specialty already. These include Belgium, Czech Republic, Estonia, Hungary, Ireland, Italy, Malta, Poland, Romania, Slovenia and the United Kingdom. Other nations are striving to do so, for example Sweden, France, Germany and Greece. There is no doubt that emergency medicine is gaining momentum and other countries will follow. Training for the specialty of emergency medicine is advanced already. Several curricula presently exist in the respective European countries. A task force, governed by the European Society for Emergency Medicine has been working hard to create a model curriculum for all of Europe, which is expected to be published in 2007. This comprises a 5‐year specialty training, with three of them spent in an ED. The curriculum follows a symptom‐oriented approach to emergency medicine, and includes a skilled description of the key competencies of the future trained emergency physicians. Given the century‐long history of the pre‐hospital emergency physician service in some European countries, a number of professional bodies exist representing pre‐hospital emergency doctors. Within the last few years, ED physicians followed suit forming organizations of their own. In some countries, the next step of amalgamation has occurred, with the merger of EMS and ED emergency physician organizations, although no country has abolished the pre‐hospital emergency physician service. The last milestone, the development of academic emergency centres, has only just started. This process will take some time. The present paper describes the present and future of emergency medicine in some European countries using these criteria.
Accuracy of triage nurses in predicting patient disposition
Authors: Holdgate Anna , Morris Jenny , Fry Margaret , Zecevic Milan 
Published: July 2007

AbstractObjective:  Increasing demand to reduce patient waiting times and improve patient flow has led to the introduction of a number of strategies such as fast track and patient streaming. The triage nurse is primarily responsible for identifying suitable patients, based on prediction of likely admission or discharge. The aim of the present study was to explore the accuracy with which triage nurses predict patient disposition.Methods:  Over two separate 1‐week periods, triage nurses at two urban tertiary hospitals electronically recorded in real time whether they thought each patient would be admitted or discharged. The patient's ultimate disposition (admission or discharge), age, sex, diagnostic group, triage category and time of arrival were also recorded.Results:  In total, 1342 patients were included in the study, of which 36.0% were subsequently admitted. Overall, the triage nurse correctly predicted the disposition in 75.7% of patients (95% CI: 73.2–78.0). Nurses were more accurate at predicting discharge than admission (83.3% vs 65.1%, P = 0.04). Triage nurses were most accurate at predicting admission in patients with higher triage categories and most accurate at predicting discharge in patients with injuries and febrile illnesses (89.6%, 95% CI: 85.6–92.6). Predicted discharge was least accurate for patients with cardiovascular disease, with 41.1% (95% CI: 26.4–57.8) of predicted discharges in this category subsequently requiring admission.Conclusion:  Triage nurses can accurately predict likely discharge in specific subgroups of ED patients. This supports the role of triage nurses in appropriately identifying patients suitable for ‘fast track’ or streaming.
Perigastric lymph node metastasis does not affect the survival of squamous cell carcinoma of the oesophagus treated with two‐field oesophagectomy
Authors: Hon Sok‐Fei , Chiu Philip Wai‐Yan , Mui Wilfred Lik‐Man , Cheung Frances Ka‐Yin , Yung Man‐Yee , Lam Candice Chuen‐Hing , Au Yeung Alex Chi‐Man , Siu Wing‐Tai , Ng Enders Kwok‐Wai 
Published: July 2007

Aim:  There are some discrepancies as to the prognostic value of perigastric lymph node (LN) metastasis in the survival of squamous oesophageal carcinoma. The present study aimed to compare survival following standard oesophagectomy in the treatment of squamous oesophageal carcinoma with or without perigastric abdominal LN metastasis.Methods:  From 1998 to 2003, 17 patients with squamous cell carcinoma of the mid or lower oesophagus who had abdominal LN metastasis upon pathological examination underwent Ivor Lewis oesophagectomy. They did not receive further adjuvant therapy. The clinical outcomes of this cohort were compared to a control of 34 patients of similar age, gender and T staging who had no perigastric nodal diseases upon oesophagectomy.Results:  There was no significant difference between the two groups in terms of the demographics, tumour size, differentiation of the tumour, duration of operation, volume of blood loss, and the type of oesophagectomy. The cumulative 3‐year survival rate was similar between those with abdominal LN metastasis or those without abdominal LN metastasis (52.9% vs 47.1%; log–rank test P = 0.61).There was also no significant difference in the rates of recurrence between the two groups (58.8% vs 58.8%; P = 0.1).Conclusions:  Perigastric LN metastasis over the lesser curvature, left gastric artery and pericardial regions does not affect the survival of patients with squamous cell carcinoma of the oesophagus treated by two‐field oesophagectomy.
Detailed description of developmental growth stages of Diplocarpon rosae in Rosa: a core building block for efficient disease management
Authors: Gachomo E.W. , Kotchoni S.O. 
Published: July 2007

AbstractBlack spot disease of roses caused by the ascomycetous fungus Diplocarpon rosae teleomorph (Marssonina rosae anamorph) is a widespread and devastating disease. Despite considerable progress in the management of black spot disease in the recent years, it is still unclear by which mechanisms this fungus colonises and invades the host system, and without a good knowledge of such infection machineries, it not possible to fully overcome the challenges of D. rosae infection. By exploring research contributions up to date, we highlight in this review the ultrastructure of D. rosae infection cycle in the host cell by emphasising on several aspects related to its in vitro and in vivo germinations, the infection mechanisms of the fungus, the different fungal structures formed in the host cells and the optimum storage conditions for D. rosae to retain its viability and pathogenicity over time. Here, attention is particularly focused on the asexual life cycle of D. rosae, with the sexual cycle being briefly discussed. In addition, a new dimension of research approaches to effectively control black spot disease of roses, that is, how to accurately use the advanced biotechnology tools to speed up the current state of the disease management, is proposed here.
The use of ultraviolet‐blocking films in insect pest management in the UK; effects on naturally occurring arthropod pest and natural enemy populations in a protected cucumber crop
Authors: Doukas D. , Payne C.C. 
Published: July 2007

AbstractStudies in polytunnels were conducted to investigate the effects of ultraviolet (UV)‐blocking films on naturally occurring insect pests and their arthropod natural enemies on a cucumber crop. Within tunnels clad with Antibotrytis (blocks light < 400 nm) and UVI/EVA (UV transmitting), 5.8 and 23.4 times more aphids, respectively, were recorded on traps compared with those on traps within tunnels clad with XL 385 (blocks light < 385 nm). When all plants within the UVI/EVA tunnels had become heavily infested with aphids, half of the plants in XL 385 tunnels were uninfested. More Coleoptera and thrips (approximately two times) were recorded under the UVI/EVA film than under the UV‐blocking films, but for other arthropod pests (e.g. whitefly, leafhoppers), clear conclusions could not be drawn as low numbers were recorded. Substantial numbers of chalcid parasitoids and syrphids were found under the UV‐blocking films, but further research is needed to evaluate fully the effect of such films on biological control of aphids. Higher syrphid numbers and more aphid mummies were recorded under the UVI/EVA film, probably because of the higher numbers of aphids present in tunnels clad with this film. The potential that UV‐blocking films have as an effective component of commercial Integrated Pest Management (IPM) systems, for protected horticultural crops, is discussed.
MATHEMATICAL FUNDAMENTALS TO DETERMINE THE KINETIC CONSTANTS OF FIRST‐ORDER CONSECUTIVE REACTIONS
Authors: ERDOĞDU FERRUH , ŞAHMURAT FATMA 
Published: July 2007

ABSTRACT An accurate mathematical analysis of the trend of experimental data to determine the kinetic constants of consecutive reactions is important for further design and optimization studies. For this purpose, the kinetics of the consecutive reactions was evaluated for different cases, and an unconstrained minimization (optimization) problem was defined to determine the kinetic constants. Minimization of least square analysis was used with the Newton's multivariable optimization procedure. The solution method for the defined optimization problem and the effect of initial guess parameters were discussed in detail. The applied optimization algorithm was then tested with simulated and literature‐reported kinetic data. The algorithm was shown to converge under different situations, and it was concluded that knowing the mathematical fundamentals and using them through different optimization techniques would be a useful tool in the evaluation of experimental data.
APPLICABILITY OF ALGINATE ENTRAPPED YEAST CELLS FOR THE PRODUCTION OF LACTOSE‐HYDROLYZED MILK
Authors: PANESAR REEBA , PANESAR PARMJIT S. , SINGH RAM S. , BERA MANAV B. 
Published: July 2007

ABSTRACT To overcome the problem of enzyme extraction and poor permeability of cell membrane to lactose, permeabilized Kluyveromyces marxianus NCIM 3465 cells as a source of β‐D‐galactosidase were employed for the production of lactose‐hydrolyzed milk. In view of the advantages of an immobilized cell system over a free cell system, the yeast cells were entrapped in alginate gel for their subsequent use in lactose hydrolysis. Different process parameters (alginate concentration, bead size, biomass load, temperature, agitation and incubation time) were monitored to enhance lactose hydrolysis in milk. Maximum lactose hydrolysis (87.9%) was observed with yeast cells immobilized in 2% (w/v) alginate concentration with a bead size of 2.90 mm at 30C under agitation (80 rpm) after 150 min of incubation. The developed system was highly stable and the alginate entrapped yeast cells can be recycled up to the eight cycle without any marked change in their ability to carry out the lactose hydrolysis.
MODEL OF THE CONTINUOUS PREFERMENTATION PROCESS IN CHEESE MANUFACTURE AND STABILITY ANALYSIS OF STEADY STATE
Authors: FUNAHASHI HARUYUKI , NAKAMURA YOSHITOSHI 
Published: July 2007

ABSTRACT The present study focused on the continuous prefermentation process affecting curd formation, and the subsequent pH changes in the first stage of cheese manufacture. Two typical continuous prefermentation systems in cheese manufacture were analyzed based on a kinetic model and the process control theory. A previously proposed mathematical model, which considers the effect of pH, adequately simulated the dynamic behavior of pH in the two continuous prefermentation processes. In the stability analysis of steady state using the Routh–Hurwitz criterion, we found that the continuous feed of a cheese starter culture prevented wash‐out and stabilized the system independent of the fraction of seed feed rate. When no cheese starter culture was fed, the stabilities of steady states were dependent on the partial differentials of the maximum specific growth rate to lactic acid concentration. The feeding of cheese starter culture was effective to improve prefermentation process performance.
OPTIMIZATION OF GLYCEROL EFFECT ON THE MECHANICAL PROPERTIES AND WATER VAPOR PERMEABILITY OF WHEY PROTEIN‐METHYLCELLULOSE FILMS
Authors: TURHAN K. NAZAN , ERDOHAN SANCAK Z. ÖZGE , AYANA BELGIZAR , ERDOĞDU FERRUH 
Published: July 2007

ABSTRACT Biopolymer films and coatings are generally designed using biological materials such as proteins, polysaccharides, lipids and their derivatives. The use of plasticizers is also required to improve the mechanical properties (tensile strength and elongation) of the films. For application of films to food systems, it is important for the developed films to possess favorable mechanical and permeability characteristics. Therefore, knowledge of optimum conditions where the water vapor permeability (WVP) is minimized while the mechanical properties are enhanced would be significant depending on the application of the edible films. In this study, the effects of glycerol, as a plasticizer, and methylcellulose (MC) ratios on WVP and mechanical properties of the whey protein films were investigated. Optimum properties of edible films were obtained by applying the complex method optimization algorithm to this multiobjective function problem, and glycerol to total polymer ratio (MC and whey protein concentrate [WPC]) of 0.356 and 0.45 was found for the films with MC : WPC ratios of 0.3 and 0.8, respectively. With respect to the results of this study, it might be concluded that optimum conditions for different edible film‐forming agents can be determined via the use of a good experimental design.
Cost‐effectiveness of rituximab in refractory cold agglutinin disease
Authors: PANWAR U. , MATHEWS C. , CULLIS J. O. 
Published: July 2007

SummaryCold haemagglutinin disease (CHAD) is an uncommon condition frequently associated with B‐cell lymphoproliferative disorders and is refractory to conventional treatments used in autoimmune haemolytic anaemia. Rituximab has been used in this condition with favourable and lasting responses. Cost has been a major limitation to its use in such indication. We present cost‐effectiveness analysis of the use of rituximab in two patients with CHAD. Rituximab successfully controlled haemolysis in both cases of CHAD and was found to be cost‐effective through reducing transfusion needs.
l‐selectin gene polymorphisms and complications of sickle cell disease
Authors: UGOCHUKWU C. C. , OKPALA I. , PANTELIDIS P. , INUSA B. , IBEGBULAM O. , ONYEKWERE O. 
Published: July 2007

SummaryWe had found high expression of l‐selectin and αMβ2 integrin on leukocytes in patients with complications of sickle cell disease (SCD). In non‐SCD patients, l‐selectin polymorphisms are associated with vasculopathy and nephropathy. Our objective was to determine if l‐selectin gene polymorphisms affect leukocyte expression of the protein, or the development of complications in SCD. By polymerase chain reaction with sequence‐specific primers incorporating mismatches at the 3′‐end, we analysed DNA from 142 HbSS patients and 102 healthy, racially matched, HbAA controls; to detect the F206L, T49S, and P213S l‐selectin gene polymorphisms. All patients were assessed for complications of SCD. Steady‐state expression of l‐selectin on leukocytes was measured by flow cytometry in 44 patients. We excluded HbSS patients on hydroxyurea, with any other disease, pregnancy, or HbF ≥ 10%. There were no significant differences in distribution of F206L, T49S or P213S l‐selectin gene polymorphisms between patients and controls (χ2 = 0.1, P > 0.05). There was no association between any of these gene polymorphisms and high expression of l‐selectin by leukocytes, or the development of complications in SCD (χ2 = 2.37, P > 0.05). The findings suggest that these three gene polymorphisms do not predispose to high leukocyte expression of l‐selectin, or development of complications in SCD.
Bolus intraperitoneal iron versus intravenous iron in peritoneal dialysis patients: a prospective study
Authors: MONIEM KHALID A. , BHANDARI SUNIL 
Published: July 2007

SUMMARYAnemia in peritoneal dialysis (PD) is related to impaired erythropoiesis and/or iron deficiency. Oral iron is insufficient to supply adequate accessible iron to patients with end‐stage renal failure. Intermittent intravenous (IV) iron supplementation is effective but inconvenient in PD patients. Intraperitoneal (IP) iron may present a more convenient method of administration. In this study, we examined the efficacy of IP iron dextran in comparison with IV iron. Prospective randomized and crossover studies were carried out. Patients with a serum ferritin less than 200 µg/L, with no contraindications, were randomized to receive either IP or IV iron. Patients randomized to IP iron were subsequently crossed over to receive IV iron. Analysis using the t‐test and Mann–Whitney U test of 16 patients (12 IP and 15 IV) was performed. IP iron did not produce an increase in storage or utilizable iron in PD patients. Hemoglobin (Hb) concentrations and erythropoietin (EPO) dose were unaffected. IV iron produced a significant increase in both circulating and storage iron, with a significant rise in Hb concentrations and no change in EPO requirements. No adverse events occurred after a total of 81 doses of iron therapy. These data suggest that IP iron in this group of patients offers no clinical efficacy in PD patients.
ON THE CYCLICALITY OF SOUTH AFRICAN FISCAL POLICY
Authors: Thornton John 
Published: July 2007

AbstractThis paper examines the cyclicality of government revenue, spending and the key fiscal balances in South Africa during 1972‐2001. The results suggest that while government revenues were largely acyclical, government spending appears to have been predominantly counter‐cyclical, in line with the recommendations of neoclassical analysis. In addition, countercyclical government spending appears to have translated into a countercyclical policy stance overall. This finding contrasts markedly with the results from other empirical studies of South Africa and other emerging market and developing economies, which typically indicate procyclical fiscal policy.
A SMALL‐SCALE DSGE MODEL FOR FORECASTING THE SOUTH AFRICAN ECONOMY
Authors: Liu Guangling (dave , Gupta Rangan 
Published: July 2007

AbstractThis paper uses a version of Hansen's (1985) Dynamic Stochastic General Equilibrium (DSGE) model to forecast the South African economy. The calibrated model, based on annual data over the period of 1970‐2000, is used to generate one‐ to eight‐quarters‐ahead out‐of‐sample forecast errors for the period of 2001:1 to 2005:4. The forecast errors are then compared with the unrestricted versions of the Classical and Bayesian VARs. A Bayesian VAR with relatively loose priors outperforms both the classical VAR and the DSGE model.
VALUE‐ADDED TAX IN A BORDERLESS SA‐BLNS REGION
Authors: Steenekamp Tjaart J 
Published: July 2007

AbstractMarket integration and the abolition of border controls increase the mobility of consumers and cross‐border shopping. This makes it difficult to maintain a destination‐based VAT. Because of differences in the size of countries, governments of different sizes may engage in inefficient tax competition. Such externalities result in a call for tax coordination and a review of VAT regimes most suitable to a globalised world. One of the ultimate objectives of an African Union is a single market. This paper introduces the potential VAT policy implications of further economic integration within Southern Africa as a prelude to an African Economic Community, drawing on the experience of the EU in particular. When the critical factors that may impact on VAT policy are viewed together with SACU's long history of customs cooperation, a form of clearing‐house regime seems appropriate. However, this may not be politically appropriate, thus clearing the way for a more conventional approach, such as the transitional EU‐VAT regime.