bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic precision of magnetic resonance imaging for preoperative prediction of the circumferential margin involvement in patients with rectal cancer
Authors: Purkayastha S. , Tekkis P. P. , Athanasiou T. , Tilney H. S. , Darzi A. W. , Heriot A. G. 
Published: November 2006

AbstractObjective  Circumferential margin involvement (CMI) is an important prognostic indicator for patients with rectal cancer. This meta‐analysis aims at evaluating the diagnostic precision of magnetic resonance imaging (MRI) for the preoperative evaluation of CMI in patients with rectal cancer.Method  Quantitative meta‐analysis was performed comparing MRI against histology after total mesorectal excision. Sensitivity, specificity and diagnostic odds ratio (DOR) were calculated for each study. Summary receiver operating characteristic (SROC) curves and subgroup analysis were undertaken. Study quality and heterogeneity were evaluated. Meta‐regression meta‐analysis was used to evaluate the significance of the difference in relative DORs.Results  Nine studies evaluating 529 patients were included. Pooled results showed an overall sensitivity and specificity for MRI detecting CMI preoperatively of 94% and 85% respectively. The SROC analysis demonstrated an overall weighted area under the curve (AUC) of 0.92 (DOR 57.21, 95% CI 18.21–179.77), without significant heterogeneity between the studies (Q‐value 14.66, P = 0.06). Good study quality further increased the sensitivity and specificity of MRI. The use of a 1.5 Tesla coil, a phased array coil and the inclusion of two interpreters also resulted in high preoperative diagnostic precision. Meta‐regression meta‐analysis showed a significant difference in the DOR for studies published in or since 2003 (P = 0.019).Conclusion  Magnetic resonance imaging can accurately predict CMI preoperatively for rectal cancer in single units and this is reproducible across different centres. This strategy has important implications for selection of patients for adjuvant therapy prior to surgery.
Trends in colorectal cancer survival following the 2‐week rule
Authors: Walsh S. R. , Gilson N. L. , Brown K. , Novell J. R. 
Published: November 2006

AbstractObjective  The 2‐week rule has reduced waiting times for a specialist opinion among patients with a suspected malignancy. We aimed at assessing the effect of this rule on colorectal cancer survival.Method  Patients diagnosed with colorectal cancer before (group 1) and after (group 2) the introduction of the 2‐week rule were identified from a prospective database. Emergency patients were excluded. Overall 2‐year survival for each group was calculated using the Kaplan–Meier method and compared using the log‐rank test.Results  Waiting times fell from 26 to 21 days (P =0.22). There was no significant difference in 2‐year survival between the groups (hazard ratio 1.1; P = 0.56). There was a slight divergence between the survival curves at 2 years.Conclusion  There has been no improvement in 2‐year survival from colorectal cancer following the introduction of the 2‐week rule.
Prioritization of colorectal referrals: a review of the 2‐week wait referral system
Authors: Rai S. , Kelly M. J. 
Published: November 2006

AbstractObjective  The 2‐week wait (TWW) fast‐track referral system for patients suspected of having colorectal cancer (CRC) has fallen well short of its expectations of streamlining prioritization of colorectal referrals. Our study reviews most of the audits/studies that have been published on the system as its inception. Our aim was to identify where the shortcomings are and also to review the various alternatives that have recently been put forward.Method  All articles on the TWW system published in mainstream peer reviewed journals were reviewed, as were all the abstracts on the system presented at the Association of Coloproctology and the British Society of Gastroenterology meetings. Implementation, compliance with guidelines, cancer detection rate, impact on waiting times and the overall effectiveness of the system are evaluated.Results  While the implementation of the system has been generally robust in most centres, the compliance with guidelines has been poor. This coupled with the inherently poor specificity of the system has resulted in a poor (and decreasing) cancer detection rate and a steadily growing volume of the hospital referrals. The system has been shown to have an adverse impact on the waiting times for routine colorectal referrals – a group that contributes significantly to the total number of CRC detected.The various alternatives to the TWW system that have been proposed recently, including our own, are discussed.Conclusion  The shortcomings of the TWW system in its original form have now been demonstrated beyond doubt. What is needed is a fresh approach to find a cost effective and viable alternative in a climate of increased expectations and finite resources.
A DYNAMICAL ANALYSIS OF ALTERNATIVE FORMS OF AGRICULTURAL LAND TENURE
Authors: Commendatore Pasquale , Currie Martin 
Published: November 2006

ABSTRACTThis paper explores a dynamic model of an agricultural sector in which farms are leased to cultivators on fixed rent contracts or on sharecropping contracts and in which cultivators are subject to credit rationing by banks. The model, which can exhibit complex dynamics, is used to compare the two pure forms of land tenure and to explore some implications of the coexistence of both types of tenure. The central conclusion from the dynamic simulations is that, contrary to the conventional proposition based on static analysis, both landowners and cultivators may be better‐off under sharecropping.
THE EVOLUTION OF PRODUCTIVITY GAPS AND SPECIALIZATION PATTERNS
Authors: Los Bart , Verspagen Bart 
Published: November 2006

ABSTRACTThis paper presents an industry‐level model of growth and trade, in which evolving specialization patterns are the endogenous result of innovation, international technology spillovers, learning‐by‐doing and balance of payments‐restricted growth. Differences between industries with regard to their share in consumption are shown to reinforce or mitigate the effects of specialization on aggregate productivity convergence patterns, depending on other parameters. The implications of the model are studied by means of simulation analyses for a wide range of parameter configurations.
INTEREST RATE PEGS, WEALTH EFFECTS AND PRICE LEVEL DETERMINACY
Authors: Annicchiarico Barbara , Marini Giancarlo 
Published: November 2006

ABSTRACTThis paper analyses the issue of price level determinacy in an optimizing general equilibrium model with overlapping generations. It is shown that under a pure interest rate peg wealth effects rule out nominal indeterminacy but give rise to multiple equilibria.
DEMOGRAPHY IN MACROECONOMIC MODELS: WHEN LABOUR SUPPLY MATTERS FOR ECONOMIC CYCLES
Authors: Manfredi Piero , Fanti Luciano 
Published: November 2006

ABSTRACTThe issue of the onset of Malthusian cycles is investigated by means of a demo‐economic model incorporating the age structure of the population. It is shown that the delayed recruitment into the labour force is a major source of demo‐economic instability, potentially leading to sustained oscillations. We also compare different modelling strategies for age structure, by showing that the results of our general model are borne out by those provided by a simpler model, based on a representation of age structure via time delays, which allows a deeper mathematical analysis. This suggests that simplified delay models may be of great help in understanding the qualitative properties of complex age structure models.
CD4 count and viral load time‐courses in patients treated with highly active antiretroviral therapy and association with the CDC staging system
Authors: Collazos J , Knobel H , Casado JL ,   on behalf of the Grupo Español para el Estudio Multifactorial de la Adherencia (GEEMA)
Published: November 2006

ObjectivesThe aim of the study was to analyse CD4 cell count and viral load dynamics in patients undergoing antiretroviral therapy and their association with the Centers for Disease Control and Prevention (CDC) classification system.MethodsCD4 cell count and viral load were determined in 2982 patients who were classified according to clinical and immunological CDC stages. Measurements were carried out at baseline and at the 3rd, 6th and 12th months.ResultsClear differences in the immunological and virological responses to therapy were observed depending on the CDC stage, with better results associated with less advanced stages. There was a marked parallelism in the CD4 cell count curves of the different CDC stages over the year of follow up, in both naïve and experienced patients, indicating that the increase in CD4 cell count at each time‐point was similar for all clinical and immunological CDC stages. However, as the baseline values were closely associated with CDC stage, the CD4 cell counts finally reached were clearly dependent on CDC stage. The highest virological responses were observed during the initial 3 months, particularly in naïve patients, but whereas naïve patients showed additional increases up to the 6th month experienced patients reached a plateau at the 3rd month. The CD4 increases were also higher during the initial 3 months but persisted during the year of follow‐up.ConclusionBoth clinical and immunological CDC stages at baseline are highly predictive of the immunological and virological response to therapy, a finding that could have clinical implications.
Impact of highly active antiretroviral therapy on the maturation of anti‐HIV‐1 antibodies during primary HIV‐1 infection
Authors: Adalid‐Peralta L , Grangeot‐Keros L , Rudent A , Ngo‐Giang‐Huong N , Krzysiek R , Goujard C , Deveau C , Le Gall M , Meyer L , Emilie D , Rouzioux C ,   for the PRIMO and ANRS Study Group
Published: November 2006

ObjectivesTo study the impact of highly active antiretroviral therapy (HAART) on isotype switching and avidity maturation of HIV‐1‐specific immunoglobulin G (IgG) in patients with primary HIV‐1 infection (PHI).MethodsWe studied the emergence and the evolution of anti‐HIV IgG antibodies by quantitative immunoblotting to analyse IgG subclasses and IgG avidity. Serum samples were obtained from 16 PHI patients from the French PRIMO Cohort Study at various points in the first year of infection: eight patients received no treatment (group I), and eight patients received efficient HAART (group II) during the study period.ResultsEarly initiation of HAART in PHI patients partially prevented an increase in anti‐HIV‐1 IgG levels. Within IgG subclasses, the amount of anti‐HIV‐1 IgG1 gradually increased with time in both groups, although levels remained lower in treated patients. The anti‐p24 IgG2 level was always lower in group II. We observed a decrease in anti‐p24 IgG3 over time in both groups. Treatment did not affect the maturation of HIV‐1 IgG avidity, which increased in both groups until month 3 and then remained high until the end of the 12‐month follow‐up period.ConclusionsHAART in PHI partially prevents the emergence of HIV‐1 IgG antibodies, but does not affect the quality of these antibodies, as reflected in their isotype and avidity.
Influence of gender and HIV transmission group on initial highly active antiretroviral therapy prescription and treatment response
Authors: Fardet L , Mary‐Krause M , Heard I , Partisani M , Costagliola D ,   for the French Hospital Database on HIV
Published: November 2006

BackgroundThe literature contains conflicting findings on the influence of gender and HIV transmission group on the initial prescription of highly active antiretroviral therapy (HAART) and its biological and clinical efficacy.MethodsWe conducted a cohort study involving 62 French hospitals. We used Cox proportional hazards models to examine whether gender and HIV transmission group influenced the timing of elective HAART initiation, and the clinical and biological response to treatment.ResultsWe studied 5735 patients enrolled between January 1997 and December 2001 who did not start HAART or develop a stage C HIV‐related event during the first 3 months after inclusion. In multivariate analysis, no gender differences were found in the interval between enrolment in the database and HAART initiation, but this interval was shorter in homosexual patients than in other transmission groups; CD4 cell counts at treatment initiation were also higher in the homosexual group. The immunovirological response to treatment did not differ according to gender, but was better in homosexual patients than in patients in other categories. Injecting drug users had the weakest immunovirological responses. Clinical outcome was not related to gender or to HIV transmission group.ConclusionsThe interval between diagnosis of HIV‐1 infection and elective HAART initiation was not influenced by gender. However, homosexual patients had higher CD4 cell counts than other patients at treatment initiation, and also had better immunovirological responses.
Efavirenz and chronic neuropsychiatric symptoms: a cross‐sectional case control study
Authors: Rihs TA , Begley K , Smith DE , Sarangapany J , Callaghan A , Kelly M , Post JJ , Gold J 
Published: November 2006

ObjectiveThe aim of the study was to investigate symptoms of long‐term central nervous system (CNS) toxicity in HIV‐positive patients treated with efavirenz (EFV).MethodsWe carried out a single‐centre, cross‐sectional case–control study comparing patients treated with EFV for at least 6 months with a matched control group. Self‐administered, standardized questionnaires including the Depression, Anxiety and Stress Scales (DASS), the Cognitive Failures Questionnaire (CFQ) and a questionnaire on unusual dreams, insomnia, fatigue, dizziness, depersonalization and derealization were administered.ResultsData for 32 matched pairs were analysed. Significantly higher total stress scores (P=0.008) were found in the EFV group. Of the patients in this group, 19% also reported severe to extremely severe levels of stress (P=0.014), indicating increased difficulty in relaxing, and being more irritable, impatient, agitated and easily upset. Nineteen per cent of patients treated with EFV also reported severe levels of anxiety (P=0.059) as assessed with the DASS scale. This patient group also reported a higher rate of unusual dreams (P=0.049). No significant differences between groups were found for measures of cognitive impairments, fatigue, dizziness, derealization or depersonalization.ConclusionEFV‐treated patients reported higher levels of severe stress and anxiety as well as a higher rate of unusual dreams than patients not treated with EFV. These differences may be an expression of persisting CNS side effects in patients who remain on EFV for a prolonged period.
Antiretroviral treatment and age‐related comorbidities in a cohort of older HIV‐infected patients
Authors: Orlando G , Meraviglia P , Cordier L , Meroni L , Landonio S , Giorgi R , Fasolo M , Faggion I , Riva A , Zambelli A , Beretta R , Gubertini G , Dedivitiis G , Jacchetti G , Cargnel A 
Published: November 2006

BackgroundThe availability of several therapeutic regimens has transformed HIV infection from a life‐threatening disease into a chronic condition. Older patients (>50 years old) with HIV infection constitute a new treatment challenge in terms of the cumulative effects of ageing and antiretroviral therapy (ART).MethodsThe immunovirological effects and metabolic interactions of 48 weeks of ART in older patients followed up in three Infectious Diseases Units in Milan, Italy since 1994 were compared with those in younger controls aged 25–35 years.ResultsThe 159 older patients and 118 controls enrolled in the study were comparable for HIV stage, baseline CD4 cell count and viral load but differed for mode of HIV transmission, comorbid conditions and related chronic treatments. Mean viral load decreased after 48 weeks of treatment by 2.6 log10 HIV RNA copies/mL and CD4 count increased by 137.5 cells/μL in older patients, and similar values for immunovirological effects were obtained in the young controls. The relative risk (RR) of an abnormal test in older patients was 7.33 [95% confidence interval (CI) 4.36–12.36] for glucose, 1.73 (95% CI 1.45–2.07) for total cholesterol, 1.56 (95% CI 1.22–2.0) for high‐density lipoprotein cholesterol, 1.26 (95% CI 1.02–1.56) for triglycerides, 6.48 (95% CI 4.36–9.66) for serum creatinine, and 0.45 (95% CI 0.35–0.58) for ALT. Moderate/severe liver and renal toxicities were recorded in the older patients but not in the controls. The tolerability of ART did not differ between the older patients and the controls. Thirty‐nine new cardiovascular, endocrine‐metabolic and neuralgic disorders (24.52 per 100 person‐years) were diagnosed in the older patients and four (3.39 per 100 person‐years) in the controls (P<0.0001).ConclusionsDiseases induced by, or related to, the toxic effects of antiretrovirals interact with age‐specific health profiles, raising new questions and challenges. Comparative epidemiological studies, research studies addressing specific questions and surveillance are needed to answer the questions that arise in clinical monitoring.
Localization of water‐soluble carbohydrates in wheat stems using imaging matrix‐assisted laser desorption ionization mass spectrometry
Authors: Robinson Sarah , Warburton Karen , Seymour Mark , Clench Malcolm , Thomas‐Oates Jane 
Published: November 2006

Summary
The pool of endogenous water‐soluble oligosaccharides found in the stems of wheat (Triticum aestivum) is being investigated as a potential indicator of grain yield. Techniques such as liquid chromatography with mass spectrometry (LC‐MS) can profile these analytes but provide no spatial information regarding their distribution in the wheat stem. The imaging matrix‐assisted laser desorption ionization (MALDI) mass spectrometry technique has not been utilized for the analysis of oligosaccharides in plant systems previously.
Imaging MALDI mass spectrometry was used to analyse cross and longitudinal sections from the stems of Triticum aestivum.
A range of oligosaccharides up to Hex11 were observed. Water‐soluble oligosaccharides were ionized as potassiated molecules, and found to be located in the stem pith that is retained predominantly around the inner stem wall.
Imaging MALDI analyses provided spatial information on endogenous oligosaccharides present in wheat stems. The technique was found to offer comparable sensitivities for oligosaccharide detection to those of our established LC‐MS method, and has potential for broad application in studying the in situ localization of other compound types in plant material.
Using NANDA, NIC, and NOC (NNN) Language for Clinical Reasoning With the Outcome‐Present State‐Test (OPT) Model
Authors: Kautz Donald D. , Kuiper RuthAnne , Pesut Daniel J. , Williams Randy L. 
Published: November 2006

PURPOSE.  To analyze the degree to which standardized nursing language was used by baccalaureate nursing students completing Outcome‐Present State‐Test (OPT) model worksheets in a clinical practicum. METHODS.  A scoring instrument was developed and 100 worksheets were retrospectively analyzed. FINDINGS.  NANDA nursing diagnoses were correctly stated in 92% of the OPT models. Nursing Outcomes Classification (NOC) outcomes were explicitly stated in 22%, and implied in 72%. Interventions matched appropriate Nursing Interventions Classification (NIC) activities in 61%. CONCLUSIONS.  NANDA, NIC, and NOC (NNN) language was used inconsistently by students in this sample. IMPLICATIONS FOR PRACTICE.  If NNN language is to advance nursing knowledge, its promotion, representation in curriculum development, and active use is necessary. Educational research is needed on the facilitators and barriers to NNN language use.
Nursing Diagnoses in a Brazilian Intensive Care Unit
Authors: De Fátima Lucena Amália , De Barros Alba Lúcia Bottura Leite 
Published: November 2006

PURPOSE.  To identify the nursing diagnoses and their most frequent related factors or risk factors in patients admitted to an intensive care unit (ICU). METHOD.  Descriptive cross‐sectional study with information from 991 admissions to an ICU during a 6‐month period. FINDINGS.  Sixteen nursing diagnoses resulting from hospitalization were most frequently identified; six had percentages greater than 40% with 29 related/risk factors. The resulting averages were 6.9 diagnoses per hospitalization and 1.2 related/risk factors per nursing diagnoses. CONCLUSIONS.  The nursing diagnoses identified seemed to be common to the clinical practice of nursing and their fundamental related/risk factors to precise clinical judgment, thus providing a basis for interventions for a desired outcome. PRACTICE IMPLICATIONS.  The findings have contributed to the development of the standardized nursing language usage in Brazilian nursing practices.
Diagnósticos de Enfermagem em uma Unidade de Terapia Intensiva Brasileira
OBJETIVO.  Identificar os diagnósticos de enfermagem e os seus fatores relacionados/risco mais freqüentemente estabelecidos aos pacientes internados numa unidade de terapia intensiva (UTI). MÉTODO.  Estudo descritivo, transversal, com informações de 991 admissões numa UTI, durante seis meses. RESULTADOS.  Dezesseis diagnósticos de enfermagem foram mais freqüentes, seis deles com percentuais acima de 40% por internação e com 29 fatores relacionados ou de risco. As médias foram de 6,9 diagnósticos de enfermagem por internação e 1,2 fatores relacionados ou de risco por diagnóstico de enfermagem. CONCLUSÕES.  Os diagnósticos de enfermagem identificados parecem ser comuns à prática clínica de enfermagem e os seus fatores relacionados ou de risco fundamentais ao julgamento clínico preciso, que subsidia à escolha da intervenção para um resultado esperado. IMPLICAÇÕES PARA A PRÁTICA.  Os resultados têm colaborado para o desenvolvimento do uso da linguagem padronizada de enfermagem no Brasil.
Redshift degeneracy in the Eiso-Epeak relation of gamma-ray bursts
Authors: Li Li-Xin 
Published: November 2006

Abstract
In this Letter we show that there is a redshift degeneracy in the Eiso–Epeak relation of gamma-ray bursts (GRBs). If a GRB has a redshift solved from the Eiso–Epeak relation that lies in the range of 0.9 &lt; z &lt; 20, a GRB that has the same observed fluence and peak spectral energy but is at a different redshift in that range also satisfies the Eiso–Epeak relation within a 1σ error, implying an extremely large error in the calculated redshift. Even if the data scatter in the Eiso–Epeak relation is reduced by a factor of 2, the error in the predicted redshift is still large enough to prevent one from constraining the redshift meaningfully. Hence, the Eiso–Epeak relation is not useful for determining the GRB distance.